Botanical Name : Ribes glandulosum Family: Grossulariaceae Genus: Ribes Species: R. glandulosum Kingdom: Plantae Order: Saxifragales
Synonyms: R. prostratum.
Common Names: Skunk Currant
Habitat :
Ribes glandulosum is native to N. America – Newfoundland to British Columbia, south to North Carolina, Michigan and Wisconsin. It grows on wet woods and rocky slopes. Description:
Ribes glandulosum is a deciduous Shrub growing to 0.4 m (1ft 4in) by 1 m (3ft 3in). It has palmately lobed leaves with 5 or 7 deeply cut segments. Flowers are in elongated clusters of 6-15 pink flowers. Fruits are red and egg-shaped, sometimes palatable but sometimes not. CLICK & SEE THE PICTURES ;
It is not frost tender. The flowers are hermaphrodite (have both male and female organs) and are pollinated by Insects.Suitable for: light (sandy), medium (loamy) and heavy (clay) soils and prefers well-drained soil. Suitable pH: acid, neutral and basic (alkaline) soils. It can grow in semi-shade (light woodland) or no shade. It prefers moist soil.
Cultivation:
Easily grown in a moisture retentive but well-drained loamy soil of at least moderate quality. Plants are quite tolerant of shade though do not fruit so well in such a position. Prefers a cool moist position. Hardy to about -20°c. Plants come into growth very early in the year. The branches are decumbent or spreading. Plants can harbour a stage of ‘white pine blister rust’, so they should not be grown in the vicinity of pine trees. Plants in this genus are notably susceptible to honey fungus. The leaves have an unpleasant smell.
Propagation:
Seed – best sown as soon as it is ripe in the autumn in a cold frame. Stored seed requires 4 – 5 months cold stratification at between 0 to 9°c and should be sown as early in the year as possible. Under normal storage conditions the seed can remain viable for 17 years or more. Prick out the seedlings into individual pots when they are large enough to handle and grow them on in a cold frame for their first winter, planting them out in late spring of the following year. Cuttings of half-ripe wood, 10 – 15cm with a heel, July/August in a frame. Cuttings of mature wood of the current year’s growth, preferably with a heel of the previous year’s growth, November to February in a cold frame or sheltered bed outdoors.
Edible Uses: Tea.
Fruit – raw or cooked. A blackcurrant, it is juicy and palatable. Another report says that it has the odour of a skunk and the skin has short bristly hairs. The fruit is about 8mm in diameter. The stems have been used to make a bitter tea.
Medicinal Uses:
The Ojibwa people take a compound decoction of the root for back pain and for “female weakness.” The Cree people use a decoction of the stem, either by itself or mixed with wild red raspberry, to prevent clotting after birth. The Algonquin people use the berries as food. Other Uses : Can be used as a ground cover plant
Disclaimer : The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplement, it is always advisable to consult with your own health care provider.
Defenition: Autism is a brain development disorder that impairs social interaction and communication, and causes restricted and repetitive behavior, all starting before a child is three years old. This set of signs distinguishes autism from milder autism spectrum disorders (ASD) such as Asperger syndrome.
Most infants and young children are very social creatures who need and want contact with others to thrive and grow. They smile, cuddle, laugh, and respond eagerly to games like “peek-a-boo” or hide-and-seek. Occasionally, however, a child does not interact in this expected manner. Instead, the child seems to exist in his or her own world, a place characterized by repetitive routines, odd and peculiar behaviors, problems in communication, and a lack of social awareness or interest in others. These are characteristics of a developmental disorder called autism……….CLICK & SEE
Autism has a strong genetic basis, although the genetics of autism are complex and it is unclear whether ASD is explained more by multigene interactions or by rare mutations. In rare cases, autism is strongly associated with agents that cause birth defects. Other proposed causes, such as childhood vaccines, are controversial and the vaccine hypotheses lack convincing scientific evidence. Most recent reviews estimate a prevalence of one to two cases per 1,000 people for autism, and about six per 1,000 for ASD, with ASD averaging a 4.3:1 male-to-female ratio. The number of people known to have autism has increased dramatically since the 1980s, at least partly due to changes in diagnostic practice; the question of whether actual prevalence has increased is unresolved.
Autism affects many parts of the brain; how this occurs is poorly understood. Parents usually notice signs in the first two years of their child’s life. Early behavioral or cognitive intervention can help children gain self-care, social, and communication skills. There is no cure. Few children with autism live independently after reaching adulthood, but some become successful, and an autistic culture has developed, with some seeking a cure and others believing that autism is a condition rather than a disorder.
Characteristics : Autism is distinguished by a pattern of symptoms rather than one single symptom. The main characteristics are impairments in social interaction, impairments in communication, restricted interests and repetitive behavior. Other aspects, such as atypical eating, are also common but are not essential for diagnosis. Individual symptoms of autism occur in the general population and appear not to associate highly, without a sharp line separating pathological severity from common traits.
Symptoms:
Autism is usually identified by the time a child is three years of age. It is often discovered when parents become concerned that their child may be deaf, is not yet talking, resists cuddling, and avoids interactions with others.
A preschool age child with “classic” autism is generally withdrawn, aloof, and fails to respond to other people. Many of these children will not even make eye contact. They may also engage in odd or ritualistic behaviors like rocking, hand flapping, or an obsessive need to maintain order.
Many children with autism do not speak at all. Those who do may speak in rhyme, have echolalia (repeating a person’s words like an echo), refer to themselves as “he” or “she”, or use peculiar language.
The severity of autism varies widely, from mild to severe. With proper supports, many of these children are able to perform well in a school setting and may be able to live independently when they grow up. Other children with autism function at a much lower level. Mental retardation is commonly associated with autism. Occasionally, a child with autism may display an extraordinary talent in art, music, or another specific area.
Autistic individuals display many forms of repetitive or restricted behavior, which the Repetitive Behavior Scale-Revised (RBS-R) categorizes as follows.
* Stereotypy is apparently purposeless movement, such as hand flapping, head rolling, or body rocking.
* Compulsive behavior is intended and appears to follow rules, such as arranging objects in a certain way.
* Sameness is resistance to change; for example, insisting that the furniture not be moved or refusing to be interrupted.
* Ritualistic behavior involves the performance of daily activities the same way each time, such as an unvarying menu or dressing ritual. This is closely associated with sameness and an independent validation has suggested combining the two factors.
* Restricted behavior is limited in focus, interest, or activity, such as preoccupation with a single television program.
* Self-injury includes movements that injure or can injure the person, such as biting oneself. Dominick et al. reported that self-injury at some point affected about 30% of children with ASD.
No single repetitive behavior seems to be specific to autism, but only autism appears to have an elevated pattern of occurrence and severity of these behaviors.
* Lack of pointing to direct others’ attention to objects (occurs in the first 14 months of life)
* Does not adjust gaze to look at objects that others are looking at
* Cannot start or sustain a social conversation
* Develops language slowly or not at all
* Repeats words or memorized passages, such as commercials
* Does not refer to self correctly (for example, says “you want water” when the child means “I want water”)
* Uses nonsense rhyming
* Communicates with gestures instead of words
* Shows a lack of empathy
* Does not make friends
* Is withdrawn
* Prefers to spend time alone, rather than with others
* May not respond to eye contact or smiles
* May actually avoid eye contact
* May treat others as if they are objects
* Does not play interactive games
Response to sensory information:
* Has heightened or low senses of sight, hearing, touch, smell, or taste
* Seems to have a heightened or low response to pain
* May withdraw from physical contact because it is overstimulating or overwhelming
* Does not startle at loud noises
* May find normal noises painful and hold hands over ears
* Rubs surfaces, mouths or licks objects
Play:
* Shows little pretend or imaginative play
* Doesn’t imitate the actions of others
* Prefers solitary or ritualistic play
Behaviors:
* Has a short attention span
* Uses repetitive body movements
* Shows a strong need for sameness
* “Acts up” with intense tantrums
* Has very narrow interests
* Demonstrates perseveration (gets stuck on a single topic or task)
* Shows aggression to others or self
* Is overactive or very passive
Causes:
The cause of autism remains unknown, although current theories indicate a problem with function or structure of the central nervous system. What we do know, however, is that parents or “inadequate parenting” do not cause autism.
Genetic factors seem to be important. For example, identical twins are much more likely than fraternal twins or siblings to both have autism. Similarly, language abnormalities are more common in relatives of autistic children. Chromosomal abnormalities and other neurological problems are also more common in families with autism.
A number of other possible causes have been suspected, but not proven. They involve digestive tract changes, diet, mercury poisoning, vaccine sensitivity, and the body’s inefficient use of vitamins and minerals.
The exact number of children with autism is not known. A report released by the U.S. Centers for Disease Control and Prevention (CDC) suggests that autism and related disorders are more common than previously thought, although it is unclear if this is due to an increasing rate of the illness or an increased ability to diagnose the illness.
Autism affects boys 3 to 4 times more often than girls. Family income, education, and lifestyle do not seem to affect the risk of autism.
Some parents have heard that the MMR vaccine that children receive may cause autism. This theory was based, in part, on two facts. First, the incidence of autism has increased steadily since around the same time the MMR vaccine was introduced. Second, children with the regressive form of autism (a type of autism that develops after a period of normal development) tend to start to show symptoms around the time the MMR vaccine is given. This is likely a coincidence due to the age of children at the time they receive this vaccine.
Several major studies have found NO connection between the vaccine and autism, however. The American Academy of Pediatrics and the Center for Disease Control and Prevention report that there is no proven link between autism and the MMR vaccine.
Some doctors attribute the increased incidence in autism to newer definitions of autism. The term “autism” now includes a wider spectrum of children. For example, a child who is diagnosed with high-functioning autism today may have been thought to simply be odd or strange 30 years ago.
Screening & Diagnosis:
:All children should have routine developmental exams by their pediatrician. Further testing may be needed if there is concern on the part of the clinician or the parents. This is particularly true whenever a child fails to meet any of the following language milestones:
* Babbling by 12 months
* Gesturing (pointing, waving bye-bye) by 12 months
* Single words by 16 months
* Two-word spontaneous phrases by 24 months (not just echoing)
* Loss of any language or social skills at any age.
These children might receive a hearing evaluation, a blood lead test, and a screening test for autism (such as the Checklist for Autism in Toddlers (CHAT) or the Autism Screening Questionnaire).
A health care provider experienced in the diagnosis and treatment of autism is usually necessary for the actual diagnosis. Because there is no biological test for autism, the diagnosis will often be based on very specific criteria laid out in a book called the Diagnostic and Statistical Manual IV.
The other pervasive developmental disorders include:
* Asperger syndrome (like autism, but with normal language development)
* Rett syndrome (very different from autism, and only occurs in females)
* Childhood disintegrative disorder (rare condition where a child acquires skills, then loses them by age 10)
* Pervasive developmental disorder – not otherwise specified (PDD-NOS), also called atypical autism.
An evaluation of autism will often include a complete physical and neurologic examination. It may also include a specific diagnostic screening tool, such as:
Children with known or suspected autism will often have genetic testing (looking for chromosome abnormalities) and perhaps metabolic testing.
Autism encompasses a broad spectrum of symptoms. Therefore, a single, brief evaluation cannot predict a child’s true abilities. Ideally, a team of different specialists will evaluate the child. They might evaluate speech, language, communication, thinking abilities, motor skills, success at school, and other factors.
Underdiagnosis and overdiagnosis are problems in marginal cases, and much of the recent increase in the number of reported ASD cases is likely due to changes in diagnostic practices. The increasing popularity of drug treatment options and the expansion of benefits has given providers incentives to diagnose ASD, resulting in some overdiagnosis of children with uncertain symptoms. Conversely, the cost of screening and diagnosis and the challenge of obtaining payment can inhibit or delay diagnosis. It is particularly hard to diagnose autism among the visually impaired, partly because some of its diagnostic criteria depend on vision, and partly because autistic symptoms overlap with those of common blindness syndromes.
The symptoms of autism and ASD begin early in childhood but are occasionally missed. Adults may seek retrospective diagnoses to help them or their friends and family understand themselves, to help their employers make adjustments, or in some locations to claim disability living allowances or other benefits.
Sometimes people are reluctant to have a child diagnosed because of concerns about labeling the child. However, failure to make a diagnosis can lead to failure to get the treatment and services the child needs.
Treatment
An early, intensive, appropriate treatment program will greatly improve the outlook for most young children with autism. Most programs will build on the interests of the child in a highly structured schedule of constructive activities. Visual aids are often helpful.
Treatment is most successful when geared toward the child’s particular needs. An experienced specialist or team should design the individualized program. A variety of effective therapies are available, including applied behavior analysis (ABA), speech-language therapy, medications, occupational therapy, and physical therapy. Sensory integration and vision therapy are also common, but there is little research supporting their effectiveness. The best treatment plan may use a combination of techniques.
APPLIED BEHAVIORAL ANALYSIS (ABA)
This program is for younger children with an autism spectrum disorder. It highly effective in many cases. ABA uses a one-on-one teaching approach that relies on reinforced practice of various skills. The goal is to get the child close to typical developmental functioning.
ABA programs are usually conducted within a child’s home, under the supervision of a behavioral psychologist. Unfortunately, these programs can be very expensive and have not been widely adopted by school systems. Parents often must seek funding and staffing from other sources, which can be hard to find in many communities.
TEACCH
Another program is called the Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH). TEACCH, developed as a statewide program in North Carolina, uses picture schedules and other visual cues. These help the child work independently and to organize and structure their environments. Though TEACCH tries to enhance a child’s adaptation and skills, there is also an acceptance of the deficits associated with autism spectrum disorders. In contrast to ABA programs, TEACCH programs do not anticipate that children will achieve typical developmental progress in response to the treatment.
MEDICINE
Medicines are often used to treat behavior or emotional problems that people with autism may have. These include hyperactivity, impulsiveness, attention problems, irritability, mood swings, outbursts, tantrums, aggression, extreme compulsions that the child finds it impossible to suppress, sleep difficulty, and anxiety. Currently, only risperidone is approved for treatment of children ages 5-16 with irritability and aggression associated with autism.
DIET
Some children with autism appear to respond to a gluten-free or a casein-free diet. Gluten is found in foods containing wheat, rye, and barley. Casein is found in milk, cheese, and other dairy products. Not all experts agree that dietary changes will make a difference, and not all reports studying this method have shown positive results.
If considering these or other dietary changes, seek guidance from both a gastroenterologist (doctor who specializes in the digestive system) and a registered dietitian. You want to be sure that the child is still receiving adequate calories, nutrients, and a balanced diet.
OTHER APPROACHES
Beware that there are widely publicized treatments for autism that do not have scientific support, and reports of “miracle cures” that do not live up to expectations. If your child has autism, it may be helpful to talk with other parents of children with autism, talk with autism specialists, and follow the progress of research in this area, which is rapidly developing.
At one time, there was enormous excitement about using secretin infusions. Now, after many studies have been conducted in many laboratories, it’s possible that secretin is not effective after all, but research is ongoing.
Support Groups
For organizations that can provide additional information and help on autism, see autism resources.
Prognosis:
There is no cure. Children recover occasionally, sometimes after intensive treatment and sometimes not; it is not known how often this happens. Most children with autism lack social support, meaningful relationships, future employment opportunities or self-determination. Although core difficulties remain, symptoms often become less severe in later childhood. Few high-quality studies address long-term prognosis. Some adults show modest improvement in communication skills, but a few decline; no study has focused on autism after midlife. Acquiring language before age six, having IQ above 50, and having a marketable skill all predict better outcomes; independent living is unlikely with severe autism. A 2004 British study of 68 adults who were diagnosed before 1980 as autistic children with IQ above 50 found that 12% achieved a high level of independence as adults, 10% had some friends and were generally in work but required some support, 19% had some independence but were generally living at home and needed considerable support and supervision in daily living, 46% needed specialist residential provision from facilities specializing in ASD with a high level of support and very limited autonomy, and 12% needed high-level hospital care. A 2005 Swedish study of 78 adults that did not exclude low IQ found worse prognosis; for example, only 4% achieved independence. A 2008 Canadian study of 48 young adults diagnosed with ASD as preschoolers found outcomes ranging through poor (46%), fair (32%), good (17%), and very good (4%); only 56% had ever been employed, most in volunteer, sheltered or part time work. Changes in diagnostic practice and increased availability of effective early intervention make it unclear whether these findings can be generalized to recently diagnosed children.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose
Definition:
A delusion is commonly defined as a fixed false belief and is used in everyday language to describe a belief that is either false, fanciful or derived from deception. In psychiatry, the definition is necessarily more precise and implies that the belief is pathological (the result of an illness or illness process). As a pathology it is distinct from a belief based on false or incomplete information or certain effects of perception which would more properly be termed an apperception or illusion.
Delusions typically occur in the context of neurological or mental illness, although they are not tied to any particular disease and have been found to occur in the context of many pathological states (both physical and mental). However, they are of particular diagnostic importance in psychotic disorders and particularly in schizophrenia and bipolar disorder.
Psychiatric definition
Although non-specific concepts of madness have been around for several thousand years, the psychiatrist and philosopher Karl Jaspers was the first to define the three main criteria for a belief to be considered delusional in his book General Psychopathology. These criteria are:
*certainty (held with absolute conviction)
*incorrigibility (not changeable by compelling counterargument or proof to the contrary)
*impossibility or falsity of content (implausible, bizarre or patently untrue)
These criteria still continue in modern psychiatric diagnosis. In the most recent Diagnostic and Statistical Manual of Mental Disorders, a delusion is defined as:
A false belief based on incorrect inference about external reality that is firmly sustained despite what almost everybody else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary. The belief is not one ordinarily accepted by other members of the person’s culture or subculture (e.g., it is not an article of religious faith).
Symptoms:
The criteria that define delusional disorder are furnished in the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision, or DSM-IV-TR, published by the American Psychiatric Association. The criteria for delusional disorder are as follows:
*non-bizarre delusions which have been present for at least one month
*absence of obviously odd or bizarre behavior
*absence of hallucinations, or hallucinations that only occur infrequently in comparison to other psychotic disorders
*no memory loss, medical illness or drug or alcohol-related effects are associated with the development of delusions
Diagnostic issues:
The modern definition and Jaspers’ original criteria have been criticised, as counter-examples can be shown for every defining feature.
Studies on psychiatric patients have shown that delusions can be seen to vary in intensity and conviction over time which suggests that certainty and incorrigibility are not necessary components of a delusional belief.
Delusions do not necessarily have to be false or ‘incorrect inferences about external reality’. Some religious or spiritual beliefs by their nature may not be falsifiable, and hence cannot be described as false or incorrect, no matter whether the person holding these beliefs was diagnosed as delusional or not.
In other situations the delusion may turn out to be true belief. For example, delusional jealousy, where a person believes that their partner is being unfaithful (and may even follow them into the bathroom believing them to be seeing their lover even during the briefest of partings) may result in the faithful partner being driven to infidelity by the constant and unreasonable strain put on them by their delusional spouse. In this case the delusion does not cease to be a delusion because the content later turns out to be true.
In other cases, the delusion may be assumed to be false by a doctor or psychiatrist assessing the belief, because it seems to be unlikely, bizarre or held with excessive conviction. Psychiatrists rarely have the time or resources to check the validity of a person’s claims leading to some true beliefs to be erroneously classified as delusional.This is known as the Martha Mitchell effect, after the wife of the attorney general who alleged that illegal activity was taking place in the White House. At the time her claims were thought to be signs of mental illness, and only after the Watergate scandal broke was she proved right (and hence sane).
Similar factors have led to criticisms of Jaspers’ definition of true delusions as being ultimately ‘un-understandable’. Critics (such as R. D. Laing) have argued that this leads to the diagnosis of delusions being based on the subjective understanding of a particular psychiatrist, who may not have access to all the information which might make a belief otherwise interpretable.
Another difficulty with the diagnosis of delusions is that almost all of these features can be found in “normal” beliefs. Many religious beliefs hold exactly the same features, yet are not universally considered delusional. Similarly, Thomas Kuhn argued in The Structure of Scientific Revolutions that scientists can hold strong beliefs in scientific theories despite considerable apparent discrepancies with experimental evidence.
These factors have led the psychiatrist Anthony David to note that “there is no acceptable (rather than accepted) definition of a delusion.” In practice psychiatrists tend to diagnose a belief as delusional if it is either patently bizarre, causing significant distress, or excessively pre-occupies the patient, especially if the person is subsequently unswayed in belief by counter-evidence or reasonable arguments.
Client interviews focused on obtaining information about the sufferer’s life situation and past history aid in identification of delusional disorder. With the client’s permission, the clinician obtains details from earlier medical records, and engages in thorough discussion with the client’s immediate family—helpful measures in determining whether delusions are present. The clinician may use a semi-structured interview called a mental status examination to assess the patient’s concentration, memory, understanding the individual’s situation and logical thinking. The mental status examination is intended to reveal peculiar thought processes in the patient. The Peters Delusion Inventory (PDI) is a psychological test that focuses on identifying and understanding delusional thinking; but its use is more common in research than in clinical practice.
Even using the DSM-IV-TRcriteria listed above, classification of delusional disorder is relatively subjective. The criteria “non-bizarre” and “resistant to change” and “not culturally accepted” are all subject to very individual interpretations. They create variability in how professionals diagnose the illness. The utility of diagnosing the syndrome rather than focusing on successful treatment of delusion in any form of illness is debated in the medical community. Some researchers further contend that delusional disorder, currently classified as a psychotic disorder, is actually a variation of depression and might respond better to antidepressants or therapy more similar to that utilized for depression. Also, the meaning and implications of “culturally accepted” can create problems. The cultural relativity of “delusions,”—most evident where the beliefs shown are typical of the person’s subculture or religion yet would be viewed as strange or delusional by the dominant culture—can force complex choices to be made in diagnosis and treatment. An example could be that of a Haitian immigrant to the United States who believed in voodoo. If that person became aggressive toward neighbors issuing curses or hexes, believing that death is imminent at the hands of those neighbors, a question arises. The belief is typical of the individual’s subculture, so the issue is whether it should be diagnosed or treated. If it were to be treated, whether the remedy should come through Western medicine, or be conducted through voodoo shamanistic treatment is the problem to be solved.
Treatments:
Delusional disorder treatment often involves atypical(also callednovelornewer-generation) antipsychotic medications, which can be effective in some patients. Risperidone(Risperdal), quetiapine(Seroquel), and olanzapine(Zyprexa) are all examples of atypical or novel antipsychotic medications. If agitationoccurs, a number of different antipsychotics can be used to conclude the outbreak of acute agitation. Agitation, a state of frantic activity experienced concurrently with anger or exaggerated fearfulness, increases the risk that the client will endanger self or others. To decrease anxiety and slow behavior in emergency situations where agitation is a factor, an injection of haloperidol(Haldol) is often given usually in combination with other medications (often lorazepam, also known as Ativan). Agitation in delusional disorder is a typical response to severe or harsh confrontation when dealing with the existence of the delusions. It can also be a result of blocking the individual from performing inappropriate actions the client views as urgent in light of the delusional reality. A novel antipsychotic is generally given orally on a daily basis for ongoing treatment meant for long-term effect on the symptoms. Response to antipsychotics in delusional disorder seems to follow the “rule of thirds,” in which about one-third of patients respond somewhat positively, one-third show little change, and one-third worsen or are unable to comply.
Cognitive therapy has shown promise as an emerging treatment for delusions. The cognitive therapist tries to capitalize on any doubt the individual has about the delusions; then attempts to develop a joint effort with the sufferer to generate alternative explanations, assisting the client in checking the evidence. This examination proceeds in favor of the various explanations. Much of the work is done by use of empathy, asking hypothetical questions in a form of therapeutic Socratic dialogue—a process that follows a basic question and answer format, figuring out what is known and unknown before reaching a logical conclusion. Combining pharmacotherapy with cognitive therapy integrates both treating the possible underlying biological problems and decreasing the symptoms with psychotherapy.
Prognosis:
Evidence collected to date indicates about 10% of cases will show some improvement of delusional symptoms though irrational beliefs may remain; 33–50% may show complete remission; and, in 30–40% of cases there will be persistent non-improving symptoms. The prognosis for clients with delusional disorder is largely related to the level of conviction regarding the delusions and the openness the person has for allowing information that contradicts the delusion.
Prevention:
Little work has been done thus far regarding prevention of the disorder. Effective means of prevention have not been identified.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.
Definition Hypersomnia refers to a set of related disorders that involve excessive daytime sleepiness.It is characterized by reoccuring episodes of excessive daytime sleepiness or prolonged nighttime sleep. Different from feeling tired due to lack of or interrupted sleep at night, persons with hypersomnia are compelled to nap repeatedly during the day, often at inappropriate times such as at work, during a meal, or in conversation. These daytime naps usually provide no relief from symptoms. Patients often have difficulty waking from a long sleep, and may feel disoriented. Other symptoms may include anxiety, increased irritation, decreased energy, restlessness, slow thinking, slow speech, loss of appetite, hallucinations, and memory difficulty. Some patients lose the ability to function in family, social, occupational, or other settings.
Description:
There are two main categories of hypersomnia: primary hypersomnia (sometimes called idiopathic hypersomnia) and recurrent hypersomnia (sometimes called recurrent primary hypersomnia). Both are characterized by the same signs and symptoms and differ only in the frequency and regularity with which the symptoms occur.
Primary hypersomnia is characterized by excessive daytime sleepiness over a long period of time. The symptoms are present all, or nearly all, of the time. Recurring hypersomnia involves periods of excessive daytime sleepiness that can last from one to many days, and recur over the course of a year or more. The primary difference between this and primary hypersomnia is that persons experiencing recurring hypersomnia will have prolonged periods where they do not exhibit any signs of hypersomnia, whereas persons experiencing primary hypersomnia are affected by it nearly all the time. One of the best documented forms of recurrent hypersomnia is Kleine-Levin syndrome, although there are other forms as well.
There are many different causes for daytime sleepiness that are not considered hypersomnia, and there are many diseases and disorders in which excessive daytime sleepiness is a primary or secondary symptom. Feelings of daytime sleepiness are often associated with the use of common substances such as caffeine, alcohol, and many medications. Other common factors that can lead to excessive daytime sleepiness that is not considered hypersomnia include shift work and insomnia. Shift work can disrupt the body’s natural sleep rhythms. Insomnia can cause excessive daytime sleepiness because of lack of nighttime sleep, and is a separate disorder.
Causes and symptoms:Hypersomnia can be caused by genetics (heredity), brain damage, and disorders such as clinical depression, uremia and fibromyalgia. Hypersomnia can also be a symptom of other sleep disorders such as narcolepsy, sleep apnea, and restless leg syndrome.
People who are overweight may be more likely to suffer from hypersomnia. This can often exacerbate weight problems as excessive sleeping decreases metabolic energy consumption, making weight loss more difficult.
Another possible cause is an infection of mononucleosis, as several instances of hypersomnia have been found to arise immediately after such an infection (Dr. Givan, MD, Riley Hospital).
In some instances, the cause of the hypersomnia cannot be determined; in these cases, it is considered to be idiopathic hypersomnia.
Hypersomnia may also occur as a side effect of taking certain medications (i.e some psychotropics for depression, anxiety, or bipolar disorder).
People experiencing hypersomnia do not get abnormal amounts of nighttime sleep. However, they often have problems waking up in the morning and staying awake during the day. People with hypersomnia nap frequently, and upon waking from the nap, do not feel refreshed. Hypersomnia is sometimes misdiagnosed as narcolepsy. In many ways the two are similar. One significant difference is that people with narcolepsy experience a sudden onset of sleepiness, while people with hypersomnia experience increasing sleepiness over time. Also, people with narcolepsy find daytime sleep refreshing, while people with hypersomnia do not.
People with Kleine-Levin syndrome have symptoms that differ from the symptoms of other forms of hypersomnia. These people may sleep for 18 or more hours a day. In addition, they are often irritable, uninhibited, and make indiscriminate sexual advances. People with Kleine-Levin syndrome often eat uncontrollably and rapidly gain weight, unlike people with other forms of hypersomnia. This form of recurrent hypersomnia is very rare.
The causes of hypersomnia remain unclear. There is some speculation that in many cases it can be attributed to problems involving the hypothalamus, but there is little evidence to support that claim.
Demographics:
Hypersomnia is an uncommon disorder. In general, 5% or fewer of adults complain of excessive sleepiness during the daytime. That does not mean all those who complain of excessive sleepiness have hypersomnia. There are many other possible causes of daytime sleepiness. Of all the people who visit sleep clinics because they feel they are too sleepy during the day, only about 5–10% are diagnosed with primary hypersomnia. Kleine-Levin syndrome is present in about three times more males than females, but it is a very rare syndrome.
Hypersomnia generally appears when the patient is between 15 and 30 years old. It does not begin suddenly, but becomes apparent slowly, sometimes over years.
Diagnosis:
Hypersomnia is characterized by excessive daytime sleepiness, and daytime naps that do not result in a more refreshed or alert feeling. Hypersomnia does not include lack of nighttime sleep. People experiencing problems with nighttime sleep may have insomnia, a separate sleep disorder. In people with insomnia, excessive daytime sleepiness may be a side effect.
The Diagnostic and Statistical Manual of Mental Disorders, which presents the guidelines used by the American Psychiatric Association for diagnosis of disorders, states that symptoms must be present for at least a month, and must interfere with a person’s normal activities. Also, the symptoms cannot be attributed to failure to get enough sleep at night or to another sleep disorder. The symptoms cannot be caused by another significant psychological disorder, nor can they be a side effect of a medicinal or illicit drug or a side effect of a general medical condition. For a diagnosis of recurrent hypersomnia, the symptoms must occur for at least three days at a time, and the symptoms have to be present for at least two years.
An adult is considered to have hypersomnia if he or she sleeps more than 10 hours per day on a regular basis for at least two weeks, or if he or she is compelled to nap repeatedly during the day.
One diagnosis tool is the Epworth Sleepiness Scale, which helps determine the extent of EDS in a subject. A self test is available from Stanford University Medical School.
Treatments:Treatment is symptomatic in nature. Stimulants, such as amphetamine, methylphenidate, and modafinil, may be prescribed. Other drugs used to treat hypersomnia include clonidine, levodopa, bromocriptine, antidepressants, and monoamine oxidase inhibitors. Changes in behavior (for example avoiding night work and social activities that delay bed time) and diet may offer some relief. Patients should avoid alcohol and caffeine. No substantial body of evidence supports the effectiveness of these treatments. Stimulants are not generally recommended to treat hypersomnia as they treat the symptoms but not the base problem. Some researchers believe that treatment of the hypothalamus may be a possible treatment for hypersomnia.
Prognosis:
Kleine-Levin syndrome has been reported to resolve occasionally by itself around middle age. Except for that syndrome, hypersomnia is considered both a lifelong disorder and one that can be significantly disabling. There is no body of evidence that concludes there is a way to treat the majority of hypersomnia cases successfully.
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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.
Mind Over Matter
The power of the mind is a curious thing, because it is so powerful yet so difficult to control sometimes. We find ourselves thinking a certain way, knowing that this thought may be creating trouble for us yet we find it difficult to stop. For example, many people have the experience of getting sick at the same time every year or every time they go on a plane. They may even be aware that their beliefs impact their experiences, so continue to think they will get sick and then they do.
Sometimes we need to get sick in order to process something or move something through our bodies. But often we get sick, or feel exhausted, because we do not make the effort to galvanize the power of our minds in the service of our physical health, which is one of its most important functions. We really can use it to communicate to our bodies, yet we often regard the two as separate entities that have little to do with one another.
Knowing this, we have the power to create physical health and mental health, simply by paying attention to the tapes running in our minds. Once we hear ourselves, we have the option to let that tape keep running or to make a new recording. We harness the power of the mind in our defense when we choose supportive, healing words that foster good health and high spirits. All we need to do is remember to tend the field of our mind with the attentive and loving hand of a master gardener tending her flower beds, culling out the weeds so that the blossoms may come to fruition.
