Psychological disorder is a complex and intricate term to define. The term is often used interchangeably used with mental disorder. It is a disorder or disruption in the normal functioning of brain, involving thoughts, behavior, moods and emotions that causes stress. The patient’s language and communication get affected. They lose ability to focus and pay attention. A significant amount of stress can cause disability of thoughts and actions. In the extreme case, the individual who is suffering from the symptoms of psychological illness is unable to meet their personal needs on their own and can also cause harm to themselves or others.
We all should understand that psychological disorders is not a social stigma or affecting one’ existence. It is one of the major reasons that refrain people from taking medical help even if that is the most urgent call at that point of time. It is essential to get the diagnosis done in order to identify problem, discover solution and go for the required treatment. According to the recent research, psychological disorder are now far more prevalent than in past. The primary cause behind this is the fast and stressful life.
There are various categories of psychological disorders based on the set of symptoms and abnormal behavioral patterns experienced by the patient. The most common disorders include abrupt patterns in eating, mood, sleep, emotions, personality and somatoform disorders. The other forms of disorders which are not so common are factilious disorders and dissociative disorders.
Cognitive disorders are maladaptation in a person’s memory, his ability to solve problems and distorts perception. Anxiety disorders, mood and psychotic disorders together constitute cognitive disorders. Dementia is one of the most common cognitive disorders. Literally, dementia means without mind. It is a serious ailment in which the person suffers loss of cognitive ability. It can be static in nature, which might have resulted from a brain injury or progressive, that results in a long term and persistent decline due to an acute damage in the body. When the cells in a particular area of brain, exhibit an abnormal pattern of growth, that part in brain either stops functioning or shows abnormal functioning. The deterioration does not always have to do with ageing. If dementia occurs before 65, it is then referred to as early onset. There is a common misunderstood as “senility”, which is condition in which brain starts deteriorating and dys-functioning as a result of ageing.
History of Dementia
It is believed dementia is as old as mankind. A French physician called Phileppe Pinel had coined this term. In the year 1801, there was a woman patient who visited to him with unusual illness process. Women had lost her memory, ability to walk, speak and use day to day common objects. Dr. Pinel named this abnormality as “demence.” With the word demence he meant incoherence of mental organs. After the patient passed away, Dr. Pinel autopsied her brain and used a primitive microscope to investigate her brain. He could find and describe two features related to demence. He observed that the brain had a fluid which occupied most of the space and it had caused it to shrink dramatically. An average brain weighs around 3 pounds, but her brain had deteriorated to be just one pound.
In 1907, a research paper was published by a German physician who treated a 50 year old lady named Augusta D., who suffered from similar symptoms as Pinel’s lady patient. Augusta D had a memory failure, paranoia, stupor, incomprehension, and reasoning power had deteriorated. Doctor mentioned in his research paper that Augusta D’s brain suffered damage in form of neuro-fibrilary tangles and some bone structure had erupted in brain tissues.
Alzheimer’s disease is a kind of dementia. It constitutes about 60-80 percent of existing dementias. Vascular dementia or Multi Infarct is another common dementia. Stroke activity or vascular conditions are the reasons that cause it. Parkinson’s disease is the third most common dementia. This is followed by Frontal Temporal dementia in which the front part of the brain is damaged. This also includes Pick’s disease, Lewy Body, Korsakov’s, Huntington’s and Progressive Aphasic form of dementia. Dementia with Lewy bodies is sometimes mistaken for Parkinson’s disease as the symptoms are quite similar. Rest of the cases have a very rare occurrence and are often not seen in patients.
Symptoms of Dementia
Dementia is often observed as a set of symptoms and not as a single disease. It is a structural damage in brain and the cognitive areas that get affected are memory, focus, language, attention and the ability of problem solving and decision making. Patients are often having personality shifts, mood swings, and emotional instability. There are some more behavioral and mental problems associated with dementia. It may influence their quality of life. Almost 20-30 percent of patients suffering from dementia are affected by depression and anxiety. Frequent attacks of aggression and agitation are seen in the patients. This is often accompanied by psychosis. Each of them have to be addressed and cured independently from dementia. There is a possibility that a patient is suffering from more than one dementing processes simultaneously.it is referred to as mixed dementia. Alzheimer’s disease sometimes has a co-occurrence with multi-infarct dementia..
As dementia becomes worse, the individuals tend to neglect themselves and may become incontinent and disinhibited. Disorganization and restlessness can be seen in patient’s conduct. Few patients wander and roam around in tension during the day, and sometimes also at night. They also tend to lose confidence, self-esteem and if they face situations which are sudden and beyond their capabilities, they often end up in showing an extreme reaction. The cause of this can be substance abuse, such as consumption of drugs or alcohol in excess, hormonal imbalance or incorrect proportion of prescribed medicines. Usually, diagnosis is carried out if the symptoms persist for six months or more. Dementia is a perplex disorder of about 48 types of such diseases in brain. Malfunctioning of cognitive areas for a shorter span of time is known as delirium.
The patients in the later stages of this disease, may face disorientation in time, place and even people. They can fail to relate with each one of these. Patients often fail to recall Dementia can be categorized as reversible or irreversible. It actually depends on the etiology of ailment. Less than 10 percent of cases are because of factors that the treatments can reverse. Many dementias are progressive in nature, they start out slowly but get worse gradually if they are not diagnosed and treated on the right time.
Usually, dementia has a tendency to develop in people in older age group. That is the reason why it is considered to be a late-life disease. Some or the other form of dementia is often seen in people who are over the age of 65. The number usually doubles after every five years, once that age factor is crossed. Almost half the people in their 80’s are seen to be suffering from dementia and is more often seen in women. The number of cases of dementia reported worldwide in the year 2010 were approximately 35 million. It is observed that people in the lower and middle income nations, sharpest increase in the number of dementia patients are predicted. It is possible to cure or partially treat certain cases of dementia. A good doctor, should never miss in his diagnosis, the potentially curable areas of a patient. The likelihood of treating potentially curable areas is 20 percent.
Dementia occurs as a result of damage to the brain cells. It hinders the ability of brain cells to communicate with each other. Mentioned below, are the dementias that can be cured:
- Dementia caused by substance abuse prevalent from long time.
- Tumors that can be eradicated
- Subdural hematoma, resulting from accumulation of blood under the external covering of brain, resulting from a ruptured blood vessel caused by injury in head.
- Disorder in metabolism, such as deficiency of a nutrient in body
- Hypothyroidism, resulting from under activity of thyroid gland
- Hypoglycemia, a condition arising due to low level of blood sugar
Dementias that do not have cure are:
- Alzheimer’s disease
- Multi infarct dementia which is caused due to multiple number of small strokes
- Dementia occurring due infectious brain and spinal cord such as AIDS
- CJD (Creutzfeldt Jakob Disease)
- Illness or malfunctioning of kidney, lungs or lever that resulted in dementia
Risk and Prevention and Diagnosis
The factors which are responsible for dementia are genetics and age. They cannot be controlled. But, preventive measures can be taken to avoid this. Some things that can help are:
- Physical exercise: Involving oneself in some or the other form of physical activity can lower the risk of few categories of dementia. Through exercise, the blood and oxygen flow to the brain is enhanced. This directly benefits the development of brain cells.
- Diet: Researchers suggest that diet has the greatest impact on the healthy functioning of brain’s health.
- Cardiovascular factors: The richest source of brain’s nutrition is the network of blood vessels. The blood vessels present in brain have a direct link o vascular dementia. Avoid smoking, consuming alcohol in limit, maintaining a healthy body weight, blood pressure, cholesterol and blood sugar levels is highly recommended.
It is not a single test which can confirm if someone is suffering from dementia. Alzheimer’s and other types of dementia are diagnosed by the doctors after a careful study of their medical history, physical examination, various lab tests, evaluating characteristic thinking changes associated with day to day behavior. It is often hard to determine the exact type of dementia the person is suffering from. This is because many a times, the changes in brain and symptoms overlap. It is then mandatory to consult a neurologist or a gero-psychologist. A CT scan or MRI scan (Magnetic Resonance Imaging) is conducted. These tests may suggest the presence of hydrocephalus, which is a reversible cause. It can also provide some results that indicate other types of dementia such as stroke (infarction). The functional neuro-imaging modalities are quite useful in investigating long term cognitive dysfunction.
Society’s take on Dementia
In many countries across the world, taking care of people suffering from dementia is a national priority. They take it as a social responsibility to invest in resources and spreading awareness among health and social service executives working for the betterment of people with this medical condition. There are a number of NGO’s and charitable organizations who raise awareness and campaign for the betterment of people with dementia. The national plans, recognition is given to the people who survive dementia and are able to lead their lives in a normal way. This becomes possible due to both physical and moral support from their family members and friends and of course, diagnosis carried out at the right time. Dementia has been referred to as a national crisis by David Cameron. It has affected close to 800 million people in the UK and they are potentially a threat to themselves and to the other individuals in society. There exists a Mental Health Act, formulated in 1983, under which the people suffering from dementia are detained so that they can be given proper assessment and treatment with care. Usually, this is the last resort if the patient’s family cannot ensure to take proper care of them.
Florida’s Backer Act in the United States gives a liberty to judiciary and other law making authorities to enforce mental evaluation for the people who develop dementia or suffer from other mental illness. A patient who drives can lead to injury or even death of their own self or others. The Driving License Authority in UK states that people with dementia, who specifically have poor memory, lack of judgment or insight, disorientation are not permitted to drive. In the mentioned case, the Agency must be informed so that the license can be revoked. However, they do acknowledge the cases with low severity that have been diagnosed at an early stage of the ailment. They are allowed to drive, after due investigation of their medical reports by the Agency’s medical team.
“What is dementia?” Dementia
“What Causes Dementia?” Causes of Dementia
“What is the history of Dementia?” The History of Dementia
“Dementia and Alzheimer’s disease” Alzheimers Dementia
“What are different types of dementia?” Types Of Dementia