• Bipolar mood disorder
(Manic-Depressive Illness)
Bipolar disorder (bipolar disorder, formerly manic-depressive illness) is a mental disorder characterized by two separate illness episodes. In one of these episodes, there is exuberance (mania), and in the other, there is depressionThese two episodes, which seem to be opposite to each other, progress with remissions and exacerbations. Except for episodes, the patient immediately returns to normal.
Although some patients have residual symptoms that partially affect daily life, the patients are cured. The episode of mania or exuberance is the episode when the mood is very high and the patient is overly enthusiastic. In this episode, the patient has, for example, exaggerated important thoughts or baseless projects, feeling much higher than he is, thoughts of grandeur, thoughts racing in the patient's mind, feeling excessively energetic, decreased need for sleep, even denying the need for sleep, attempting exciting or fun activities without considering the consequences (spending too much money, driving too fast). On the other hand, the period of depression is the opposite of the situation written above.
In depression, the patient may experience unhappiness, pessimism, hopelessness, decrease in self-confidence, feelings of worthlessness, exaggerated feelings of guilt or regret, not being able to enjoy the activities he used to enjoy, changes such as loss of appetite or insomnia, thoughts of death and suicide, and unexplained pain in his body. Bipolar disorder does not differ between societies and is seen in 2-3% on average. The proportion of early women is equal and the average age of onset is between 20 and 25.
• Depression
Looking at the prevalence of depression, it is seen between 8 and 10% in the society, according to a study published at the beginning of 2010. The lifetime risk of getting sick is that one in ten in men and one out of every four or five in women will suffer from depression at least once in their lifetime. The difference of depression from the usual depressed mood or demoralization is that the person not only feels emotionally sad, unhappy, sad, but also has hopelessness, helplessness and pessimism about his situation, perceiving himself as inadequate and worthless in this situation, and even committing suicide as a solution, isolating himself from the society as a behavior, withdrawal from social life, gradually becoming stagnant, not being able to enjoy anything and showing reluctance, and deteriorated sleep and appetite.
On the other hand, the risk of death by suicide (successful suicide risk) due to depression that is not treated effectively is around 15%. Apart from this, patients cannot continue their activities in life and their work, family and social life are adversely affected. Depression currently ranks fourth among the most disabling diseases in the world, and will be second in 2020. In developed countries, it is always the first in terms of disability. At the same time, poorly treated depression paves the way for alcohol and substance use problems and other mental illnesses. Prolonged and poorly treated depression also paves the way for physical diseases and worsens the course of physical diseases such as diabetes and heart diseases and even increases the risk of death.
• Generalized Anxiety Disorder
People with Generalized Anxiety Disorder (GAD) have “a state of constant, excessive, and inappropriate anxiety.” Excessive worry negatively affects a person's daily life and even prevents them from continuing their usual life activities. These people think of the worst possible outcome in every situation, everything is out of their control, there is no good possibility or reversal possible. Excessive worry and anxiety in GAD are often related to issues such as health, family, money or work. The uncontrollable state of anxiety is present almost daily for at least six months and lasts throughout the day. The lifetime prevalence of GAD is 5-6%. In other words, 5-6 out of every 100 people may experience this condition at any time in their lives. Anxiety sensitivity increases with age. GAD is the most common anxiety disorder in old age.
• Panic Attack
It is mainly characterized by abrupt and recurrent episodes of intense anxiety or fear that leave one terrified. We call PANIC ATTACKS to these seizures, which our patients often call “crises”. Panic Attacks start suddenly, become more severe, and peak within 10 minutes, often lasting 10-30 minutes (rarely up to 1 hour) and then go away on their own.
WHAT ARE THE SYMPTOMS OF PANIC ATTACK?
Chest pain or tightness in the chest, Palpitations, strong or fast heartbeat, Sweating, Shortness of breath or feeling suffocation, Nausea or abdominal pain, Dizziness, lightheadedness, feeling like you will fall or fainting, Numbness or tingling, Chills, shivers, or hot flashes, Shaking or trembles, Feeling yourself or others changed, strange and different, Fear of losing control or going crazy, Fear of death,
A Panic Attack has at least 4 or more of these symptoms.
• Panic Disorder
It is a psychological disorder, where, along with recurrent unexpected Panic Attacks, patients experience • persistent worry that there will be more Panic Attacks in between attacks • persistent sadness with the belief that Panic Attacks may lead to dire consequences, such as “having a heart attack and dying”, “losing control and going crazy” or “having a stroke” or • behavioral changes (such as not going to work, not doing sports, not doing housework, not eating or drinking some food or drink, carrying medicine, water, alcohol, various foods) as a coping method against attacks and possible bad consequences.
• Social Phobia
Social phobia is an anxiety disorder in which the individual has a distinct and persistent fear of being embarrassed or bashed in social situations where he or she is concerned that he may be judged by others. These people are afraid of situations that require them to interact with others or to perform an action in the presence of others and try to avoid them as much as possible.
They think that others will make negative judgments about them such as being anxious, weak, demented, or stupid. They may be afraid of public speaking, with the concern that they will notice their hands or voices shaking, or they may be extremely anxious when talking to others for fear of appearing unable to speak properly. They may avoid eating, drinking, or writing in front of others because they fear that other people will be embarrassed to see their hands shake. Social phobia comes in two forms.
If the fears cover many social situations, it is the generalized type, if it covers some situations (such as signing in front of others, eating, speaking), it is the non-generalized type. The lifetime prevalence of SF is 2 to 13%. It is one of the most common psychiatric diseases. In a study conducted with university students in Turkey, 24% of them were found to have this disorder.
• Eating Disorders
Eating Disorders is a diagnostic group that includes psychiatric diseases such as anorexia nervosa, bulimia nervosa, and binge eating disorder defined in recent years. These diseases are of mental origin and although physical symptoms seem to be in the foreground, they are associated with serious mental problems. The main symptoms in anorexia nervosa are the desire to have a thin body, extreme fear of gaining weight, distorted body image, and cessation of menstruation.
The patient develops special behavioral patterns with the aim of losing weight. About half of patients lose weight by severely reducing whole food intake. Some exercise intensely. The other half of the patients follow a strict diet, occasionally binge eating, losing control, and then vomit. Patients may also use drugs such as laxatives (diarrhea) and diuretics (water expellers) to reduce the weight-building effect of the foods they consume.
As a result, the patient becomes weakened to such an extent that his health was threatened. Bulimia nervosa is an eating disorder condition characterized by binge eating attacks and subsequent vomiting. Since patient still wants to have a thin body, she resorts to various ways to throw out what they eat and to eliminate the calorie-forming effects, just as in anorexia nervosa. However, unlike this picture, the patient is slightly overweight or has a normal body weight. It is reported that anorexia nervosa is one in a thousand and bulimia nervosa is one in one percent in young girls. It is rare in men. In clinical samples, the male to female ratio is 1/10.
• Adult Attention Deficit and Hyperactivity Disorder
Attention Deficit and Hyperactivity Disorder (ADHD) is a chronic neuropsychiatric disorder that begins in childhood and can continue throughout life. Heredity, genetics, and neuroimaging studies on its biological origins have contributed significantly to our understanding of this disorder. Although it is a well-defined psychiatric disorder, both social-cultural objections to the diagnosis of ADHD and added psychiatric comorbidities cause it to remain a poorly understood disorder.
In addition, the fact that different symptoms of the disease come to the fore at certain periods can confuse parents, educators and even physicians. The prevalence of ADHD in the community is reported to be approximately 8% in childhood, 6% in adolescence and 4% in adulthood. Attention deficit, hyperactivity and impulsive behaviors that are already present in childhood become noticeable when they start school.
Children who cannot sit in the classroom, who have intense problems with their friends during games and who can be delayed in reading activities can be noticed relatively quickly and directed to seek medical help. In other words, when the leading symptoms are hyperactivity, there is an earlier application for treatment than when the symptoms related to inattention are prominent. However, the number of seeking treatment and reaching effective treatments is quite low when the prevalence of the disorder is evaluated.
• Schizophrenia
Schizophrenia is a disorder that affects emotions, thoughts and behaviors, and is characterized by hallucinations and delusions. Delusions: Thoughts that cannot be changed despite being proven to be wrong and are not connected to reality. Hallucinations: Sensory perceptions of hearing, sight, taste, smell, and touch that are not perceived by others and do not exist in reality.
People with schizophrenia may be withdrawn, emotionally dull, and display inappropriate and complex behaviors. They have no insight into their ailments, leading to disruption in their private, social and professional lives. It is important for patients and their relatives to have knowledge about these symptoms and to be aware that the symptoms can be controlled with the right treatment. Those who have these symptoms should consult a psychiatrist.
• Alcohol and Substance Addiction
ALCOHOL AND SUBSTANCE ADDICTION
Addiction is the continued use of substance or alcohol despite adversely affecting life and health. Addiction is a chronic brain disease that must be treated. There are many neurochemical and neurophysiological changes in the brain related to addiction. Addiction has behavioral, social, biological and genetic causes, but no single cause is sufficient to explain addiction. The psychological characteristics of the person, genetic predisposition, environmental factors, accessibility to the substance, family structure, social environment and cultural characteristics are the most important factors in the person's initiation of substance use and transformation into addiction. Addiction is not something that happens overnight.
There is no clear information about after how long the addiction will develop. This varies according to the type of substance used by the person, the purity of the substance, the frequency and amount of use, and the physical and mental structure of the person. Addiction is a vicious cycle. The person first becomes curious about the substance, but at the same time fears the effects of the substance. If curiosity overcomes fear, the person who starts using it by saying "it won’t hurt" thinks that he will never use it after trying it once, but he cannot stop using substances. In the next stage, the person begins to deny that he has a problem with substance use and thinks that he is in control, that he can quit whenever he wants, and he believes that too. He does not listen to the warnings of those around him.
People who develop substance or alcohol addiction start taking more of the substances they are addicted to than they intended. They make a constantly futile effort to quit or use it in a controlled way. They spend a lot of time obtaining, using or recovering from the substances they use, and as a result, they start to disrupt their daily work. Students' school attendance and academic performance drops, and they come into conflict with their families. Their friend groups start changing. They start coming home late, lying, spending most of their time in their room. Adults, on the other hand, start to have problems at work, they cannot spare enough time for their families and neglect them, and they enter into a state of constant conflict and argument. In addition to all these, they continue to use substances even though they know that they have physical and psychological problems. They decide to quit many times, but they never succeed. They experience feelings of guilt and failure for failing. They take more substance to get rid of these feelings.
For the diagnosis of addiction, it is sufficient to meet only three of the criteria listed below.
• Development of tolerance to the substance used, withdrawal symptoms when the substance is discontinued or reduced,
• In vain efforts to control or quit substance,
• Spending a great deal of time obtaining, using or quitting the substance,
• Negatively affected social, professional and personal activities due to substance use,
• Taking the substance in longer times and in higher quantities,
• Continuing substance use despite the emergence or increase of physical or mental problems,
Addiction is a treatable disease.
Especially in people who follow the treatment principles, the rate of quitting alcohol and substance is very high. Treatment includes not only quitting alcohol and drugs, but also returning to social life and maintaining a healthy life. This is possible by building an alcohol-free and substance-free lifestyle. In alcohol, addiction treatment is long-term. The longer the person stays in treatment, the more likely the treatment will be successful. The duration of treatment varies from person to person. Not using alcohol or substances for 6 months is called "partial recovery" in the medical literature. For this reason, it is beneficial to continue the treatment for at least 6 months, even if it is intermittent. However, the treatment should continue for up to a year.
It is reported that at the end of one year, treatment should be continued when necessary. There are studies suggesting that treatment for addiction should last a lifetime. First of all, when the person attended a treatment, his body should be purified from alcohol and substances. This is called detoxification. It requires the application of a medical treatment as serious withdrawal symptoms will occur when alcohol and substance are stopped. Medication alone is not enough. It is ensured that the person gets to know himself/herself, learns the behavior of alcohol and substance use, understands the reasons for alcohol and substance use, and learns what to do in order not to start again. For this purpose, individual and group therapies are useful. The education of the family and the dependent person is also included in the treatment. The longer the treatment period, the higher the chance of success.
