Hoarding Disorder, 4

“Your comments on hoarding disorder as a mental illness are spot on. My parents don’t even want to talk to us for fear we will try to get them to clean up the environment and make them get rid of something as useless as an empty Kleenex box!”

Personally, I recommend that family members do not attempt to manage this issue, as the likelihood of fractured relationships is high. They are often embarrassed, sometimes malnourished, and extremely indecisive. Hoarders may come to the attention of authorities because of healthy and safety concerns related to their living conditions. I suggest that social service be asked to make a site visit, a psychiatrist evaluates them for a potential diagnosis of hoarding, and a competent  counselor or case worker help the elderly individuals to work through this problem. As family members, you can be cheerful, and loving and verbally reward them about how spacious things now look and how you enjoy visiting with them.

 Diagnostic criteria include:

1 – a persistent difficulty discarding or parting with possessions, regardless of their actual value

2 - the difficulty is because of a personal perceived need to save the items and the associated distress when trying to discard them

3 – this results in more items that clutter living areas and are stacked on every available space. This interferes with their intended use and a healthy living environment unless third parties intervene.

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Hoarding Disorder, 3

Estimates for the United States are that 2-6% of the general population have a hoarding disorder. Around 200,000 cases are diagnosed per year. Risk factors include blood relatives with the disorder; Adverse Childhood Experiences or ACE’s; personal vulnerability due to avoidant personality traits’ deficits in processing attention and memory information; Maladaptive cognitive content related to the meaning of possessions and one’s emotional attachment to their possessions; tendencies toward perfectionism, indecisiveness, procrastination, difficulties in planning and making decisions, and emotional reinforcement associated with pleasure in acquisition and saving and anxiety or discomfort in discarding or giving away.

Hoarding Disorder, 2

Hoarders are uncomfortable inviting guests over to the chaos—even beloved family members. Some may have good insight and realize that their hoarding is a serious problem or have poor insight and not recognize their behavior as unhealthy. Estimates are that eighty percent of hoarders shop excessively, buying unnecessary items or duplicates of what they already own but can no longer locate. Some also hoard animals that they cannot care for. Hoarders may come to the attention of authorities because of healthy and safety concerns related to their living conditions. Although hoarding is more commonly seen in older adults (55-94 years), the mental illness appears to begin at ages 11-15 years, starting to cause significant impairment when the individuals are in their 30’s. In addition to the hoarding issue, man also have depression (57%), social phobia (29%), generalized anxiety disorder (28%), and attention deficit disorder (28%).

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Humorous takes on the English Language

1.     Why is the man who invests all your money called a broker?

 2.     When cheese gets its picture taken, what does it say?

 3.     Why is a person who plays the piano called a pianist but a person who drives a racing car not called a racist?

 4.      Why are a wise man and a wise guy opposites?

 5.     Why do overlook and oversee mean opposite things?

 

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Hoarding Disorder

“My husband and I just moved back to the State after living abroad for over 20 years and with limited availability for return visits. We can hardly get find a place to walk in my parent’s home much less a place to sit. What is going on here?”

 Hoarding disorder is a mental illness that falls in the obsessive-compulsive disorders spectrum. It is characterized by difficulty in parting with or discarding possessions and more commonly seen in individuals who excessively save items and in whom the idea of discarding any item causes extreme mental stress. Hoarders cannot bear to be separated from any of their belongings, which results in excessive clutter to an extent that impairs every-day functioning and may create health and safety risks. They tend to live in situations with rooms that are stacked full of items, hallways may be difficult to pass through due to the amount of clutter. Sinks, tables, and chairs may be unusable. Hoarders may come to the attention of authorities because of health and safety concerns related to their living conditions. 

Gender Dysphoria, 3

 

Interestingly, gender dysphoria is seen in children during childhood, though many children do not end up with gender dysphoria in adulthood. Sometimes, for example, a very bright and forward-thinking girl will believe that if she were only a boy, there would be more opportunities for her—a rather sad commentary on societal expectations and equality. It is important to recognize that not all transgender or gender diverse people experience dysphoria. My observations are that if a little boy wants to dress in female-style clothing and a little girl wants to dress in male-style clothing, wise parents make very little comment and let them be. Studies show that typically the majority of such children—once they reach adulthood—decide they are happy with who they are. My opinion is that deciding to undergo the extensive gender reassignment surgery and a lifetime of hormone therapy more properly belongs to brains in their late twenties, when the brain is more mature. It is a decision not to be undertaken lightly.

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Gender Dysphoria, 2

The initial condition for the identification of Gender Dysphoria in both adults and teenagers is a noticeable incongruence between the gender the individuals believe themselves to be, and who society perceives them to be. The specific cause of Gender Dysphoria is unknown. As with other conditions, it likely is a spectrum or continuum. Genes, hormones during gestation, social factors, and environmental factors (e.g., parenting) all may be contributors. Individuals who are born with ambiguous genitalia, which can raise questions about their gender, may develop Gender Dysphoria—especially if the arbitrary assignment of gender at birth does not match brain and biology. Interestingly, Gender Dysphoria is not identical to nor synonymous with homosexuality. Each individual goes through a unique change. Some may want a short-term change and be content with cross-dressing. Others may desire a complete change and seek gender assignment surgery. 

Gender Dysphoria

Back to the original question of a few days ago. The term Gender Dysphoria is relatively new terminology. It also is referred to as Gender Identity Disorder, Gender Incongruence, or Transgenderism. It describes a condition where a person believes there is a mismatch between their assigned gender and who they believe they really are.  is characterized by discomfort or distress due to a mismatch between the person’s biological sex assigned at birth and the person’s own perception of their appropriate gender. Meaning that what their brain tells them about who they are innately, does not match the gender assigned to them at birth. Gender Dysphoria has no known physical symptoms. Individuals with this condition, however, may experience and display a range of characteristic feelings and behaviors.

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Lexophilia, Take 2

 

1.     An acupuncture is a jab well done.

2.     A lot of money is tainted: ‘Taint yours, and ‘taint mine.

3.     You can tune a piano, but you can't tuna fish

4.     When Ma saw her first strands of gray hair, she thought she’d dye.

5.     Velcro is a rip off.

6.     Class trip to the Coca-Cola factory—I hope there’s no pop quiz.

7.     The turtle won a race with a rabbit by a hair.

8.     PMS jokes are not funny, period.

9.     My doctor said I need glasses, but for the life of me I don't see why.

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BDD Prevalence

Estimates for the United States are that Body Dysmorphic Disorder occurs at a rate of 2.5 percent in males and 2.2 percent in females—interesting that it is slightly higher in males. More than three million cases are diagnosed annually Unfortunately, they tend to seek surgical opportunities rather than balanced mental health counseling for this mental illness. There are risk factors including blood relatives with body dysmorphic disorder or obsessive-compulsive disorder; adverse childhood experiences of ACE’s; perfectionism, societal pressure related to expectations of beauty; having another mental health condition such as an anxiety or depressive disorder; abnormal brain structure or function, sexual trauma, or serotonin insufficiency or imbalance. Michael Jackson is said to have suffered from BDD.

BDD & Comorbid Conditions

Substance use disorders are often comorbid (co-occurring) with body dysmorphic disorders. Alcohol and many othr drugs may be used to help the individual reduce feelings of anxiety, especially in social situations. The underlying cause of this disorder is elusive. The prognoses is linked with the degree of insight the person has in relation to disliking something about their appearance that others sometimes cannot even see. being used to reduce anxiety in social situations. If you want more information, you can look it up in the DSM-5.

 

Expensive & Repetitive Procedures

Individuals with body dysmorphic disorder may undergo many unneeded cosmetic surgeries, dental procedures, or dermatological procedures to correct what they perceived is a flaw. No one can seem to help them understand that most people have something they don't particularly like about themselves—and unless it is really disfiguring, it’s best to avoid repeated surgeries. When they do request surgical procedures, typically and unfortunately, they are often dissatisfied with the results, Of course, because BDD is an internal perception problem. In fact, the scaring from the surgeries can often leave them looking much worse (in the opinion of others) than the flaw was to begin with. Some have traveled around the world and nearly bankrupted themselves for a perceived flaw that most other people do not even notice. 

Body Dysmorphic Disorder

"Can you please explain Dysmorphic to me? I think children of 7-12 are way too young to decide their brains do not match their body.”

I can give you some information. However, I wonder if you are really asking about Body Dysmorphic Disorder or about Gender Dysphoria? These are two very different conditions. I’ll briefly describe each one and you decide which you were really asking about. Body Dysmorphic Disorder (BDD) is a mental illness characterized by a specific focus on a perceived flaw in one's appearance. BBD typically shows about ages 12-13 with an average onset of 16-17. The individuals experience distress due to a perceived physical anomaly, such as a scar, the shape or size of a body part, a birthmark, a prominent mole, or freckle, scoliosis syndrome or some other personal feature. They tend to frequently examine themselves in the mirror, comparing their appearance to that of others, often avoiding social events and photographs or going to great lengths to wear clothing that covers the perceived blemish or flaw.

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Glymphatic System & Sleep Position

“I always sleep on my back or stomach because I don’t want to wrinkle my face.”

The general consensus seems to be that if you sleep on you back you may reduce facial wrinkles. “Hopkins Medicine” suggests that sleep position may need to be adjusted for what is better for your health. For example, it has been known for a long time that pregnant women in the third trimester maximize circulation for both mother and fetus by sleeping on their left side. For people with GERD problems, sleeping on their left side may lower the risk of symptoms. Studies suggest that in terms of the glymphatic system draining waste products from the brain, sleeping on your right side may be a good option. It may also help protect people with heart failure from further health damage. For me, I’d take the wrinkles rather than risk Alzheimer’s because my beta-amyloid waste was not being efficiently discarded.

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Sleep & Waste Products

Research is showing a molecular connection between the sleep-wake cycle and the brain’s cleaning system. Meaning, the glymphatic system appears to be able to remove and discard beta-amyloid from brain tissue—when the brain gets sufficient sleep. Cut sleep short, and the glymphatic system may have insufficient time to discard this waste product. How does the waste leave the brain? Several research projects discovered that Dural venous sinuses (venous channels that receive blood from the cerebral veins) and meningeal arteries are lined with conventional lymphatic vessels (part of the immune system). Apparently, the lymphatic vessels act as a conduit to the glymphatic system. 

More Glymphatic Chores

It sometimes amazes me that even with all the brain research in the past couple of decades, scientists are still finding out new things , amazing things, about the human brain. In addition to eliminating waste products in the brain, the glymphatic system also facilitates brain-wide distribution of several compounds, including glucose, lipids, amino acids, growth factors, and neuromodulators. Interestingly, researchers discovered that the glymphatic system functions mainly during sleep. In effect, it seems to go “off line” and is largely disengaged during wakefulness. The biological need for sleep across all species may therefore reflect that the brain must enter a state of activity that enables elimination of potentially neurotoxic waste products, including beta-amyloid. It’s been known for years that parts of the brain are much busier during sleep than when the brain is awake. 

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Glymphatic System & Beta-Amyloid

Dr. Nedergaard and her colleagues, discovered that the glymphatic system can help remove the toxic protein known as beta-amyloid from brain tissue. Beta-amyloid is well known for accumulating in the brains of patients with Alzheimer's disease. Other research has shown that brain levels of beta-amyloid decrease during sleep. In their new study, the team tested the idea that sleep might affect beta-amyloid clearance by regulating the glymphatic system. Indeed, there appears to be a link between the amount of sleep the brain receives, and the effectiveness of the glymphatic system’s ability to clear beta-amyloid from brain tissue. The study was funded by NIH’s National Institute of Neurological Disorders and Stroke (NINDS).

 

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Glymphatic System

“What in the world is the glymphatic system?”

One of the most amazing and interesting findings of recent brain research findings, that's what. In 2013, a Danish Neuroscientist, Maiken Nedergaard, PhD, and her colleagues at the University of Rochester Medical Center, discovered a system that drains waste products from the brain. Cerebrospinal fluid, a clear liquid surrounding the brain and spinal cord, moves through the brain along a series of channels that surround blood vessels. The system is managed by the brain’s glial cells. Therefore, Dr. Nedergaard named it the glymphatic system because of the glial cells. (This was two years before Dr. Jonathan Kipnis and associates discovered that the brain had an immune system, with vessels running through the three meningeal coverings of the brain.) 

Enjoy Lexophilia

A lexophile is a person who is enamored of words, especially those set in a new framework. Have fun with these.

 1.     A calendar’s days are numbered.

2.     A boiled egg is very hard to beat.

3.     He had a photographic memory that was never developed.

4.     A plateau is a high form of flattery.

5.     Those who get too big for their britches will find themselves exposed in the end.

6.     When you’ve seen one shopping center you’ve seen a mall.

7.     If you jump off a Paris bridge, you are in Seine.

8.     Bakers trade bread recipes on a knead to know basis.

9.     Santa’s helpers are subordinate clauses.

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Excuses, Excuses

"Surely a nap is better than nothing!” many protest. I would reply “dream on,” except they would only be dreaming if they were sleeping. Research at the University of Michigan reported that while naps can help slightly, the effect is so minor as not to be meaningful. In college I did my share of short-sheeting my sleep in favor of studying, yes, but often just hanging out with friends. After a year of that, my immune system protested loudly. It took a couple of months to build it back up. I began studying the phenomenon of sleep and all the tasks that must be done during slow-wave sleep, and I made a decision. I enjoy living. Sleep deprivation is not an option. Period.

Avoid Shortening Your Lifespan

It appears that many have underestimated the critical importance of 6-8 hours of uninterrupted, slow-wave sleep. I can’t tell you the number of times I’ve heard a variation on this lament: “There is simply too much to do. I work 8-10 hours a day at work, then come home and make dinner.  I have to help the kids with their homework and make lunches for school the next day, and housework is never done. I cannot afford the time to get more than 4-5 hours of sleep per night—and sometimes less.” Previous research has suggested that losing one hour of sleep each night that your brain needs, will shorten your life. I would rather miss doing some tasks that are not essential in the big picture of life in favor of a long, and healthy lifespan. Sleep deprivation is deadly over time. I doubt I will ever wish that I had spent more time on household tasks!

 
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Myth of Napping

The results of a Michigan State University study on the benefits of napping in an attempt to compensate for sleep deprivation reported several clear findings. 

        1)     A lack of sufficient slow-wave sleep reduces cognitive ability

 2)     While naps can help slightly, the effect is so minor as not to be meaningful

 3)    Naps do not restore cognitive function if you are not getting 6-8 hours of uninterrupted, slow-wave sleep

If  you get 6-8 hours of slow-wave sleep at night  still feel better with a short 15-30 minute nap, that's one thing. Trying to compensate for sleep deprivation by napping, however, appears to be a dead-end street.

Naps Cannot Compensate

“I only sleep a few hours at night but like to take a 2-3 hour nap in the afternoon. My doctor says that is unhealthy. I don’t get it!”

 Michigan State University released study results that reported: “naps do not restore cognitive function if you are not getting 6-8 hours of uninterrupted slow-wave sleep.” Based on this information I would say your doctor knows what he or she is talking about, and if you want to live a long and healthy life, it would be prudent to pay attention. Reportedly, the study looked at two specifics: 1) Vigilant attention: an ability to consistently pay attention over time; 2) Place-keeping: an ability to follow a specific sequence of steps accurately without missing or repeating any.

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