Showing posts with label Biological disorders. Show all posts
Showing posts with label Biological disorders. Show all posts

Anorexia nervosa| symptoms, causes, risk factors and treatment|

 Anorexia nervosa

Anorexia nervosa is an eating disorder and a serious mental health condition accompanied by a loss of appetite due to the fear of becoming obese. Anorexic people intentionally try to keep their body weight low by restricting food intake and exercising excessively due to the fear of becoming obese. Even though their body weight drops to a dangerous level. The patient often has a distorted image of their body; emotional challenges; and constant starvation may lead to other problems and diseases like osteoporosis, low blood pressure, cessation of menstruation, constipation, and others. 

Prevealance 

Both sexes can be affected by anorexia nervosa. However, such feelings largely affect girls just after the onset of puberty, between the ages of 12 to 21 years. These girls are often immature psychologically and unable to cope with the challenges of puberty and their emerging sexuality. The loss of feminine characteristics enables the girls to retreat into a child-like state in which they feel safe. 
Females outnumber males by a factor of ten. Though it is more common in females, its effects are more life-threatening in males as compared to females due to the mistaken belief that men are not affected by anorexia. 
It also more often affects models, as the fashion industry encourages the behaviour of restricting food or skipping meals, which may lead to severe emotional and mental health issues. 

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Symptoms 

Anorexia nervosa is an eating disorder characterised by the starvation of the body, which may lead to a significant loss in body weight and body mass. Food deprivation and malnutrition may lead to serious Physical, emotional, psychological, and physiological symptoms include the following: 

  • Physical symptoms 

  • Lose of a normal body mass index for one's age and height. 
  • The cessation of the menstrual cycle occurs due to prolonged weight loss. 
  • Malnutrition may lead to dry hair and skin as well as hair thinning, swollen hands and feet, discoloration of the skin, particularly the feet, and infertility. 
  • Loss of muscle mass at an extreme level causes fatigue and muscle pain. 

  • Physiological symptoms 

Continuous loss in body mass, weight loss, and malnutrition may also affect body function. The physiological symptoms include: 
  • Constant starvation, which may cause low blood pressure.
  • Bloating or an upset stomach could occur. Abdominal distension.
  • Loss in normal body temperature along with cold hands and feet and intolerance to cold. 
  • Bad breath and food deprivation may be the effects of ketoacidosis. 

  • Emotional and behavioural symptoms 

Anorexic person can be demonstrated by their emotional and behavioural acts. 
  • Self-induced vomiting in order to get rid of food 
  • Anorexics also take drugs or pills and laxatives to flush out the food. 
  • Exercising excessively even when the body is too weak.
  • They isolate themselves from events, family members, and the public. 
  • They frequently lie about the food they have consumed. 
  • Always eating selectively
  • Avoid eating around other people. 
  • Self-esteem loss
  • Performing food rituals like eating food on their own terms and arranging and cutting it in their own order. 

  • Psychological symptoms 

Food deprivation may lead to severe psychological issues. 
  • Depression 
  • Insomnia 
  • Admire and idealise the thinner body.
  • Mood swing 
  • Self-harming thoughts and acts
  • The perception that their body is over-weighted.
  • Their ideal body representation is altered. 
  • Continually checking the mirror and perceiving the flaws. 
  • Even after extreme hunger, denying to eat and laying of hunger.

Causes and risk factors for anorexia nervosa 

Anorexia nervosa can be caused by several factors. It can be psychological, environmental, or genetic.

  • Environmental factors 

The environment can influence a person's psychology and behaviour greatly. Early research suggests that eating disorders may be caused by environmental factors such as: 
  • Criticism in one's life about their body weight, shape, and eating habits.
  • Continues pressure to fit into a body or shape from society, culture, relationships, family, or peers. 
  • Past life trauma and racism.
  • A person who has faced bullying about their weight or body shape may develop anorexia. 
  • An obsessive personality or a sense of perfectionism could be a factor. 

  • Genetic factors 

Genetics could be a possible risk factor for causing anorexia nervosa. Although the exact gene for anorexia has not been discovered, it could be by following: 
  • Anorexia nervosa can run in families; those who have an eating disorder can be at great risk of getting the disease. 
  • In a research study, two gene have been discovered  ESRRA and HDAC4,  can cause eating disorders in an individual and be a risk factor for the disease. 

  • Biological factors 

Biological dysfunctionalities and dysregulations of certain biological functions in the human body can cause disease. For example, 
  • Brain and hormonal changes during puberty can be associated with anorexia nervosa. 
  • Dysfunctional of the neuroendocrine hormonal system that signals between the brain and the digestive system and controls hunger. 
  • Dysregulations of the brain’s neurochemicals like serotonin, dopamine, and norepinephrine disturb biological pathways that regulate the hunger and appetite of an individual. 

Anorexia Risk Factors 

Prolonged anorexia causes several complications in the body, which may lead to severe health problems and may cause serious health issues and diseases.
  • It can cause malnutrition, which may lead to several diseases like gastro-intestinal disease, constipation, heartburn, liver problems, nausea,  cyclic vomiting syndrome. 
  • Kidney problems like distal renal tubular acidosis, in which the kidney is unable to remove acid from the blood.
  • Heart problems like heart failure, slow heart beats Anemia, which is caused by the deficiency of RBSs.
  • Decrease in bone mass, osteoporosis, calcium deficiency, vitamin K deficiency. 
  • Hormonal problems reduce the level of oestrogen in females and testosterone in males. 
  • It also have effects on fertility. 
  • Muscle weakness, pain, fatigue, and tiredness 
  • Skin problems like sarcoidosis (patches on the skin), dry skin, and loss of hair.
  • It can lead to mental health problems like OCD, depression, anxiety, suicidal attempts, and serious self-injury.

Treatment 

Anorexic people's treatment is based on how long the individual is affected by the disease and how much the individual is affected by other complications. Psychiatric therapy is the best way to cure the disease. No other such medication has been found yet to cure the disease. However, antidepressants are given to treat mental health problems like depression. 

Psychiatric therapy 

Psychiatric therapy is suitable to treat patients. It includes:

  • Cognitive-behavioral therapy (CBT):  It is therapy based on weekly sessions for up to 40 weeks (9 to 10 months) done by the practitioner with the aim of helping the person to feel good around food, develop eating habits and new ways of thinking, behaving, and managing stress. 
  • Maudsley Anorexia Nervosa Treatment for Adults (MANTRA): It is a therapeutic treatment for adults. It includes 20 sessions; the first 10 are regular on a weekly basis; the other 10 are flexible based on the available time you have. The aim is to realise the individual's causes of anorexia and change their behaviour patterns towards food. It also includes family for cure and fast recovery. 
  • Specialist Supportive Clinical Management (SSCM): It includes 20 sessions conducted by the practitioner with the main aim of exploring the causes of the problems that were the cause of the disease. To know the importance of nutrition and how it helps in gaining weight It also focuses on helping the patients come back to a normal routine, whether at work, school, etc. 

Heath complications 

The health issues can be treated by medication and hospitalisation of the anorexic person.

 Sources

Treasure, J. (2013). Anorexia nervosa: A survival guide for families, friends and sufferers. Psychology Press.
Watson, H. J., Yilmaz, Z., & Thornton, L. M. (2019). Hü bel CA, Coleman JR, Gaspar HA et al. Genome-wide association study identifies eight risk loci and implicates metabo-psychiatric origins for anorexia nervosa. Nat Genet, 51, 1207-1214.


Sleep paralysis| sleep disorder| causes, prevention and treatments.

Sleep paralysis

Sleep paralysis is a worldwide phenomenon that was once thought to be caused by evil creatures such as demons, witches, or vampires appearing at night to frighten humans. Different cultures have different ideas and beliefs about it. It is known as a "night mare" in English, which means "evil sleep riding on people's chests while sleeping." In Chinese it is called "govei nulim" means being pressed down by a ghost. In Japanese traditions, it is believed that it is a vengeful sprite who sits on the person's chest while sleeping for revenge. According to new research, it is called "old hag syndrome," which is another name for sleep paralysis. "Old hag" means an evil creature who leaves her body at night and sits on the chests of victims. 

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Figure 1 depicts a creature ride on someone's chest at night in order to suffocate them.

What is Sleep Paralysis? 

Definition 

Sleep paralysis a frightening phenomenon where a person suddenly finds himself unable to move, speak, or react for a few seconds or minutes between the stage of wakefulness and sleep. It usually occurs upon falling asleep or just upon waking. 

Symptoms 

The main symptoms of sleep paralysis include the following: 
While sleeping  a person is unable to move their legs and arms, nor can they speak or react a bit. It seems like a bit of a paralysis of his body. 
The experience is quite terrifying and lasts from  few seconds to minutes. 
Some people may also experience hallucinations. 
The patient may also have frightening experiences, such as the sensation of floating, hearing or seeing things that do not exist. 
Some may also feel pressure on the chest, as if someone is pressing and suffocating the chest.

 

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Prevalence 

Sleep paralysis affects both genders equally. The average age when it first occurs is early teen age, at age 14-17 years. It affects people of all ages, but it is most prevalent in adolescents (14-17) and the elderly (60+). It is also common in students and psychiatric patients. The average number of individuals who experience sleep paralysis is 4 out of every 100 individuals.

Cause or reason behind it. 

Sleep paralysis occurs during REM sleep. REM is a sleep cycle during which a person’s brain is fully active and frequently dreams, but the muscles of the body are fully relaxed or turned off. The brain releases two chemicals, i.e., GABA and glycine, which turn off some specialised brain cells that perform voluntary movement in the body in order to prevent the body from physical damage during sleep. This condition is called atonia. When a person wakes up quickly during REM, they might experience mild paralysis.

REM Sleep

REM sleep (rapid eye movement) is the stage of the sleep cycle during which the body is fully relaxed but the brain is more active and continuously dreaming. At this stage, a person’s eyes are rapidly moving, the breathing rate is high, intense dreaming occurs at this stage, and a body is fully relaxed.

 

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Types of sleep paralysis 

Sleep paralysis occurs in two ways.:
Predormital sleep paralysis: If it occurs while you are falling asleep, it is called predormital sleep paralysis or hypnogogic sleep paralysis. 
Post-dormital sleep paralysis: If it occurs when you are waking up, it’s called post-dormital sleep paralysis (PDSP), or hypnopompic sleep paralysis.

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Classification of sleep paralysis 

It is mainly classified into two. 
1. Isolated sleep paralysis (ISP): It is more common, infrequent, and lasts for a short duration. Approximately one minute or less. In some cases, it might occur once in an individual's life. 
2. Recurrent Isolated Sleep Paralysis (RISP): It is a more chronic condition, and individuals may experience regular episodes throughout their lives, and they may last for hours or longer. 

Problems arise from sleep paralysis 

Sleep paralysis is not life-threatening but it can cause depression, anxiety, loss of sleep, terror experiences etc. 

Causes of sleep paralysis 

Lack of sleep can disturb the sleep cycle, which can cause sleep paralysis. 
Sleeping on your back or on your stomach, it can occur at any position. 
Keeping electronic devices near your head while sleeping may also cause it, because electrical devices have their own frequency and radiation which may harm you while sleeping. 
Changes in sleep schedule and time can disrupt the body's natural biological cycles, known as circadian rhythms.
Use of sleep-inducing drugs such as caffeine or alcohol. 
Mental stress or disorder, eating large meals at night, which may cause bloating and disrupt sleep. 
Inheritance may also be the cause of sleep paralysis. 

Sleep paralysis risk factors

People who have sleep disorders like narcolepsy, sleep apnea, and restless leg syndrome are all at risk for sleep paralysis. 
Mental illnesses like anxiety, depression, terror, stress, or bipolar disorder are risk factors for sleep paralysis.
 Disrupted circadian rhythms i-e 24 hours sleep wake cycle due to heavy work, lack of sleep, drugs are great  risk factor causes Sleep paralysis 
Sleep paralysis can also be inherited and can run in families.

Genetics role in sleep paralysis 

Sleep paralysis is inherited and can run in families. 
According to the new research, the variation in PER2 gene is associated with sleep paralysis. Which is located on the long arm of chromosome 2. The PER2 gene is responsible for controlling circadian rhythms  the 24 biological cycles that help to govern the sleep wake cycles.

Prevention 

Clear your mind before going to sleep. 
Avoid taking alcoholic drinks and heavy meals before bed. 
Don’t sleep on your back and stomach. 
Relaxation of the mind and body before sleep is helpful.
Relieve the stress, so sleeping becomes easier and the effect is minimized. 
Avoid watching horror movies before bed. 

Treatment 

Improving sleep habits—such as making sure you get six to eight hours of sleep each night.
Taking antidepressants as prescribed to help regulate sleep cycles
Treating any mental health problems that may contribute to sleep paralysis 
Treating any other sleep disorders, such as narcolepsy or leg cramps. 
Wiggling finger or toes of the victim so they can be able to realise the condition and be able to move.