LIST OF TREATABLE DIAGNOSES
Losing a loved one, taking on a new job, moving home locations, embracing divorce and/or separation can all be incredibly stressful experiences. Grief, loss, despair, defeat are all familiar terms in such situations. To assist patients through these events, Paramount Health offers services that may be of significant benefit. Addressing such aforementioned stressors is imperative so as to avoid progression vs worsening of symptoms.
Anxiety disorders are the most common of psychiatric/mental health illnesses. Persons with anxiety are generally familiar with such terms as: nervousness, restlessness, angst, irritability, agitation, panic (“anxiety”) attacks, discontent, dysphoria, discomfort, and fear. Anxiety is made manifest in many forms that may include excessive worry, muscle tension, obsessive thoughts/compulsive behaviors, social anxiety, fear of crowds, fear of public speaking, panic attacks, nausea, GI upset, Irritable Bowel Syndrome (IBS), pain, fear of illness, preoccupation with illness/disease or any type of ‘body-related’ symptoms. Anxiety disorders are managed by medications and/or psychotherapy.
ADHD, formerly known as “ADD,” is a highly heritable illness that may cause a combination of the following signs/symptoms: difficulty with sustaining attention/maintaining concentration, distractibility, forgetfulness, poor listening ability, procrastination, poor organization and/or poor attention to detail, restlessness, fidgetiness, intrusiveness, impulsivity, difficulty waiting in turn, difficulty engaging in tasks quietly. Most cases of ADHD are appreciable not only in childhood but persist into adulthood making this a life-long illness to be addressed. Medication best manages symptoms of ADHD.
Persons with Autism Spectrum Disorders (which includes the diagnosis formerly known as “Asperger’s Syndrome”) generally struggle with communication, socialization and interpersonal relations. This is a congenital disorder meaning patients are born with such illness and signs of such may be noticeable within the first few months of life. Patients with Autism often become obsessive about routines and/or topics (albeit sometimes only one or a few); they are commonly misunderstood and many false beliefs about the pathophysiology and manifestations of Autism exist. Persons with Autism often struggle with anxiety, mood dysregulation, irritability and/or aggression, amongst other symptoms. Behavioral intervention, psychotherapy and medication management all have a place in the treatment of such illness.
Bipolar Disorder is an inherited mood disorder; many misconceptions about this illness are present in society today. The term ‘bipolar’ is inappropriately and erroneously embraced/utilized. Persons with Bipolar Illness usually struggle (predominantly) with depression but also are familiar with anxiety, sleep dysregulation and mania (or hypomania)--periods of days, weeks, or even months of elevated energy, decreased need for sleep and elevated and/or irritable mood. Substance and alcohol abuse are more common in people who have a bipolar disorder diagnosis; many times they are labeled as ‘alcoholics’ or ‘drug abusers’ and the proper addressing of the bipolar illness is ignored/untreated. Bipolar disorders are best managed by medication +/- psychotherapy.
Chronic pain is usually associated with an array of psychiatric symptoms; these may include: insomnia, agitation, anxiety, panic attacks, depression, irritability, dysphoria, anger, mood instability, and somatic (“body-experienced”) symptoms. Psychiatry plays an enormously important role in the management of chronic pain as such aforementioned symptoms, when controlled/managed, are generally associated with improvement of chronic pain. Further, many psychiatric treatments (psychotherapy and medication management alike) directly reduce/improve chronic pain. Pain and psychiatric symptoms are usually associated ‘hand-in-hand,’ that is, persons with more intense pain are generally more anxious/depressed, and persons with more anxiety/depression usually have more severe pain.
Depressive disorders are a highly debilitating set of illnesses, poorly understood by many. Persons with Depression (usually referring to either Major Depressive Disorder [MDD] or Persistent Depressive Disorder [Dysthymia]) are often intimately familiar with: sadness, hopelessness, worthlessness, guilt, shame, loss of interest in previously enjoyable activities (anhedonia), sleep dysregulation, insomnia, irritability, limited concentration or attention, low energy, changes in appetite (usually decreased) and in some cases, suicidal thinking, ideation, planning, intent, gestures or attempts. Depression is not ‘a choice’ and ‘strength of will’ is not applicable to symptoms related to this illness. Depressive disorders respond most robustly to medication management but psychotherapy may be suitable as adjunctive treatment (and in some cases may be effective as sole treatment).
People who suffer from Dementia experience progressive cognitive (thought/behavior processing) decline, often over months or years. Many causes of Dementia exist with the most common causes seen in the United States to include Alzheimer’s and Vascular Dementia. Symptoms of Dementia may be caused by a variety of conditions such as medical illness, medication side effects, substance/alcohol abuse, brain injury/head trauma. Depending on the cause of a specific type of Dementia, symptoms may be reversible vs permanent/progressive. Persons who suffer from dementia commonly experience associated symptoms that may include: depression, mood instability, anxiety, panic attacks, irritability, agitation, psychosis (often auditory or visual hallucinations or delusions), sleep dysregulation, insomnia. Alzheimer’s, Vascular, Lewy Body, Frontotemporal, Parkinson’s Dementias are all incurable, however, these conditions are treatable and the quality of life and/or severity of symptoms can be managed with multiple treatment options (generally including medication management, psychotherapy, environmental modifications, outpatient programs).
Eating disorders are more common than many would suspect; notable eating disorders include: Binge-Eating Disorder (BED), Bulimia Nervosa, Anorexia Nervosa. Persons with eating disorders often struggle with body-image and may have obsessive thoughts and/or rituals related to eating behaviors. Persons with eating disorders may ingest excessive quantities of food, to a point of discomfort, they may also feel shame/guilt for such action which may (or may not) be followed by compensatory behaviors, designed to off-set binging (e.g. purging, use of laxatives, over-exercising, fasting). Eating disorders may be managed with medications and/or psychotherapy.
Persons who experience Gender Identity Disorder (GID) usually feel from an early age that their outwardly manifested gender (male, female) is not consistent with how they experience gender internally--for example, a person may have a male body but will appreciate self as being ‘female’ from an intellectual and emotional perspective. People with Gender Dysphoria (synonymous with GID) are best treated with a multi-specialty approach that would include psychiatry, endocrinology and surgical specialists. Symptoms may be improved by use of a variety of medications and psychotherapy may also be of benefit, however, many benefit most significantly from surgical intervention. Treatment protocols vary person-to-person. “Conversion Therapy” is ineffective, inhumane and unethical.
Oppositional Defiant Disorder, Conduct Disorder, and Intermittent Explosive Disorder
are all examples of Impulse Control Disorders. These issues all have a common theme--difficulty maintaining self-control (of emotions and/or behaviors). Such disorders frequently cause significant impairment in social, occupational and interpersonal relationships. Medication and Psychotherapy both may be of benefit in managing these conditions.
Various medical problems and/or medications can cause or contribute to psychiatric signs or symptoms produced in an individual. Depending on the cause, these problems may be temporary versus permanent--but in either case, treatments are available to manage such symptoms or signs. Usually, treatment involves adding, reducing or discontinuing certain medications; other methods may be employed depending on the issue at hand.
For persons who are being seen by non-psychiatric providers, if/when psychiatric symptoms/signs become present, a psychiatrist may be consulted to assist with proper diagnosis and management of such problems.
Obsessive Compulsive Disorders would include: OCD, Body Dysmorphic Disorder, Hoarding Disorder, Excoriation Disorder (skin-picking), and Trichitillomania (hair-pulling). Common among these disorders, persons suffering from such will frequently experience obsessions (recurrent and/or persistent urges, thoughts, imagery that pervade the mind despite being intrusive and/or undesired) and compulsions (behaviors or mental exercises that are repeated rigidly, usually in response to an obsession). These problems can generally be managed with medication and/or therapy. A person cannot be ‘talked out of’ being obsessive in thought or compulsive in action; further, this is not a ‘choice’ but is an illness.
Persons with a personality disorder struggle with social, occupational and/or interpersonal relationships, but may or may not experience signs and symptoms of anxiety or depression. Usually difficulties are noted with coping maturely, especially in psychologically stressful situations. Many people manifest signs or symptoms suggestive of a personality disorder, but may in fact be demonstrating such behaviors for another reason altogether. Personality Disorders include: Antisocial, Borderline, Paranoid, Schizoid, Schizotypal, Dependent, Avoidant, Histrionic and Narcissistic types. Having a personality disorder is not a choice, but it is a difficulty for the person who has one, and usually for his/her family, friends and acquaintances. These problems are managed with medication and/or therapy.
PTSD affects nearly 9% of the population; generally this illness presents after a person has experienced (or witnessed) a traumatic event that may have put a person at risk of great harm, loss of control or death (versus actually experiencing/witnessing these tragedies). Persons with this illness frequently experience nightmares, anxiety, agitation/irritability, isolation, mood instability, panic attacks, fear and avoidance of traumatic stimuli; they may also experience ‘mental fog’ and have difficulty regulating anger. PTSD is managed with medication and/or therapy. Early intervention is ideal, however, people with chronic PTSD can also experience a dramatic improvement in quality of life with a reduction versus elimination of symptoms with proper treatment (and adequate time for such).
Persons with Psychotic Disorders (which includes Schizophrenia and Schizoaffective Disorder) experience some form of ‘loss of being in touch with reality.’ This phenomenon is not generally present 100% of the time, but is noted frequently (in most cases) and is quite problematic--these illnesses may be associated with other signs and symptoms such as anxiety/fear, depression, mania, agitation/irritability, and insomnia. Psychosis frequently is observed in the form of delusions (fixed false beliefs that prevail despite evidence contradicting such beliefs or no rationale for holding such a strong belief)--these are often persecutory, erotic, grandiose, and/or paranoid in nature. Another common form of psychosis would be a hallucination. These are experiences a person has that suggests a reception of sensory stimuli, without in fact, having a tangible stimuli present (e.g. a person may perceive he/she is observing another person crossing the road, while in fact, no other person exists in reality at that time/place). Delusions and hallucinations are usually perceived as being ‘real’ and ‘tangible’ by the person experiencing such. Psychotic disorders are treated with medications.
Many causes of sexual dysfunction exist; some problems that people experience with sexual interest or performance may be related to Neurological, Endocrinological or Urological illness, whereas other forms have a Psychiatric cause. Depending on the root-cause of sexual dysfunction, treatment for such an issue would be entirely different. If the cause is purely psychiatric in nature, therapy and/or medication may prove of benefit. Both men and women can/do experience sexual dysfunction--this may include problems with sexual arousal, libido, endurance, orgasm and/or gratification in some form or other.
Some persons struggle with insomnia, which can be either a primary psychiatric illness, or may be related secondarily to an alternate psychiatric or medical illness (or may be related to a drug/medication). Other people may experience problems with circadian structure whereas some may chronically be inclined to ‘fall asleep early and wake up early’ (advanced phase sleep disorder) and yet others may be inclined to ‘fall asleep late and wake up late’ (delayed phase sleep disorder). These conditions are not ‘choices’ or ‘decisions’ but are variants of normal circadian structure. Either way, managing these disorders will often be achieved either with improving sleep-hygiene and/or with use of therapy and/or medication.
Certain persons manifest psychiatric stressors/symptoms in the form of somatic symptoms/signs. The term ‘somatic’ refers to ‘body’ and the implication with this terminology is that various systems in the body will manifest distress (physically) when it is experienced (emotionally) by a person. Such illnesses would include: Illness Anxiety Disorder (Hypochondriasis), Somatic Symptom Disorder and Conversion Disorder. Persons who experience these types of illness may feel an abnormally high level of fear/anxiety about becoming ill or may become preoccupied with somatic sensations/signs (e.g. itching, nausea, bloating, hot flashes, achiness, cough) and have exaggerated concerns about such (unconsciously driven). Commonly, persons with somatic symptom illnesses will note an exacerbation in symptoms when feeling increased levels of stress. Neurological, Gastrointestinal and Urological symptoms/signs are common--such as numbness, tingling, seizure-like activity, headaches, difficulty urinating, diarrhea, constipation, vomiting, nausea, weakness, sexual dysfunction. Such illnesses are usually managed with medication and therapy.
Athletes are prone to specific psychiatric symptoms and illnesses, often depending on what type of activity they are involved with. These persons also necessitate specific treatments aimed at retaining versus improving performance while addressing/mitigating any mental health issues. This may be managed with either therapy and/or medication.
Substance abuse comes in many forms; this is a widely prevalent problem. Common substances of abuse include: Alcohol, Cocaine, Methamphetamine (or other Stimulants), Benzodiazepines (or other sedatives), MDMA (Ecstasy), LSD (“Acid”), Opioids (Heroin, Hydrocodone, Oxycodone, Hydromorphone, Fentanyl, Codeine), PCP, Cannabis (and synthetic Cannabinoids), and Inhalants. Individuals who struggle with abuse and/or dependence on such substances can experience sobriety with proper intervention, treatment, dedication and determination to attain wellness. These disorders are treated with either medications, therapy or substance-abuse related programs. The abuse of aforementioned substances and the conditions related to such are indeed illnesses, however, accountability is essential for those who seek to obtain and maintain sobriety.
Some persons experience involuntary sudden, recurrent, rapid and non-rhythmic movements or vocalizations--such behaviors are deemed ‘tics.’ Tic Disorders include Tourette’s Disorder and Persistent Motor or Vocal Tic Disorders. If/when such an issue presents itself, the first order of business is to determine/isolate the cause of such signs. If not related to a medical or medication-related cause, these illnesses are often transient in nature and signs will dissipate with time. In cases where such problems persist, medication may be of benefit in managing such a condition.
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