How does one develop an anxious personality?

The truth is that no one knows. As with most mental health disorders, there are many speculations and everything or everyone has been blamed at one point in time. Experts believe that it is perhaps due to altered level of neurotransmitters in the brain but why the levels of these darn chemicals change is a mystery. Bad genes and bad environment are two universal themes for almost all mental health disorders.

Anxiety disorders tend to develop 1) in females more often than males, 2) in those who have had a trouble childhood, 3) those with a certain personality (A-type) and 4) in those who abuse illicit drugs or alcohol. When the disorder is not treated it can leads to severe anxiety, depression, trouble sleeping, headaches, teeth grinding and problems with the bowel. Moreover, severe anxiety can affect interpersonal relationships, your job and make life for everyone around you miserable.

I think I may have anxiety. Is there any online testing available for my disorder?

Yes, there are several anxiety disorder tests available online that can help determine if you have an anxious personality. All humans develop some degree of anxiety but the symptoms are always well controlled and rapidly disappear. However, in some people, anxiety takes over the person’s mind and can be very troubling. Over the long period, one can develop anxiety, depression, panic attacks, hysteria, paranoia and the quality of life becomes poor.  There are many online mental health sites that offer social anxiety tests and the results are available instantly. In fact, many of these tests are free. 

The tests for anxiety are in a simple question and answer format. The questions pertain to everyday life scenarios. Moreover, the questions also ask if you have any physical symptoms when you develop anxiety. For example, one may develop tremors, sweating, fast heart rate, rapid breathing or even diarrhea during an anxiety attack. Other aspects of the social anxiety tests include your emotional mood. Are you very afraid of trivial things, do you develop intense anger, disappointment, are you depressed or have uncontrolled episodes of crying or feelings of helplessness?  The tests for anxiety  will also determine your behavior during the attack like fidgeting, pacing, cussing or avoidance. What should be understood that everyone has such symptoms to some degree. However, if these symptoms persist and affect your life style, then the anxiety is serious.

Is ginseng good for the mind?

For decades Orientals have been ingesting ginseng in large amounts. Now this fad has started in North America. Ginseng is a herb widely touted to treat many medical disorders of the brain and nerves. This herb is always listed as a best seller and brings in billions of dollars to the health supplement industry. But does it really work?

The latest studies show that ginseng when administered to healthy individuals does have very mild benefits on behavior cognition and quality of life. However, the results were not very impressive, not seen in all individuals and only seen with the panaz ginseng.

So the bottom line is that if you have money, then buy ginseng. If you do not have money, eat a healthy diet of fruit and vegetables, walk everyday and do not smoke- these simple lifestyle changes beat ginseng any day.

 

What is Fetishism?

Fetishism is sexual excitement with use of inanimate objects. Fetishism is a mental health disorder classified by DSM criteria. The disorder usually presents with intense sexual arousal, excitement and erotic fantasies involving inanimate objects for at least 6 months. Moreover, the disorder can cause a variety of behavior changes and interferes with normal social behavior and interpersonal relationships. In rare cases, the fetish can be so intense that it also interferes with work.

Fetishism is not a rare disorder. While the exact number of people who dabble into this type of behavior is not known, it is estimated that at least 1-5 percent of the population has some degree of fetishism. Most fetishists tend to be males. Fetishism tends to peak in early adolescence and continues as long as the individual is sexually active. Both men and women while masturbating may fantasize about a fetish object or they may rub, suck, wear or insert the item(s) into their body orifices. In most cases, fetishism is a solitary sexual behavior but it is not unusual for couples to practice fetishism. Some people smell the fetish or may ask the sexual partner to wear the object during sexual activity. It is believed that close to 30% of couples practice fetishism in their sexual relationships- however, the fetish is controlled and does not affect their personal lives.

One may develop a fetish to any number of objects but the most common are rubber, plastic, shoes, leather, underwear, hair, high heel shoes, boots, stockings and clothing. In many cases, the fetish is so strong that without it, the individual may be unable to achieve a sexual satisfaction. Practicing fetishism is not illegal but when the individual starts to combine it with other sexual disorders like voyeurism or pedophilia, then it results in criminal behavior.

It is widely believed that fetishism is a learned behavior and not something, that is genetically acquired. Individuals with fetishes often tell of physical or sex abuse during childhood.  Many males who have fetishes also practice other sexual behaviors like masochism, sadism and transvestism

People who are into fetishism enjoy the behavior and find it erotic. Thus, most people never willingly seek help.  Some individuals run into trouble with the law and are required to seek help. The treatment of fetishism is a combination of cognitive behavior therapies and medications.  Common drugs used to treat fetishes include drugs which reduce sexual hormones and anti anxiety agents. In most cases, therapy is not required for fetishes.

Paraphilia- disorder of sexual preference

Paraphilia is a medical term to denote sexual deviation, sexual perversion or a disorder of sexual preference. Unlike curiosity, paraphilia is characterized by repetitive, strong sexual arousal to unusual stimuli (not always sexual). Not all Paraphilias as such are illegal (like cross-dressing), but some like pedophilia are considered criminal.

The recognition of paraphilia as deviant sexual behavior was established by Von Krafft Ebbing in 1886. Since then the study of paraphilias has been exhaustive in the field of forensic psychiatry. Today, paraphilias are bona fide disorders recognized in the category of sexual and gender identify disorders in the DSM IV.

For some unknown reason paraphilias occur almost exclusively in males. The paraphilia often starts during early puberty and is almost fully developed by the end of the 2^nd decade of life. Men in all cultures have been reported to develop different paraphilias. In many cases, multiple paraphilias may co-exist at the same time. At least 5-10 percent of men have as many as 5-7 paraphilias.

In most cases, the individual never seeks help and is only seen by health professional after legal troubles starts. To make a diagnosis of a paraphilia one must have intense and recurrent sexual fantasies or sexual urges that usually involve inanimate objects, children, and non-consenting adults. The behavior is often associated with torment or humiliation of others. In addition, the activity must have lasted at least 6 months and caused significant emotional distress and difficulties in interpersonal relationships.

Some of the common paraphilias include:

• Pedophilia –sexual activity involving children
• Exhibitionism -exposing one's genitalia
• Fetishism  is a love for specific objects like underwear or pantyhose
• Frotteurism is rubbing against strangers (esp. in crowded places)
• Sexual masochism (pain or humiliation of self
• Sexual sadism which involves pain or humiliation of others
• Transvestic fetishism –involves wearing clothes of the opposite sex
• Voyeurism involves peeping

Other rare paraphilias include:

- Telephone scatologia- making obscene sexually explicit phone calls

- Necrophilia- have love of dead bodies

- Zoophilia is having sex with animals

- Corprophilias is love of fecal material

- Urophilia is love of urine

The majority of paraphiliacs also have other issues like a history substance abuse, personality disorders, history of aggression and most are loners. Even after diagnosis is made, paraphiliacs are not motivated to undergo treatment. Most become non-complaint because in fact there are no good treatments for these disorders. The few motivated patients can be helped with cognitive behavior therapy to reduce the sexual urges.

Drug therapy is often used with psychosocial treatments for maximal benefit. The commonly used drugs to diminish the sex drive include provera, lupron and androcur. In addition, SSRIs are also used to decrease the sexual urges. There are no real data on prognosis but anecdotal reports suggest that treatment is difficult and relapses are common.  Most people with paraphilia remain addicted to these behaviors and often end up with legal problems. The majority eventually remain incarcerated.

Exhibitionism 101

Exhibitionism is the revelation of one's sexual organs to non-consenting strangers chiefly for personal erotic excitement or pleasure. Exhibitionism is also known in lay terms as “flashing".

Exhibitionism is a bona fide psychiatric disorder include in DSM IV. The diagnostic criteria for exhibitionism entail that the individual has experienced strong sexual urges/arousal when exposing his/her genitals to strangers for at least 6 months.  Going to New Orleans and flashing the breasts once or twice would not be considered exhibitionism by this criteria. Moreover the individual has either acted upon these urges or they also cause significant personal distress or interpersonal difficulties.

In most cases, the exhibitionist will expose genitals to strangers but in some cases may also actively masturbate in front of the victim. It is the shock of the victim that induces the sexual arousal for the exhibitionist. Usually there is no physical contact with the victim but this also depends on circumstances. Evidence today indicates that there are also aggressive exhibitionists who will touch or grab the victim.

Exhibitionists are quite cunning individuals and usually employ tricks to attract the unsuspecting victim to a certain area. Usually isolated areas are selected but more often than not, the exhibitionist rarely makes any attempt to hide his/her identify. It is this risk factor that is critical for achieving sexual arousal.

The real number of exhibitionists in the general population is unknown but among sex offenders, it appears that almost 30% have exhibitionist tendencies. While the majority of culprits are males, there are reports that exhibitionism is also common in females. This is common at adult dancing parlors and strip tease bars. Moreover, wearing of skimpy clothes, revealing outfits or see though clothes is also considered exhibitionism-but somehow society rarely complains when it is the female who is the offender!

Exhibitionism usually first surfaces in early teenage years and peaks in the adolescence years. The victims of exhibitionists are usually adult females or children. Most exhibitioners are married or engaged in steady relationships but when closely examined, these individuals do have some degree of sexual dysfunction within the relationship. Although exhibitionism is primarily seen in the younger age groups, it also occurs in the elderly- albeit at a much lower incidence.

Often individuals with exhibitionist tendencies are involved into voyeurism frotterism and have some degree of pedophilic interests.

The majority of individuals with exhibitionism tendencies only come to treatment when they are in legal difficulties or arrested. The treatment of such behaviors is cognitive behavior therapy coupled with SSRI to decrease the sex drive. Those who are aggressive may also be considered for hormonal sex drive reducing medications.

 
The prognosis of these individuals is poor. The therapies often fail because the individuals are non-compliant and relapses are common. Most end up incarcerated or labeled as sexual deviants and have difficulty adjusting to normal life.

Body dysmorphic Disorder and Plastic Surgery!

In today’s society, an increasing number of women are seeking cosmetic surgery to correct physical flaws in their body. While having a “nip and a tuck” here and there is perfectly acceptable, there are some women who are addicted to cosmetic surgery. Statistics reveal that more than 20 percent of women seek multiple cosmetic procedures and at least 15 percent never receive any satisfaction. 

Studies now show that some people -both men and women, who repeatedly seek cosmetic surgery, may be afflicted with a mental disorder known as body dysmorphic disorder. In these people, the simple “nip and tuck” or “Botox” injection does absolutely nothing to satisfy their mind.

In people with body dysmorphic disorder, every minor flaw on their body is perceived as a huge imperfection that leads to a lot of anxiety and stress. These individuals become so fixated with their physical beauty that they become dysfunctional when they view their body.

Typically, these individuals become heavy users of cosmetic surgery. Unfortunately, the majority of plastic surgeons never consider the emotional component and continue to perform more procedures as it is a source of income for them. Rather than recommending these patients for some type of psychological counseling, these unfortunate individuals are sliced and diced everywhere on their body.

It is believed that in the USA alone close to 8 percent of people have body dysmorphic disorder who need treatment.

In a recent study done at Rhode Island and Philadelphia hospitals, doctors observed that less than 2 percent of patients with body dysmorphic disorder were relieved of their symptoms after plastic surgery. One quarter of patents did improve but in some, the symptoms of body dysmorphic disorder actually worsened after the procedures. The study authors mentioned that these people cannot be treated with a scalped or a Botox syringe, but need something else.

"Physicians need to be aware that psychiatric treatments for BDD such as serotonin reuptake inhibitors and cognitive behavioral therapy appear to be effective for what can be a debilitating disorder," the researchers wrote.