Medix Biggner (2025)

09/10/2023

Overview:

Astigmatism (uh-STIG-muh-tiz-um) is a common and generally treatable imperfection in the curvature of the eye that causes blurred distance and near vision.

Astigmatism occurs when either the front surface of the eye (cornea) or the lens inside the eye has mismatched curves. Instead of having one curve like a round ball, the surface is egg-shaped. This causes blurred vision at all distances.

Astigmatism is often present at birth and may occur in combination with nearsightedness or farsightedness. Often it's not pronounced enough to require corrective action. When it is, treatment options are corrective lenses or surgery.

Symptoms:

Signs and symptoms of astigmatism may include:
Blurred or distorted vision
Eyestrain or discomfort
Headaches
Difficulty with night vision
Squinting

When to see a doctor:

See an eye doctor if your eye symptoms detract from your enjoyment of activities or interfere with your ability to perform everyday tasks. An eye doctor can determine whether you have astigmatism and, if so, to what degree. He or she can then advise you of your options to correct your vision.
Children and adolescents
Children may not realize their vision is blurry, so they need to be screened for eye disease and have their vision tested by a pediatrician, an ophthalmologist, an optometrist or another trained screener at the following ages and intervals.
During the newborn period
At well-child visits until they reach school age
During school years, every 1 to 2 years at well-child visits, at the eye doctor, or through school or public screenings

Causes:

The eye has two structures with curved surfaces that bend (refract) light onto the retina, which makes the images:

The cornea, the clear front surface of the eye along with the tear film
The lens, a clear structure inside the eye that changes shape to help the eye focus on near objects
In a perfectly shaped eye, each of these elements has a round curvature, like the surface of a smooth ball. A cornea or lens with such curvature bends (refracts) all incoming light equally to make a sharply focused image directly on the retina at the back of the eye.
Simplified anatomy of the eye
Simplified anatomy of the eye
This simplified illustration of the eye shows the elements most involved in astigmatism: the cornea and the lens.

A refractive error;
If either the cornea or the lens is egg-shaped with two mismatched curves, light rays aren't bent the same, which means that two different images form. These two images overlap or combine and result in blurred vision. Astigmatism is a type of refractive error.

Astigmatism ;occurs when the cornea or lens is curved more steeply in one direction than in another. You have corneal astigmatism if your cornea has mismatched curves. You have lenticular astigmatism if your lens has mismatched curves.

Either type of astigmatism can cause blurred vision. Blurred vision may occur more in one direction: horizontally, vertically or diagonally.

Astigmatism; may be present from birth, or it may develop after an eye injury, disease or surgery. Astigmatism isn't caused or made worse by reading in poor light, sitting too close to the television or squinting.
Astigmatism
Astigmatism
Astigmatism is a type of refractive error caused when either the cornea or the lens has mismatched curves. This makes vision blurry because there are two image points.
Other refractive errors

Astigmatism may occur in combination with other refractive errors, which include:
Nearsightedness (myopia). This occurs when the cornea is curved too much or the eye is longer than usual. Instead of being focused precisely on the retina, light is focused in front of the retina, making distant objects seem blurry.
Farsightedness (hyperopia). This occurs when the cornea is curved too little or the eye is shorter than usual. The effect is the opposite of nearsightedness. When the eye is in a relaxed state, light never comes to a focus at the back of the eye, making nearby objects seem blurry.

06/10/2023

Overview:

Bell's palsy is a condition that causes sudden weakness in the muscles on one side of the face. In most cases, the weakness is temporary and significantly improves over weeks. The weakness makes half of the face appear to droop. Smiles are one-sided, and the eye on the affected side resists closing.

Bell's palsy is also known as acute peripheral facial palsy of unknown cause. It can occur at any age. The exact cause is unknown. Experts think it's caused by swelling and inflammation of the nerve that controls the muscles on one side of the face. It could be caused by a reaction that occurs after a viral infection.

Symptoms usually start to improve within a few weeks, with complete recovery in about six months. A small number of people continue to have some Bell's palsy symptoms for life. Rarely, Bell's palsy occurs more than once.

Symptoms:

Facial weakness
Facial paralysis
Enlarge image
Signs and symptoms of Bell's palsy come on suddenly and may include:

Rapid onset of mild weakness to total paralysis on one side of your face — occurring within hours to days
Facial droop and difficulty making facial expressions, such as closing your eye or smiling
Drooling
Pain around the jaw or in or behind your ear on the affected side
Increased sensitivity to sound on the affected side
Headache
A loss of taste
Changes in the amount of tears and saliva you produce
In rare cases, Bell's palsy can affect the nerves on both sides of your face.

When to see a doctor:

Seek medical help right away if you experience any type of paralysis because you may be having a stroke. Bell's palsy is not caused by a stroke, but it can cause similar symptoms.

If you have facial weakness or drooping, see your health care provider if you have facial weakness or drooping to find out the underlying cause and severity of the illness.

Causes:

Although the exact reason Bell's palsy occurs isn't clear, it's often related to having a viral infection. Viruses that have been linked to Bell's palsy include viruses that cause:

Cold sores and ge***al herpes (herpes simplex)
Chickenpox and shingles (herpes zoster)
Infectious mononucleosis (Epstein-Barr)
Cytomegalovirus infections
Respiratory illnesses (adenovirus)
German measles (rubella)
Mumps (mumps virus)
Flu (influenza)
Hand-foot-and-mouth disease (coxsackievirus)
The nerve that controls facial muscles passes through a narrow corridor of bone on its way to the face. In Bell's palsy, that nerve becomes inflamed and swollen — usually related to a viral infection. Besides facial muscles, the nerve affects tears, saliva, taste and a small bone in the middle of the ear.

Risk factors:

Bell's palsy occurs more often in people who:

Are pregnant, especially during the third trimester, or who are in the first week after giving birth
Have an upper respiratory infection, such as the flu or a cold
Have diabetes
Have high blood pressure
Have obesity
Recurrent attacks of Bell's palsy are rare. But when they do recur, there's often a family history of recurrent attacks. This suggests that Bell's palsy might have something to do with your genes.

Complications:

A mild case of Bell's palsy typically disappears within a month. Recovery from a more severe case where the face was completely paralyzed can vary. Complications may include:

Irreversible damage to your facial nerve.
Irregular regrowth of nerve fibers. This may result in involuntary contraction of certain muscles when you're trying to move other muscles (synkinesis). For example, when you smile, the eye on the affected side may close.
Partial or complete blindness of the eye that won't close. This is caused by excessive dryness and scratching of the clear protective covering of the eye (cornea).

05/10/2023

Ataxia:

Ataxia is a degenerative disease of the nervous system. Many symptoms of Ataxia mimic those of being drunk, such as slurred speech, stumbling, falling, and incoordination. These symptoms are caused by damage to the cerebellum, the part of the brain that is responsible for coordinating movement. Ataxia treatment involves a combination of medication to treat symptoms and therapy to improve quality of life.

People affected by Ataxia may experience problems with using their fingers and hands, arms, legs, walking, speaking or moving their eyes. Ataxia affects people of all ages. Age of symptom-onset can vary widely, from childhood to late-adulthood. Complications from the disease are serious and oftentimes debilitating. Some types of Ataxia can lead to an early death.

Symptoms:

Ataxia symptoms vary by person and type of Ataxia. Rate of progression varies as well. Symptoms may worsen slowly, over decades – or quickly, over mere months. Common symptoms of Ataxia are:

Lack of coordination
Slurred speech
Trouble eating and swallowing
Deterioration of fine motor skills
Difficulty walking
Gait abnormalities
Eye movement abnormalities
Tremors
Heart problems
Individuals with Ataxia often require the use of wheelchairs, walkers, and/or scooters to aid in their mobility.

Lack of Coordination infographic
Printable Ataxia Fact Sheets
Between 15,000 – 20,000 people are estimated to have Spinocerebellar Ataxia (SCA) in the US.

Tens of thousands more are affected by recessive, sporadic, and as yet unknown forms of Ataxia.
Diagnosis
Ataxia is diagnosed using a combination of strategies that may include medical history, family history, and a complete neurological evaluation. Various blood tests may be performed to rule out other disorders. Genetic blood tests are available for many types of hereditary Ataxia.

Taking an active role and advocating for patient needs is important when seeking an Ataxia diagnosis. Begin with a discussion with a primary care physician. However, some physicians may not be familiar with Ataxia because it is a rare disease. If Ataxia is suspected, the primary care physician will likely make a referral to a neurologist. Neurologists will have the expertise needed to confirm a diagnosis and determine the type of Ataxia. NAF maintains a list of neurologists that are familiar with Ataxia. This list is a good starting place to look for neurologists that have experience working with Ataxia patients. Gather the following information before a neurologist appointment:

List of general health exams and current medications
Record of any medical test results, including MRI and CT scans of the brain
Reports of any genetic testing that has been done
Information about medical conditions that exist in the biological family (grandparents, parents, aunts, uncles, siblings, and cousins)
Information about when symptoms were first noticed, how they’ve changed, which activities are difficult because of symptoms, and what makes symptoms better or worse.

Receiving a diagnosis of Ataxia can be overwhelming. It might feel like there is nothing you can do – but there is! We have resources to get you started on your journey. Learn, join the network of support, and get involved in making a difference. Here are some things that you can do:

Treatment:

The goal of Ataxia treatment is to improve the quality of life and requires an individualized approach. It is important to work closely with a neurologist to develop a plan to address symptoms. Speech and language therapy, occupational therapy, and physical therapy are common treatment options. They are sometimes used in conjunction with medication therapy to manage symptoms. Many research efforts are currently underway to find more effective treatments for Ataxia.

04/10/2023

ALS

Overview:

Amyotrophic lateral sclerosis (a-my-o-TROE-fik LAT-ur-ul skluh-ROE-sis), known as ALS, is a nervous system disease that affects nerve cells in the brain and spinal cord. ALS causes loss of muscle control. The disease gets worse over time.

ALS is often called Lou Gehrig's disease after the baseball player who was diagnosed with it. The exact cause of the disease is still not known. A small number of cases are inherited.

ALS often begins with muscle twitching and weakness in an arm or leg, trouble swallowing or slurred speech. Eventually ALS affects control of the muscles needed to move, speak, eat and breathe. There is no cure for this fatal disease.

Symptoms:

Symptoms of ALS vary from person to person. Symptoms depend on which nerve cells are affected. ALS generally begins with muscle weakness that spreads and gets worse over time. Symptoms might include:

Trouble walking or doing usual daily activities.
Tripping and falling.
Weakness in the legs, feet or ankles.
Hand weakness or clumsiness.
Slurred speech or trouble swallowing.
Weakness associated with muscle cramps and twitching in the arms, shoulders and tongue.
Untimely crying, laughing or yawning.
Thinking or behavioral changes.
ALS often starts in the hands, feet, arms or legs. Then it spreads to other parts of the body. Muscles get weaker as more nerve cells die. This eventually affects chewing, swallowing, speaking and breathing.

There's generally no pain in the early stages of ALS. Pain also is not common in the later stages. ALS doesn't usually affect bladder control. It also usually doesn't affect the senses, including the ability to taste, smell, touch and hear.

Causes:

ALS affects the nerve cells that control voluntary muscle movements such as walking and talking. These nerve cells are called motor neurons. There are two groups of motor neurons. The first group extends from the brain to the spinal cord to muscles throughout the body. They're referred to as upper motor neurons. The second group extends from the spinal cord to muscles throughout the body. They're referred to as lower motor neurons.

ALS causes both groups of motor neurons to gradually deteriorate and then die. When motor neurons are damaged, they stop sending messages to the muscles. As a result, the muscles can't function.

For about 10% of people with ALS, a genetic cause can be identified. For the rest, the cause is not known.

Researchers continue to study possible causes of ALS. Most theories center on a complex interaction between genes and factors in the environment.

Risk factors:
Established risk factors for ALS include:

Genetics.
For about 10% of people with ALS, a risk gene was passed down from a family member. This is called hereditary ALS. In most people with hereditary ALS, their children have a 50% chance of inheriting the gene.

Age.
Risk increases with age up to age 75. ALS is most common between the ages of 60 and the mid-80s.
S*x. Before the age of 65, slightly more men than women develop ALS. This s*x difference disappears after age 70.
Environmental factors, such as the following, have been associated with an increased risk of ALS.

Smoking.
Evidence supports that smoking is an environmental risk factor for ALS. Women who smoke seem to be at even higher risk, particularly after menopause.
Environmental toxin exposure. Some evidence suggests that exposure to lead or other substances in the workplace or at home might be linked to ALS. Much study has been done, but no one agent or chemical has been consistently associated with ALS.
Military service. Studies indicate that people who have served in the military are at higher risk of ALS. It's not clear what about military service might trigger

ALS.
It might include exposure to certain metals or chemicals, traumatic injuries, viral infections, or intense exertion.
Complications
As the disease progresses, ALS causes complications, such as:

Breathing problems:
Over time, ALS leads to weakness of the muscles used to breathe. People with ALS might need a device such as a mask ventilator to help them breathe at night. The device is similar to what someone with sleep apnea might wear. This type of device supports the person's breathing through a mask worn over the nose, the mouth or both.

Some people with advanced ALS choose to have a tracheostomy. This is a surgically created hole at the front of the neck leading to the windpipe. A ventilator may work better on a tracheostomy than on a mask.

The most common cause of death for people with ALS is breathing failure. Half of people with ALS die within 14 to 18 months of diagnosis. However, some people with ALS live 10 years or longer.

Speaking problems:
Most people with ALS develop weakness of the muscles used to form speech. This usually starts with slower speech and occasional slurring of words. It then becomes harder to speak clearly. This can progress to the point that others can't understand the person's speech. Other forms of communication and technology are used to communicate.

Eating problems:
People with ALS can develop weakness of the muscles involved with swallowing. This can lead to malnutrition and dehydration. They are also at higher risk of getting food, liquids or saliva into the lungs, which can cause pneumonia. A feeding tube can reduce these risks and ensure proper hydration and nutrition.

Dementia:
Some people with ALS have problems with language and decision-making. Some are eventually diagnosed with a form of dementia called frontotemporal dementia.

Treatment:

Exercise, in moderation, may help maintain muscle strength and function. There is no cure and no proven treatment for ALS But some Medications.

24/09/2023

What is an eye infection?

An eye infection is a disease of the eye that you get because of a microorganism like a bacterium, a virus or a fungus. The most common eye infection is pink eye (conjunctivitis).

Viruses cause most cases of pink eye, but bacteria can cause pink eye, too. You can’t treat viral infections with antibiotics. Antibiotics only work on bacterial infections.

Eye infections can happen in one eye or both eyes. Some infections aren’t serious. Others are medical emergencies that can cause vision loss. Eye infections can affect nearly any part of your eye.

You can have an infection on your eyelid, your conjunctiva or cornea, or the external parts of your eye.

How common are eye infections?

Eye infections are common. About 1 million people in the U.S. go to their healthcare providers or to hospitals with eye infections each year. Many of these infections happen to people who wear contact lenses.

What are some common eye infections?

Blepharitis.
Cellulitis.
Dacryocystitis (an infection of your tear sac that can happen when your tear ducts become blocked and can’t drain properly).
Pink eye.
Endophthalmitis.
Stye.
Uveitis.

Symptoms and Causes

What are the signs and symptoms of an eye infection?

An infected eye may look or feel different than usual. Early signs and symptoms of an eye infection may include:

Red eyes.
Itching or irritation.
Eye pain.
Watery eyes.
Swelling.
Later signs and symptoms of eye infections may include:

Discharge (yellow, sticky pus) from your eyes.
Eyelashes that stick together because of discharge.
Sensitivity to light (photophobia).
Blurred vision.
Fever.
What causes an eye infection?

You can get eye infections from bacteria, fungi (plural of fungus), parasites and viruses. These small organisms can enter your eyes in many different ways, including eye injuries.

One of the most common ways to get an eye infection is to sleep in your contact lenses. It’s also common to get an eye infection if you don’t properly clean your lenses.

What bacteria commonly cause eye infections?

Both gram-negative and gram-positive bacteria can cause eye infections. Gram-negative bacteria are bacteria that providers can’t see during a Gram stain test, though they’re detectable in a bacterial culture test. Gram-positive bacteria are visible in a Gram stain test. Some of the more common bacterial causes of infections in your eyes include:

Bacillus.
Enterobacteriaceae.
Haemophilus influenza.
Moraxella spp.
Neisseria gonorrhoeae.
Pseudomonas aeruginosa (P. aeruginosa).
Staphylococcus aureus (S. aureus).
Streptococcus pneumoniae (S. pneumoniae).
What viruses commonly cause eye infections?

Herpes simplex type 1.
Varicella zoster virus.
Adenovirus.
What types of fungi cause eye infections?

Fungi belonging to the Candida species cause about 66% of endophthalmitis cases that happen after corneal transplant surgery. You might also get a fungal infection after cataract surgery.

You can get an eye infection if you have an eye injury because of an item from the outdoors, such as a stick or a plant, contaminated with Fusarium. You can also get an eye infection that happens because of a fungal bloodstream infection.

Management and Treatment

How is an eye infection treated?

Treatment for eye infections depends on what’s causing your eye infection. It might include anti-infective medication in various forms, such as eye drops, ointments or tablets. It usually takes 24 to 48 hours for antibacterial medications to work.

You may have to let viral or allergic infections clear on their own, but you may be able to make yourself more comfortable with the following home remedies:

Using damp, warm or cool compresses to make your eyes feel better.
Using lubricating eye drops (artificial tears).
Using over-the-counter (OTC) pain relievers.
Avoiding allergens that caused the reaction in the first place.

Prevention

How can I prevent eye infections?

You may not be able to prevent every eye infection, but you can take steps to reduce your risk. These may include:

Making sure you follow directions on how to use your contact lenses, how to clean them and how long to wear them.
Wearing protective eye gear when you work or participate in sports.
Avoiding allergens that bother your eyes and taking allergy medicine to prevent irritation.
Avoiding people who may be ill.
Practicing good hand hygiene.
Not sharing items, like towels or eye makeup, that touch your eye.
Throwing out cosmetics if you develop an eye infection so you won’t get re-infected.

12/09/2023

What Is Depression?

Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Fortunately, it is also treatable. Depression causes feelings of sadness and/or a loss of interest in activities you once enjoyed. It can lead to a variety of emotional and physical problems and can decrease your ability to function at work and at home.

Feeling sad or having a depressed mood
Loss of interest or pleasure in activities once enjoyed
Changes in appetite — weight loss or gain unrelated to dieting
Trouble sleeping or sleeping too much
Loss of energy or increased fatigue
Increase in purposeless physical activity (e.g., inability to sit still, pacing, handwringing) or slowed movements or speech (these actions must be severe enough to be observable by others)
Feeling worthless or guilty
Difficulty thinking, concentrating or making decisions
Thoughts of death or su***de
Symptoms must last at least two weeks and must represent a change in your previous level of functioning for a diagnosis of depression.

Also, medical conditions (e.g., thyroid problems, a brain tumor or vitamin deficiency) can mimic symptoms of depression so it is important to rule out general medical causes.

Depression affects an estimated one in 15 adults (6.7%) in any given year. And one in six people (16.6%) will experience depression at some time in their life. Depression can occur at any time, but on average, first appears during the late teens to mid-20s. Women are more likely than men to experience depression. Some studies show that one-third of women will experience a major depressive episode in their lifetime. There is a high degree of heritability (approximately 40%) when first-degree relatives (parents/children/siblings) have depression.

Depression Is Different From Sadness or Grief/Bereavement

The death of a loved one, loss of a job or the ending of a relationship are difficult experiences for a person to endure. It is normal for feelings of sadness or grief to develop in response to such situations. Those experiencing loss often might describe themselves as being “depressed.”

But being sad is not the same as having depression. The grieving process is natural and unique to each individual and shares some of the same features of depression. Both grief and depression may involve intense sadness and withdrawal from usual activities. They are also different in important ways:

In grief, painful feelings come in waves, often intermixed with positive memories of the deceased. In major depression, mood and/or interest (pleasure) are decreased for most of two weeks.
In grief, self-esteem is usually maintained. In major depression, feelings of worthlessness and self-loathing are common.
In grief, thoughts of death may surface when thinking of or fantasizing about “joining” the deceased loved one. In major depression, thoughts are focused on ending one’s life due to feeling worthless or undeserving of living or being unable to cope with the pain of depression.
Grief and depression can co-exist For some people, the death of a loved one, losing a job or being a victim of a physical assault or a major disaster can lead to depression. When grief and depression co-occur, the grief is more severe and lasts longer than grief without depression.

Distinguishing between grief and depression is important and can assist people in getting the help, support or treatment they need.

Risk Factors for Depression

Depression can affect anyone—even a person who appears to live in relatively ideal circumstances.

Several factors can play a role in depression:

Biochemistry: Differences in certain chemicals in the brain may contribute to symptoms of depression.
Genetics: Depression can run in families. For example, if one identical twin has depression, the other has a 70 percent chance of having the illness sometime in life.
Personality: People with low self-esteem, who are easily overwhelmed by stress, or who are generally pessimistic appear to be more likely to experience depression.
Environmental factors: Continuous exposure to violence, neglect, abuse or poverty may make some people more vulnerable to depression.
How Is Depression Treated?

Depression is among the most treatable of mental disorders. Between 80% and 90% percent of people with depression eventually respond well to treatment. Almost all patients gain some relief from their symptoms.

Before a diagnosis or treatment, a health professional should conduct a thorough diagnostic evaluation, including an interview and a physical examination. In some cases, a blood test might be done to make sure the depression is not due to a medical condition like a thyroid problem or a vitamin deficiency (reversing the medical cause would alleviate the depression-like symptoms). The evaluation will identify specific symptoms and explore medical and family histories as well as cultural and environmental factors with the goal of arriving at a diagnosis and planning a course of action.

Medication

Brain chemistry may contribute to an individual’s depression and may factor into their treatment. For this reason, antidepressants might be prescribed to help modify one’s brain chemistry. These medications are not sedatives, “uppers” or tranquilizers. They are not habit-forming. Generally antidepressant medications have no stimulating effect on people not experiencing depression.

Antidepressants may produce some improvement within the first week or two of use yet full benefits may not be seen for two to three months. If a patient feels little or no improvement after several weeks, his or her psychiatrist can alter the dose of the medication or add or substitute another antidepressant. In some situations other psychotropic medications may be helpful. It is important to let your doctor know if a medication does not work or if you experience side effects.

Psychiatrists usually recommend that patients continue to take medication for six or more months after the symptoms have improved. Longer-term maintenance treatment may be suggested to decrease the risk of future episodes for certain people at high risk.

Psychotherapy

Psychotherapy, or “talk therapy,” is sometimes used alone for treatment of mild depression; for moderate to severe depression, psychotherapy is often used along with antidepressant medications. Cognitive behavioral therapy (CBT) has been found to be effective in treating depression. CBT is a form of therapy focused on the problem solving in the present. CBT helps a person to recognize distorted/negative thinking with the goal of changing thoughts and behaviors to respond to challenges in a more positive manner.

Psychotherapy may involve only the individual, but it can include others. For example, family or couples therapy can help address issues within these close relationships. Group therapy brings people with similar illnesses together in a supportive environment, and can assist the participant to learn how others cope in similar situations.

Depending on the severity of the depression, treatment can take a few weeks or much longer. In many cases, significant improvement can be made in 10 to 15 sessions.

Electroconvulsive Therapy (ECT)

ECT is a medical treatment that has been most commonly reserved for patients with severe major depression who have not responded to other treatments. It involves a brief electrical stimulation of the brain while the patient is under anesthesia. A patient typically receives ECT two to three times a week for a total of six to 12 treatments. It is usually managed by a team of trained medical professionals including a psychiatrist, an anesthesiologist and a nurse or physician assistant. ECT has been used since the 1940s, and many years of research have led to major improvements and the recognition of its effectiveness as a mainstream rather than a "last resort" treatment.

Self-help and Coping

There are a number of things people can do to help reduce the symptoms of depression. For many people, regular exercise helps create positive feeling and improves mood. Getting enough quality sleep on a regular basis, eating a healthy diet and avoiding alcohol (a depressant) can also help reduce symptoms of depression.

Depression is a real illness and help is available. With proper diagnosis and treatment, the vast majority of people with depression will overcome it. If you are experiencing symptoms of depression, a first step is to see your family physician or psychiatrist. Talk about your concerns and request a thorough evaluation. This is a start to addressing your mental health needs.

Related Conditions

Peripartum depression (previously postpartum depression)
Seasonal depression (Also called seasonal affective disorder)
Bipolar disorders
Persistent depressive disorder (previously dysthymia) (description below)
Premenstrual dysphoric disorder (description below)
Disruptive mood dysregulation disorder (description below)
Premenstrual Dysphoric Disorder (PMDD)

PMDD was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013. A woman with PMDD has severe symptoms of depression, irritability, and tension about a week before menstruation begins.

Common symptoms include mood swings, irritability or anger, depressed mood, and marked anxiety or tension. Other symptoms may include decreased interest in usual activities, difficulty concentrating, lack of energy or easy fatigue, changes in appetite with specific food cravings, trouble sleeping or sleeping too much, or a sense of being overwhelmed or out of control. Physical symptoms may include breast tenderness or swelling, joint or muscle pain, a sensation of “bloating,” or weight gain.

These symptoms begin a week to 10 days before the start of menstruation and improve or stop around the onset of me**es. The symptoms lead to significant distress and problems with regular functioning or social interactions.

For a diagnosis of PMDD, symptoms must have occurred in most of the menstrual cycles during the past year and must have an adverse effect on work or social functioning. Premenstrual dysphoric disorder is estimated to affect between 1.8% to 5.8% of menstruating women every year.

PMDD can be treated with antidepressants, birth control pills, or nutritional supplements. Diet and lifestyle changes, such as reducing caffeine and alcohol, getting enough sleep and exercise, and practicing relaxations techniques, can help.

Premenstrual syndrome (PMS) is similar to PMDD in that symptoms occur seven to 10 days before a woman’s period begins. However, PMS involves fewer and less severe symptoms than PMDD.

Disruptive Mood Dysregulation Disorder

Disruptive mood dysregulation disorder is a condition that occurs in children and youth ages 6 to 18. It involves a chronic and severe irritability resulting in severe and frequent temper outbursts. The temper outbursts can be verbal or can involve behavior such as physical aggression toward people or property. These outbursts are significantly out of proportion to the situation and are not consistent with the child’s developmental age. They must occur frequently (three or more times per week on average) and typically in response to frustration. In between the outbursts, the child’s mood is persistently irritable or angry most of the day, nearly every day. This mood is noticeable by others, such as parents, teachers, and peers.

In order for a diagnosis of disruptive mood dysregulation disorder to be made, symptoms must be present for at least one year in at least two settings (such as at home, at school, with peers) and the condition must begin before age 10. Disruptive mood dysregulation disorder is much more common in males than females. It may occur along with other disorders, including major depressive, attention-deficit/hyperactivity, anxiety, and conduct disorders.

Disruptive mood dysregulation disorder can have a significant impact on the child’s ability to function and a significant impact on the family. Chronic, severe irritability and temper outbursts can disrupt family life, make it difficult for the child/youth to make or keep friendships, and cause difficulties at school.

Treatment typically involves psychotherapy (cognitive behavior therapy) and/or medications.

Persistent Depressive Disorder

A person with persistent depressive disorder (previously referred to as dysthymic disorder) has a depressed mood for most of the day, for more days than not, for at least two years. In children and adolescents, the mood can be irritable or depressed, and must continue for at least one year.

In addition to depressed mood, symptoms include:

Poor appetite or overeating
Insomnia or hypersomnia
Low energy or fatigue
Low self-esteem
Poor concentration or difficulty making decisions
Feelings of hopelessness
Persistent depressive disorder often begins in childhood, adolescence, or early adulthood and affects an estimated 0.5% of adults in the United States every year. Individuals with persistent depressive disorder often describe their mood as sad or “down in the dumps.” Because these symptoms have become a part of the individual’s day-to-day experience, they may not seek help, just assuming that “I’ve always been this way.”

The symptoms cause significant distress or difficulty in work, social activities, or other important areas of functioning. While the impact of persistent depressive disorder on work, relationships and daily life can vary widely, its effects can be as great as or greater than those of major depressive disorder.

A major depressive episode may precede the onset of persistent depressive disorder but may also arise during (and be superimposed on) a previous diagnosis of persistent depressive disorder.

Medix Biggner

09/10/2023

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