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WHY YOU CAN’T STAY AWAKE: SYMPTOMS OF NARCOLEPSY

admin — Mon, 11 Jul 2011 18:44:38 +0000

In addition to daytime sleep attacks, the primary symptoms of narcolepsy include sleep paralysis, hallucinations, and cataplexy. Sleep paralysis—sudden inability to move—occurs at the beginning or the end of sleep and renders immobile virtually every voluntary muscle except those around the eyes. When hallucinations are present, they usually come at the beginning of sleep; they may be vivid, realistic, and sometimes violent.Cataplexy—an attack of muscle weakness or dysfunction lasting from a few seconds to a few minutes—is one of the most disconcerting features of narcolepsy, largely because of the suddenness with which it appears. An attack can be triggered by almost any form of emotional arousal, from anger to athletic activity to excitement—even the mere anticipation of excitement. A mother of three told me she had to allow her children to run amok; she was unable to discipline them because doing so would trigger an attack. Another patient reported that his fraternity brothers considered it an evening’s entertainment to regale him with jokes, just to get him to laugh so that they could watch him collapse. Another described his sadness at having to stay away from Yankees baseball games. During any thrilling moment, he said, just as the other fans were rising to their feet, he would crumple to the floor of the stands. In one case reported in the literature a patient became cataplectic every time he had an orgasm. He had naturally come to believe that such paralysis was simply part of the sexual experience. Sometimes the consequences can be disastrous. A narcoleptic butcher fell asleep while wielding a meat cleaver and awakened to find he had lopped off three of his fingers.Cataplexy may involve all of the muscles or just a select few; the severity ranges from a slight loss of tone to complete paralysis. Victims do not lose consciousness. Not all narcoleptics experience cataplexy; in some, however, the attacks are frequent. People with narcolepsy may notice excessive daytime sleepiness as much as a year before the onset of cataplexy.Memory difficulties are also reported by about half of narcoleptics. In addition, some experience symptoms in the eyes: fatigue, difficulty focusing, double vision. Except for cataplexy, however, these symptoms are not unique to narcolepsy but are found in other disorders as well.*151\226\8*

ALCOHOLISM RECOVERY PROCESS: CONTINUING TREATMENT PHASE

admin — Sat, 22 Jan 2011 15:54:37 +0000

The alcoholic learns, as do others with a chronic disease, the importance of being able to identify situations, and their responses to them, that may signal a flare-up. For the alcoholic, this entails maintaining a continuing awareness of the alcoholic status, if sobriety is to continue. The alcoholic certainly will not continue to see the counselor for a lifetime as a reminder of the need to be vigilant. However, each one will need to develop other alternatives to succeed in staying sober.
“Why do I drink ” This is the recurrent theme of many active alcoholics and those beginning active treatment. In our experience, focusing on this question, even when it seems most pressing to the client, is of little value. It takes the client off the hot seat. It looks to the past and to causes “out there.” The more important question is the nitty-gritty of the present moment: “What can be done now?” If there is a time to deal with the “whys,” it comes during the continuing treatment phase. Don’t misunderstand. Long hours spent studying what went wrong, way back, are never helpful. Rather, the reason can be discerned from the present, daily-life events, on those occasions when taking a drink is most tempting. Dealing with these can provide the alcoholic with a wealth of practical information about himself for his immediate use. Dealing with the present is of vital importance. The alcoholic, who has spent his recent life in a drugged state, has had less experience than most of us (which isn’t much) in attending to the present. His automatic tendency is to analyze the past and/or worry about the future. The only part of life that he can hope to handle effectively is the present.
A client’s hope for change often must be sparked by the counselor’s belief in that possibility. Your attitudes about your clients and their potential for health exerts a powerful influence. This doesn’t mean you cannot and will not become frustrated, impatient, or angry at times. Whether therapy can proceed depends on what you do with these feelings. You can only carry them so long before the discomfort becomes unbearable. Then you will either pretend they aren’t there or unload them on the client. Either way your thinking can become “she can never change,” “this guy is hopeless,” or “she’s just not ready.” When that happens, counseling is not possible even if the people continue meeting. A better approach is to have a coworker with whom you can discuss these feelings of impotence and frustration. Doing this makes it easier to say “I know he can change, even if I can’t imagine how it will happen. Certainly, stranger things have happened in the history of the world.” At this point therapy can proceed. However, if an impasse in working with a particular client isn’t broken through, the client should be referred to a coworker.
Treatment is a process involving people. People have their ups and downs, good days, bad days. Some that you think will make it, won’t. Some that you are sure don’t have a chance will surprise you. There will be days when you will wonder why you ever got into this. On others it will seem a pretty good thing to be doing. Remembering that it is an unpredictable process may help you keep your balance.
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ALCOHOLISM RECOVERY PROCESS: ACTIVE TREATMENT PHASE

admin — Sat, 15 Jan 2011 15:53:57 +0000

At this point of acknowledgment, seeing alcohol as the culprit, and with a desire to change, the alcoholic by himself is at a dead end. If he knew what to do, he would have done it. Thus he, in essence, turns the steering of his life over to the counselor or therapist. The counselor, in turn, must respond by providing clear, concrete, simple stage directions. The alcoholic needs to have a rehabilitative regimen set forth for him. He needs his environment simplified. The number of decisions he is confronted with must be pared down. He is able to deal with little more than “How am I going to get through this day (or hour) without a drink? ” Effort needs to be centered on doing whatever is necessary to buy sober time. To quote the old maxim: “Nothing succeeds like success.” A day sober turns on the light a little. It has become something that is possible. For the alcoholic, this is an achievement. It does not guarantee continued sobriety, but it demonstrates the possibility. In the sober time, the alcoholic is gaining skills. He discovers behavior that can be of assistance in handling those events that previously would have prompted drinking.
Although we are not attempting to discuss specific techniques of treatment here, a mention of AA is nonetheless in order. Anyone in the alcoholism treatment field will acknowledge that clients who take up AA have a much better chance of recovery. This is not accidental. AA has combined the key ingredients essential for recovery. It provides support; it embodies hope. It provides concrete suggestions without cajoling. Its slogans are the simple guideposts needed to reorder a life. And its purpose is never lost.
The necessity for a direct and uncluttered approach to the alcoholic cannot be overstressed. He is not capable of handling anything else. This is one of several reasons for the belief that alcoholism has to be the priority item on any treatment agenda. The only exceptions are life-threatening or serious medical problems. For the alcoholic to work actively and successfully on a list of difficulties is overwhelming. Interestingly enough, when alcoholism treatment is undertaken, the other problems often fade. Furthermore, waiting to treat the alcoholism until some other matter is settled invites the alcoholic’s ambivalence to surface. This waiting feeds the part of him that says, “Well, maybe it isn’t so bad after all,” or “I’ll wait and see how it goes.” Generally the matters are unsolvable because an actively drinking alcoholic has no inner resources to tackle anything. He is drugged.
Focusing on alcoholism as a priority, the alcoholic’s acceptance of this, and providing room and skills to experience sobriety make up the meat of therapy. As this takes place, the alcoholic is able to assume responsibility for managing his life, using the tools he has acquired. With this, the working relationship between counselor and client shifts. They collaborate in a different way. The counselor may be alert to potential problematic situations, but the client increasingly takes responsibility for identifying them and selecting ways to deal with them. Rather than being a guide, the counselor is a resource, someone with whom the client can check things out. At this point, the alcoholic’s continuing treatment has begun.
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POWER OVER PANIC/ QUESTIONS AND ANSWERS: WILL HYPNOSIS HELP? AND PEOPLE BECOMING HOUSEBOUND

admin — Mon, 18 May 2009 08:35:38 +0000

Question

Will hypnosis help?

Answer

Hypnotism can produce a very positive response in the short term. The result will not last if we have no understanding of the disorder and don’t know how to manage the attacks and anxiety ourselves. In conjunction with panic/anxiety management skills, hypnotism can help while we work with aspects of the disorder. If we use an audio tape of the hypnosis session during periods of high anxiety and attacks, the tape must teach us how to control the anxiety and the attacks. The control does not come from a cassette tape.

Some people use subliminal tapes in an effort to ease their symptoms. We must know what the subliminal message of the tape is and, more importantly, we should consciously know and learn how to manage anxiety and the attacks ourselves.

Question

I have heard about people becoming housebound. I am the opposite. I can’t bear to be in the house. As soon as my husband goes to work I have to get out of the house. I spend my days travelling on buses or walking around shopping centres. Is this part of the disorder?

Answer

This does happen to some people. If they have difficulty in being alone, going out and being around other people is better than staying home. It can also happen to people who were housebound, but for another reason. As people progress in their recovery, some may go through a stage where the thought of being home all day brings back too many memories of their disorder. They prefer to go out as much as they can. This stage does pass.

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SEASONAL AFFECTIVE DISORDER (SAD): SIMULATING THE DAWN

admin — Wed, 29 Apr 2009 08:41:58 +0000

Dr Michael Terman from Columbia University originally showed that simulating a summer dawn in the middle of winter could have a salutary effect in people with SAD, helping them to wake up and feel better during the day. He accomplished this by means of a machine that turned the bedroom lights on gradually, as though the shade on the window were becoming gradually brighter as on a sunny morning in the summertime. Since this initial observation, dawn-simulators have become more compact and affordable and have been shown to help people wake up in the morning and have anti-depressant effects in controlled studies. A commonly used version fits easily into the palm of the hand and can be connected to an ordinary bedside lamp. Although not usually sufficient in itself to reverse the symptoms of SAD, a dawn-simulator is an excellent way to get the day off to a brisk start and is a very useful part of the overall programme for managing this condition.

Another innovation to come out of Terman’s department at Columbia is the use of high-dose negative ions – charged air particles emitted from a small device that looks like an air purifier. According to one study, negative ions in high dosages may have anti-depressant effects in SAD patients. More work is warranted, though, before this treatment can be recommended with any degree of confidence. Negative ions are emitted from flowing water under natural circumstances, whereas positive ions are emitted from all sorts of indoor machinery.

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COMING OFF TRANQUILIZERS: MASSAGE

admin — Tue, 21 Apr 2009 05:15:56 +0000

Work in pairs. Allow your partner to sit in the chair in the position that has been discussed, with closed eyes. Support their forehead and gently massage the scalp from the hair line to the back of the neck. If headaches are a problem, support their head on your chest and work with both hands, stroking their brow with the first fingers from the centre to the temples, using firm strokes.

You and your partner will soon get over the embarrassment of being touched when you realize how relaxing massage can be. Continue to support the forehead and with the other hand move the muscles of the neck on both sides of the spine in a circular movement. Switch off your intellect and let your hands do the work. Next place your hands over the shoulders with the fingers pointing towards the chest and the thumbs on the back. Use these to massage the muscles of the shoulders. Find out from your partner any areas that need particular attention. Continue by supporting your partner with your arm across the top of their chest, tipping them forward and working around both shoulder blades and down each side of the spine. Finish off by stroking lightly and rapidly from the head down the back. Place one hand on the upper and one on the underside of the arm and use the same stroking to the finger tips. Repeat with the other arm. Take at least fifteen minutes over the massage. The person in the chair might want to sit for few minutes, enjoying feeling more relaxed, before doing the same for you.

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WITHDRAWAL SYMPTOMS: PERCEPTION DIFFICULTIES

admin — Tue, 21 Apr 2009 05:13:55 +0000

Some of the action of the drugs is on the temporal lobe of the brain. During withdrawal, this area is trying to get back to normal. For a time this may result in temporal lobe symptoms. Perception difficulties are included. This means your senses (sight, sound, touch, taste and smell) may appear to be playing tricks on you. Your senses have been dulled by the drugs for so long that you have slowly become accustomed to altered perception. This may increase a little before it clears. Don’t be alarmed if things seem odd at first. You will realize that this is how the world looked before drugs. Lights and colours may seem so bright at first that you need sunglasses. Many people have forgotten the pleasure of colour and are thrilled by their gardens. One woman kept scrubbing her carpet thinking it looked dull. When she came off her drugs she said she felt as though the colours were leaping out at her they were so bright. Overbreathing also heightens perception. If you see a dirty mark on the wall as a beetle or a coat hanging behind the door as a person, these are perceptual disturbances. If there is no mark on the wall nor a coat behind the door, and yet you see these things, these could be hallucinations. Many people say that faces seem to change as they look at them, or heads appear larger than they should be when they watch television. Buildings can appear too tall and thin, or bent at the top. These are temporary disturbances and will go in time.

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WITHDRAWAL SYMPTOMS: HOW TO COPE WITH PANIC ATTACKS

admin — Tue, 21 Apr 2009 05:11:49 +0000

If your attitude is ‘I will die, be sick, faint, wet my pants, etc., if I don’t fight this panic attack’, you will encourage more attacks. It will become a trigger for stimulating more hormones and more fear. If you teach your body to give the correct messages to your brain, you can break this chain reaction.

When an attack comes, breathe out long and hard, and pause before you breathe in. Dr Hibbert suggests putting a cold wet cloth on the cheeks. This acts on the diving reflex and slows down the breathing very effectively. If you slow down your breathing (by breathing from the abdomen) it will be impossible for symptoms to become worse. Abdominal breathing is allowing full lung expansion by raising the abdomen on the in-breath.

Cupping the hands or hold a paper (not plastic) bag over the nose and mouth whilst breathing normally will increase carbon dioxide levels and help to calm you within a few minutes.

Try not to be embarrassed about letting those around you know what is wrong. One young woman who shouts for help during attacks has learnt to explain that she is suffering from drug withdrawal symptoms, and that it will pass in a minute.

Dr Weekes’s book was not written for people coming off drugs, but the illness she describes, which many would think of as a nervous breakdown, is very similar—a chemical nervous breakdown if you like. Some people are afraid of the words ‘nervous breakdown’. It really means exhausted nerves. You will recover, no matter how long you have been ill, if you after your attitude from ‘I feel so bad I will never get better’ to ‘I know I will get better if I accept the illness, help my body to cope with it, and wait for time to heal’.

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WHAT TO DO IF YOU FEEL YOU ARE DEPENDENT ON TRANQUILLIZERS

admin — Tue, 21 Apr 2009 05:09:29 +0000

If you are in the ‘Catch 22′ situation of feeling ill whilst you are taking the pills; worse when you stop; and have symptoms of increased anxiety and depression, panic attacks, sweating, insomnia—see your doctor.

You will need the doctor’s advice before reducing your pills. Tranquillizers are also used for conditions other than nervous illness. You may need an alternative prescription.

It may be that your doctor has a good knowledge of withdrawal procedure, and is sympathetic and willing to guide you through. If this is not the case, and he refuses to believe how ill you feel, or is hostile because he feels you are trying to tell him his job, seek help from a support group. These are run nation-wide, usually by ex-users who have a great deal of experience because of the enormous numbers of people coming for help. All you need is your doctor’s approval to come off, and then you can refer to your nearest group. They will help you to work out a slow withdrawal programme that can be carried out at home.

The Elderly and Tranquillizers or Sleeping Pills

Complete withdrawal in the elderly dependent person is often inadvisable, although it may be necessary to reduce the dose slowly until the side-effects (toxic confusion and loss of balance) are minimized.

Write to the following addresses for your nearest contact:

Middlesex HA3 7QX

or telephone your nearest MIND group.

RELEASE

169 Commercial Street

London El 3BW

Tel: 01 603 8654 (24 hours)

Remember: It is dangerous to stop your drugs abruptly, Acute withdrawal should only be carried out in hospital.

Tranx

17 Peel Road Harrow

MIND

22 Harley Street London Wl

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