BDC #31 - EDNOS: the deadliest-but-totally-unwellknown eating disorder

Do you know about eating disorder? Probably you are quite familiar with anorexia and bulimia, or with over-eating lead to obesity. However, are you sure those are the only eating disorders?

UNFORTUNATELY NO

There is the deadliest, the most common, but totally hidden from public attention; the EDNOS, an abbreviation of Eating Disorder Not Otherwise Specified. It is an eating disorder that doesn't yet meet the criteria for anorexia, bulimia, nor obese over-eating, but still has a significant constriction towards eating behaviour. 

There are 3 spectrum of EDNOS in general:

1. those with the threshold similar to anorexia or bulimia,

2. those with mixture of both disorders, or

3. those with extremely atypical to either of the major disorders.

People with EDNOS usually don't go to the super extreme as the 2 major disorders, but they DO experience the same uneasiness, guilt, and unusual obsession towards foods and those thoughts per-occupied their mind and control their lives. In the end, people with EDNOS tend to be "yo-yo dieters". There are series of eating-limitation and binge-eating through the whole life. Thus, in other words, EDNOS is actually the most common eating disorder appeared. HOWEVER, sadly enough, most of therapists categorize people with EDNOS as "Not-sick-enough" and just suggest the patients to "eat properly" and say "it's just only in your mind".

BL**DY HELL!!!

People with EDNOS are as sick as anorexic, bulimic, or food-obsess patients. They are totally exhausted in mind and it might lead to depression, or even worse. They might actually SCREAM for your help.

There are some expert propose to put EDNOS into DSN-5 Eating Disorder group with some subgroups. There are at least 6 subgroups (as written in wikipedia):

1. Atypical Anorexia Nervosa in which all criteria for anorexia nervosa are met except that the individual’s weight is within or above the normal range
2. Subthreshold Bulimia Nervosa (low frequency or limited duration) in which all criteria for bulimia nervosa are met except the binge eating and compensatory behaviors occur on average less than once a week and for less than 3 months
3. Subthreshold Binge Eating Disorder (low frequency or limited duration) in which all criteria for binge eating disorder are met, except the binge eating occurs on average less than once a week and for less than 3 months
4. Purging Disorder (PD) in which patients purge without binging; they consume a normal amount of food and typically maintain normal weight
5. Night Eating Syndrome (NES) in which patients have nocturnal eating episodes, or eat a large proportion of their daily calorie intake after dinner
6. Other Feeding or Eating Condition Not Elsewhere Classified which is a residual category for all other cases that are clinically significant but do not meet the criteria for formal eating disorder diagnoses.

People with EDNOS, as like any other eating disorders, also have high health risks such as osteoporosis, kidney problems, ulcers, heart failure, etc.

THUS....

If you FEEL and THINK you might have eating-behaviour problems
OR you know somebody who might have problems...

SEEK FOR HELP!!!

Don't let the food eat you up !!! 

Check some links for more info:
http://www.waldenbehavioralcare.com/resources/popular-searches/endos-facts/
http://www.b-eat.co.uk/get-help/about-eating-disorders/types-of-eating-disorder1/ednos/
http://www.nationaleatingdisorders.org/eating-disorders-not-otherwise-specified-ednos

 

I don't own the picture, click for direct link

  

 

      

The Tale of a Boy in a Coffee Shop #38

"Should there be any reason for us to miss you, cheeky boy?" The young lady rubbed his head lightly and went to the kitchen.

"Why shouldn't be any reason for it?" The young boy eyes reverted to the old lady, deep and intense.

"Whether there really is any reason or not, is it important for you?" The old lady returned the gaze as deep as the one she got.

"Well, it's not really. It is simply out of my curiosity. I don't see any harm from it." The young boy raised his two shoulders with light expression.

"Don't you ever miss somebody, or want to do something simply because it's been a while?" The young lady came back from the kitchen, bringing 2 pieces of pancake with simple cinnamon sugar on top of it. 

The young boy naturally accepted the plate and started digging the just-ready-from-the-pan pancakes in front of him. While chewing his pancake, his eyes were day-dreaming through the jars across the bar.

"I think I have, sometimes. Like when I was in the harbour, I really missed my mother's tomato soup, or our fresh milk, or the smell of freshly made butter. I got tired with the smell of fishes, so I really missed my home."

The old lady smiled and rubbed her hand on the young boy's head softly. "And why was that?"

"It was because...." The young boy let his words hanging on the empty air.

The day suddenly got warmer as the autumn weather changed frequently through the days.

"I think there is indeed no need for real reason, huh?" The young boy continued his lovely breakfast.

And their days started as usual.

BDC #30 - Schizoid Personality Disorder: Just simply a poker face and loner

Have you ever checked your own personality or mental disorder? Well, just out of curiosity? If yes, how many of you got a tendency of Schizoid Personality Disorder?

Don't worry, Schizoid is not the same as Schizophrenia. You know, the voices in you head..like in the movies.
"Kill your self"
"Kill them"

NO...it's not the same...rest assured

 Schizoid Personality Disorder is actually a personality disorder included in group of conditions "Cluster A" or eccentric personality disorder. People with schizoid tend to be distant, detached, and indifferent to social relationship.

The term "schizoid" was firstly used in 1908 by Eugen Bleuler to designate a human tendency to direct their attention toward their inner lives and away from the external world. Bleuler labeled this exaggeration of the tendency as the schizoid personality.


Studies on the schizoid personality have developed along two distinct paths. The first one is the descriptive psychiatry, focuses on overtly observable, behavioral and describable symptoms and finds its clearest exposition in the DSM-IV revised.
The descriptive tradition began in 1925as Ernst Kretschmer tried to describe the observable schizoid behaviors, which he organized into three groups of characteristics:

1. unsociability, quietness, reservedness, seriousness, eccentricity
2. timidity, shyness with feelings, sensitivity, nervousness, excitability
3. pliability, honesty, indifference, silence, cold emotional attitudes.

The second path, the dynamic psychiatry, began in 1924 with observations by Eugen Bleuler, who observed that the schizoid person and schizoid pathology were not things to be set apart.
Following the dynamic path, W. R. D. Fairbairn presented in 1940 the four central schizoid themes:

1. the need to regulate interpersonal distance as a central focus of concern, 
2. the ability to mobilize self preservative defenses and self-reliance, 
3. a pervasive tension between the anxiety-laden need for attachment and the defensive need for distance that manifests in observable behavior as indifference, and 
4. an overvaluation of the inner world at the expense of the outer world.

Theodore Millon, in his book (2004; Personality disorder in modern life), identified four subtypes of schizoid. Any individual with schizoid may exhibit none or one of the following:

Subtype	Features
Languid schizoid (including depressive features)	Marked inertia; deficient activation level; intrinsically phlegmatic, lethargic, weary, leaden, lackadaisical, exhausted, enfeebled.
Remote schizoid (including avoidant, schizotypal features)	Distant and removed; inaccessible, solitary, isolated, homeless, disconnected, secluded, aimlessly drifting; peripherally occupied.
Depersonalized schizoid (including schizotypal features)	Disengaged from others and self; self is disembodied or distant object; body and mind sundered, cleaved, dissociated, disjoined, eliminated.
Affectless schizoid (including compulsive features)	Passionless, unresponsive, unaffectionate, chilly, uncaring, unstirred, spiritless, lackluster, unexcitable, unperturbed, cold; all emotions diminished.

It might be easy to spot a real loner. However, there are more people with a hidden schizoid tendency. Many fundamentally schizoid individuals present with an engaging, interactive personality style that contradicts the observable characteristic and definitions of the schizoid personality. Klein classifies these individuals as secret schizoids. They present themselves as socially available, interested, engaged and involved in interacting, BUT remain emotionally withdrawn and sequestered within the safety of the internal world.
Therefore, Klein gives big precaution that we should not miss identifying the schizoid patient because we cannot see the patient's withdrawal through the patient's defensive, compensatory interaction with external reality. He also suggests that we need to ask the patient what his or her subjective experience is in order to detect the presence of the schizoid refusal of emotional intimacy.
Actually, descriptions of the schizoid personality as "hidden" behind an good-cheeful-appearance of emotional engagement have been recognized as far back as 1940 with Fairbairn's description of schizoid exhibitionism, where the schizoid individual is able to express a great deal of feeling and to ake it impressive in social contacts, yet, in reality gives nothing and loses nothing. Because they are practically only "playing a part," their own personalities are not actually involved. According to Fairbairn, "the person disowns the part which he is playing and thus the schizoid individual seeks to preserve his own personality intact and immune from compromise."

There is no solid medications to treat individual with schizoid, unless they suffer heavy depression, they might get some pills. However, the main problem of the schizoid personalities can only be help with talk therapies. We need to explore more, why did they start to withdraw their selves.  

So, how deep are you willing to involve and help people with schizoid tendency? Try to check on some voices of them. (check out the blog below)

 I don't own the picture, try to check the blog ^^

BDC #29 - Narcolepsy: Are you sure sleeping is a good thing?

Have you ever watched some movies where there are some characters can suddenly fall a sleep, while eating, talking, or even walking? Weird... right? Sounds so unreal?! INDEED... !!

 

BUT, it's not actually a hyperbolic medical condition. It is a real one, and it's called narcolepsy.

Narcolepsy is a chronic neurological disorder where the patient's brain fail to regulate the sleep-awake cycle properly. It's not because of psychological problems nor mental illness, but more likely due to some abnormalities which affect the biological factors in the brain. Narcolepsy could as be triggered by environmental influence, such as virus infection.

There are some consistent symptoms of narcolepsy, as written in Wikipedia (I know.. I am too lazy to write my own words);

「The classic symptoms of the disorder, often referred to as the "tetrad of narcolepsy," are cataplexy, sleep paralysis, hypnagogic hallucinations, and excessive daytime sleepiness.　Other symptoms include automatic behaviors. It is important to be noted that these symptoms may not occur altogether in all patients.

• Cataplexy is an episodic condition featuring loss of muscle function, ranging from slight weakness such as limpness at the neck or knees, sagging facial muscles, weakness at the knees (often referred to as "knee buckling"), or inability to speak clearly, to a complete body collapse. Episodes may be triggered by sudden emotional reactions such as laughter, anger, surprise, or fear, and may last from a few seconds to several minutes. The person remains conscious throughout the episode. In some cases, cataplexy may resemble epileptic seizures. Usually speech is slurred and vision is impaired (double vision, inability to focus), but hearing and awareness remain normal. Cataplexy also has a severe emotional impact on narcoleptics, as it can cause extreme anxiety, fear, and avoidance of people or situations that might elicit an attack. Some narcolepsy affected persons also experience heightened senses of taste and smell.
• Sleep paralysis is the temporary inability to talk or move when waking (or less often, when falling asleep). It may last a few seconds to minutes. This is often frightening but is not dangerous.
• Hypnagogic hallucinations are vivid, often frightening, dreamlike experiences that occur while dozing, falling asleep. Hypnopompic hallucinations refer to the same sensations while awakening from sleep.
• Automatic behavior means that a person continues to function (talking, putting things away, etc.) during sleep episodes, but awakens with no memory of performing such activities. It is estimated that up to 40 percent of people with narcolepsy experience automatic behavior during sleep episodes. Sleep paralysis and hypnagogic hallucinations also occur in people who do not have narcolepsy, but more frequently in people who are suffering from extreme lack of sleep. Cataplexy is generally considered to be unique to narcolepsy and is analogous to sleep paralysis in that the usually protective paralysis mechanism occurring during sleep is inappropriately activated. The opposite of this situation (failure to activate this protective paralysis) occurs in rapid eye movement behavior disorder.」

「There is no cure for narcolepsy, but medications and lifestyle modifications can help you manage the symptoms. As the Mayo Clinic suggests:

• Stimulants. Drugs that stimulate the central nervous system are the primary treatment to help people with narcolepsy stay awake during the day. Doctors often try modafinil (Provigil) or armodafinil (Nuvigil) first for narcolepsy because it isn't as addictive as older stimulants and doesn't produce the highs and lows often associated with older stimulants. Side effects of modafinil are uncommon, but they may include headache, nausea or dry mouth.
  Some people need treatment with methylphenidate (Concerta, Ritalin, others) or various amphetamines. These medications are very effective but may sometimes cause side effects such as nervousness and heart palpitations and can be addictive.
  
• Selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs). Doctors often prescribe these medications, which suppress REM sleep, to help alleviate the symptoms of cataplexy, hypnagogic hallucinations and sleep paralysis. They include fluoxetine (Prozac, Sarafem, others) and venlafaxine (Effexor XR). Side effects can include sexual dysfunction and digestive problems.
• Tricyclic antidepressants. These older antidepressants, such as protriptyline (Vivactil), imipramine (Tofranil) and clomipramine (Anafranil), are effective for cataplexy, but many people complain of side effects, such as dry mouth and lightheadedness.
• Sodium oxybate (Xyrem). This medication is highly effective for cataplexy. Sodium oxybate helps to improve nighttime sleep, which is often poor in narcolepsy. In high doses it may also help control daytime sleepiness. It must be taken in two doses, one at bedtime and one up to four hours later. Xyrem can have serious side effects, such as nausea, bed-wetting and worsening of sleepwalking. Taking sodium oxybate together with other sleeping medications, narcotic pain relievers or alcohol can lead to difficulty breathing, coma and death.」

In short.... It is a TROUBLESOME condition... and the medicines basically lead to side effects. Thus, BE GRATEFUL you have a normal sleeping pattern.. and DON'T EVER...EVER ruin it by serial all nights....

I did mention before, narcolepsy is mainly caused by abnormalities in the brain's biological function, though the exact related genes are not revealed yet. However, there is a rising concern that virus infection in the form of vaccination might became the lead cause of the increase of narcolepsy cases for these past 5 years. By the early of this year, there are some reports stating that the swine flu (A/H1N1) vaccine has increase the number of narcolepsy cases in 3 countries; Finland, Sweden, and UK. (psst...there are some links to papers investigating the relation of the vaccine and the increasing cases of narcolepsy. You can try to read it thoroughly). Although the government already agreed that the vaccine might be the cause of narcolepsy, they don't immediately agree to give some compensation to the patients; as what Josh and Chloe are fighting to get. 
As the accumulation of the evidence getting bigger, the governments in European countries finally stated that the swine flu vaccine should not be given to people under 20 as the high risk of narcolepsy.


So, how is your sleep?

 

BDC #28 - Pupula Duplex: Is it real or merely a myth?

Have you ever imagined yourself, having a super power? Being invisible, having laser eyes, flying? Well, in my point of view, it's a really common thing to happen. But, how about if this super power is for real? How about if you have the "Evil Eyes"?

Evil Eyes? Yup, Evil Eyes, as scary as in the movies. Something that allow you to "see more" than normal eyes. Something that looks like picture above.

HOLLY MOLLY!!!!

Is that what you say? You think I am joking?

NOPE!! This is a real medical condition called Pupula duplex. It is a condition where the eye develops double irises, corneas, and retinas in one eyeball. It can be happened either on both or only one eye of the patient. As you can guess, this mutation is way too weird to be happened for real. It is not even officially accepted in the medical literature, since there is no evidence if there is a person ever have this symptom. People merely believe that it is a mythological condition, where there is only one person in history ever had it, and it was the famous Chinese Emperor, Liu Ch'ung. Check the Ripley's Museum!!!! AND If you guys check more details, there is a claim by Robert Ripley himself that he met a real double-irises man in 1931 named Henry Hawn who lived in Mills Kentucky.   

 

Emperor Liu Ch'ung's statue at Ripley's Museum

To put it more real, there is actually a real medical condition named Polycoria. It is a condition where the eye may has several openings in the iris that result from local hypoplasia of the iris stroma and pigment epithelium. Those multiple pupils all have a sphincter and the ability to contract like a pupil in normal eyes.  

However, there are still lots of debates regarding the truth of this condition. Some ophthalmologist even say it a HOAX...

So, it's up to you to believe it or not...