Eating disorders

“…compulsive eating is basically a refusal to be fully alive. No matter what we weigh, those of us who are compulsive eaters have anorexia of the soul. We refuse to take in what sustains us. We live lives of deprivation. And when we can’t stand it any longer, we binge. The way we are able to accomplish all of this is by the simple act of bolting — of leaving ourselves — hundreds of times a day.”

 — Geneen Roth, Women, Food and God: An Unexpected Path to Almost Everything

According to the American Psychological Association, eating disorders are behavioral problems marked by severe and persistent disturbances in eating patterns, as well as upsetting thoughts and emotions. 70 million people worldwide are estimated to suffer from an eating disorder, according to the World Health Organization (WHO). Women between the ages of 15 and 35 are particularly susceptible to eating disorders.

Typically, eating disorders emerge throughout adolescence or early adulthood. Anorexia and Bulimia are rare disorders that develop before puberty or after the age of 40. 90% of instances are diagnosed before the age of twenty, while less than 10% of all cases occur before the age of ten. Clearly, adolescent stressful events, such as self-consciousness, puberty, and peer pressure, can contribute significantly to the onset of these diseases. An eating disorder frequently begins as a result of a stressful life experience. This could include exposure to violence, family conflict, school-related stress, or loss. It does not appear to be related to someone’s race or socioeconomic background. Rather, these conditions affect people of all ages and socioeconomic statuses.

Preoccupations with food, weight, or shape, as well as worry about eating or the consequences of consuming specific foods, are common symptoms of eating disorders. Restrictive eating or avoiding particular meals, binge eating, purging by vomiting or laxative usage, or compulsive exercise are some of the behaviors associated with eating disorders. Addiction-like behavior can be a result of these habits. They frequently co-occur with other psychiatric disorders, most frequently mood and anxiety disorders, obsessive-compulsive disorder, and issues with alcohol and other drugs.

It’s important to know that there are many different types of eating disorders like anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant restrictive food intake disorder, other specified feeding and eating disorder, pica, and rumination disorder. Anorexia, bulimia, and binge eating are only some of the most common.

When anorexia nervosa–also known as anorexia–is diagnosed, the patient has an unusually low body weight, a strong fear of gaining weight, and an excessively distorted perception of weight. Individuals suffering from anorexia place a great premium on maintaining a healthy weight and shape, often by severe measures that significantly disrupt their lives. People with anorexia often drastically restrict their food intake in order to avoid weight gain or to maintain their weight loss. Vomiting after eating or using laxatives, diet pills, diuretics, or enemas as laxatives are two common methods of restricting caloric intake. Excessive exercise may also be used as a weight-loss strategy. However much weight is dropped, the worry of gaining it all back persists in the person’s subconscious mind. In the end, anorexia isn’t truly a food-related disorder. It’s a dangerous and potentially lethal technique to deal with emotional issues. It’s common for people with anorexia to see thinness as a sign of self-worth.

Bulimia Nervosa; People with bulimia may surreptitiously eat enormous amounts of food and then purge, seeking to get rid of the excess calories in an unhealthy manner. People with bulimia utilize a variety of strategies to burn calories and avoid weight gain. It’s possible that after a binge, you’ll self-induce vomiting or take laxatives or weight-loss pills, or diuretics. Fasting, severe diets, or intense activity can also be used to burn calories and prevent weight gain.

Binge eating disorder– characterized by recurring bouts of overeating. Binge eating is characterized by feelings of inadequacy during the binge, humiliation, sadness, or guilt afterward, and the absence of unhealthy compensatory behaviors (e.g., purging). It’s the most frequent eating disorder in the United States, according to the CDC. It is one of the most recently identified eating disorders in the DSM-5.

Avoidant restricted food intake disorder – is characterized by an abnormal pattern of eating that results in a prolonged inability to achieve nutritional requirements and severe selective eating. ARFID is characterized by food avoidance or a restricted diet. Infancy or early childhood is a common time for food avoidance or restriction to begin, and it may continue until adulthood. However, it can begin at any age. ARFID can have a negative influence on families regardless of the age of the person afflicted, resulting in greater stress during mealtimes and other social eating situations.

Causes of Eating disorders

Eating disorders are extremely complicated illnesses, and scientists are constantly discovering their origins. Although eating disorders are always associated with food and weight difficulties, the majority of specialists now believe that eating disorders are triggered by individuals attempting to cope with overwhelming feelings and painful emotions through food management. Regrettably, this eventually has a detrimental effect on a person’s physical and emotional health, self-esteem, and sense of control. Some people are more likely to develop an eating disorder because they have a genetic predisposition, but these diseases can also affect people who have no family history of the problem.

An idealized body type in the culture places unnecessary pressure on individuals to meet unattainable norms. Thinness (for women) or muscularity (for men) is frequently associated with popularity, success, attractiveness, and happiness in popular culture and media imagery. When it comes to young people, peer pressure may be a tremendous motivator. Pressure can manifest as teasing, bullying, or scorn based on one’s size or weight. A history of physical or sexual abuse may also contribute to the development of an eating disorder in some individuals. Emotional Well-Being—Perfectionism, impulsive conduct, and problematic relationships can all contribute to a person’s low self-esteem and predispose them to develop eating disorders.

Various treatments are used to treat eating disorders. Individualized treatment regimens for eating problems are available. You will almost certainly be assisted by a team of providers, including doctors, dietitians, nurses, and therapists. Psychotherapy, medication, nutritional counseling, and weight loss monitoring may all be used as therapies.

References

WHO- The Gender and Health Reserach Series, pdf

Mayo clinic- Eating disorders

Eating Disorders | NAMI: National Alliance On Mental Illness. (n.d.). Eating Disorders | NAMI: National Alliance on Mental Illness. https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Eating-Disorders.

Gulf Bend MHMR Center. (n.d.). Gulf Bend MHMR Center. https://www.gulfbend.org/poc/view_doc.php?type=doc&id=11746&cn=46.

What Are Eating Disorders?. (n.d.). What Are Eating Disorders?. https://www.psychiatry.org/patients-families/eating-disorders/what-are-eating-disorders.

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Bipolar disorder

Bipolar disorder, formerly known as manic depression, is characterized by significant mood fluctuations that include emotional highs (mania or hypomania) and lows (depression). Bipolar disorder is a type of mental illness that results in drastic changes in a person’s mood, energy level, and ability to think rationally. People suffering from bipolar experience extremes of emotion referred to as mania and depression, which are distinct from the ordinary ups and downs that most people experience. When you are depressed, you may have feelings of sadness or hopelessness and lose interest or pleasure in the majority of activities. When your mood swings into mania or hypomania (a milder form of mania), you may experience feelings of euphoria, increased energy, or extraordinary irritability. These mood swings can have an impact on one’s sleep, energy, activity, judgment, behavior, and capacity to think effectively.

Mood swings might occur infrequently or repeatedly throughout the year. Between bouts, most people will have some emotional symptoms, but some may not. According to the WHO, over 45 million individuals worldwide are affected by this illness. The typical age of occurrence is around 25, however, it can develop in the teens or even in childhood. Males and females are equally affected by the illness. A person with bipolar disorder can also have manic phases without experiencing depressive episodes.

Bipolar disorder and associated disorders come in a variety of forms. They may include manic or hypomanic episodes, as well as depression.

  • Bipolar I Disorder is characterized by manic episodes lasting at least seven days or by manic symptoms severe enough to require immediate hospitalization. 
  • In contrast to Bipolar I Disorder, Bipolar II Disorder is marked by a pattern of depressed and hypomanic episodes, but not full-blown manic episodes.
  • Cyclothymic Disorder (also known as Cyclothymia) – characterized by episodes of hypomania and depression symptoms lasting at least two years (1 year in children and adolescents). 

Occasionally, a person may exhibit bipolar disorder symptoms that may not fall into one of the three categories given below, which is referred to as “other specified and unspecified bipolar and related diseases.” Bipolar II disorder is not a subtype of bipolar I disorder; rather, it is a distinct diagnosis. While manic episodes in bipolar I disease can be intense and frightening, those with bipolar II condition may experience prolonged depression, resulting in major impairment.

Causes and risks

Bipolar disorder has no recognized etiology, however, several factors may play a role. They include environment, biological differences in brain structure, and function, and genetics. Bipolar disorder is more likely in first-degree relatives, such as siblings or parents. Researchers are searching for genes linked to bipolar disease.

Signs and Symptoms

Bipolar symptoms might vary. But they entail mood episodes: Symptoms of mania episode include: elated or ecstatic Feeling jittery or energized, Having a short fuse or appearing impatient, Thoughts rushing and speech frantic, Sleeping less, thinking you’re special, talented, or powerful. Spending a lot of money, drinking excessively, or engaging in dangerous sex, all of which reveal a lack of judgment.

Symptoms of depression episodes include sadness, hopelessness, and worthlessness. Loneliness or social isolation Slowly speaking, feeling speechless, or forgetting a lot Lacking energy, Oversleeping, Overeating or undereating. Inability to complete simple tasks and lack of enthusiasm in routine activities; Suicide or death thoughts.

A mixed episode is characterized by the coexistence of manic and depressed symptoms. For instance, you may feel incredibly depressed, empty, or hopeless while also feeling extremely invigorated. Certain individuals with bipolar illness may experience lesser symptoms. For instance, you may suffer from hypomania rather than mania. With hypomania, you may feel quite terrific and find that you are able to accomplish a great deal. You may have the impression that nothing is wrong. It’s possible, however, that you’ll be noticed by those closest to you. They may notice that your action is out of character for you. Following hypomania, you may have extreme depression.

Individuals diagnosed with bipolar illness may also suffer from co-occurring disorders such as anxiety, attention-deficit hyperactivity disorder (ADHD), posttraumatic stress disorder (PTSD), and substance use disorders/dual diagnosis. Bipolar patients with psychotic symptoms may be misdiagnosed with schizophrenia. Bipolar disorder is also frequently mistaken for Borderline Personality Disorder (BPD).

Prevention and treatment

There is no foolproof method of preventing bipolar disorder. It is important to get treatment as soon as a mental health illness is detected. Preventing modest symptoms from becoming major mania or depression: Take note of warning indications. Managing and monitoring symptoms early can help prevent worsening episodes.  Involving family or friends in spotting red flags. Avoid using drugs or alcohol– consumption of alcoholic beverages or recreational substances can exacerbate your symptoms and increase their likelihood of recurrence.

There are numerous strategies to treat and manage bipolar disorder: Psychotherapy–including cognitive behavioral therapy and family-focused therapy–can assist you in identifying and altering troublesome emotions, ideas, and behaviors. It can provide you and your family with assistance, information, skills, and coping mechanisms. Consult your physician about drugs such as mood stabilizers, antipsychotic medications, and, to a lesser extent, antidepressants.

Bear in mind that while bipolar disorder is a chronic illness, long-term, consistent therapy can help reduce symptoms– enabling you to maintain and live a healthy lifestyle.

References

Mental Disorders. (2019, November 28). Mental disorders. https://www.who.int/news-room/fact-sheets/detail/mental-disorders.

Bipolar Disorder: MedlinePlus. (2021, September 22). Bipolar Disorder: MedlinePlus. https://medlineplus.gov/bipolardisorder.html.

NIMH » Bipolar Disorder. (n.d.). National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/health/topics/bipolar-disorder.

Bipolar Disorder – Symptoms And Causes. (2021, February 16). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955.

Bipolar Disorder | NAMI: National Alliance On Mental Illness. (n.d.). Bipolar disorder | NAMI: National Alliance on Mental Illness. https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Bipolar-Disorder.

Why are family gatherings such a wellspring of anxiety?

It’s that time of year again when everyone gathers with their loved ones to celebrate the holidays. Family reunions are the type of venue where you catch up, re-energize, laugh your brains off, and just take a breather from your routinely individual insanity. However, it is not an easy task for everyone. Family gatherings are anything but a vacation; they’re more akin to the most difficult exam you’ve ever taken in college. Shhh, this can trigger so much stress, especially if you haven’t studied for the exam in question hence anxiety. 

Despite the fact that these are the individuals with whom we spend the most of our upbringing, they may not know who we are at some point, particularly if there are walls or disagreements lurking somewhere. During family get-gatherings, there are a lot of expectations and memories to tell. We set ourselves up to be disappointed in one another because we have high expectations of one another. And we invent stories to explain why the individuals in our lives either meet or fall short of our expectations. Many (if not all) people develop their own way of looking at the world, values, beliefs, and so on when they are away from home for a period of time, such as while attending college. We create our own cultures that are distinct from that in which we grew up, and these cultures may or may not be in agreement with what our parents know or have taught us. For this reason, we have a tendency to move more distant from them, despite the fact that they remain close to our hearts. For some holidays, though, it is simply impossible to avoid these pounding head scenarios. You only return home for a little period of time each year to check in, and even then, there is a great deal of apprehension upon your arrival. When this dynamic is combined with the customary holiday health pandemonium, the result is a tremendous amount of stress on the body and the mind.

There is always that one person of the family, whether it is Uncle Sam, Auntie Karen, or perhaps that sibling who has always followed the rules or something– who is invariably digging up dirt on someone. Perhaps they are still inquisitive about whatever remained hidden for a while– they are now ready and eager to poke some faces. It could be that adorable little niece or nephew who recalls your age and wonders why you are still single compared to the rest of your family members. Then everyone looks at you with this curious eye, and the room, which had before been filled with noise, is now filled with silence– and you’re thinking, “Pretty face, just shut the fuck up.” You know that favorite family member to whom you confide practically everything– until they become tipsy or intoxicated and begin spilling some of your secrets, sometimes unknowingly. Well, welcome to the world of family gatherings.

Perhaps they are still inquisitive about whatever remained hidden for a while– they are now ready and eager to poke some faces.

Prior to going, personally, I tend to take it easy in order to prepare for anything that may come up. I take a deep breath and mentally situate myself in that zone where I am prepared for anything—more like the armor necessary to maintain my sanity. I’m not going to lie; I’m rather adept at pitching for myself. For instance, if someone said, “Oh, when are we going to meet your partner?” or possibly asked me directly, “When are you getting married?” I’ll go over all of the data about how things have changed in our present generation, including the fact that the average age for getting married is approximately 28/29 (is that correct, by the way?). To keep my sanity, I can make up figures on the spot if necessary. No kidding, on the following question, I tend to continue my numbers higher until someone stops talking about it. 

To be honest, if attending a family gathering will ruin your week or month and temporarily wreck your mental health, it is perfectly acceptable to grant yourself permission to skip family gatherings and celebrations. If you can act as your own advocate in the midst of never-ending disagreements and possible triggers while maintaining your sanity–go ahead, rock it and emerge with your head held high like a giraffe. My view is that they eventually tire of it and cease bothering you and that you eventually tire of it as well, knowing that they will never mentally ruin you or something like that. When you establish your own boundaries and advocate for them, others are forced to respect them. You should be aware that things are more difficult when dealing with family members than they appear on the surface. However, that does not imply that you are unable to thrive through the wilderness. How do you deal with anxiousness that arises during family gatherings?

Always keep in mind that your mental health is vital and that you should look after yourself.

How are you today?

A person attends a party or social gathering with pals and then slips into bed, only to rip up to the pillow and find themselves alone. At this celebration, I’m sure a few individuals asked the person ‘how are you?’ or, for those who hadn’t seen each other in a long time, “how have you been”— I’m fine, how are you? the definitive response in its entirety.

When someone asks that question, it may sound so innocuous that we automatically respond with something as easy as I’m fine, good, or fine, or even simply a grin if we are feeling very sentimental. However, how are you truly? This question is accompanied by a sense of gravity on the part of the receiver. Perhaps if spoken truthfully, one would not have time to listen—perhaps one was merely inquiring. Perhaps I am unable to express it in a single phrase; perhaps it is too much to comprehend where to begin or end. Perhaps I’m unable to fathom how the fuck I am. As a result, my automatic system will anticipate my one-word response… I’m good.

The person asking the question to a greater extent does not mean the inquiry; they are simply asking to be kind and, of course, do not want to hear the whole tale about how you are not well…We have evolved to the automation of simply being with the intention of nothingness. We pose questions and provide fake responses because that is simply how things are. We have been socialized to conceal our emotions from the outside world. The majority of us cannot fathom responding with “I’m feeling quite down today, but thank you for asking” rather than “OK, thanks for asking.” This is something we are all guilty of… but why?

When was the last time you honestly answered that question?

Many people are suffering on the inside, despite the fact that they are surrounded by quite a large number of caring people, such as friends, family, mentors, et cetera. Why? Perhaps they are concerned that no one will pay attention or understand them. Perhaps they believe that regardless of the scenario, it does not matter as much as it should. Perhaps they are apprehensive about being criticized. We are so disconnected from one another that we are unable to see or feel the people who are sitting right next to us, silently suffering. Only after it is too late do we regretfully open our eyes. Despite everyone’s pleas to be heard, no one is listening.

It’s possible that these one-worded responses are a ruse. These one-worded responses conceal a great deal of emotion. They hold so much that is on the edge of shattering. They weigh so much on the precipice of oblivion. They numb us for an extended period of time and exacerbate denial and repression of feelings. Nonetheless, there is undoubtedly a party of unwelcome guests in our heads (thoughts)– erupting like fireworks, we are simply watching, and hoping someone/ anyone will hear the explosions.

When was the last time you asked that question genuinely, intending to listen?

Every day, we all experience our mental health to varying degrees. I believe it is critical that we convey our true feelings. In addition to this, your feelings are valid; you have the right to experience any emotion you desire. You are not overreacting; you are simply feeling what you are feeling, and that’s okay.

It appears as though the only individuals remaining to genuinely ask the question are experts such as therapists, doctors, and mentor health personnel. What if we all asked the question truthfully and listened intently to the responses of others?

History of mental health

Even in developed countries, mental health has not always been seen as such. It does have a journey, a transformation, and advocacy for its current state. Mental illnesses have a long nasty past and continue so today through stigmatization and prejudices.

Since the ancient period, there have been three main notions on the causes of mental illness: supernatural, somatic, and psychogenic. For the supernatural,  It was claimed that demonic or bad spirits are to blame for mental conditions, as well as gods’ displeasure and the gravitational pull of the Earth. An example of a supernatural explanation for mental illness is the trephination procedure.  Prehistoric people drilled holes in the skulls of people suffering from mental disorders to heal head injuries and epilepsy, as well as to let evil spirits trapped in the head be expelled from the skull. [1] As early as 2700 B.C.E., the Chinese idea of “yin and yang,” or the balance of opposing positive and negative physiological forces, was used to explain mental (and physical) sickness. Somatogenic theories classify physical dysfunctions as a result of sickness, hereditary inheritance, or brain injury or imbalance. Traumatic or stressful experiences, maladaptive learned associations, and cognitions, or distorted perceptions are the focus of psychogenic theories of mental illness.

When it came to mental health conditions, Greek doctors didn’t believe in supernatural explanations. Hippocrates (460–370 BC) endeavored to detach superstition and religion from medicine by establishing the concept that one of the four basic physiological fluids(humors) such as blood, black bile, yellow bile, and phlegm to be responsible for the causation of illness whether physical or mental.  He did not believe that mental illness was shameful or that people suffering from it should be penalized for their actions. Hippocrates divided mental illness into four categories: epilepsy, manic, melancholy, and brain fever.

According to Greek philosopher Plato (429-347 BCE), he believed that community and families should care for the mentally ill humanely using reasoned conversations because of the important role that early learning and social environment play a role in the development of mental problems. Also,  Galen (A.D. 129-199), a Greek physician, stated that mental diseases were caused by physical or mental factors such as fear, shock, intoxication, head traumas, puberty, and shifts in menstruation cycles.[2]

Instead of accepting Hippocrates’ theory of four humors, philosopher Cicero and physician Asclepiades (c. 124-40 BC) in Rome said that melancholy is not caused by excess black bile but rather by feelings of sadness, dread, and fury. Roman doctors used massages and warm baths to cure mental disorders.  When it comes to physical and mental health, they embraced the concept of “contrariis contrarius,” which means opposite by opposite, and used contrasting stimuli to achieve a state of equilibrium.

Economic and political turbulence endangered the Roman Catholic Church’s dominance in the late Middle Ages, which resulted in the rise of the Church and the demise of the Roman Empire. Between the 11th and 15th centuries, mental disorders were once again described as devil possession, and procedures like exorcisms, flogging, prayer, touching relics, chanting, attending religious sites, and holy water were employed to cleanse the individual of the Devil’s control. At this moment, supernatural conceptions of mental illness dominated Europe, bolstered by natural disasters such as plagues and famines. The afflicted were jailed, beaten, and even executed in extreme situations.

Women, particularly those with mental health issues, began to be viewed as witches in the 13th century. The Malleus Maleficarum (1486) was written by two Dominican monks during the peak of the witch trials during the 15th through 17th centuries when the Protestant Reformation had thrown Europe into religious conflict. However, both Reginald Scot’s and Johann Weyer’s writings were condemned by the church’s Inquisition— their writings claimed that mental sickness was not a result of demonic possession, but rather a result of a malfunctioning metabolism and disease. Only in the 1700s and 1800s did witch-hunting begin to wane, after more than one hundred thousand people were accused of being witches and burned to death. [3][4]

Protests against the living conditions of the mentally ill began in the 18th century and during the periods of 1800s and 1900s, a more humane perspective on mental disease emerged. While working at the St. Boniface Hospital in Florence, Vincenzo Chiarughi (1759–1820), an Italian physician and educator, dismantled the chains that bound people there in 1785. Patients were freed from their chains, moved to rooms that were well-ventilated and well-lit, and encouraged to engage in purposeful activity on the grounds of La Bicêtre and the Salpêtrière in 1793 and 1795, respectively, by French physician Philippe Pinel (1745–1826) and former patient Jean-Baptiste Pussin. [5]

Humanitarian changes began in England as a result of religious concerns. William Tuke (1732–1822) pushed the Yorkshire Society to build a retreat in 1796, where patients were treated as guests, not as captives. The standard of treatment was based on dignity and kindness in addition to the therapies and moral value of physical labor. [6]

While in America, Benjamin Rush (1745-1813), the pioneer of American psychiatry, pushed humane treatment for the mentally ill. His profession featured therapies like blood-letting and purgatives, the design of a “tranquilizing chair,” and a strong belief in astrology, which shows that he couldn’t escape the beliefs of his day. Dorothea Dix (1802-1887), a retired teacher worked tirelessly to change the public’s attitude toward persons with mental disorders and to establish institutions where they may get humane treatment. She was the driving force behind the mental hygiene movement, which aimed to improve patients’ physical health as well. She was a proponent of the creation of public hospitals. She aided in the establishment of around Thirty mental facilities in the United States and Canada between 1840 and 1880. [7] In Massachusetts and New York, the first asylums were erected in the 1830s. By 1860, twenty-eight of thirty-three states had established mental institutions (Braslow 1997). People with mental illnesses were able to heal from their illnesses because of moral therapy movements in both the United States and Europe.

However, a large number of academics strongly opposed mental health facilities. This “tale of noble intentions gone wrong” is what Shorter calls the rise of American asylums (Shorter 1997, 33). Asylums were built in the nineteenth century on the premise of “moral therapy,” a theory that maintained that meticulously structured institutions might provide a haven from the chaos of regular life. The mentally ill can gradually adjust to and eventually adopt a sense of normalcy in an orderly setting that encourages regular social interaction, work, and recreation. [8]

Due to a deterioration in morality in the late 19th-century moral treatment approaches led to two rival perspectives – biological or somatogenic and psychogenic or psychology by the 20th century. The biological approach is challenged by the psychological or psychogenic perspective, which asserts that emotional or psychological variables have a role in the development of mental diseases. Emil Kraepelin (1856-1926), a German psychiatrist, noticed that symptoms appeared in clusters, which he referred to as syndromes. These syndromes were distinct mental disorders, each with a distinct cause, course, and outcome. When he released Compendium der Psychiatrie in 1883, he laid the groundwork for the Diagnostic and Statistical Manual of Mental Disorders (DSM) currently in its 5th edition, which is based on his classification system for mental disorders (published in 2013). Clinicians and psychiatrists now use the “Diagnostic and Statistical Manual of Mental Disorders” (DSM) to diagnose psychiatric conditions.

Despite this, not all countries adhere to the latest standards. Many cultures, particularly developing countries, continue to believe brain disorders in the context of metaphysical affiliations, exorcisms, taboos, bad luck to the family, et cetera. Psychological illness is often misunderstood by the general public, which leads to stigmatization and dehumanization of those who are afflicted. To this day so many people are homeless and are left on the streets, where they are mocked, beaten, harassed, jailed, and so on. These countries have very few if any, facilities or resources for mental health care. Many people are stuck in limbo in a state of ignorance, unsure of what might be wrong. People suffering from mental illnesses are dying at an alarming rate, yet they can be saved. Developing countries have an urgent need for education and advocacy for mental health.

References

[1] Restak, R. (2000). Mysteries of the mind. Washington, DC: National Geographic Society.

[2] “1.3. The History Of Mental Illness – Essentials Of Abnormal Psychology.” 1.3. The History Of Mental Illness – Essentials Of Abnormal Psychology, Opentext.wsu.edu, 5 January. 2018, https://opentext.wsu.edu/abnormalpsychology/chapter/1-4-the-history-of-mental-illness/.

[3] Schoeneman, T. J. (1977). The role of mental illness in the European witch hunts of the sixteenth and seventeenth centuries: An assessment. Journal of the History of the Behavioral Sciences, 13(4), 337–351.

[4] Zilboorg, G., & Henry, G. W. (1941). A history of medical psychology. New York: W. W. Norton

[5] Micale, M. S. (1985). The Salpêtrière in the age of Charcot: An institutional perspective on medical history in the late nineteenth century. Journal of Contemporary History, 20, 703–731.

[6] Bell, L. V. (1980). Treating the mentally ill: From colonial times to the present. New York: Praeger.

[7] Viney, W., & Zorich, S. (1982). Contributions to the history of psychology: XXIX. Dorothea Dix and the history of psychology. Psychological Reports, 50, 211–218.

[8] Melissa Schrift, et al. “Mental Illness, Institutionalization and Oral History in Appalachia: Voices of Psychiatric Attendants.” Journal of Appalachian Studies, vol. 19, no. 1/2, Apr. 2013, pp. 82–107. 

Farreras, Ingrid G.. “History Of Mental Illness | Noba.” Noba, Nobaproject.com, https://nobaproject.com/modules/history-of-mental-illness.

Mindfulness

It wasn’t until the late 1970s that mindfulness meditation began to be addressed as a therapeutic intervention to improve psychological well-being, despite the fact that research on the subject had begun as early as the 1960s. Nowadays, mindfulness is applied in a variety of circumstances, and there are many diverse interpretations of the term available. The inventor of mindfulness-based stress reduction (MBSR), one of the most extensively researched and widely applied mind­fulness programs in the world, JON KABAT-ZINN, defines mindfulness as follows: “Mindfulness is about being fully awake and present in our lives.” Each moment’s extraordinary vividness must be perceived in order to be fully appreciated.” Diana Winston of UCLA’s Mindful Awareness Research Center defines mindfulness as paying attention to present-moment experience with open curiosity and a readiness to stay with whatever is happening at any given time. [1]

Most of the time, when this happens, it is completely unexpected, such as while hiking on a mountain trail on a crisp fall day, or while being completely immersed in a task or play that you are not pondering about the past or the future, or while connecting with someone in such a way that it appears as if time has stopped completely. It is always possible to be alive and whole in the present moment, but it is sometimes difficult to achieve, especially during times of difficulties and external demands, as we have experienced.

Positive psychological consequences of mindfulness include an increase in subjective well-being, a reduction in psychological symptoms and emotional reactivity, as well as an improvement in behavioral regulation. A mindfulness-based approach is advised as a treatment for some individuals who are struggling with common mental health issues such as stress, anxiety, and depression. Also included are people who just want to enhance their mental health and well-being through relaxation and meditation. [2]

Mindfulness as a kind of behavioral intervention for clinical problems dates back to the work of Jon Kabat-Zinn, who investigated the use of mindfulness meditation in treating patients with chronic pain, which is now known as Mindfulness-Based Stress Reduction (MBSR). Several different interventions have been created that are based on mindfulness-related principles and practices, including Mindfulness-Based Cognitive Therapy (MBCT), Dialectical Behavior Therapy (DBT), Acceptance and Commitment Therapy (ACT), and other forms of cognitive-behavioral therapy (ACT).[3] ACT and DBT are both cognitive-behavioral treatments that incorporate elements of mindfulness into their treatment plans. [4]

In psychotherapy, mindfulness-based cognitive therapy (MBCT) is a method of treatment that combines cognitive therapy with meditation and the cultivation of a present-oriented, nonjudgmental attitude known as “mindfulness.” Therapists Zindel Segal, Mark Williams, and John Teasdale came up with the idea of MBCT as a way to build on the principles of cognitive therapy. Using cognitive therapy in conjunction with a program developed in 1979 by Jon Kabat-Zinn called mindfulness-based stress reduction (MBSR), they hoped to improve the effectiveness of therapy. With MBCT, the primary goal is to assist patients suffering from chronic depression in learning how to avoid relapses by refraining from engaging in those habitual thought processes that perpetuate and worsen depression. According to a study published in The Lancet, mindfulness-based cognitive therapy (MBCT) was just as effective at preventing depression recurrence as maintenance antidepressant medication. Individuals who suffer from recurrent depression can benefit from mindfulness-based cognitive therapy (MBCT), which has been found to reduce the risk of relapse by approximately 50 percent on average.[5]

I have explored in depth Mindfulness-Based Stress Reduction (MBSR), so that is where I will be concentrating my efforts. Mindfulness-Based Stress Reduction (MBSR) is a technique that tries to address the unconscious thoughts, feelings, and behaviors that are believed to contribute to stress and psychological health. I strongly advise looking into this technique because it is quite beneficial. The 8-week certified stress reduction program is based on rigorous mindfulness training and is provided free of charge by the Palouse Mindfulness website. Participants in an MBSR course become more familiar with their own behavior patterns as a result of the regular mindfulness training that the course provides, particularly in the context of stressful situations. They also learn that, while they may not always be able to change the situations in which they find themselves, they do have the ability to select how they will respond to those circumstances. MBSR describes this as a transition from reacting to responding, with the latter involving a sharper view of the circumstances by becoming more in touch with the thoughts, sensations, and emotions that are currently present. [6]

As an effective alternative to existing medical and/or psychological treatment, MBSR has been shown to significantly improve the outcomes of treatment for the following conditions: anxiety and panic attacks, Asthma, cancer, and chronic illness, depression, eating disorders, fatigue, fibromyalgia, gastrointestinal distress, grief, headaches, heart disease, high blood pressure, pain, post-traumatic stress disorder, skin disorders, sleep problems, work, family, and financial stress, and work, family, and financial stress (Center for Mindfulness). When it comes to practicing mindfulness or yoga, there are essentially no obstacles. As long as you have a conscious mind, you can engage in mindfulness practices, and as long as you have a moving body, you can engage in yoga practices.

There are actually multiple distinct ways to practice or participate in mindfulness, each with a different emphasis on a different aspect of the discipline. Focus Mindfulness, particularly mindfulness practiced with an emphasis on focus, entails turning inside to examine what is going on in your mind. Awareness Mindfulness, In contrast to focusing, exercising awareness places an emphasis on the exterior rather than the inward. When you are aware, you are looking at your thoughts and feelings from a different viewpoint than you are used to having, and you are not attaching any judgment to what you are seeing. Breathing exercises, body scans, object meditation, mindful eating, walking meditation, mindful stretching, and mindful listening are just a few examples of mindfulness exercises. [7]

According to research, the practice of “mindfulness” is becoming more popular as a component of mental health treatment in recent years. You may include mindfulness practices in your daily routine. To practice mindfulness, you don’t need any specific equipment, such as a meditation cushion or bench, or any other unique equipment, but you do need to set aside some time and space to do so. The goal of mindfulness is not to quiet the mind or to reach a state of permanent tranquility. The purpose is straightforward: strive to devote full attention to the present moment, without passing judgment on it.[8]

References

[1] Carrión, Victor G., et al. Applied Mindfulness : Approaches in Mental Health for Children and Adolescents. Vol. First edition, American Psychiatric Association Publishing, 2019.

[2] “How to Look after Your Mental Health Using Mindfulness.” Mental Health Foundation, 14 July 2021, https://www.mentalhealth.org.uk/publications/how-look-after-your-mental-health-using-mindfulness.

[3] Keng, Shian-Ling, et al. “Effects of Mindfulness on Psychological Health: A Review of Empirical Studies.” Clinical Psychology Review, U.S. National Library of Medicine, Aug. 2011, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3679190/.

[4] What’s New | Association for Contextual Behavioral Science. https://contextualscience.org/.

[5] Schimelpfening, Nancy. “How Mindfulness-Based Cognitive Therapy Works.” Verywell Mind, Verywell Mind, 14 July 2021, https://www.verywellmind.com/mindfulness-based-cognitive-therapy-1067396.

[6] Institute for Mindfulness-Based Approaches :: What Is MBSR?, https://www.institute-for-mindfulness.org/offer/mbsr/what-is-mbsr.

[7] “MBSR: 25 Mindfulness-Based Stress Reduction Exercises and Courses.” PositivePsychology.com, 10 Mar. 2021, https://positivepsychology.com/mindfulness-based-stress-reduction-mbsr/.

[8] “The Power of Mindfulness for Your Mental Health.” Rogers Behavioral Health, https://rogersbh.org/about-us/newsroom/blog/power-mindfulness-your-mental-health#:~:text=The%20practice%20of%20%E2%80%9Cmindfulness%E2%80%9D%20is,relax%20the%20body%20and%20mind.

“Center for Mindfulness – UMass Memorial Medical Center – UMass Memorial Health.” UMass Memorial Health, http://Www.ummhealth.org, https://www.ummhealth.org/umass-memorial-medical-center/services-treatments/center-for-mindfulness.

What about stress?

There is no universally accepted definition of stress. As a result, measuring stress is difficult if there is no agreement on what stress should be defined as. People have very different ideas about what constitutes stress. Most people consider stress to be something that causes only harm; however, any definition of stress should include positive stress as well. The most common definition of stress is a state of mental or emotional strain or tension caused by adverse or extremely demanding circumstances. The American Institute of Stress defines stress as “a condition or feeling experienced when a person perceives that demands exceed the personal and social resources the individual is able to mobilize.” My favorite definition is the Stoic’s, “the friction of conflicting obligations.” Stress is a mental and physical reaction to what you perceive to be happening.

Acute stress, for example, is the fight or flight response, in which the body prepares for defense. Chronic stress is characterized by a persistent sense of pressure and overload over an extended period of time. Eustress, the positive connotations—which is the bitter-sweet excitement that comes with overwhelming emotions, such as marriage, promotion, lottery, or meeting new people. You know when you finally get to that milestone you’ve been looking forward to, like graduation, so thrilled about advancement but with lingering thoughts of what comes after, like oh shit, I’m now an adult or the reality of responsibilities like student loans? Or when you’re ecstatic to get your firstborn child but have no idea how to parent or even what to do when it arrives. The other sort of stress is distress, which has negative connotations such as divorce or financial difficulties, among other things. Distinguishing between the unpleasant or damaging type of stress known as distress, which often connotes sickness, and eustress, which often connotes euphoria, is critical. Both eustress and distress cause the body to have nearly identical non-specific responses to the many positive and negative stimuli acting on it. Eustress, on the other hand, produces far less harm than distress. This proves beyond a shadow of a doubt that how a person handles stress influences whether or not they can successfully adapt to change.

What causes stress?

According to Dr. Cynthia Ackrill, a leader in the field of stress mastery, believing that stress is something that happens to us is a myth. For example, if I say that my girlfriend is stressing me out, she is only a stressor; the stress is caused by my reaction to what I perceive to be happening. A stressor is someone or something that presents you with a challenge. What is the true source of stress? Perception. The majority of stress is caused by perception. We become stressed when our perception does not match our expectations.

“We suffer more from imagination than from reality.”

Seneca

Stress, according to the Stoics, is optional. Stress isn’t something that happens to you, as psychologists and neuroscientists have recently confirmed. That is definitely true; I believe stress is optional, but stressors are not. Stressors will always be present in our lives every day, minute, and second; what matters is how you respond to that stressor. Because stress is caused by perception, relieving stress is essentially a matter of training your perceptions. As the Stoics put it, mastering the discipline of perception.

I did think once that I had to carry the entire world on my back. When a problem arose, whether it was controllable or not, I made every effort to control the situation. My mind’s racing thoughts increased my adrenaline levels. I was always so stressed that I thought my heart would burst one day. I spoke with this woman, and she told me something I will never forget: the world existed before you were born, and it will exist after you are gone; control what you can and let go of the rest. That was the exact day I said, “Fuck it.” Of course, I encounter stressors, but my reaction to them has shifted so dramatically that I occasionally relish the challenges. It is important to consider how you perceive the situation. The way one perceives the situation has a significant impact.

Stress can be unhealthy, but it can also be beneficial.

Kelly McGonigal, a health psychologist, highlighted a massive piece of research at the University of Wisconsin-Madison in her TED talk, which shocked many people. A study of 29,000 people over an eight-year period discovered that your attitude toward stress has a far greater impact on your health than the stress itself. People who were under a lot of stress and believed it was bad for their health had a 43 percent increased risk of dying. Nonetheless, in the study, people who experienced too much stress but did not perceive stress as harmful had the lowest risk of dying. The researchers now estimate that 182,000 people died prematurely over the eight years they tracked mortality, not from stress, but from the assumption that stress is bad for you. This equates to more than 20,000 deaths per year. If that calculation is true, stress was the 15th leading cause of death in the United States last year, killing more people than skin cancer, HIV/AIDS, and homicide combined.

According to the study, if you believe that stress is always harmful to you, your prediction will come true. You’re also correct if you believe stress is a positive thing because it energizes, challenges, and motivates you. People who had a positive attitude toward stress lived for several years longer than those who had a negative attitude toward stress, which is a remarkable finding. Short-term stress can strengthen your immune system, make you more social, help you learn better, and even improve your memory. Stress boosts motivation, increases resiliency, and promotes growth.

Reducing stress

There are a number of ways one can reduce stress, exercising, meditation, mindfulness meditation, counseling, finding a hobby, journaling, reading, cold showers- Cold exposure is a hot trend. Silicon Valley swears by taking cold showers first thing in the morning to reduce stress and boost mental fortitude. It’s been dubbed the “secret weapon” and most cost-effective “biohack” in the pursuit of ageless vitality by anti-aging researchers. Dissecting the situation aids in narrowing it down and locating the source of the problem; pause and analyze. What is the source of this? Is this something I’ve brought on myself? What can do? Is it under my control or not? Careless about what others think of you, please…don’t you think it’s easier to be yourself than to try to be someone you’re not—your happiness and peace of mind are too important to be placed on the whims of others? Life is too short to be swayed by the opinions of others. Accept yourself for who you are and what makes you unique. 

Photo by Download a pic Donate a buck! ^ on Pexels.com

References

“Daily Life.” The American Institute of Stress, 18 Dec. 2019, https://www.stress.org/daily-life.

“Dealing with Stress: 12 Proven Strategies for Stress Relief from Stoicism.” Daily Stoic, 16 Feb. 2021, https://dailystoic.com/stress-relief/.

McGonigal, Kelly. “How to Make Stress Your Friend.” TED, https://www.ted.com/talks/kelly_mcgonigal_how_to_make_stress_your_friend/up-next?language=en.

Anxiety

Anxiety is such a whisperer. In fact, it never ceases to purr upon humanity. Uncertainty fills and frightens many people’s minds. It’s like a constant rustling wind. It can cause you to sweat, feel agitated and tense, and cause your heart to race. It is apprehension or fear of what is to come. It is your body’s normal physiological response to stress. For example, you may feel anxious when confronted with a difficult situation or before making a critical decision, as the consequences may occupy your thoughts. Anxiety is a normal part of the human experience.

People with anxiety disorders, on the other hand, frequently experience intense, excessive, and persistent worry and fear about everyday situations. Anxiety disorders frequently involve repeated episodes of intense anxiety, fear, or terror that peak within minutes (panic attacks). Anxiety and panic disrupt daily activities, are difficult to control, are out of proportion to the actual danger, and can last for a long time. To avoid these feelings, you may avoid places or situations. Symptoms may appear in childhood or adolescence and persist into adulthood. Generalized anxiety disorder, social anxiety disorder (social phobia), specific phobias, and separation anxiety disorder are all examples of anxiety disorders. You can have multiple anxiety disorders.

Risk factors for anxiety disorders?

Biological risk factors, such as genes, If you have a family history of anxiety disorders, you are more likely at risk to develop the disorder. That implies that your genes play a role. Scientists have yet to discover an “anxiety gene.” So just because your parent or a close relative has one doesn’t mean you’ll get one as well. Stressful or traumatic events—Children who have experienced abuse or trauma, or who have witnessed traumatic events, are more likely to develop an anxiety disorder at some point in their lives. Anxiety disorders can develop in adults who have experienced a traumatic event. When you suffer from depression for an extended period of time, you are more likely to develop an anxiety disorder. Certain personality traits, such as shyness or behavioral inhibition — feeling uneasy around and avoiding unfamiliar people, situations, or environments.

What are the symptoms of an anxiety disorder?

Anxiety disorders are characterized by symptoms such as cold or sweaty hands, dry mouth, heart palpitations, nausea, and numbness or tingling in the hands or feet. Shortness of breath, muscle tension Panicked, fearful, and unsettled, Nightmares, Uncontrollable, obsessive thoughts, repeated thoughts or flashbacks of traumatic experiences Inability to remain calm and still Problems sleeping due to ritualistic behaviors such as hand washing. Please contact your health care provider if you are experiencing symptoms of an anxiety disorder.

Anxiety in developed and developing countries.

Developed countries have higher rates of anxiety in their populations than developing countries, according to a finding that even the researchers were surprised by. There was a higher proportion of people with generalized anxiety disorder, or GAD — defined as excessive and uncontrollable worry that interferes with a person’s life — and with severe GAD in higher-income countries. The findings were published in JAMA Psychiatry by the researchers, who are members of the WHO World Mental Health Survey Consortium. Australia and New Zealand, both classified as high-income countries, had the highest lifetime prevalence rates, at 8% and 7.9%, respectively. Nigeria (0.1%) and Shenzhen, China (0.2%) had the lowest reported rates; both were classified as low-income areas. Anxiety disorders affect approximately 18.1 percent of the population in the United States each year. Researchers hypothesized that lower-income countries’ prevalence rates might differ due to relative political or economic instability. These factors may have directly contributed to higher rates — or indirectly contributed to lower rates, because people may not have reported “excessive” anxiety because their concerns were justified by the issues they faced. This could be true because mental disorders are still largely a mystery in most developing countries.

It is not unusual for someone suffering from anxiety to also suffer from depression, or vice versa. Is it possible to have both depression and anxiety? Anxiety disorders affect nearly half of those who are diagnosed with depression. Depression and anxiety are distinct conditions, but they frequently coexist. Anxiety can be a sign of clinical (major) depression. Anxiety disorders, such as generalized anxiety disorder, panic disorder, or separation anxiety disorder, are also common triggers for depression. Several people have anxiety disorders as well as clinical depression.

References

15, Kate Sheridan March, et al. “Rich Countries Are More Anxious than Poorer Countries.” STAT, 15 Mar. 2017, https://www.statnews.com/2017/03/15/anxiety-rich-country-poor-country/.

“Anxiety Disorders.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 4 May 2018, https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961.

“Anxiety Disorders: Types, Causes, Symptoms & Treatments.” Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/9536-anxiety-disorders.

“Facts & Statistics: Anxiety and Depression Association of America, ADAA.” Facts & Statistics | Anxiety and Depression Association of America, ADAA, https://adaa.org/understanding-anxiety/facts-statistics.

“Risk Factors for Anxiety.” WebMD, WebMD, https://www.webmd.com/anxiety-panic/ss/slideshow-anxiety-risk-factors.

Your human, its’ okay to feel it all

That’s true, you’re only human, and it’s perfectly fine to experience whatever feelings you want. Feelings and moods are frequently mistaken with emotions, but the three concepts are not interchangeable. What exactly are emotions? Emotion is defined as “a complex reaction pattern integrating experiential, behavioral, and physiological factors,” according to the American Psychological Association (APA). Emotions are how people react to issues or circumstances that are important to them. They are a type of conscious mental reaction (such as rage or fear) that is subjectively felt as a strong emotion focused on a single object and is usually accompanied by physiological and behavioral changes in the body. A subjective experience, a physiological response, and a behavioral or expressive response are the three components of emotional experiences. Emotional experiences give rise to feelings. This is considered in the same category as hunger or pain because a person is aware of the sensation. An emotion produces a feeling, which can be impacted by memories, beliefs, and other variables. Mood on the other hand is described by the APA as “any short-lived emotional state, usually of low intensity.”[1]

Emotions are, on one level, like energy waves that vary in shape and intensity, much like ocean waves. Their nature, like all-natural events, is for them to appear and vanish swiftly. Several things can happen if you try to stop this process by acting out or suppressing it. When it comes to dealing with uncomfortable emotions, most individuals respond in one of two ways: they act out or suppress. The dangers of suppressing those powerful emotions are considerably worse.

Unfortunately (and ironically), attempting to “talk yourself out of your emotions” frequently leads to “greater rumination and perseveration.” In other words, you will continue to think about and hang on to the emotions you are attempting to avoid. Anyone who has had a deep-tissue massage can attest to how the body stores suppressed emotions. Suppression is stored in the body and causes a slew of negative consequences, such as anxiety, depression, stress-related illness, substance misuse, and suicide.[2]

What about Repressing emotions?

Repression is the other most prevalent method. The tendency to ignore unpleasant feelings is referred to as repression. Repressed emotions are unconsciously avoided emotions. This is when painful feelings, thoughts, or memories are pushed out of your consciousness involuntarily. This allows you to forget about them. You might do this to protect your positive self-image. These are feelings that haven’t been processed. They can, however, influence your actions. Over time, repressed emotions might lead to health issues. If you were raised in a dysfunctional family, you may have learned to suppress your feelings. These feelings may include fear, anger, pain, or shame.[3] Pennebaker and his colleagues (1997) found that people who conceal their emotions also reduce their body’s immune function, rendering them more susceptible to illnesses ranging from common colds to cancer.[4]

Repression VS Suppression

Sigmund Freud proposed suppression as a voluntary kind of repression in 1892. It’s the deliberate act of pushing undesired, anxiety-inducing ideas, memories, feelings, fantasies, and desires out of one’s conscious awareness. Suppression, the unconscious process of removing painful memories, ideas, and impulses from consciousness, is more amenable to controlled tests than repression. If you’re grieving the loss of a loved one or the end of a relationship, you may make the conscious decision to stop thinking about it in order to go on with your life. In another instance, you may feel compelled to tell your employer how you truly feel about him and his heinous behavior, but you conceal your feelings because you need the job. The desire is aware in both circumstances, but it is prevented by willpower arising from a rational decision to avoid the behavior. In general, “forgotten” thoughts, memories, and desires can have an impact on actions, conscious thoughts, and feelings, and might manifest as symptoms or even as mental illnesses such as depression, anxiety, and so on.[5]

However, there is another technique to control our emotions: feeling and processing them. Allow it to burn at the moment, and if necessary, take a break to regulate your emotions. Although not everyone processes information in the same manner, you should be able to recognize the indicators. Identify and label your feelings while remembering to be kind and compassionate to yourself, and then decide how you’ll deal with them — either by deciding how you’ll fix the problem if you have control over it, or how you’ll cope with them better in the future if you don’t. You can try several ways of processing feelings to see what works best for you. Journaling, painting, venting to a friend, spending time in nature, meditation, and so on are all alternatives. Everyone needs an outlet for their emotions, whether it’s crying or yelling at a wall—it’ll feel a lot better than keeping them bottled up inside. Emotional regulation is vital because it enables you to live a healthy lifestyle, both mentally and physically. Take care of yourself, you know—the majority of the work is done on the inside, and the outside world can only add to that.

References

[1]Posted June 27, 2019 by UWA | Psychology and Counseling News. “The Science of Emotion: Exploring the Basics of Emotional Psychology.” UWA Online, 22 June 2020, https://online.uwa.edu/news/emotional-psychology/.

[2]About the Author Margaret Cullen Margaret Cullen, and Margaret Cullen Margaret Cullen. “How to Regulate Your Emotions without Suppressing Them.” Greater Good, https://greatergood.berkeley.edu/article/item/how_to_regulate_your_emotions_without_suppressing_them.

[3]“Repressed Emotions: How to Spot and Release Them.” WebMD, WebMD, http://www.webmd.com/mental-health/what-to-know-repressed-emotions.

[4]Pub, Open Access. “Consequences of Repression of Emotion: Physical Health, Mental Health and General Well Being.” Pen Access Pub, openaccesspub.org/ijpr/article/999.

[5]Berlin, Heather A. “Defense Mechanisms: Neuroscience Meets Psychoanalysis.” Scientific American, Scientific American, 1 Apr. 2009, http://www.scientificamerican.com/article/neuroscience-meets-psychoanalysis/.