Panic Attacks

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One of the numerous Anxiety Disorders is the panic attack, and this medical condition can overtake an individual in any given situation.  Once an individual has had their initial attack, they’re automatically conditioned to have more of them.  The following scenario is an example of what occurs for members of this population.

They’re driving taking the same routes they always have on the way to work, pick up the children, visit relatives and friends, or shop at the mall.  Suddenly, a sensation of an alarm goes off inside their head.  It’s a feeling of doom, death, and loss of control. Physiological reactions begin with clammy hands on the steering wheel, and a tight grip on the wheel for dear life. Perspiration appears on the forehead, upper lip. Their heart is beating rapidly, and entire body is trembling.  They believe they’re having a heart attack, and pull over to the side of the road to collect themselves.

Panic attacks occur because of biological predisposition, learned behavior (i.e., catastrophizing), the individual was subjected to a tremendous amount of stress the prior year before the panic attacks began, or an abnormality in the brain.  Also, this medical difficulty can result from positive events (i.e., getting married, new employer, childbirth, purchasing a residence, etc.).

Panic attacks can be treated successfully (after the physician has ruled out a heart condition) with relaxation methods (i.e., yoga, meditation), psychotherapy, Cognitive Behavioral Therapy (CBT), and a temporary low-dosage drug therapy.


Conversion Disorder: A Neurological Issue

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If an individual is going to suffer psychologically from a stressful/traumatic event, Post-Traumatic Stress Disorder (PTSD) is generally the condition they will experience.  However, there are individuals who may experience repressed memory.  This difficulty pertains to the brain’s inability to handle the event, the individual attempting to block memory of the event, with memory of the event tossed involuntarily into the subconscious (unconsciousness). Another result which can occur from these events is a conversion disorder.  Let’s place this medical condition under a microscope for examination.

A conversion disorder is when the individual experiences neurological ailments brought on soon after an emotionally stressful event, with neurological assessments unable to rationalize the problem.  The disorder can leave the individual with sudden numbness, paralysis, deafness, blindness, seizures, mute, and other neurological difficulties. Members of the population who are more at risk are those who have had earlier physical ailments, or mental health issues (i.e., dissociative disorder [escape from reality], or a personality disorder). Also, there is no malingering on the individual’s part because these physical challenges are genuine.

In particular circumstances, ailments can dissipate automatically within a few weeks.  Be that as it may, an individual needs to seek medical attention immediately.  Psychotherapy, stress management, and physical rehabilitation are valuable treatments in bringing relief for those who experience neurological issues from these types of events.


The Duty to Protect and the Duty to Warn

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Confusion still exists among members of the psychological community regarding the Duty to Protect and Duty to Warn doctrines.  They are mutually exclusive principles. Professionals will first need to learn from respective state law whether both principles apply, if only one of them is allowed, and if the language is nuanced before entering their occupation.  Let’s examine these principles to gain a better understanding what they concern.

The Duty to Protect doctrine indicates that members of the psychological community have a legal and ethical obligation to protect the patient.  One of the important aspects is the therapist engaging in the most professional behavior.  They must offer the highest, ethical treatment to their patients. Also, even though it can be difficult to predict, the therapist has the duty to protect the patient from harming themselves.  Another factor is confidentiality regarding statements from the patient made in therapy, and a solid infrastructure to keep medical records from public consumption.

The Duty to Warn* doctrine indicates that when a therapist has a reasonable belief that a patient will harm a member of the public, the therapist has a number of options available: Contact the intended victim (without revealing the patient’s name), relatives and friends of the intended victim, law enforcement giving the patient’s name and the intended victim’s, implement an aggressive out-patient therapy for the patient, or have the patient hospitalized on an emergency basis.  This doctrine gives the therapist permission to set aside patient confidentiality in order to protect the community.

Examples of Varied State Laws Concerning the Doctrines are Michigan, Ohio, and Vermont allow for both doctrines, while The Duty to Protect doctrine is applicable for Texas, but not the Duty to Warn doctrine.  Also, The Duty to Protect doctrine is allowed in Utah, including Common Law Duty of Care (in place of the Duty to Warn doctrine).

The clinical practitioner will have to remain apprised of state laws where they decide to practice, or experience disciplinary action from their Board of Psychology and malpractice from patients.

*There are regions where therapists can warn intended victims, but aren’t obligated to do so.


Depression: The Invisible Illness

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There are several medical illnesses which are unnoticeable to the casual observer, and depression is one of them.*  Depression is a sense of sadness which lasts for a lengthy period of time.  The difficulty can occur from medications, aging, stress, genetics, learned behavior, life events, biochemical environment (organic), and a host of other reasons. Sometimes there are unknown causations. Depression is painful because the individual can experience body aches, a loss of sleep and appetite, motivation, self-esteem, and they may no longer engage in activities which were fulfilling.  Irritability and a history of angry outbursts (anger management issues) are also symptoms of depression.  One of the results from depression is a lower immune system, providing a window for physical ailments. The brain can become damaged from long-term depression, in which case psychotropic medication is required.  With all of these particulars to consider, how should we respond when a loved one informs us they’re feeling depressed?

People who experience cancer, broken limbs, lupus, arthritis, sclerosis of the liver, bronchitis, etc. would be taken seriously because these are physically-oriented conditions. In the same manner, depression should be taken seriously, even though we’re incapable of seeing the illness.**  We must always demonstrate compassion by listening, suggesting therapy, and possibly accompanying them to therapy sessions to show support. Compassion might be the most important step for loved ones returning towards a positive mental health.

*There are individuals who experience depression and may not realize it.  They may have indicated they felt emotionally out of sorts, unwell, just a little blue, and believe, mistakenly, their emotional state is an acceptable way of living.

**All conditions which require visits to a medical practitioner should be taken seriously.