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What is a menstrual cp?

A menstrual cup is a type of reusable feminine hygiene product. It’s a small, flexible funnel-shaped cup made of rubber or silicone that you insert into your vagina to catch and collect period fluid.

Cups can hold more blood than other methods, leading many women to use them as an eco-friendly alternative to tampons. And depending on your flow, you can wear a cup for up to 12 hours.Keep reading to learn more about how to insert and remove a menstrual cup, how to clean it, and more.

How to use a menstrual cup

If you’re interested in using a menstrual cup, talk with your gynecologist. Although you can buy any of the brands online or in most stores, you’ll first have to find out what size you need. Most menstrual cup brands sell small and large versions.

To figure out the right menstrual cup size for you, you and your doctor should consider:

• your age
• length of your cervix
• whether or not you have a heavy flow
• firmness and flexibility of the cup
• cup capacity
• strength of your pelvic floor muscles
• if you’ve given birth vaginally

Smaller menstrual cups are usually recommended for women younger than 30 years old who haven’t delivered vaginally. Larger sizes are often recommended for women who are over 30 years old, have given birth vaginally, or have a heavier period.

Before you put in your menstrual cup

When you use a menstrual cup for the first time, it may feel uncomfortable. But “greasing” your cup can help make the process smooth. Before you put in your cup, lubricate the rim with water or a water-based lube (lubricant). A wet menstrual cup is much easier to insert.

How to put in your menstrual cup

If you can put in a tampon, you should find it relatively easy to insert a menstrual cup. Just follow these steps to use a cup:

1. Wash your hands thoroughly.
2. Apply water or a water-based lube to the rim of the cup.
3. Tightly fold the menstrual cup in half, holding it in one hand with the rim facing up.
4. Insert the cup, rim up, into your vagina like you would a tampon without an applicator. It should sit a few inches below your cervix.
5. Once the cup is in your vagina, rotate it. It will spring open to create an airtight seal that stops leaks.

You shouldn’t feel your menstrual cup if you’ve inserted the cup correctly. You should also be able to move, jump, sit, stand, and do other everyday activities without your cup falling out. If you’re having trouble putting in your cup, speak with your doctor.

When to take your menstrual cup out

You can wear a menstrual cup for 6 to 12 hours, depending on whether or not you have a heavy flow. This means you can use a cup for overnight protection.

You should always remove your menstrual cup by the 12-hour mark. If it becomes full before then, you’ll have to empty it ahead of schedule to avoid leaks.

How to take your menstrual cup out

To take out a menstrual cup, just follow these steps:

1. Wash your hands thoroughly.
2. Place your index finger and thumb into your vagina. Pull the stem of the cup gently until you can reach the base.
3. Pinch the base to release the seal and pull down to remove the cup.
4. Once it’s out, empty the cup into the sink or toilet.

Cup aftercare

Reusable menstrual cups should be washed and wiped clean before being reinserted into your vagina. Your cup should be emptied at least twice a day.

Reusable menstrual cups are durable and can last for 6 months to 10 years with proper care. Throw away disposable cups after removal.

What are the advantages of using menstrual cups?

A menstrual cup

• is affordable
• is safer than tampons
• holds more blood than pads or tampons
• is better for the environment than pads or tampons
• can’t be felt during sex (some brands)
• can be worn with an IUD

Many women choose to use menstrual cups because:

• They’re budget friendly. You pay a one-time price for a reusable menstrual cup, unlike tampons or pads, which have to be continually bought and can cost upward of $100 a year.
• Menstrual cups are safer. Because menstrual cups collect rather than absorb blood, you’re not at risk of getting toxic shock syndrome (TSS), a rare bacterial infection associated with tampon use.
• Menstrual cups hold more blood. A menstrual cup can hold about one to two ounces of menstrual flow. Tampons, on the other hand, can only hold up to a third of an ounce.
• They’re eco-friendly. Reusable menstrual cups can last a long time, which means you’re not contributing more waste to the environment.
• You can have sex. Most reusable cups need to be taken out before you have sex, but the soft disposable ones can stay in while you get intimate. Not only will your partner not feel the cup, you also won’t have to worry about leaks.
• You can wear a cup with an IUD. Some companies claim a menstrual cup could dislodge an IUD, but a 2012 study debunked that belief. If you’re concerned, though, check with your doctor about using a menstrual cup.

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What are the disadvantages of using menstrual cups?

A menstrual cup

• can be messy
• may be hard to insert or remove
• may be tough to find the right fit
• may cause an allergic reaction
• may cause vaginal irritation

Menstrual cups may be an affordable and environmentally friendly option, but you still need to keep a few things in mind:

• Cup removal can be messy. You may find yourself in a place or position that makes it difficult or awkward to remove your cup. That means you may not be able to avoid spills during the process.
• They can be tough to insert or remove. You may find that you’re not getting the right fold when you put in your menstrual cup. Or you may have a hard time pinching the base to pull the cup down and out.
• It can be hard to find the right fit. Menstrual cups aren’t one-size-fits-all, so you may find it difficult to find the right fit. That means you may have to try out a few brands before finding the perfect one for you and your vagina.
• You may be allergic to the material. Most menstrual cups are made from latex-free materials, making it a great option for people with latex allergies. But for some people, there’s a chance the silicone or rubber material can cause an allergic reaction.
• It may cause vaginal irritation. A menstrual cup may irritate your vagina if the cup isn’t cleaned and cared for properly. It may also cause discomfort if you insert the cup without any lubrication.
• There can be an increased chance for infection. Wash the menstrual cup very well. Rinse and let it dry. Don’t reuse a disposable menstrual cup. Wash your hands after.

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How much does it cost?

Menstrual cups are more cost-effective than tampons and pads. You can pay, on average, $20 to $40 for a cup and not have to purchase another one for at least six months. Tampons and pads can cost an average of $50 to $150 a year, depending on how long and heavy your period is and how often you have your period.

Like tampons and pads, menstrual cups aren’t covered by insurance plans or Medicaid, so using a cup would be an out-of-pocket expense.

How to choose the right feminine hygiene product for you

For many women, using a menstrual cup is a no-brainer. Before you make the switch, make sure you know what you need in a feminine hygiene product:

• Will a cup cost you less?
• Is it easier to use?
• Do you want to have sex during your period?

If you answered yes to these questions, then the menstrual cup is right for you. But if you’re still unsure, talk with your gynecologist about your options and what menstrual product may work best for you.

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Antisocial personality disorder, sometimes called sociopathy, is a mental disorder in which a person consistently shows no regard for right and wrong and ignores the rights and feelings of others. People with antisocial personality disorder tend to antagonize, manipulate or treat others harshly or with callous indifference. They show no guilt or remorse for their behavior.

Individuals with antisocial personality disorder often violate the law, becoming criminals. They may lie, behave violently or impulsively, and have problems with drug and alcohol use. Because of these characteristics, people with this disorder typically can’t fulfill responsibilities related to family, work or school.

Every personality is unique. In some cases, a person’s way of thinking and behaving can be destructive — both to others and to themselves. People with antisocial personality disorder (ASPD) have a mental health condition that causes patterns of manipulation and violation of others around them. This condition overwhelms their personality.

ASPD typically begins during childhood or early adolescence and continues into adulthood. People with ASPD display a long-term pattern of:

• disregarding the law
• violating the rights of others
• manipulating and exploiting others

People with the disorder commonly don’t care if they break the law. They may lie and place others at risk without feeling any remorse.

• manipulating and exploiting others

People with the disorder commonly don’t care if they break the law. They may lie and place others at risk without feeling any remorse.

What Causes Antisocial Personality Disorder?

Personality is the combination of thoughts, emotions and behaviors that makes everyone unique. It’s the way people view, understand and relate to the outside world, as well as how they see themselves. Personality forms during childhood, shaped through an interaction of inherited tendencies and environmental factors.

The exact cause of antisocial personality disorder isn’t known, but:

• Genes may make you vulnerable to developing antisocial personality disorder — and life situations may trigger its development
• Changes in the way the brain functions may have resulted during brain development

The exact cause of ASPD is unknown. Genetic and environmental factors may play a role. You may be at greater risk of developing the disorder if you’re male and you:

• were abused as a child
• grew up with parents who had ASPD
• grew up with alcoholic parents

Symptoms

Antisocial personality disorder signs and symptoms may include:

• Disregard for right and wrong
• Persistent lying or deceit to exploit others
• Being callous, cynical and disrespectful of others
• Using charm or wit to manipulate others for personal gain or personal pleasure
• Arrogance, a sense of superiority and being extremely opinionated
• Recurring problems with the law, including criminal behavior
• Repeatedly violating the rights of others through intimidation and dishonesty
• Impulsiveness or failure to plan ahead
• Hostility, significant irritability, agitation, aggression or violence
• Lack of empathy for others and lack of remorse about harming others
• Unnecessary risk-taking or dangerous behavior with no regard for the safety of self or others
• Poor or abusive relationships
• Failure to consider the negative consequences of behavior or learn from them
• Being consistently irresponsible and repeatedly failing to fulfill work or financial obligations

Adults with antisocial personality disorder typically show symptoms of conduct disorder before the age of 15. Signs and symptoms of conduct disorder include serious, persistent behavior problems, such as:

• Aggression toward people and animals
• Destruction of property
• Deceitfulness
• Theft
• Serious violation of rules

Although antisocial personality disorder is considered lifelong, in some people, certain symptoms — particularly destructive and criminal behavior — may decrease over time. But it’s not clear whether this decrease is a result of aging or an increased awareness of the consequences of antisocial behavior.

When to see a doctor

People with antisocial personality disorder are unlikely to seek help on their own. If you suspect that a friend or family member may have the disorder, you might gently suggest that the person seek help from a mental health professional and offer to help them find one.

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How Is Antisocial Personality Disorder Diagnosed?

A diagnosis of ASPD cannot be made in people younger than 18. Symptoms that resemble ASPD in those people may be diagnosed as a conduct disorder. People older than 18 can be diagnosed with ASPD only if there’s a history of conduct disorder before the age of 15.

A mental health provider can question individuals who are over 18 years about past and current behaviors. This will help detect signs and symptoms that could support a diagnosis of ASPD.

You must meet certain criteria to be diagnosed with the condition. This includes:

• a diagnosis of conduct disorder before the age of 15
• documentation or observation of at least three symptoms of ASPD since the age of 15
• documentation or observation of symptoms of ASPD that don’t occur only during schizophrenic or manic episodes (if you have schizophrenia or bipolar disorder)

Risk factors

Certain factors seem to increase the risk of developing antisocial personality disorder, such as:

• Diagnosis of childhood conduct disorder
• Family history of antisocial personality disorder or other personality disorders or mental health disorders
• Being subjected to abuse or neglect during childhood
• Unstable, violent or chaotic family life during childhood

Men are at greater risk of having antisocial personality disorder than women are.

Complications

Complications, consequences and problems of antisocial personality disorder may include, for example:

• Spouse abuse or child abuse or neglect
• Problems with alcohol or substance use
• Being in jail or prison
• Homicidal or suicidal behaviors
• Having other mental health disorders such as depression or anxiety
• Low social and economic status and homelessness
• Premature death, usually as a result of violence

Prevention

There’s no sure way to prevent antisocial personality disorder from developing in those at risk. Because antisocial behavior is thought to have its roots in childhood, parents, teachers and pediatricians may be able to spot early warning signs. It may help to try to identify those most at risk, such as children who show signs of conduct disorder, and then offer early intervention.

How Is Antisocial Personality Disorder Treated?

ASPD is very difficult to treat. Typically, your doctor will try a combination of psychotherapy and medication. It’s hard to assess how effective the available treatments are in dealing with ASPD’s symptoms.

Psychotherapy

Your psychologist may recommend different types of psychotherapy based on the your situation.

Cognitive behavioral therapy can help reveal negative thoughts and behaviors. It can also teach ways of replacing them with positive ones.

Psychodynamic psychotherapy can increase awareness of negative, unconscious thoughts and behaviors. This can help the person change them.

Medications

No medications are specifically approved for the treatment of ASPD. Your doctor may prescribe:

• antidepressants
• mood stabilizers
• antianxiety medications
• antipsychotic medications

Your doctor may also recommend a stay in a mental health hospital where you can receive intensive treatment.

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Attention deficit hyperactivity disorder (ADHD) is a mental health disorder that can cause above-normal levels of hyperactive and impulsive behaviors. People with ADHD may also have trouble focusing their attention on a single task or sitting still for long periods of time.

Attention-deficit/hyperactivity disorder (ADHD) is a chronic condition that affects millions of children and often continues into adulthood. ADHD includes a combination of persistent problems, such as difficulty sustaining attention, hyperactivity and impulsive behavior.

Children with ADHD may also struggle with low self-esteem, troubled relationships and poor performance in school. Symptoms sometimes lessen with age. However, some people never completely outgrow their ADHD symptoms. But they can learn strategies to be successful.

While treatment won’t cure ADHD, it can help a great deal with symptoms. Treatment typically involves medications and behavioral interventions. Early diagnosis and treatment can make a big difference in outcome.

Types of ADHD

To make ADHD diagnoses more consistent, the APA has grouped the condition into three categories, or types. These types are predominantly inattentive, predominantly hyperactivity-impulsive, and a combination of both.

Predominantly inattentive

As the name suggests, people with this type of ADHD have extreme difficulty focusing, finishing tasks, and following instructions.

Experts also think that many children with the inattentive type of ADHD may not receive a proper diagnosis because they don’t tend to disrupt the classroom. This type is most common among girls with ADHD.

Predominantly hyperactive-impulsive type

People with this type of ADHD show primarily hyperactive and impulsive behavior. This can include fidgeting, interrupting people while they’re talking, and not being able to wait their turn.

Although inattention is less of a concern with this type of ADHD, people with predominantly hyperactive-impulsive ADHD may still find it difficult to focus on tasks.

Combined hyperactive-impulsive and inattentive type

This is the most common type of ADHD. People with this combined type of ADHD display both inattentive and hyperactive symptoms. These include an inability to pay attention, a tendency toward impulsiveness, and above-normal levels of activity and energy.

The type of ADHD you or your child has will determine how it’s treated. The type you have can change over time, so your treatment may change, too.

Symptoms

The primary features of ADHD include inattention and hyperactive-impulsive behavior. ADHD symptoms start before age 12, and in some children, they’re noticeable as early as 3 years of age. ADHD symptoms can be mild, moderate or severe, and they may continue into adulthood.

ADHD occurs more often in males than in females, and behaviors can be different in boys and girls. For example, boys may be more hyperactive and girls may tend to be quietly inattentive.

There are three subtypes of ADHD:

• Predominantly inattentive. The majority of symptoms fall under inattention.
• Predominantly hyperactive/impulsive. The majority of symptoms are hyperactive and impulsive.
• Combined. This is a mix of inattentive symptoms and hyperactive/impulsive symptoms.

Inattention

A child who shows a pattern of inattention may often:

• Fail to pay close attention to details or make careless mistakes in schoolwork
• Have trouble staying focused in tasks or play
• Appear not to listen, even when spoken to directly
• Have difficulty following through on instructions and fail to finish schoolwork or chores
• Have trouble organizing tasks and activities
• Avoid or dislike tasks that require focused mental effort, such as homework
• Lose items needed for tasks or activities, for example, toys, school assignments, pencils
• Be easily distracted
• Forget to do some daily activities, such as forgetting to do chores

Hyperactivity and impulsivity

A child who shows a pattern of hyperactive and impulsive symptoms may often:

• Fidget with or tap his or her hands or feet, or squirm in the seat
• Have difficulty staying seated in the classroom or in other situations
• Be on the go, in constant motion
• Run around or climb in situations when it’s not appropriate
• Have trouble playing or doing an activity quietly
• Talk too much
• Blurt out answers, interrupting the questioner
• Have difficulty waiting for his or her turn
• Interrupt or intrude on others’ conversations, games or activities

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Typical developmental behavior vs. ADHD

Most healthy children are inattentive, hyperactive or impulsive at one time or another. It’s typical for preschoolers to have short attention spans and be unable to stick with one activity for long. Even in older children and teenagers, attention span often depends on the level of interest.

The same is true of hyperactivity. Young children are naturally energetic — they often are still full of energy long after they’ve worn their parents out. In addition, some children just naturally have a higher activity level than others do. Children should never be classified as having ADHD just because they’re different from their friends or siblings.

Children who have problems in school but get along well at home or with friends are likely struggling with something other than ADHD. The same is true of children who are hyperactive or inattentive at home, but whose schoolwork and friendships remain unaffected.

When to see a doctor

If you’re concerned that your child shows signs of ADHD, see your pediatrician or family doctor. Your doctor may refer you to a specialist, such as a developmental-behavioral pediatrician, psychologist, psychiatrist or pediatric neurologist, but it’s important to have a medical evaluation first to check for other possible causes of your child’s difficulties.

r pediatrician or family doctor. Your doctor may refer you to a specialist, such as a developmental-behavioral pediatrician, psychologist, psychiatrist or pediatric neurologist, but it’s important to have a medical evaluation first to check for other possible causes of your child’s difficulties.

Causes

While the exact cause of ADHD is not clear, research efforts continue. Factors that may be involved in the development of ADHD include genetics, the environment or problems with the central nervous system at key moments in development.

Despite how common ADHD is, doctors and researchers still aren’t sure what causes the condition. It’s believed to have neurological origins. Genetics may also play a role.

Research suggests that a reduction in dopamine is a factor in ADHD. Dopamine is a chemical in the brain that helps move signals from one nerve to another. It plays a role in triggering emotional responses and movements.

Other research suggests a structural difference in the brain. Findings indicate that people with ADHD have less gray matter volume. Gray matter includes the brain areas that help with:

• speech
• self-control
• decision-making
• muscle control

Researchers are still studying potential causes of ADHD, such as smoking during pregnancy.

Despite how common ADHD is, doctors and researchers still aren’t sure what causes the condition. It’s believed to have neurological origins. Genetics may also play a role.

Research suggests that a reduction in dopamine is a factor in ADHD. Dopamine is a chemical in the brain that helps move signals from one nerve to another. It plays a role in triggering emotional responses and movements.

Other research suggests a structural difference in the brain. Findings indicate that people with ADHD have less gray matter volume. Gray matter includes the brain areas that help with:

• speech
• self-control
• decision-making
• muscle control

Researchers are still studying potential causes of ADHD, such as smoking during pregnancy.

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ADHD testing and diagnosis

There’s no single test that can tell if you or your child has ADHD. A recent study highlighted the benefits of a new test to diagnose adult ADHD, but many clinicians believe an ADHD diagnosis can’t be made based on one test.

To make a diagnosis, your doctor will assess any symptoms you or your child has had over the previous six months.

Your doctor will likely gather information from teachers or family members and may use checklists and rating scales to review symptoms. They’ll also do a physical exam to check for other health problems.

If you suspect that you or your child has ADHD, talk to your doctor about getting an evaluation. For your child, you can also talk to their school counselor. Schools regularly assess children for problems that may be affecting their educational performance.

For the assessment, provide your doctor or counselor with notes and observations about you or your child’s behavior.

If they suspect ADHD, they may refer you or your child to an ADHD specialist. Depending on the diagnosis, they may also suggest making an appointment with a psychiatrist or neurologist.

Risk factors

Risk factors for ADHD may include:

• Blood relatives, such as a parent or sibling, with ADHD or another mental health disorder
• Exposure to environmental toxins — such as lead, found mainly in paint and pipes in older buildings
• Maternal drug use, alcohol use or smoking during pregnancy
• Premature birth

Although sugar is a popular suspect in causing hyperactivity, there’s no reliable proof of this. Many issues in childhood can lead to difficulty sustaining attention, but that’s not the same as ADHD.

Complications

ADHD can make life difficult for children. Children with ADHD:

• Often struggle in the classroom, which can lead to academic failure and judgment by other children and adults
• Tend to have more accidents and injuries of all kinds than do children who don’t have ADHD
• Tend to have poor self-esteem
• Are more likely to have trouble interacting with and being accepted by peers and adults
• Are at increased risk of alcohol and drug abuse and other delinquent behavior

Coexisting conditions

ADHD doesn’t cause other psychological or developmental problems. However, children with ADHD are more likely than others to also have conditions such as:

• Oppositional defiant disorder (ODD), generally defined as a pattern of negative, defiant and hostile behavior toward authority figures
• Conduct disorder, marked by antisocial behavior such as stealing, fighting, destroying property, and harming people or animals
• Disruptive mood dysregulation disorder, characterized by irritability and problems tolerating frustration
• Learning disabilities, including problems with reading, writing, understanding and communicating
• Substance use disorders, including drugs, alcohol and smoking
• Anxiety disorders, which may cause overwhelming worry and nervousness, and include obsessive compulsive disorder (OCD)
• Mood disorders, including depression and bipolar disorder, which includes depression as well as manic behavior
• Autism spectrum disorder, a condition related to brain development that impacts how a person perceives and socializes with others
• Tic disorder or Tourette syndrome, disorders that involve repetitive movements or unwanted sounds (tics) that can’t be easily controlled

Prevention

To help reduce your child’s risk of ADHD:

• During pregnancy, avoid anything that could harm fetal development. For example, don’t drink alcohol, use recreational drugs or smoke cigarettes.
• Protect your child from exposure to pollutants and toxins, including cigarette smoke and lead paint.
• Limit screen time. Although still unproved, it may be prudent for children to avoid excessive exposure to TV and video games in the first five years of life.

ADHD treatment

Treatment for ADHD typically includes behavioral therapies, medication, or both.

Types of therapy include psychotherapy, or talk therapy. With talk therapy, you or your child will discuss how ADHD affects your life and ways to help you manage it.

Another therapy type is behavioral therapy. This therapy can help you or your child with learning how to monitor and manage your behavior.

Medication can also be very helpful when you’re living with ADHD. ADHD medications are designed to affect brain chemicals in a way that enables you to better control your impulses and actions.

ADHD medication

The two main types of medications used to treat ADHD are stimulants and nonstimulants.

Central nervous system (CNS) stimulants are the most commonly prescribed ADHD medications. These drugs work by increasing the amounts of the brain chemicals dopamine and norepinephrine.

Examples of these drugs include methylphenidate (Ritalin) and amphetamine-based stimulants (Adderall).

If stimulants don’t work well for you or your child, or if they cause troublesome side effects, your doctor may suggest a nonstimulant medication. Certain nonstimulant medications work by increasing levels of norepinephrine in the brain.

These medications include atomoxetine (Strattera) and some antidepressants such as bupropion (Wellbutrin).

Natural remedies for ADHD

In addition to — or instead of — medication, several remedies have been suggested to help improve ADHD symptoms.

For starters, following a healthy lifestyle may help you or your child manage ADHD symptoms. The Centers for Disease Control and Prevention (CDC)recommends the following:

• eat a healthy, balanced diet
• get at least 60 minutes of physical activity per day
• get plenty of sleep
• limit daily screen time from phones, computers, and TV

Studies have also shown that yoga, tai chi, and spending time outdoors can help calm overactive minds and may ease ADHD symptoms.

Mindfulness meditation is another option. Research in adults and teens has shown meditation to have positive effects on attention and thought processes, as well as on anxiety and depression.

Avoiding certain allergens and food additives are also potential ways to help reduce ADHD symptoms.

Is ADHD a disability?

While ADHD is a neurodevelopmental disorder, it’s not considered a learning disability. However, ADHD symptoms can make it harder for you to learn. Also, it’s possible for ADHD to occur in some individuals who also have learning disabilities.

To help relieve any impact on learning for children, teachers can map out individual guidelines for a student with ADHD. This may include allowing extra time for assignments and tests or developing a personal reward system.

Although it’s not technically a disability, ADHD can have lifelong effects.

ADHD and depression

If you or your child has ADHD, you’re more likely to have depression as well. In fact, the rate of major depression in children with ADHD is more than five times higherTrusted Source than in children without ADHD. Up to 31 percent of adults with ADHD have been found to also have depression.

This may feel like an unfair double whammy, but know that treatments are available for both conditions. The treatments often overlap. Talk therapy can help treat both conditions. Also, certain antidepressants, such as bupropion, can sometimes help ease ADHD symptoms.

Of course, having ADHD doesn’t guarantee that you’ll have depression, but it’s important to know it’s a possibility.

Tips for coping with ADHD

If you or your child has ADHD, a consistent schedule with structure and regular expectations may be helpful. For adults, using lists, keeping a calendar, and setting reminders are good ways to help you get and stay organized. For children, it can be helpful to focus on writing down homework assignments and keeping everyday items, such as toys and backpacks, in assigned spots.

Learning more about the disorder in general can also help you learn how to manage it. Organizations like Children and Adults with Attention Deficit Disorder or the Attention Deficit Disorder Association provide tips for management as well as the latest research.

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Intellectual disability (ID), once called mental retardation, is characterized by below-average intelligence or mental ability and a lack of skills necessary for day-to-day living. People with intellectual disabilities can and do learn new skills, but they learn them more slowly. There are varying degrees of intellectual disability, from mild to profound. The term “mental retardation” is no longer used, as it’s offensive and has a negative tone.

If your child has an intellectual disability (ID), their brain hasn’t developed properly or has been injured in some way. Their brain may also not function within the normal range of both intellectual and adaptive functioning. In the past, medical professionals called this condition “mental retardation.”

There are four levels of ID:

• mild
• moderate
• severe
• profound

Sometimes, ID may be classified as:

• “other”
• “unspecified”

ID involves both a low IQ and problems adjusting to everyday life. There may also be learning, speech, social, and physical disabilities.

Severe cases of ID may be diagnosed soon after birth. However, you might not realize your child has a milder form of ID until they fail to meet common developmental goals. Almost all cases of ID are diagnosed by the time a child reaches 18 years of age.

What is intellectual disability?

Someone with intellectual disability has limitations in two areas. These areas are:

• Intellectual functioning. Also known as IQ, this refers to a person’s ability to learn, reason, make decisions, and solve problems.
• Adaptive behaviors. These are skills necessary for day-to-day life, such as being able to communicate effectively, interact with others, and take care of oneself.

IQ (intelligence quotient) is measured by an IQ test. The average IQ is 100, with the majority of people scoring between 85 and 115. A person is considered intellectually disabled if they have an IQ of less than 70 to 75.

To measure a child’s adaptive behaviors, a specialist will observe the child’s skills and compare them to other children of the same age. Things that may be observed include how well the child can feed or dress themselves; how well the child is able to communicate with and understand others; and how the child interacts with family, friends, and other children of the same age.

Intellectual disability is thought to affect about 1% of the population. Of those affected, 85% have mild intellectual disability. This means they are just a little slower than average to learn new information or skills. With the right support, most will be able to live independently as adults.

Symptoms of intellectual disability

Symptoms of ID will vary based on your child’s level of disability and may include:

• failure to meet intellectual milestones
• sitting, crawling, or walking later than other children
• problems learning to talk or trouble speaking clearly
• memory problems
• inability to understand the consequences of actions
• inability to think logically
• childish behavior inconsistent with the child’s age
• lack of curiosity
• learning difficulties
• IQ below 70
• inability to lead a fully independent life due to challenges communicating, taking care of themselves, or interacting with others

If your child has ID, they may experience some of the following behavioral issues:

• aggression
• dependency
• withdrawal from social activities
• attention-seeking behavior
• depression during adolescent and teen years
• lack of impulse control
• passivity
• tendency toward self-injury
• stubbornness
• low self-esteem
• low tolerance for frustration
• psychotic disorders
• difficulty paying attention

Some people with ID may also have specific physical characteristics. These can include having a short stature or facial abnormalities.

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Levels of intellectual disability

ID is divided into four levels, based on your child’s IQ and degree of social adjustment.

Mild intellectual disability

Some of the symptoms of mild intellectual disability include:

• taking longer to learn to talk, but communicating well once they know how
• being fully independent in self-care when they get older
• having problems with reading and writing
• social immaturity
• increased difficulty with the responsibilities of marriage or parenting
• benefiting from specialized education plans
• having an IQ range of 50 to 69

Moderate intellectual disability

If your child has moderate ID, they may exhibit some of the following symptoms:

• are slow in understanding and using language
• may have some difficulties with communication
• can learn basic reading, writing, and counting skills
• are generally unable to live alone
• can often get around on their own to familiar places
• can take part in various types of social activities
• generally having an IQ range of 35 to 49

Severe intellectual disability

Symptoms of severe ID include:

• noticeable motor impairment
• severe damage to, or abnormal development of, their central nervous system
• generally having an IQ range of 20 to 34

Profound intellectual disability

Symptoms of profound ID include:

• inability to understand or comply with requests or instructions
• possible immobility
• incontinence
• very basic nonverbal communication
• inability to care for their own needs independently
• the need of constant help and supervision
• having an IQ of less than 20

Other intellectual disability

People in this category are often physically impaired, have hearing loss, are nonverbal, or have a physical disability. These factors may prevent your child’s doctor from conducting screening tests.

Unspecified intellectual disability

If your child has an unspecified ID, they will show symptoms of ID, but their doctor doesn’t have enough information to determine their level of disability.

What causes intellectual disability?

Doctors can’t always identify a specific cause of ID, but causes of ID can include:

• trauma before birth, such as an infection or exposure to alcohol, drugs, or other toxins
• trauma during birth, such as oxygen deprivation or premature delivery
• inherited disorders, such as phenylketonuria (PKU) or Tay-Sachs disease
• chromosome abnormalities, such as Down syndrome
• lead or mercury poisoning
• severe malnutrition or other dietary issues
• severe cases of early childhood illness, such as whooping cough, measles, or meningitis
• brain injury

Anytime something interferes with normal brain development, intellectual disability can result. However, a specific cause for intellectual disability can only be pinpointed about a third of the time.

The most common causes of intellectual disability are:

• Genetic conditions. These include things like Down syndrome and fragile X syndrome.
• Problems during pregnancy. Things that can interfere with fetal brain development include alcohol or drug use, malnutrition, certain infections, or preeclampsia.
• Problems during childbirth. Intellectual disability may result if a baby is deprived of oxygen during childbirth or born extremely premature.
• Illness or injury. Infections like meningitis, whooping cough, or the measles can lead to intellectual disability. Severe head injury, near-drowning, extreme malnutrition, infections in the brain, exposure to toxic substances such as lead, and severe neglect or abuse can also cause it.
• None of the above. In two-thirds of all children who have intellectual disability, the cause is unknown.

How is intellectual disability diagnosed?

To be diagnosed with ID, your child must have below-average intellectual and adaptive skills. Your child’s doctor will perform a three-part evaluation that includes:

• interviews with you
• observations of your child
• standard tests

Your child will be given standard intelligence tests, such as the Stanford-Binet Intelligence Test. This will help the doctor determine your child’s IQ.

The doctor may also administer other tests such as the Vineland Adaptive Behavior Scales. This test provides an assessment of your child’s daily living skills and social abilities, compared to other children in the same age group.

It’s important to remember that children from different cultures and socioeconomic statuses may perform differently on these tests. To form a diagnosis, your child’s doctor will consider the test results, interviews with you, and observations of your child.

Your child’s evaluation process might include visits to specialists, who may include a:

• psychologist
• speech pathologist
• social worker
• pediatric neurologist
• developmental pediatrician
• physical therapist

Laboratory and imaging tests may also be performed. These can help your child’s doctor detect metabolic and genetic disorders, as well as structural problems with your child’s brain.

Other conditions, such as hearing loss, learning disorders, neurological disorders, and emotional problems can also cause delayed development. Your child’s doctor should rule these conditions out before diagnosing your child with ID.

You, your child’s school, and your doctor will use the results of these tests and evaluations to develop a treatment and education plan for your child.

Can intellectual disability be prevented?

Certain causes of intellectual disability are preventable. The most common of these is fetal alcohol syndrome. Pregnant women shouldn’t drink alcohol. Getting proper prenatal care, taking a prenatal vitamin, and getting vaccinated against certain infectious diseases can also lower the risk that your child will be born with intellectual disabilities.

In families with a history of genetic disorders, genetic testing may be recommended before conception.

Certain tests, such as ultrasound and amniocentesis, can also be performed during pregnancy to look for problems associated with intellectual disability. Although these tests may identify problems before birth, they cannot correct them.

Treatment options for intellectual disability

Your child will probably need ongoing counseling to help them cope with their disability.

You will get a family service plan that describes your child’s needs. The plan will also detail the services that your child will need to help them with normal development. Your family needs will also be addressed in the plan.

When your child is ready to attend school, an Individualized Education Program (IEP) will be put in place to help them with their educational needs. All children with ID benefit from special education.

The federal Individuals with Disabilities Act (IDEA) requires that public schools provide free and appropriate education to children with ID and other developmental disabilities.

The main goal of treatment is to help your child reach their full potential in terms of:

• education
• social skills
• life skills

Treatment may include:

• behavior therapy
• occupational therapy
• counseling
• medication, in some cases

What is the long-term outlook?

When ID occurs with other serious physical problems, your child may have a below-average life expectancy. However, if your child has mild to moderate ID, they will probably have a fairly normal life expectancy.

When your child grows up, they may be able to work a job that complements their level of ID, live independently, and support themselves.

Support services are available to help adults with ID live independent and fulfilling lives.

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Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn’t worth living.

More than just a bout of the blues, depression isn’t a weakness and you can’t simply “snap out” of it. Depression may require long-term treatment. But don’t get discouraged. Most people with depression feel better with medication, psychotherapy or both.

Depression is classified as a mood disorder. It may be described as feelings of sadness, loss, or anger that interfere with a person’s everyday activities.

People experience depression in different ways. It may interfere with your daily work, resulting in lost time and lower productivity. It can also influence relationships and some chronic health conditions.

Conditions that can get worse due to depression include:

• arthritis
• asthma
• cardiovascular disease
• cancer
• diabetes
• obesity

It’s important to realize that feeling down at times is a normal part of life. Sad and upsetting events happen to everyone. But, if you’re feeling down or hopeless on a regular basis, you could be dealing with depression.

Depression is considered a serious medical condition that can get worse without proper treatment. Those who seek treatment often see improvements in symptoms in just a few weeks.

Depression symptoms

Depression can be more than a constant state of sadness or feeling “blue.”

Major depression can cause a variety of symptoms. Some affect your mood, and others affect your body. Symptoms may also be ongoing, or come and go.

The symptoms of depression can be experienced differently among men, women, and children differently.

Men may experience symptoms related to their:

• mood, such as anger, aggressiveness, irritability, anxiousness, restlessness
• emotional well-being, such as feeling empty, sad, hopeless
• behavior, such as loss of interest, no longer finding pleasure in favorite activities, feeling tired easily, thoughts of suicide, drinking excessively, using drugs, engaging in high-risk activities
• sexual interest, such as reduced sexual desire, lack of sexual performance
• cognitive abilities, such as inability to concentrate, difficulty completing tasks, delayed responses during conversations
• sleep patterns, such as insomnia, restless sleep, excessive sleepiness, not sleeping through the night
• physical well-being, such as fatigue, pains, headache, digestive problems

Women may experience symptoms related to their:

• mood, such as irritability
• emotional well-being, such as feeling sad or empty, anxious or hopeless
• behavior, such as loss of interest in activities, withdrawing from social engagements, thoughts of suicide
• cognitive abilities, such as thinking or talking more slowly
• sleep patterns, such as difficulty sleeping through the night, waking early, sleeping too much
• physical well-being, such as decreased energy, greater fatigue, changes in appetite, weight changes, aches, pain, headaches, increased cramps

Children may experience symptoms related to their:

• mood, such as irritability, anger, mood swings, crying
• emotional well-being, such as feelings of incompetence (e.g. “I can’t do anything right”) or despair, crying, intense sadness
• behavior, such as getting into trouble at school or refusing to go to school, avoiding friends or siblings, thoughts of death or suicide
• cognitive abilities, such as difficulty concentrating, decline in school performance, changes in grades
• sleep patterns, such as difficulty sleeping or sleeping too much
• physical well-being, such as loss of energy, digestive problems, changes in appetite, weight loss or gain

Depression causes

There are several possible causes of depression. They can range from biological to circumstantial.

Common causes include:

• Family history. You’re at a higher risk for developing depression if you have a family history of depression or another mood disorder.
• Early childhood trauma. Some events affect the way your body reacts to fear and stressful situations.
• Brain structure. There’s a greater risk for depression if the frontal lobe of your brain is less active. However, scientists don’t know if this happens before or after the onset of depressive symptoms.
• Medical conditions. Certain conditions may put you at higher risk, such as chronic illness, insomnia, chronic pain, or attention-deficit hyperactivity disorder (ADHD).
• Drug use. A history of drug or alcohol misuse can affect your risk.

About 21 percent of people who have a substance use problem also experience depression. In addition to these causes, other risk factors for depression include:

• low self-esteem or being self-critical
• personal history of mental illness
• certain medications
• stressful events, such as loss of a loved one, economic problems, or a divorce

Many factors can influence feelings of depression, as well as who develops the condition and who doesn’t.

However, in many cases, healthcare providers are unable to determine what’s causing depression.

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Depression test

There isn’t a single test to diagnose depression. But your healthcare provider can make a diagnosis based on your symptoms and a psychological evaluation.

In most cases, they’ll ask a series of questions about your:

• moods
• appetite
• sleep pattern
• activity level
• thoughts

Because depression can be linked to other health problems, your healthcare provider may also conduct a physical examination and order blood work. Sometimes thyroid problems or a vitamin D deficiency can trigger symptoms of depression.

Don’t ignore symptoms of depression. If your mood doesn’t improve or gets worse, seek medical help. Depression is a serious mental health illness with the potential for complications.

If left untreated, complications can include:

• weight gain or loss
• physical pain
• substance use problems
• panic attacks
• relationship problems
• social isolation
• thoughts of suicide
• self-harm

Types of depression

Depression can be broken into categories depending on the severity of symptoms. Some people experience mild and temporary episodes, while others experience severe and ongoing depressive episodes.

There are two main types: major depressive disorder and persistent depressive disorder.

Major depressive disorder

Major depressive disorder is the more severe form of depression. It’s characterized by persistent feelings of sadness, hopelessness, and worthlessness that don’t go away on their own.

In order to be diagnosed with clinical depression, you must experience 5 or more of the following symptoms over a 2-week period:

• feeling depressed most of the day
• loss of interest in most regular activities
• significant weight loss or gain
• sleeping a lot or not being able to sleep
• slowed thinking or movement
• fatigue or low energy most days
• feelings of worthlessness or guilt
• loss of concentration or indecisiveness
• recurring thoughts of death or suicide

There are different subtypes of major depressive disorder, which the American Psychiatric Association refers to as “specifiers.”

These include:

• atypical features
• anxious distress
• mixed features
• peripartum onset, during pregnancy or right after giving birth
• seasonal patterns
• melancholic features
• psychotic features
• catatonia

Persistent depressive disorder

Persistent depressive disorder (PDD) used to be called dysthymia. It’s a milder, but chronic, form of depression.

In order for the diagnosis to be made, symptoms must last for at least 2 years. PDD can affect your life more than major depression because it lasts for a longer period.

It’s common for people with PDD to:

• lose interest in normal daily activities
• feel hopeless
• lack productivity
• have low self-esteem

Depression can be treated successfully, but it’s important to stick to your treatment plan.

Risk factors

Depression often begins in the teens, 20s or 30s, but it can happen at any age. More women than men are diagnosed with depression, but this may be due in part because women are more likely to seek treatment.

Factors that seem to increase the risk of developing or triggering depression include:

• Certain personality traits, such as low self-esteem and being too dependent, self-critical or pessimistic
• Traumatic or stressful events, such as physical or sexual abuse, the death or loss of a loved one, a difficult relationship, or financial problems
• Blood relatives with a history of depression, bipolar disorder, alcoholism or suicide
• Being lesbian, gay, bisexual or transgender, or having variations in the development of genital organs that aren’t clearly male or female (intersex) in an unsupportive situation
• History of other mental health disorders, such as anxiety disorder, eating disorders or post-traumatic stress disorder
• Abuse of alcohol or recreational drugs
• Serious or chronic illness, including cancer, stroke, chronic pain or heart disease
• Certain medications, such as some high blood pressure medications or sleeping pills (talk to your doctor before stopping any medication)

Complications

Depression is a serious disorder that can take a terrible toll on you and your family. Depression often gets worse if it isn’t treated, resulting in emotional, behavioral and health problems that affect every area of your life.

Examples of complications associated with depression include:

• Excess weight or obesity, which can lead to heart disease and diabetes
• Pain or physical illness
• Alcohol or drug misuse
• Anxiety, panic disorder or social phobia
• Family conflicts, relationship difficulties, and work or school problems
• Social isolation
• Suicidal feelings, suicide attempts or suicide
• Self-mutilation, such as cutting
• Premature death from medical conditions

Prevention

There’s no sure way to prevent depression. However, these strategies may help.

• Take steps to control stress, to increase your resilience and boost your self-esteem.
• Reach out to family and friends, especially in times of crisis, to help you weather rough spells.
• Get treatment at the earliest sign of a problem to help prevent depression from worsening.
• Consider getting long-term maintenance treatment to help prevent a relapse of symptoms.

Treatment for depression

Living with depression can be difficult, but treatment can help improve your quality of life. Talk to your healthcare provider about possible options.

You may successfully manage symptoms with one form of treatment, or you may find that a combination of treatments works best.

It’s common to combine medical treatments and lifestyle therapies, including the following:

Medications

Your healthcare provider may prescribe:

• antidepressants
• antianxiety
• antipsychotic medications

Psychotherapy

Speaking with a therapist can help you learn skills to cope with negative feelings. You may also benefit from family or group therapy sessions.

Light therapy

Exposure to doses of white light can help regulate your mood and improve symptoms of depression. Light therapy is commonly used in seasonal affective disorder, which is now called major depressive disorder with seasonal pattern.

Alternative therapies

Ask your healthcare provider about acupuncture or meditation. Some herbal supplements are also used to treat depression, like St. John’s wort, SAMe, and fish oil.

Talk with your healthcare provider before taking a supplement or combining a supplement with prescription medication because some supplements can react with certain medications. Some supplements may also worsen depression or reduce the effectiveness of medication.

Exercise

Aim for 30 minutes of physical activity 3 to 5 days a week. Exercise can increase your body’s production of endorphins, which are hormones that improve your mood.

Avoid alcohol and drugs

Drinking or misusing drugs may make you feel better for a little bit. But in the long run, these substances can make depression and anxiety symptoms worse.

Learn how to say no

Feeling overwhelmed can worsen anxiety and depression symptoms. Setting boundaries in your professional and personal life can help you feel better.

Take care of yourself

You can also improve symptoms of depression by taking care of yourself. This includes getting plenty of sleep, eating a healthy diet, avoiding negative people, and participating in enjoyable activities.

Sometimes depression doesn’t respond to medication. Your healthcare provider may recommend other treatment options if your symptoms don’t improve.

These include electroconvulsive therapy (ECT), or repetitive transcranial magnetic stimulation (rTMS) to treat depression and improve your mood.

Natural treatment for depression

Traditional depression treatment uses a combination of prescription medication and counseling. But there are also alternative or complementary treatments you can try.

It’s important to remember that many of these natural treatments have few studies showing their effects on depression, good or bad.

Likewise, the U.S. Food and Drug Administration (FDA) doesn’t approve many of the dietary supplements on the market in the United States, so you want to make sure you’re buying products from a trustworthy brand.

Talk to your healthcare provider before adding supplements to your treatment plan.

Supplements

Several types of supplements are thought to have some positive effect on depression symptoms.

St. John’s wort

Studies are mixed, but this natural treatment is used in Europe as an antidepressant medication. In the United States, it hasn’t received the same approval.

S-adenosyl-L-methionine (SAMe)

This compound has shown in limited studies to possibly ease symptoms of depression. The effects were best seen in people taking selective serotonin reuptake inhibitors (SSRIs), a type of traditional antidepressant.

5-hydroxytryptophan (5-HTP)

5-HTP may raise serotonin levels in the brain, which could ease symptoms. Your body makes this chemical when you consume tryptophan, a protein building block.

Omega-3 fatty acids

These essential fats are important to neurological development and brain health. Adding omega-3 supplements to your diet may help reduce depression symptoms.

Essential oils

Essential oils are a popular natural remedy for many conditions, but research into their effects on depression is limited.

People with depression may find symptom relief with the following essential oils:

• Wild ginger: Inhaling this strong scent may activate serotonin receptors in your brain. This may slow the release of stress-inducing hormones.
• Bergamot: This citrusy essential oil has been shown to reduce anxiety in patients awaiting surgery. The same benefit may help individuals who experience anxiety as a result of depression, but there’s no research to support that claim.

Other oils, such as chamomile or rose oil, may have a calming effect when they’re inhaled. Those oils may be beneficial during short-term use.

Vitamins

Vitamins are important to many bodily functions. Research suggests two vitamins are especially useful for easing symptoms of depression:

• Vitamin B: B-12 and B-6 are vital to brain health. When your vitamin B levels are low, your risk for developing depression may be higher.
• Vitamin D: Sometimes called the sunshine vitamin because exposure to the sun supplies it to your body, Vitamin D is important for brain, heart, and bone health. People who are depressed are more likely to have low levels of this vitamin.

Many herbs, supplements, and vitamins claim to help ease symptoms of depression, but most haven’t shown themselves to be effective in clinical research.

Improve your quality of life with the support of BetterHelp’s licensed therapists. Speak to a therapist during a phone or video session and stay connected throughout your day with BetterHelp’s messaging platform.

Preventing depression

Depression isn’t generally considered to be preventable. It’s hard to recognize what causes it, which means preventing it is more difficult.

But once you’ve experienced a depressive episode, you may be better prepared to prevent a future episode by learning which lifestyle changes and treatments are helpful.

Techniques that may help include:

• regular exercise
• getting plenty of sleep
• maintaining treatments
• reducing stress
• building strong relationships with others

Bipolar depression

Bipolar depression occurs in certain types of bipolar disorder, when the person experiences a depressive episode.

People with bipolar disorder may experience significant mood swings. Episodes in bipolar 2, for instance, typically range from manic episodes of high energy to depressive episodes of low energy.

This depends on the type of bipolar disorder you have. A diagnosis of bipolar 1 only has to have the presence of manic episodes, not depression.

Symptoms of depression in people with bipolar disorder may include:

• loss of interest or enjoyment from normal activities
• feeling sad, worried, anxious, or empty
• not having energy or struggling to complete tasks
• difficulty with recall or memory
• sleeping too much or insomnia
• weight gain or weight loss as a result of increased or decreased appetite
• contemplating death or suicide

If bipolar disorder is treated, many will experience fewer and less severe symptoms of depression, if they experience depressive episodes.

Depression and anxiety

Depression and anxiety can occur in a person at the same time. In fact, research has shown that over 70 percentTrusted Source of people with depressive disorders also have symptoms of anxiety.

Though they’re thought to be caused by different things, depression and anxiety can produce several similar symptoms, which can include:

• irritability
• difficulty with memory or concentration
• sleep problems

The two conditions also share some common treatments.

Both anxiety and depression can be treated with:

• therapy, like cognitive behavioral therapy
• medication
• alternative therapies, including hypnotherapy

If you think you’re experiencing symptoms of either of these conditions, or both of them, make an appointment to talk with your healthcare provider.

Managing episodes of anxiety and depression is possible with support. Our newsletter offers helpful techniques from our experts and compassionate personal stories to empower you in your journey.

Depression and obsessive-compulsive disorder (OCD)

Obsessive-compulsive disorder (OCD) is a type of anxiety disorder. It causes unwanted and repeated thoughts, urges, and fears (obsessions).

These fears cause you to act out repeated behaviors or rituals (compulsions) that you hope will ease the stress caused by the obsessions.

People diagnosed with OCD frequently find themselves in a loop of obsessions and compulsions. If you have these behaviors, you may feel isolated because of them. This can lead to withdrawal from friends and social situations, which can increase your risk for depression.

It’s not uncommon for someone with OCD to also have depression. Having one anxiety disorder can increase your odds for having another. Up to 80 percentTrusted Source of people with OCD also have major depression.

This dual diagnosis is a concern with children, too. Their compulsive behaviors, which may be first developing at a young age, can make them feel unusual. That can lead to withdrawing from friends and can increase the chance of child developing depression.

Depression with psychosis

Some individuals who have been diagnosed with major depression may also have symptoms of another mental disorder called psychosis. When the two conditions occur together, it’s known as depressive psychosis.

Depressive psychosis causes people to see, hear, believe, or smell things that aren’t real. People with the condition may also experience feelings of sadness, hopelessness, and irritability.

The combination of the two conditions is particularly dangerous. That’s because someone with depressive psychosis may experience delusions that cause them to have thoughts of suicide or to take unusual risks.

It’s unclear what causes these two conditions or why they can occur together, but treatment can successfully ease symptoms. Treatments include medications and electroconvulsive therapy (ECT).

Understanding the risk factors and possible causes can help you be aware of early symptoms.

Depression in pregnancy

Pregnancy is often an exciting time for people. However, it can still be common for a pregnant woman to experience depression.

Symptoms of depression during pregnancy include:

• changes in appetite or eating habits
• feeling hopeless
• anxiety
• losing interest in activities and things you previously enjoyed
• persistent sadness
• troubles concentrating or remembering
• sleep problems, including insomnia or sleeping too much
• thoughts of death or suicide

Treatment for depression during pregnancy may focus entirely on talk therapy and other natural treatments.

While some women do take antidepressants during their pregnancy, it’s not clear which ones are the safest. Your healthcare provider may encourage you to try an alternative option until after the birth of your baby.

The risks for depression can continue after the baby arrives. Postpartum depression, which is also called major depressive disorder with peripartum onset, is a serious concern for new mothers.

Depression and alcohol

Research has established a link between alcohol use and depression. People who have depression are more likely to misuse alcohol.

Out of the 20.2 million U.S. adults who experienced a substance use disorder, about 40 percent had a cooccurring mental illness.

According to a 2012 study, 63.8 percentTrusted Source of people who are alcohol dependent have depression.

Drinking alcohol frequently can make symptoms of depression worse, and people who have depression are more likely to misuse alcohol or become dependent on it.

Outlook for depression

Depression can be temporary, or it can be a long-term challenge. Treatment doesn’t always make your depression go away completely.

However, treatment often makes symptoms more manageable. Managing symptoms of depression involves finding the right combination of medications and therapies.

If one treatment doesn’t work, talk with your healthcare provider. They can help you create a different treatment plan that may work better in helping you manage your condition.

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Physical therapy (also known as physiotherapy) and chiropractic care have some similarities.

Both disciplines treat and manage pain and stiffness in your body. Both are practiced by licensed professionals with years of education in the sciences.

But their approaches can be slightly different.

In this article, we’ll take a closer look at these two disciplines, how they differ, what benefits they offer, and how to choose between the two if you have pain, joint stiffness, or difficulty moving.

What are the similarities between physical therapy and chiropractic care?

Physical therapists and chiropractors have similar goals in mind for patients, but they may go about achieving these goals in different ways.

Some of the similarities they share include the following:

• Both focus on managing pain and discomfort using noninvasive and nonsurgical techniques.
• Both may use manual or hands-on therapy to treat a specific condition.
• Both may treat, or co-treat, the same conditions.
• Both may focus on wellness plans for their patients beyond what they can do during a session.
• Both evaluate your symptoms by taking your health history, examining you, and even ordering certain tests.
• Both physical therapists and chiropractors are licensed health professionals with years of education and training.

What are the key differences?

Physical therapy/ physiotherapy	Chiropractic care
Pain-free movement is one of the key primary goals.	Pain relief and misalignment of the spine are key primary goals.
Focuses on how the body moves and functions as a whole.	Focuses mostly on issues related to back pain, neck pain, joint pain in the arms or legs, and headaches.
Physical therapists help you perform stretches and exercises to improve your mobility.	Chiropractors perform manipulations and adjustments to help your body heal itself.
Physical therapists work in just about any healthcare environment, as well as your home.	Chiropractors usually need specialized spaces and equipment to perform adjustments and manipulations.

What does a physical therapist do?

A physiotherapist/physical therapist, also known as a PT, focuses on improving your ability to move and function without pain which, in turn, helps boost your quality of life.

The goal of PT is for you to achieve the highest level of movement possible to function in daily life.

PTs evaluate you, guide you in stretches and exercises, and educate you on ways to stay active and healthy.

Physical therapy treatment may include:

• an evaluation of your pain, flexibility, and movement
• exercises, stretches, or hands-on manipulation to help you get stronger and move better
• posture education with instruction on how to move to avoid injury or pain
• heat or cold therapy and a variety of other modalities to reduce pain
• a wellness plan to improve your overall health

You may find that you only need a few sessions with a PT before you notice an improvement in your condition.

Or, you may need long-term PT to get relief. Your PT will evaluate your progress and put together a treatment plan for you.

PTs must earn a doctorate in physical therapy (DPT) before becoming licensed.

Why use physical therapy?

PT may be a helpful treatment option if you:

• have limited movement due to:
  • an accident
  • injury
  • surgery
  • a health condition
• feel pain related to movement
• want to maintain or increase your ability to move with ease
• need to build strength and combat the effects of a health condition, such as:
  • osteoarthritis
  • rheumatoid arthritis
  • multiple sclerosis
  • Parkinson’s disease
  • stroke
  • COPD

PTs practice in a variety of settings, including:

• hospitals
• outpatient clinics or offices
• athletic facilities
• rehabilitation centers
• schools
• workplaces
• homes

Are there different types of PT?

Physical therapists may specialize in one demographic, such as children or older adults.

They may also focus on one type of condition, such as sports injuries or a specific health condition like:

• psoriatic arthritis
• bone injuries and osteoporosis
• Parkinson’s disease

What does a chiropractor do?

Chiropractors are licensed professionals with doctorate degrees who use a hands-on approach to ease pain and inflammation by manipulating parts of your body.

The philosophy behind chiropractic care is that your body can heal itself with interventions performed by a chiropractor.

Chiropractic care, like physical therapy, doesn’t involve taking medications or undergoing surgery. You may want to try chiropractic care before undergoing more invasive treatments.

Chiropractic care covers many health conditions for people of all ages. It focuses specifically on the musculoskeletal and nervous systems.

A chiropractor may:

• evaluate symptoms based on a physical exam and tests
• provide adjustments to areas of the body or use techniques like spinal manipulation to help decrease pain and inflammation
• discuss other forms of treatment
• recommend doing certain exercises at home or making lifestyle adjustments to reduce pain and inflammation

Why use chiropractic care?

Chiropractic care may be a helpful treatment option if you have:

• back pain
• neck pain
• joint pain (like your knees, hips, elbow)
• headaches

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Chiropractors vs. an osteopath

An osteopath is a doctor of osteopathic medicine, also known as a DO. They are licensed physicians who graduate from an osteopathic medical school instead of a traditional medical school.

Like a doctor of medicine (MD), a DO must first earn a bachelor’s degree. This is followed by four years of medical school and a residency that could last 1 to 7 years depending on the area of practice.

Both chiropractors and DOs receive specialized training that focuses on the relationship between the musculoskeletal system and overall health.

Unlike DOs, chiropractors aren’t licensed physicians. They typically don’t have to complete residencies in approved facilities.

Which therapy to choose? 

So, what’s the best way to determine which type of therapy is right for you? That really depends on the type of condition you have and your specific needs.

Sometimes, depending on your condition, you may even want to use both PT and chiropractic care to help relieve pain and improve your quality of life.

It’s important to talk to your doctor when trying to decide on the type of therapy you need. Your doctor can advise you and help explain how a particular therapy may help improve your symptoms.

The bottom line

Both physical therapy, also known as physiotherapy, and chiropractic care focus on managing pain and other symptoms using noninvasive techniques. Both disciplines use hands-on therapy to treat specific conditions.

Physical therapy focuses on how the body moves and functions as a whole.

A physical therapist will work with you on exercises and stretches to help you move more easily with less pain. They may also use hands-on manipulation for some conditions.

Chiropractic care primarily focuses on disorders of the musculoskeletal and nervous systems. Chiropractors use manipulations and adjustments to help your body heal itself.

If you have pain — or find it hard to move around easily — talk to your doctor about whether PT or chiropractic care may be helpful.

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A phobia is an irrational fear of something that’s unlikely to cause harm. The word itself comes from the Greek word phobos, which means fear or horror.

Hydrophobia, for example, literally translates to fear of water.

When someone has a phobia, they experience intense fear of a certain object or situation. Phobias are different than regular fears because they cause significant distress, possibly interfering with life at home, work, or school.

People with phobias actively avoid the phobic object or situation, or endure it within intense fear or anxiety.

Phobias are a type of anxiety disorder. Anxiety disorders are very common. They’re estimated to affect more than 30 percent of U.S. adults at some time in their lives.

In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the American Psychiatric Association outlines several of the most common phobias.

Agoraphobia, a fear of places or situations that trigger fear or helplessness, is singled out as a particularly common fear with its own unique diagnosis. Social phobias, which are fears related to social situations, are also singled out with a unique diagnosis.

Specific phobias are a broad category of unique phobias related to specific objects and situations. Specific phobias affect an estimated 12.5 percent of American adults.

Phobias come in all shapes and sizes. Because there are an infinite number of objects and situations, the list of specific phobias is quite long.

According to the DSM, specific phobias typically fall within five general categories:

• fears related to animals (spiders, dogs, insects)
• fears related to the natural environment (heights, thunder, darkness)
• fears related to blood, injury, or medical issues (injections, broken bones, falls)
• fears related to specific situations (flying, riding an elevator, driving)
• other (choking, loud noises, drowning)

These categories encompass an infinite number of specific objects and situations.

There’s no official list of phobias beyond what’s outlined in the DSM, so clinicians and researchers make up names for them as the need arises. This is typically done by combining a Greek (or sometimes Latin) prefix that describes the phobia with the -phobia suffix.

For example, a fear of water would be named by combining hydro (water) and phobia (fear).

There’s also such a thing as a fear of fears (phobophobia). This is actually more common than you might imagine.

People with anxiety disorders sometimes experience panic attacks when they’re in certain situations. These panic attacks can be so uncomfortable that people do everything they can to avoid them in the future.

For example, if you have a panic attack while sailing, you may fear sailing in the future, but you may also fear panic attacks or fear developing hydrophobia.

Personality disorders are a group of mental health conditions that are characterized by inflexible and unhealthy patterns of thinking, feeling, and behaving. These inner experiences and behaviors often differ from the expectations of the culture in which someone lives.

People with personality disorders usually have a hard time getting along with others and dealing with everyday problems in the ways that are expected by a cultural group. They commonly believe that their way of thinking and behaving is completely normal. However, they tend to have a view of the world that is quite different than others. As a result, they may find it difficult to participate in social, educational, and family activities. They also place blame on others for their challenges. These behaviors and attitudes often cause problems and limitations in relationships, social encounters, and work or school settings. They may also make people with personality disorders feel isolated, which can contribute to depression and anxiety.

The cause of personality disorders isn’t known. However, it is believed that they may be triggered by genetic and environmental influences, most prominently childhood trauma.

Personality disorders tend to emerge in the teenage years or early adulthood. The symptoms vary depending on the specific type of personality disorder. Treatment typically includes talk therapy and medication.

What Are the Different Types of Personality Disorders?

There are numerous different types of personality disorders. They are grouped into three clusters based on similar characteristics and symptoms. Some people may have signs and symptoms of multiple personality disorders.

Cluster A: Suspicious

• Paranoid personality disorder: People with paranoid personality disorder are very distrustful of others and suspicious of their motives. They also tend to hold grudges.
• Schizoid personality disorder: People with this type of disorder display little interest in forming personal relationships or partaking in social interactions. They usually don’t pick up on normal social cues, so they can seem emotionally cold.
• Schizotypal personality disorder: In schizotypal personality disorder, people believe they can influence other people or events with their thoughts. They often misinterpret behaviors. This causes them to have inappropriate emotional responses. They may consistently avoid having intimate relationships.

Cluster B: Emotional and Impulsive

• Antisocial personality disorder: People with antisocial personality disorder tend to manipulate or treat others harshly without expressing remorse for their actions. They may lie, steal, or abuse alcohol or drugs.
• Borderline personality disorder: People with this type of disorder often feel empty and abandoned, regardless of family or community support. They may have difficulty dealing with stressful events. They may have episodes of paranoia. They also tend to engage in risky and impulsive behavior, such as unsafe sex, binge drinking, and gambling.
• Histrionic personality disorder: In histrionic personality disorder, people frequently try to gain more attention by being overly dramatic or sexually provocative. They are easily influenced by other people and are extremely sensitive to criticism or disapproval.
• Narcissistic personality disorder: People with narcissistic personality disorder believe that they are more important than others. They tend to exaggerate their achievements and may brag about their attractiveness or success. They have a deep need for admiration, but lack empathy for other people.

Cluster C: Anxious

• Avoidant personality disorder: People with this type of disorder often experience feelings of inadequacy, inferiority or unattractiveness. They usually dwell on criticism from others and avoid participating in new activities or making new friends.
• Dependent personality disorder: In dependent personality disorder, people heavily depend on other people to meet their emotional and physical needs. They usually avoid being alone. They regularly need reassurance when making decisions. They may also be likely to tolerate physical and verbal abuse.
• Obsessive-compulsive personality disorder: People with obsessive-compulsive personality disorder have an overwhelming need for order. They strongly adhere to rules and regulations. They feel extremely uncomfortable when perfection isn’t achieved. They may even neglect personal relationships to focus on making a project perfect.

Common phobias list

Studying specific phobias is a complicated process. Most people don’t seek treatment for these conditions, so cases largely go unreported.

These phobias also vary based on cultural experiences, gender, and age.

A 1998 survey of more than 8,000 respondents published in the British Journal of Psychiatry Trusted Source found that some of the most common phobias include:

• acrophobia, fear of heights
• aerophobia, fear of flying
• arachnophobia, fear of spiders
• astraphobia, fear of thunder and lightning
• autophobia, fear of being alone
• claustrophobia, fear of confined or crowded spaces
• hemophobia, fear of blood
• hydrophobia, fear of water
• ophidiophobia, fear of snakes
• zoophobia, fear of animals

Unique phobias

Specific phobias tend to be incredibly specific. Some so much so that they may only affect a handful of people at a time.

These are difficult to identify because most people don’t report unusual fears to their doctors.

Examples of some of the more unusual phobias include:

• alektorophobia, fear of chickens
• onomatophobia, fear of names
• pogonophobia, fear of beards
• nephophobia, fear of clouds
• cryophobia, fear of ice or cold

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The sum of all fears so far

A
Achluophobia	Fear of darkness
Acrophobia	Fear of heights
Aerophobia	Fear of flying
Algophobia	Fear of pain
Alektorophobia	Fear of chickens
Agoraphobia	Fear of public spaces or crowds
Aichmophobia	Fear of needles or pointed objects
Amaxophobia	Fear of riding in a car
Androphobia	Fear of men
Anginophobia	Fear of angina or choking
Anthophobia	Fear of flowers
Anthropophobia	Fear of people or society
Aphenphosmphobia	Fear of being touched
Arachnophobia	Fear of spiders
Arithmophobia	Fear of numbers
Astraphobia	Fear of thunder and lightning
Ataxophobia	Fear of disorder or untidiness
Atelophobia	Fear of imperfection
Atychiphobia	Fear of failure
Autophobia	Fear of being alone
B
Bacteriophobia	Fear of bacteria
Barophobia	Fear of gravity
Bathmophobia	Fear of stairs or steep slopes
Batrachophobia	Fear of amphibians
Belonephobia	Fear of pins and needles
Bibliophobia	Fear of books
Botanophobia	Fear of plants
C
Cacophobia	Fear of ugliness
Catagelophobia	Fear of being ridiculed
Catoptrophobia	Fear of mirrors
Chionophobia	Fear of snow
Chromophobia	Fear of colors
Chronomentrophobia	Fear of clocks
Claustrophobia	Fear of confined spaces
Coulrophobia	Fear of clowns
Cyberphobia	Fear of computers
Cynophobia	Fear of dogs
D
Dendrophobia	Fear of trees
Dentophobia	Fear of dentists
Domatophobia	Fear of houses
Dystychiphobia	Fear of accidents
E
Ecophobia	Fear of the home
Elurophobia	Fear of cats
Entomophobia	Fear of insects
Ephebiphobia	Fear of teenagers
Equinophobia	Fear of horses
F, G
Gamophobia	Fear of marriage
Genuphobia	Fear of knees
Glossophobia	Fear of speaking in public
Gynophobia	Fear of women
H
Heliophobia	Fear of the sun
Hemophobia	Fear of blood
Herpetophobia	Fear of reptiles
Hydrophobia	Fear of water
Hypochondria	Fear of illness
I-K
Iatrophobia	Fear of doctors
Insectophobia	Fear of insects
Koinoniphobia	Fear of rooms full of people
L
Leukophobia	Fear of the color white
Lilapsophobia	Fear of tornadoes and hurricanes
Lockiophobia	Fear of childbirth
M
Mageirocophobia	Fear of cooking
Megalophobia	Fear of large things
Melanophobia	Fear of the color black
Microphobia	Fear of small things
Mysophobia	Fear of dirt and germs
N
Necrophobia	Fear of death or dead things
Noctiphobia	Fear of the night
Nosocomephobia	Fear of hospitals
Nyctophobia	Fear of the dark
O
Obesophobia	Fear of gaining weight
Octophobia	Fear of the figure 8
Ombrophobia	Fear of rain
Ophidiophobia	Fear of snakes
Ornithophobia	Fear of birds
P
Papyrophobia	Fear of paper
Pathophobia	Fear of disease
Pedophobia	Fear of children
Philophobia	Fear of love
Phobophobia	Fear of phobias
Podophobia	Fear of feet
Pogonophobia	Fear of beards
Porphyrophobia	Fear of the color purple
Pteridophobia	Fear of ferns
Pteromerhanophobia	Fear of flying
Pyrophobia	Fear of fire
Q-S
Samhainophobia	Fear of Halloween
Scolionophobia	Fear of school
Selenophobia	Fear of the moon
Sociophobia	Fear of social evaluation
Somniphobia	Fear of sleep
T
Tachophobia	Fear of speed
Technophobia	Fear of technology
Tonitrophobia	Fear of thunder
Trypanophobia	Fear of needles or injections
U-Z
Venustraphobia	Fear of beautiful women
Verminophobia	Fear of germs
Wiccaphobia	Fear of witches and witchcraft
Xenophobia	Fear of strangers or foreigners
Zoophobia	Fear of animals

How Is a Personality Disorder Diagnosed?

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is a reference doctors and mental health professionals use to help diagnose mental health conditions. Each personality disorder has criteria that must be met for a diagnosis. A primary care or mental health provider will ask you questions based on these criteria to determine the type of personality disorder. In order for a diagnosis to be made, the behaviors and feelings must be consistent across many life circumstances. They should also cause significant distress and impairment in at least two of the following areas:

• the way you perceive or interpret yourself and other people
• the way you act when dealing with other people
• the appropriateness of your emotional responses
• how well you can control your impulses

In some cases, your primary care or mental health provider may perform blood tests to determine whether a medical problem is causing your symptoms. They may also order a screening test for alcohol and drugs.

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How Is a Personality Disorder Treated?

Treatment can vary depending on the type and severity of your personality disorder. It may include psychotherapy and medications.

Psychotherapy

Psychotherapy, or talk therapy, may help in managing personality disorders. During psychotherapy, you and a therapist can discuss your condition, as well as your feelings and thoughts. This can provide you with insight on how to manage your symptoms and behaviors that interfere with your daily life.

There are many different types of psychotherapy. Dialectical behavior therapy can include group and individual sessions where people learn how to tolerate stress and improve relationships. Cognitive behavioral therapy aims to teach people how to change negative thinking patterns so they can better cope with everyday challenges.

Medication

There aren’t any drugs approved for the treatment of personality disorders. However, certain types of prescription medications might be helpful in reducing various personality disorder symptoms:

• antidepressants, which can help improve a depressed mood, anger, or impulsivity
• mood stabilizers, which prevent mood swings and reduce irritability and aggression
• antipsychotic medications, also known as neuroleptics, which may be beneficial for people who often lose touch with reality
• anti-anxiety medications, which help relieve anxiety, agitation, and insomnia

What Is the Outlook for Someone with a Personality Disorder?

The most important aspect of treating a personality disorder is the recognition that the problem exists in the first place. People with these types of disorders believe that their personality traits are normal, so they can become quite upset when someone suggests that they may have a personality disorder.

If someone recognizes that they have a personality disorder and engages in treatment, they should see an improvement in their symptoms. It’s beneficial for friends or family members to be involved in their therapy sessions as well. It’s also important for someone with a personality disorder to avoid drinking alcohol and using illicit drugs. These substances can have a negative impact on emotions and interfere with treatment.

How to Help Someone with a Personality Disorder

If you are close to someone you suspect might have a personality disorder, you should encourage them to seek help. They may get angry or defensive, but it’s important to avoid arguing with them. Instead, focus on expressing your feelings and voicing your concerns about their behaviors.

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A personality disorder is a type of mental disorder in which you have a rigid and unhealthy pattern of thinking, functioning and behaving. A person with a personality disorder has trouble perceiving and relating to situations and people. This causes significant problems and limitations in relationships, social activities, work and school.

In some cases, you may not realize that you have a personality disorder because your way of thinking and behaving seems natural to you. And you may blame others for the challenges you face.

Personality disorders usually begin in the teenage years or early adulthood. There are many types of personality disorders. Some types may become less obvious throughout middle age.

Personality disorders are a group of mental health conditions that are characterized by inflexible and unhealthy patterns of thinking, feeling, and behaving. These inner experiences and behaviors often differ from the expectations of the culture in which someone lives.

People with personality disorders usually have a hard time getting along with others and dealing with everyday problems in the ways that are expected by a cultural group. They commonly believe that their way of thinking and behaving is completely normal. However, they tend to have a view of the world that is quite different than others. As a result, they may find it difficult to participate in social, educational, and family activities. They also place blame on others for their challenges. These behaviors and attitudes often cause problems and limitations in relationships, social encounters, and work or school settings. They may also make people with personality disorders feel isolated, which can contribute to depression and anxiety.

The cause of personality disorders isn’t known. However, it is believed that they may be triggered by genetic and environmental influences, most prominently childhood trauma.

Personality disorders tend to emerge in the teenage years or early adulthood. The symptoms vary depending on the specific type of personality disorder. Treatment typically includes talk therapy and medication.

What Are the Different Types of Personality Disorders?

There are numerous different types of personality disorders. They are grouped into three clusters based on similar characteristics and symptoms. Some people may have signs and symptoms of multiple personality disorders.

Cluster A: Suspicious

• Paranoid personality disorder: People with paranoid personality disorder are very distrustful of others and suspicious of their motives. They also tend to hold grudges.
• Schizoid personality disorder: People with this type of disorder display little interest in forming personal relationships or partaking in social interactions. They usually don’t pick up on normal social cues, so they can seem emotionally cold.
• Schizotypal personality disorder: In schizotypal personality disorder, people believe they can influence other people or events with their thoughts. They often misinterpret behaviors. This causes them to have inappropriate emotional responses. They may consistently avoid having intimate relationships.

Cluster B: Emotional and Impulsive

• Antisocial personality disorder: People with antisocial personality disorder tend to manipulate or treat others harshly without expressing remorse for their actions. They may lie, steal, or abuse alcohol or drugs.
• Borderline personality disorder: People with this type of disorder often feel empty and abandoned, regardless of family or community support. They may have difficulty dealing with stressful events. They may have episodes of paranoia. They also tend to engage in risky and impulsive behavior, such as unsafe sex, binge drinking, and gambling.
• Histrionic personality disorder: In histrionic personality disorder, people frequently try to gain more attention by being overly dramatic or sexually provocative. They are easily influenced by other people and are extremely sensitive to criticism or disapproval.
• Narcissistic personality disorder: People with narcissistic personality disorder believe that they are more important than others. They tend to exaggerate their achievements and may brag about their attractiveness or success. They have a deep need for admiration, but lack empathy for other people.

Cluster C: Anxious

• Avoidant personality disorder: People with this type of disorder often experience feelings of inadequacy, inferiority or unattractiveness. They usually dwell on criticism from others and avoid participating in new activities or making new friends.
• Dependent personality disorder: In dependent personality disorder, people heavily depend on other people to meet their emotional and physical needs. They usually avoid being alone. They regularly need reassurance when making decisions. They may also be likely to tolerate physical and verbal abuse.
• Obsessive-compulsive personality disorder: People with obsessive-compulsive personality disorder have an overwhelming need for order. They strongly adhere to rules and regulations. They feel extremely uncomfortable when perfection isn’t achieved. They may even neglect personal relationships to focus on making a project perfect.

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Causes

Personality is the combination of thoughts, emotions and behaviors that makes you unique. It’s the way you view, understand and relate to the outside world, as well as how you see yourself. Personality forms during childhood, shaped through an interaction of:

• Your genes. Certain personality traits may be passed on to you by your parents through inherited genes. These traits are sometimes called your temperament.
• Your environment. This involves the surroundings you grew up in, events that occurred, and relationships with family members and others.

Personality disorders are thought to be caused by a combination of these genetic and environmental influences. Your genes may make you vulnerable to developing a personality disorder, and a life situation may trigger the actual development.

Symptoms

Types of personality disorders are grouped into three clusters, based on similar characteristics and symptoms. Many people with one personality disorder also have signs and symptoms of at least one additional personality disorder. It’s not necessary to exhibit all the signs and symptoms listed for a disorder to be diagnosed.

Cluster A personality disorders

Cluster A personality disorders are characterized by odd, eccentric thinking or behavior. They include paranoid personality disorder, schizoid personality disorder and schizotypal personality disorder.

Paranoid personality disorder

• Pervasive distrust and suspicion of others and their motives
• Unjustified belief that others are trying to harm or deceive you
• Unjustified suspicion of the loyalty or trustworthiness of others
• Hesitancy to confide in others due to unreasonable fear that others will use the information against you
• Perception of innocent remarks or nonthreatening situations as personal insults or attacks
• Angry or hostile reaction to perceived slights or insults
• Tendency to hold grudges
• Unjustified, recurrent suspicion that spouse or sexual partner is unfaithful

Schizoid personality disorder

• Lack of interest in social or personal relationships, preferring to be alone
• Limited range of emotional expression
• Inability to take pleasure in most activities
• Inability to pick up normal social cues
• Appearance of being cold or indifferent to others
• Little or no interest in having sex with another person

Schizotypal personality disorder

• Peculiar dress, thinking, beliefs, speech or behavior
• Odd perceptual experiences, such as hearing a voice whisper your name
• Flat emotions or inappropriate emotional responses
• Social anxiety and a lack of or discomfort with close relationships
• Indifferent, inappropriate or suspicious response to others
• “Magical thinking” — believing you can influence people and events with your thoughts
• Belief that certain casual incidents or events have hidden messages meant only for you

Cluster B personality disorders

Cluster B personality disorders are characterized by dramatic, overly emotional or unpredictable thinking or behavior. They include antisocial personality disorder, borderline personality disorder, histrionic personality disorder and narcissistic personality disorder.

Antisocial personality disorder

• Disregard for others’ needs or feelings
• Persistent lying, stealing, using aliases, conning others
• Recurring problems with the law
• Repeated violation of the rights of others
• Aggressive, often violent behavior
• Disregard for the safety of self or others
• Impulsive behavior
• Consistently irresponsible
• Lack of remorse for behavior

Borderline personality disorder

• Impulsive and risky behavior, such as having unsafe sex, gambling or binge eating
• Unstable or fragile self-image
• Unstable and intense relationships
• Up and down moods, often as a reaction to interpersonal stress
• Suicidal behavior or threats of self-injury
• Intense fear of being alone or abandoned
• Ongoing feelings of emptiness
• Frequent, intense displays of anger
• Stress-related paranoia that comes and goes

Histrionic personality disorder

• Constantly seeking attention
• Excessively emotional, dramatic or sexually provocative to gain attention
• Speaks dramatically with strong opinions, but few facts or details to back them up
• Easily influenced by others
• Shallow, rapidly changing emotions
• Excessive concern with physical appearance
• Thinks relationships with others are closer than they really are

Narcissistic personality disorder

• Belief that you’re special and more important than others
• Fantasies about power, success and attractiveness
• Failure to recognize others’ needs and feelings
• Exaggeration of achievements or talents
• Expectation of constant praise and admiration
• Arrogance
• Unreasonable expectations of favors and advantages, often taking advantage of others
• Envy of others or belief that others envy you

Cluster C personality disorders

Cluster C personality disorders are characterized by anxious, fearful thinking or behavior. They include avoidant personality disorder, dependent personality disorder and obsessive-compulsive personality disorder.

Avoidant personality disorder

• Too sensitive to criticism or rejection
• Feeling inadequate, inferior or unattractive
• Avoidance of work activities that require interpersonal contact
• Socially inhibited, timid and isolated, avoiding new activities or meeting strangers
• Extreme shyness in social situations and personal relationships
• Fear of disapproval, embarrassment or ridicule

Dependent personality disorder

• Excessive dependence on others and feeling the need to be taken care of
• Submissive or clingy behavior toward others
• Fear of having to provide self-care or fend for yourself if left alone
• Lack of self-confidence, requiring excessive advice and reassurance from others to make even small decisions
• Difficulty starting or doing projects on your own due to lack of self-confidence
• Difficulty disagreeing with others, fearing disapproval
• Tolerance of poor or abusive treatment, even when other options are available
• Urgent need to start a new relationship when a close one has ended

Obsessive-compulsive personality disorder

• Preoccupation with details, orderliness and rules
• Extreme perfectionism, resulting in dysfunction and distress when perfection is not achieved, such as feeling unable to finish a project because you don’t meet your own strict standards
• Desire to be in control of people, tasks and situations, and inability to delegate tasks
• Neglect of friends and enjoyable activities because of excessive commitment to work or a project
• Inability to discard broken or worthless objects
• Rigid and stubborn
• Inflexible about morality, ethics or values
• Tight, miserly control over budgeting and spending money

Obsessive-compulsive personality disorder is not the same as obsessive-compulsive disorder, a type of anxiety disorder.

When to see a doctor

If you have any signs or symptoms of a personality disorder, see your doctor or other primary care professional or a mental health professional. Untreated, personality disorders can cause significant problems in your life that may get worse without treatment.

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How Is a Personality Disorder Diagnosed?

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is a reference doctors and mental health professionals use to help diagnose mental health conditions. Each personality disorder has criteria that must be met for a diagnosis. A primary care or mental health provider will ask you questions based on these criteria to determine the type of personality disorder. In order for a diagnosis to be made, the behaviors and feelings must be consistent across many life circumstances. They should also cause significant distress and impairment in at least two of the following areas:

• the way you perceive or interpret yourself and other people
• the way you act when dealing with other people
• the appropriateness of your emotional responses
• how well you can control your impulses

In some cases, your primary care or mental health provider may perform blood tests to determine whether a medical problem is causing your symptoms. They may also order a screening test for alcohol and drugs.

Risk factors

Although the precise cause of personality disorders is not known, certain factors seem to increase the risk of developing or triggering personality disorders, including:

• Family history of personality disorders or other mental illness
• Abusive, unstable or chaotic family life during childhood
• Being diagnosed with childhood conduct disorder
• Variations in brain chemistry and structure

Complications

Personality disorders can significantly disrupt the lives of both the affected person and those who care about that person. Personality disorders may cause problems with relationships, work or school, and can lead to social isolation or alcohol or drug abuse.

How Is a Personality Disorder Treated?

Treatment can vary depending on the type and severity of your personality disorder. It may include psychotherapy and medications.

Psychotherapy

Psychotherapy, or talk therapy, may help in managing personality disorders. During psychotherapy, you and a therapist can discuss your condition, as well as your feelings and thoughts. This can provide you with insight on how to manage your symptoms and behaviors that interfere with your daily life.

There are many different types of psychotherapy. Dialectical behavior therapy can include group and individual sessions where people learn how to tolerate stress and improve relationships. Cognitive behavioral therapy aims to teach people how to change negative thinking patterns so they can better cope with everyday challenges.

Online therapy options

Read our review of the best online therapy options to find the right fit for you.

Medication

There aren’t any drugs approved for the treatment of personality disorders. However, certain types of prescription medications might be helpful in reducing various personality disorder symptoms:

• antidepressants, which can help improve a depressed mood, anger, or impulsivity
• mood stabilizers, which prevent mood swings and reduce irritability and aggression
• antipsychotic medications, also known as neuroleptics, which may be beneficial for people who often lose touch with reality
• anti-anxiety medications, which help relieve anxiety, agitation, and insomnia

What Is the Outlook for Someone with a Personality Disorder?

The most important aspect of treating a personality disorder is the recognition that the problem exists in the first place. People with these types of disorders believe that their personality traits are normal, so they can become quite upset when someone suggests that they may have a personality disorder.

If someone recognizes that they have a personality disorder and engages in treatment, they should see an improvement in their symptoms. It’s beneficial for friends or family members to be involved in their therapy sessions as well. It’s also important for someone with a personality disorder to avoid drinking alcohol and using illicit drugs. These substances can have a negative impact on emotions and interfere with treatment.

How to Help Someone with a Personality Disorder

If you are close to someone you suspect might have a personality disorder, you should encourage them to seek help. They may get angry or defensive, but it’s important to avoid arguing with them. Instead, focus on expressing your feelings and voicing your concerns about their behaviors.

REQUEST AN APPOINTMENT OR BOOK A CONSULANT – Sargam.dange.18@gmail.com

REQUEST AN APPOINTMENT OR BOOK A CONSULANT – Sargam.dange.18@gmail.com

Autism spectrum disorder (ASD) is a broad term used to describe a group of neurodevelopmental disorders.

These disorders are characterized by problems with communication and social interaction. People with ASD often demonstrate restricted, repetitive, and stereotyped interests or patterns of behavior.

ASD is found in individuals around the world, regardless of race, culture, or economic background. According to the Centers for Disease Control and Prevention (CDC)Trusted Source, autism does occur more often in boys than in girls, with a 4 to 1 male-to-female ratio.

The CDC estimated in 2014 that nearly 1 in 59 children have been identified with ASD.

There are indications that instances of ASD are on the rise. Some attribute this increase to environmental factors. However, experts debate whether there’s an actual increase in cases or just more frequent diagnoses.

Autism spectrum disorder is a condition related to brain development that impacts how a person perceives and socializes with others, causing problems in social interaction and communication. The disorder also includes limited and repetitive patterns of behavior. The term “spectrum” in autism spectrum disorder refers to the wide range of symptoms and severity.

Autism spectrum disorder includes conditions that were previously considered separate — autism, Asperger’s syndrome, childhood disintegrative disorder and an unspecified form of pervasive developmental disorder. Some people still use the term “Asperger’s syndrome,” which is generally thought to be at the mild end of autism spectrum disorder.

Autism spectrum disorder begins in early childhood and eventually causes problems functioning in society — socially, in school and at work, for example. Often children show symptoms of autism within the first year. A small number of children appear to develop normally in the first year, and then go through a period of regression between 18 and 24 months of age when they develop autism symptoms.

While there is no cure for autism spectrum disorder, intensive, early treatment can make a big difference in the lives of many children.

What are the different types of autism?

The DSM (Diagnostic and Statistical Manual of Mental Disorders) is published by the American Psychiatric Association (APA) and is used by clinicians to diagnose a variety of psychiatric disorders.

The fifth and most recent edition of the DSM was released in 2013. The DSM-5 currently recognizes five different ASD subtypes, or specifiers. They are:

• with or without accompanying intellectual impairment
• with or without accompanying language impairment
• associated with a known medical or genetic condition or environmental factor
• associated with another neurodevelopmental, mental, or behavioral disorder
• with catatonia

Someone can be diagnosed with one or more specifiers.

Prior to the DSM-5, people on the autism spectrum may have been diagnosed with one of the following disorders:

• autistic disorder
• Asperger’s syndrome
• pervasive development disorder-not otherwise specified (PDD-NOS)
• childhood disintegrative disorder

It’s important to note that a person who received one of these earlier diagnoses hasn’t lost their diagnosis and won’t need to be reevaluated.

According to the DSM-5, the broader diagnosis of ASD encompasses disorders such as Asperger’s syndrome.

What are the symptoms of autism?

Autism symptoms typically become clearly evident during early childhood, between 12 and 24 months of age. However, symptoms may also appear earlier or later.

Early symptoms may include a marked delay in language or social development.

The DSM-5 divides symptoms of autism into two categories: problems with communication and social interaction, and restricted or repetitive patterns of behavior or activities.

Problems with communication and social interaction include:

• issues with communication, including difficulties sharing emotions, sharing interests, or maintaining a back-and-forth conversation
• issues with nonverbal communication, such as trouble maintaining eye contact or reading body language
• difficulties developing and maintaining relationships

Restricted or repetitive patterns of behavior or activities include:

• repetitive movements, motions, or speech patterns
• rigid adherence to specific routines or behaviors
• an increase or decrease in sensitivity to specific sensory information from their surroundings, such as a negative reaction to a specific sound
• fixated interests or preoccupations

Individuals are evaluated within each category and the severity of their symptoms is noted.

In order to receive an ASD diagnosis, a person must display all three symptoms in the first category and at least two symptoms in the second category.

What causes autism?

The exact cause of ASD is unknown. The most current research demonstrates that there’s no single cause.

Some of the suspected risk factors for autism include:

• having an immediate family member with autism
• genetic mutations
• fragile X syndrome and other genetic disorders
• being born to older parents
• low birth weight
• metabolic imbalances
• exposure to heavy metals and environmental toxins
• a history of viral infections
• fetal exposure to the medications valproic acid (Depakene) or thalidomide (Thalomid)

According to the National Institute of Neurological Disorders and Stroke (NINDS), both genetics and environment may determine whether a person develops autism.

Multiple sources, old and new Trusted Source, have concluded that the disorder isn’t caused by vaccines, however.

A controversial 1998 study proposed a link between autism and the measles, mumps, and rubella (MMR) vaccine. However, that study has been debunked by other research and was eventually retracted in 2010

What tests are used to diagnose autism?

An ASD diagnosis involves several different screenings, genetic tests, and evaluations.

Developmental screenings

The American Academy of Pediatrics (AAP) recommends that all children undergo screening for ASD at the ages of 18 and 24 months.

Screening can help with early identification of children who could have ASD. These children may benefit from early diagnosis and intervention.

The Modified Checklist for Autism in Toddlers (M-CHAT) is a common screening tool used by many pediatric offices. This 23-question survey is filled out by parents. Pediatricians can then use the responses provided to identify children that may be at risk of having ASD.

It’s important to note that screening isn’t a diagnosis. Children who screen positively for ASD don’t necessarily have the disorder. Additionally, screenings sometimes don’t detect every child that has ASD.

Other screenings and tests

Your child’s physician may recommend a combination of tests for autism, including:

• DNA testing for genetic diseases
• behavioral evaluation
• visual and audio tests to rule out any issues with vision and hearing that aren’t related to autism
• occupational therapy screening
• developmental questionnaires, such as the Autism Diagnostic Observation Schedule (ADOS)

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Diagnoses are typically made by a team of specialists. This team may include child psychologists, occupational therapists, or speech and language pathologists.

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How is autism treated?

There are no “cures” for autism, but therapies and other treatment considerations can help people feel better or alleviate their symptoms.

Many treatment approaches involve therapies such as:

• behavioral therapy
• play therapy
• occupational therapy
• physical therapy
• speech therapy

Massages, weighted blankets and clothing, and meditation techniques may also induce relaxing effects. However, treatment results will vary.

Alternative treatments

Alternative treatments for managing autism may include:

• high-dose vitamins
• chelation therapy, which involves flushing metals from the body
• hyperbaric oxygen therapy
• melatonin to address sleep issues

Research on alternative treatments is mixed, and some of these treatments can be dangerous.

Before investing in any of them, parents and caregivers should weigh the research and financial costs against any possible benefits.

Can diet have an impact on autism?

There’s no specific diet designed for people with ASD. Nevertheless, some autism advocates are exploring dietary changes as a way to help minimize behavioral issues and increase overall quality of life.

A foundation of the autism diet is the avoidance of artificial additives. These include preservatives, colors, and sweeteners.

An autism diet may instead focus on whole foods, such as:

• fresh fruits and vegetables
• lean poultry
• fish
• unsaturated fats
• lots of water

Some autism advocates also endorse a gluten-free diet. The protein gluten is found in wheat, barley, and other grains.

Those advocates believe that gluten creates inflammation and adverse bodily reactions in certain people with ASD. However, scientific research is inconclusive on the relationship between autism, gluten, and another protein known as casein.

Some studies, and anecdotal evidence, have suggested that diet can help improve symptoms of attention-deficit hyperactivity disorder (ADHD), a condition similar to autism. Find out more about the ADHD diet.

How does autism affect kids?

Children with autism may not reach the same developmental milestones as their peers, or they may demonstrate loss of social or language skills previously developed.

For instance, a 2 year old without autism may show interest in simple games of make-believe. A 4 year old without autism may enjoy engaging in activities with other children. A child with autism may have trouble interacting with others or dislike it altogether.

Children with autism may also engage in repetitive behaviors, have difficulty sleeping, or compulsively eat nonfood items. They may find it hard to thrive without a structured environment or consistent routine.

If your child has autism, you may have to work closely with their teachers to ensure they succeed in the classroom.

Many resources are available to help children with autism as well as their loved ones.

Local support groups can be found through the national nonprofit The Autism Society. The organization Autism Speaks also provides targeted toolkits intended for the parents, siblings, grandparents, and friends of children with autism.

Autism and exercise

Children with autism may find that certain exercises can play a role in alleviating frustrations and promoting overall well-being.

Any type of exercise that your child enjoys can be beneficial. Walking and simply having fun on the playground are both ideal.

Swimming and being in water can serve as both exercise and a sensory play activity. Sensory play activities can help people with autism who may have trouble processing signals from their senses.

Sometimes contact sports can be difficult for children with autism. You can instead encourage other forms of challenging yet strengthening exercises.

How does autism affect girls?

Because of its gender-specific prevalence, autism is often stereotyped as a boys’ disease. According to the trusted source ASDs are about 4 times more common in boys than in girls.

However, this doesn’t mean that autism doesn’t occur in girls. In fact, the CDC estimates that 0.66 percent, or around 1 in every 152 girls, have autism. Autism may even present differently in women.

In comparison to recent decades, autism is being tested earlier and more often now. This leads to higher reported rates in both boys and girls.

How does autism affect adults?

Families who have loved ones with ASD may worry about what life with autism looks like for an adult.

A minority of adults with ASD may go on to live or work independently. However, many adults with ASD require continued aid or intervention throughout their lives.

Introducing therapies and other treatments early in life can help lead to more independence and better quality of life.

Sometimes people who are on the spectrum aren’t diagnosed until much later in life. This is due, in part, to a previous lack of awareness among medical practitioners.

Seek help if you suspect you have adult autism. It’s not too late to be diagnosed.

Why is autism awareness important?

April is World Autism Month. It’s also been deemed National Autism Awareness Month in the United States. However, many advocates have rightly called for the need to increase awareness about ASDs year-round, and not just during 30 select days.

Autism awareness also requires empathy and an understanding that ASDs are different for everyone.

Certain treatments and therapies can work for some people but not others. Parents and caregivers can also have differing opinions on the best way to advocate for a child with autism.

Understanding autism and people who are on the spectrum starts with awareness, but it doesn’t end there.

Risk factors

The number of children diagnosed with autism spectrum disorder is rising. It’s not clear whether this is due to better detection and reporting or a real increase in the number of cases, or both.

Autism spectrum disorder affects children of all races and nationalities, but certain factors increase a child’s risk. These may include:

• Your child’s sex. Boys are about four times more likely to develop autism spectrum disorder than girls are.
• Family history. Families who have one child with autism spectrum disorder have an increased risk of having another child with the disorder. It’s also not uncommon for parents or relatives of a child with autism spectrum disorder to have minor problems with social or communication skills themselves or to engage in certain behaviors typical of the disorder.
• Other disorders. Children with certain medical conditions have a higher than normal risk of autism spectrum disorder or autism-like symptoms. Examples include fragile X syndrome, an inherited disorder that causes intellectual problems; tuberous sclerosis, a condition in which benign tumors develop in the brain; and Rett syndrome, a genetic condition occurring almost exclusively in girls, which causes slowing of head growth, intellectual disability and loss of purposeful hand use.
• Extremely preterm babies. Babies born before 26 weeks of gestation may have a greater risk of autism spectrum disorder.
• Parents’ ages. There may be a connection between children born to older parents and autism spectrum disorder, but more research is necessary to establish this link.

Complications

Problems with social interactions, communication and behavior can lead to:

• Problems in school and with successful learning
• Employment problems
• Inability to live independently
• Social isolation
• Stress within the family
• Victimization and being bullied

Prevention

There’s no way to prevent autism spectrum disorder, but there are treatment options. Early diagnosis and intervention is most helpful and can improve behavior, skills and language development. However, intervention is helpful at any age. Though children usually don’t outgrow autism spectrum disorder symptoms, they may learn to function well.

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It is often difficult for people to recognise that they have become dependent on alcohol or other drugs. They may see it as a temporary situation because they are in physical pain or because they are dealing with a difficult situation such as grief, loss, anxiety or trauma. 

Asking for help when you first suspect you have a problem is important so that you can get support to make changes. The earlier you reach out the better – but it’s never too late.

Signs of alcohol or other drug dependence 

Some signs that you may have an alcohol or other drug problem are: 

• changed eating or sleeping habits 
• caring less about your appearance 
• spending more time with people who drink or use drugs to excess
• missing appointments, classes or work commitments 
• losing interest in activities that you used to love 
• getting in trouble in school, at work or with the law 
• getting into more arguments with family and friends 
• friends or family asking you if you have a substance abuse problem 
• relying on drugs or alcohol to have fun or relax 
• having blackouts 
• drinking or using drugs when you are alone 
• keeping secrets from friends or family 
• finding you need more and more of the substance to get the same feeling. 

Often it is family and friends who first recognise that a person they care about has an alcohol or drug problem. They may have noticed them acting differently – being withdrawn, always tired, increasingly hostile or easily upset. They may ask the person straight out if they have a problem. 

If that happens to you, you might feel threatened or criticised. Try to remember that they’re trying to look out for your wellbeing. A positive first step would be to listen, reflect, and be honest with yourself about what they had to say.

Recognising an alcohol and drug problem

There is no particular type of person who becomes dependent on alcohol or other drugs. It can happen to anyone.

What starts as occasional use of a drug or one prescription of pain-relieving medication, for example, can get out of control as time passes – especially in times of pain or stress. You may find you need bigger doses to get the same feeling or to lessen the pain. Eventually, you may depend on the drug to feel good or to get through your day. 

Other signs that you are becoming dependent on alcohol or other drugs include: 

• having intense urges for the substance – this could be once a day or several times a day 
• needing more of a substance to get the same effect 
• fixating about making sure you have a constant supply of the substance 
• spending money on the substance, even when you cannot afford it 
• cutting back on social or other activities 
• not meeting your work, family or study responsibilities 
• lying to people about your alcohol or drug use when they ask 
• doing things that are illegal so you can get the substance, such as stealing 
• taking risks such as driving when you are under the influence of the substance 
• trying but failing to stop using the substance 
• experiencing withdrawal symptoms when you try to stop taking the substance. 

Reducing or stopping use of alcohol or other drugs

Cutting down on alcohol or other drugs is hard to do because repeated alcohol or drug use makes the body more dependent and changes the brain. Brain scans of people who are dependent on alcohol or other drugs often show changes in the areas of the brain that help you learn and remember and make decisions. 

The best thing you can do is to talk to someone you trust so you do not have to deal with this challenge alone.

What is alcoholism, or alcohol use disorder?

Alcoholism has been known by a variety of terms, including alcohol abuse and alcohol dependence. Today, it’s referred to as alcohol use disorder.

It occurs when you drink so much that your body eventually becomes dependent on or addicted to alcohol. When this happens, alcohol becomes the most important thing in your life.

People with alcohol use disorder will continue to drink even when drinking causes negative consequences, like losing a job or destroying relationships with people they love. They may know that their alcohol use negatively affects their lives, but it’s often not enough to make them stop drinking.

Some people may drink alcohol to the point that it causes problems, but they’re not physically dependent on alcohol. This used to be referred to as alcohol abuse.

What causes it?

The cause of alcohol use disorder is still unknown. Alcohol use disorder develops when you drink so much that chemical changes in the brain occur. These changes increase the pleasurable feelings you get when you drink alcohol. This makes you want to drink more often, even if it causes harm.

Eventually, the pleasurable feelings associated with alcohol use go away and the person with alcohol use disorder will engage in drinking to prevent withdrawal symptoms. These withdrawal symptoms can be quite unpleasant and even dangerous.

Alcohol use disorder typically develops gradually over time. It’s also known to run in families.

What are the risk factors?

Although the exact cause of alcohol use disorder is unknown, there are certain factors that may increase your risk for developing this disease.

Known risk factors include having:

• more than 15 drinks per week if you’re male
• more than 12 drinks per week if you’re female
• more than 5 drinks per day at least once a week (binge drinking)
• a parent with alcohol use disorder
• a mental health problem, such as depression, anxiety, or schizophrenia

You may also be at a greater risk for alcohol use disorder if you:

• are a young adult experiencing peer pressure
• have low self-esteem
• experience a high level of stress
• live in a family or culture where alcohol use is common and accepted
• have a close relative with alcohol use disorder

What are the symptoms?

Symptoms of alcohol use disorder are based on the behaviors and physical outcomes that occur as a result of alcohol addiction.

People with alcohol use disorder may engage in the following behaviors:

• drinking alone
• drinking more to feel the effects of alcohol (having a high tolerance)
• becoming violent or angry when asked about their drinking habits
• not eating or eating poorly
• neglecting personal hygiene
• missing work or school because of drinking
• being unable to control alcohol intake
• making excuses to drink
• continuing to drink even when legal, social, or economic problems develop
• giving up important social, occupational, or recreational activities because of alcohol use

People with alcohol use disorder may also experience the following physical symptoms:

• alcohol cravings
• withdrawal symptoms when not drinking, including shaking, nausea, and vomiting
• tremors (involuntary shaking) the morning after drinking
• lapses in memory (blacking out) after a night of drinking
• illnesses, such as alcoholic ketoacidosis (includes dehydration-type symptoms) or cirrhosis

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Self-testing: Do I misuse alcohol?

Sometimes it can be hard to draw the line between safe alcohol use and the misuse of alcohol. if you answer “yes” to some of the following questions:

• Do you need to drink more in order to feel the effects of alcohol?
• Do you feel guilty about drinking?
• Do you become irritable or violent when you’re drinking?
• Do you have problems at school or work because of drinking?
• Do you think it might be better if you cut back on your drinking?

The National Council on Alcoholism and Drug Dependence and AlcoholScreening.org offer more comprehensive self-tests. These tests can help you assess whether you misuse alcohol.

Professional diagnosis

Your doctor or healthcare provider can diagnose alcohol use disorder. They’ll do a physical exam and ask you questions about your drinking habits.

Your doctor may ask if you:

• drive when you’re drunk
• have missed work or have lost a job as a result of your drinking
• need more alcohol to feel “drunk” when you drink
• have experienced blackouts as a result of your drinking
• have tried to cut back on your drinking but couldn’t

Your doctor may also use a questionnaire that assesses alcohol use disorder to help diagnose your condition.

Typically, a diagnosis of alcohol use disorder doesn’t require any other type of diagnostic test. There’s a chance your doctor may order blood work to check your liver function if you show signs or symptoms of liver disease.

Alcohol use disorder can cause serious and lasting damage to your liver. Your liver is responsible for removing toxins from your blood. When you drink too much, your liver has a harder time filtering the alcohol and other toxins from your bloodstream. This can lead to liver disease and other complications.

How is it treated?

Treatment for alcohol use disorder varies, but each method is meant to help you stop drinking altogether. This is called abstinence. Treatment may occur in stages and can include the following:

• detoxification or withdrawal to rid your body of alcohol
• rehabilitation to learn new coping skills and behaviors
• counseling to address emotional problems that may cause you to drink
• support groups, including 12-step programs such as Alcoholics Anonymous (AA)
• medical treatment for health problems associated with alcohol use disorder
• medications to help control addiction

There are a couple of different medications that may help with alcohol use disorder:

• Naltrexone (ReVia) is used only after someone has detoxed from alcohol. This type of drug works by blocking certain receptors in the brain that are associated with the alcoholic “high.” This type of drug, in combination with counseling, may help decrease a person’s craving for alcohol.
• Acamprosate is a medication that can help re-establish the brain’s original chemical state before alcohol dependence. This drug should also be combined with therapy.
• Disulfiram (Antabuse) is a drug that causes physical discomfort (such as nausea, vomiting, and headaches) any time the person consumes alcohol.

You may need to seek treatment at an inpatient facility if your addiction to alcohol is severe. These facilities will provide you with 24-hour care as you withdraw from alcohol and recover from your addiction. Once you’re well enough to leave, you’ll need to continue to receive treatment on an outpatient basis.

What’s the outlook for a person with alcohol use disorder?

Recovering from alcohol use disorder is difficult. Your outlook will depend on your ability to stop drinking. Many people who seek treatment are able to overcome the addiction. A strong support system is helpful for making a complete recovery.

Your outlook will also depend on the health complications that have developed as a result of your drinking. Alcohol use disorder can severely damage your liver. It can also lead to other health complications, including:

• bleeding in the gastrointestinal (GI) tract
• damage to brain cells
• cancer in the GI tract
• dementia
• depression
• high blood pressure
• pancreatitis (inflammation of the pancreas)
• nerve damage
• changes in mental status, including Wernicke-Korsakoff syndrome (a brain disease that causes symptoms such as confusion, vision changes, or memory loss)

How can you prevent alcohol use disorder?

You can prevent alcohol use disorder by limiting your alcohol intake. According to the National Institute on Alcohol Abuse and Alcoholism, women shouldn’t drink more than one drink per day, and men shouldn’t drink more than two drinks per day.

See your doctor if you begin to engage in behaviors that are signs of alcohol use disorder or if you think that you may have a problem with alcohol. You should also consider attending a local AA meeting or participating in a self-help program such as Women for Sobriety.

What is drug dependence?

Drug dependence occurs when you need one or more drugs to function. The American Psychiatric Association (APA) used to distinguish between dependence and abuse. Abuse was considered the mild or early phase of inappropriate drug use that led to dependence. People viewed dependence as a more severe problem than abuse.

The APA replaced “dependence” and “abuse” with “substance use disorder” in the 2013 edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This diagnosis focuses on the disorder involving the use of the substance.

Drug dependence vs. drug addiction

People sometimes use the terms “addiction” and “dependence” interchangeably. Dependence is not the same as addiction.

Addiction

Addiction can occur without being dependent on drugs.

Addiction may involve:

• using drugs despite the consequences
• being unable to stop using drugs
• neglecting social and work obligations because of drug use

Dependence

It’s possible to be dependent on drugs without being addicted. Dependence can be a bodily response to a substance. This often occurs if you rely on medications to control a chronic medical condition. These conditions may include:

• high blood pressure
• diabetes
• glaucoma

Dependence may involve:

• some or all the symptoms of addiction
• development of a high tolerance for the substance as your body adapts to the drug, leading to a desire for larger or more frequent doses
• physical symptoms of withdrawal when you attempt to stop using the drug

How drug abuse can lead to dependence

The National Institute on Drug Abuse estimates 22.7 million Americans need help treating a drug or alcohol problem. In some cases, people may take a prescription medication for pain or another medical condition. This kind of use can sometimes develop into a substance use disorder.

The following are known triggers for substance use disorders:

• having a family history of addiction
• living in an environment where illegal drugs are often used and easy to access
• having a history of anxiety
• having a history of depression
• having a history of other mental health conditions

Drug users typically pass through certain stages on the way to drug dependence. One way that healthcare providers describe these stages is with the Jellinek Curve. The curve tracks typical stages experienced through occasional use, dependence, disorder, and rehabilitation.

These stages include:

1. You use drugs for recreation. You take them infrequently and in social settings.
2. You start using drugs on a regular basis, often abandoning family and friends in favor of drug use. You become concerned about losing access to drugs.
3. You become addicted to drugs as you become more tolerant to their effects and preoccupied with getting them. You may abandon most or all your previous interests and relationships.
4. You become dependent on drugs and unable to live without them. Your physical and mental health deteriorates.

Recognizing the symptoms of drug dependence

You can often determine if an addiction has turned into dependence by looking at behavior. When a person addicted to drugs hasn’t had them for a period of time, this can cause a physical reaction. Physical symptoms of withdrawal occur when the body becomes stressed without the drug. These symptoms include:

• anxiety
• depression
• muscle weakness
• nightmares
• body aches
• sweating
• nausea
• vomiting

What drugs are most likely to cause dependency?

Treating drug dependence

When drug abuse escalates to dependence, treatment becomes complicated. You must stop using the drug, but doing so abruptly can cause physical symptoms. You may need the help of a healthcare provider to rid your body of the substance. This can be done on an inpatient or outpatient basis.

Substances that mimic the effects of illegal drugs may help reduce the symptoms of withdrawal during treatment. Detox programs use a combination of therapy and medical treatment to ease dependence and treat the disorder. Ongoing therapy sessions may be needed after you’re released from a treatment program.

Extreme cases of intoxication, withdrawal, or overdose may need emergency care before addiction and dependence can be treated.

Long-term outlook for people with drug dependence

If left untreated, dependence on illicit drugs can be dangerous. You may increase your drug use as your body adapts to the drugs. This can result in overdose or death.

Treatment can reverse dependence, but you must want to be treated. Sometimes, treatment is successful the first time, but relapse is common. Ongoing therapy and support groups can help you recover, stay on track, and address symptoms of relapse.

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