Health Digest Daily » Mental Health

Disasters & Trauma & Your Mental Health

Sunny — Mon, 06 Aug 2007 23:45:03 +0000

Disasters and trauma are an unfortunate part of life. Every person is affected differently by a trauma, but none the less, disasters ultimately will have some sort of impact on just about everyone. Different factors determine how a disaster or trauma will affect one's mental health. Broaching the subject of "mental health" still carries a stigma for some, but there is nothing to be embarrassed about. Realizing what normal feelings and reactions may result from a trauma is the first step in determining if one needs professional help.

What exactly constitutes a "disaster" or a "trauma"? That truly depends on the person. However, the following is a list of such known occurrences:

–Various accidents
–Physical, emotional or sexual abuse
–Neglect
–War experience
–Alcoholism
–Illness, surgery or disability
–The death of a family member of friend
–A natural disaster

Obviously, this list is in no way conclusive, but meant as a help for someone experiencing intense emotions due to a traumatic experience.

After someone experiences a traumatic event or disaster, they may feel a whole host of emotions. Most will feel some level of anxiety, grief and/or anger. Other normal experiences after such events include shock, inability to focus, difficulty making decisions, loss of appetite of overeating, crying, headaches and difficulty sleeping. These responses are normal and some are to be expected. Over time, these negative emotions should lessen.

But for some, these emotions and disturbances don't lessen over time. The following list is a brief example of warning signs that you may need to contact your health provider and seek professional medical help to alleviate your distress.

These signs include:
–Continued nightmares and thoughts about the event
–Inability to stop thinking and ruminating about what happened
–Continual avoidance of thoughts, feelings or conversations that remind you of the event
–Inappropriate avoidance of places or people that remind you of the event
–Fearful of the future
–Difficulty falling asleep or staying asleep
–Easily startled or "jumpy"
–Overly concerned about safety
–Having intense feelings of guilt, worthless or hopeless
–Not enjoying activities you once enjoyed
–Any thoughts of death or suicide

When these feelings are so intense that they affect your daily ability to function, that also is a strong indicator that professional help is in order. Even if the trauma occurred years ago, you may have never fully overcome it. Professional health providers can help diagnose potential underlying problems or prescribe medication that can significantly improve your daily life.

It may even be the case that you have been diagnosed with anxiety, depression or even phobias without realizing that trauma is the cause. It has recently become accepted to look at traumas and disasters as serious causes of mental illness. If your current diagnosis and treatment are not delivering the results that you want, make an appointment with your health provider. Don't give up on your treatment. Life events occur and can cause great pain and significant emotional disturbances, but these events need not dictate your life. Give yourself time to heal, but do seek professional treatment if your symptoms are significantly disturbing your daily life.

Overview of Mental Health & Mental Illness

Sunny — Sat, 21 Jul 2007 21:00:06 +0000

Although a largely "invisible" condition not easily discernible at a glance for most, mental illness is, indeed, a disease every bit as real as cancer or diabetes and if it is severe and/or protracted enough, it requires medical intervention to be cured or managed.

There's an unfortunate stigma that if you suffer from a more "common" illness such as depression or anxiety disorder, especially, you should be ashamed of it and should hide it or should "buck up and just get over it already." Yet, just as you wouldn't think you should simply get over leukemia by yourself and absolutely need medical treatment for your best chances at recovery from it, so, too, do cases of more severe and protracted mental illness such as clinical depression, for example. Even so-called "mild" cases of mental illness, such as acute but temporary depression or a mild case anxiety, if protracted, can benefit from at least temporary intervention, such as a brief course of medication, to "get over the hump" and begin to feel better.

The National Mental Health Institute (NMHI) states (using 2004 US Census figures) that approximately 26.2% or 57.7 million people suffer from some kind of mental illness. About 6% have a serious mental illness. Mental illness is the leading cause of disability in the United States today for people from 18 to 44 years of age.

The World Health Organization (WHO), the World Bank and Harvard conducted the Global Burden of Disease study and found that mental illness and its sometimes-resultant suicide accounted for 15% of the burden of disease in developed countries such as the United States.

The NMHI conducted the National Comorbidity Survey – Replication (NCS-R) in 2005 and found that the most common disorders in a 12-month span were of some type of specific phobia, such as claustrophobia (fear of enclosed spaces) or arachnophobia (fear of spiders, the most common phobia) at 9%; social phobia, 7% and major depressive disorder, 7%. The most common disease categories were anxiety disorders, 18%; mood disorders, 10%; impulse control disorders (such as the "intermittent explosive disorder" sometimes seen as a component in road rage), 29% and substance abuse disorders, 4%. In terms of disorders that are seen as "chronic" and lasting the lifetime of a given individual are anxiety disorders, 29%; mood disorders, 21%; impulse control disorders, 25% and substance abuse disorders, 15%.

Although the above figures are focused on adults, children and adolescents, too, suffer from mental illness. Although it is normal for children to be moody and "depressed" to a certain extent, especially in the adolescent years as they deal with the myriad of pressures going on in their lives as well as hormonal, growth and other physical changes, children and adolescents do, indeed, suffer from serious mental illness requiring medical intervention and this has become a much-needed focus in the last two decades.

The Surgeon General's 1999 report on mental health states that figures for children are not as well documented as that for adults, but the estimate is that about 20% suffer from some form of mental illness with about 5-9% suffering from what is known as "severe emotional disturbance," or SED.

Daily Tips to Improve Your Mental Health

Sunny — Sat, 30 Jun 2007 16:30:26 +0000

"How are you feeling?" Many people will answer, "I'm fine." But inside they are really feeling confused, disappointed or frustrated.

Many of these feelings are due to holding on to outdated concepts from previous experiences that cause us to act in ways that do not validate our lives. Practicing the daily keyword activities listed below can help you enjoy the benefits of balanced mental health.

Sunday
Inspiration: Feed your creativity. Immerse yourself in gardening, painting, craftwork or drawing and enjoy the creativity you possess.

Result: Dedicating time to activities solely for their enjoyment reinforces your sense of worth and relieves stress.

Monday
Perception: Consciously listening to your thoughts. Visually challenge thoughts that are counterproductive by writing them on paper. Select your words carefully to clearly convey information. Speak kindly, but honestly with everyone.

Result: Honest communication begins with yourself. By bringing negative thoughts out of your mind and on to paper, you will able to release them.

Tuesday
Exhilaration: Experience the vitality of life. Give your body freedom of movement in dance, games like Twister or sports. Learn a new physical skill such as CPR or self defense. Organize a paint party with your friends.

Result: Group activities are one of the best ways to revitalize yourself and others. Eliminating movement restrictions on your body also helps resolve emotional and mental barriers.

Wednesday
Mediation: Take a neutral position. Volunteer and befriend a person who needs to be heard. Practice compassion and acceptance of the feelings of others. Detach from your perspective and simply focus on the facts of the situation without judgement.

Result: By releasing the need to be "right" and accepting things as they are, you send the signal of acceptance to your psyche, which helps you achieve better mental balance.

Thursday
Expansion: Enhancing the big picture. Take a project to the next level. Pass on your skills by teaching them to a young person. Help a friend move to a new home or study a new subject to improve your skills.

Result: Actively engaging in bringing about change shows us the positive side of transformation, strengthening our mental and emotional balance for when the unexpected occurs.

Friday
Enrichment: Counting your blessings. Write a list of everything you are grateful to have in your life. Extend assistance to an elderly person you know. Contribute books, music or other media to your local library or school.

Result: Sharing with others reinforces your own sense of security and trust in the unlimited abundance of life. This helps to alleviate anxiety and frustration.

Saturday

Determination: Perseverance and completion. Make the call and resolve an issue that is in limbo. Keep the promise you made to a friend months ago. Clean out the garage or the attic. Sit down with the person with whom you have a misunderstanding and clear the air.

Result: Living your personal truth is a cornerstone of good mental health and it takes courage. When you make a commitment and see it through to its conclusion, you demonstrate loyalty to your character.

Dealing With Growing Older

Sunny — Mon, 11 Jun 2007 19:30:07 +0000

To some people, growing old can be looked on negatively. However, this is most definitely an opinion and nowhere near fact. Millions of seniors live successful and extremely fulfilling lives. In the words of Henry Ford, "If you think you can do a thing or think you can't do a thing, you're right." Now to apply this to you…If you think you're old or you think you aren't, you're right.

Old is an extremely relative word in any context. Someone may say, "I feel old." Old compared to what? Are you comparing that to a newborn baby or Methuselah? In order to make any sense of the word, you must compare it to something else. Someone is only old compared to someone who hasn't been around as long. There is always someone older. This is not just true in age but in every area of life. If you look hard enough, there is always someone bigger or smarter or faster. If one compares his vertical leap to Michael Jordan, they'll probably be disappointed. This is referred to as the law of relativity. Use it to your advantage.

You do something better than anyone else alive. Focus on the things you do well and you'll be much happier. Anyone can get depressed if they compare things they aren't proud of to someone else.

Socialization is also a big part of being happy in the midst of any situation. Those that sit alone in their house tend to get depressed. There is an endless supply of friends just waiting to be made, but they probably won't walk in your front door. Get out there and get involved!

There are countless activities for you to try. One of the best you could be involved in is regular exercise. Not only will it keep you around longer, but it will increase your level of happiness. Join a water aerobics class. Go jogging with friends. Start a cycling group. There is no end to the amazing activities that you can be a part of.

Another source of conflict for many seniors is their constant worry about the past. They may ask themselves, "What could have been?" "What if I did this differently?" "What have I done with my life?" Don't worry! Let go of the past. What's done is done. If you are experiencing guilt in any area of your life, you must release it. Guilt is a crippling emotion that does you absolutely no good whatsoever. Let it go and move on.

You can move into a promising future. It's never too late to do what you want. Beethoven wrote some of his best work after he was deaf. Many great people have accomplished amazing feats in their senior years. You can too. The only thing that's holding you back from doing anything you want to do is your limiting beliefs. It's all in your perception. Young is only a state of mind. Decide what it is that you want to accomplish and go for it!

Children's Mental Health Issues

Sunny — Tue, 29 May 2007 00:45:07 +0000

In a world where most adults have trouble coping, it is very important to observe our children and watch for any signs that they are maybe having trouble coping. Children, just like adults, can have mental health disorders. According to studies, as many as one in five children have a mental health disorder and one in ten have a serious mental health problem.

There are generally three categories of mental disorders, emotional, behavioral and other.

Emotional disorders are also known as anxiety and mood disorders. This category includes, but not limited to disorders such as: depression, bipolar disorder, separation anxiety, anxiety disorder, post-traumatic stress and OCD (obsessive-compulsive disorder). Health experts have suggested that left untreated this category of disorder could result in suicide.

Behavior disorders are also referred to as disruptive disorders. This category includes, but is not limited to disorders such as: ADD (attention deficit Disorder)/ADHD (attention deficit hyperactivity disorder), conduct disorder, aggressive and/or defiant behavior, disruptive disorder and oppositional defiant disorder. Left untreated this category of disorders could lead to dropping out of school and involvement in criminal behavior.

Other disorders include, but not limited to: eating disorders and schizophrenia. These disorders should not be left untreated as death could result.

There are believed to be two major caused of children's metal health disorders, biology and environmental:

Biological causes included but are not limited to, genetics, damage to the central nervous system or chemical imbalances.

Environmental causes include but are not limited to, stress, exposure to violence, stress, losses through death or divorce or environmental toxins.

Because children typically have trouble describing their thoughts and feelings it is up to the adults around them to be aware of and troubling symptoms that included but are not limited to:

–A child is troubled by feelings like: sadness and hopelessness for no apparent reason, extremely angry most of the time, crying a lot, overreaction to minor issues, feelings of worthlessness or guilty, anxious or worried, unable to get over the loss or death of someone important, extremely fearful or having unexplained fear, obsessing about physical appearances, worried that his/her mind is being controlled or is out of control.

–A child experiences life changing circumstances resulting in: school performance declines, no longer interested in things they once loved, changes in eating or sleeping patterns, avoiding friends and family and wanting to be alone, daydreaming to much, feeling like life is too difficult to handle, hearing voices, having suicidal thoughts.

–A child experiences: poor concentration and is unable to make up his/her mind, unable to sit still, worried about being harmed, a need to wash or clean things repeatedly or perform certain routines over and over.

–A child's behavior cause problems such as: the abuse of alcohol or other drugs, eating and purging, laxative abuse, obsessively dieting or exercising, a blatant disregard for others or other people's property, setting fires, abusing animals.

There are a variety of treatment options for mental health disorders in children. They include individual, group and family therapy, medication and play therapy. Treatments are most beneficial when they are home, school and community based.

Overview of Depression

Sunny — Sat, 12 May 2007 13:45:05 +0000

People can be depressed for short periods of time in a natural manner due to a job loss, a death or a failed task of major importance, for instance. However, when a person's depression lasts a long time, serious clinical depression, known as an illness or disorder, can be an issue, affecting family, work…nearly everything in the sufferer's life.

Some of the basic symptoms of depression are:
-Overriding sadness
-Loss of energy
-Loss of hope and pleasure – in life, in others, in working towards your life's goals…in anything…
-Difficulty focusing and concentrating
-Frequent irrational emotional displays like crying
-Headaches and other types of body-aches and irregularities
-Lack of sleep or too much sleep
-Loss of appetite and weight suddenly
Types and Causes of Depression

Health sciences note different types and causes of depression. Some major types are:

- Bipolar disorder, also known as manic depression – this is largely due to a chemical imbalance in the brain, and may be a result of extreme stress or even an inherited condition due to genetics. Symptoms can include sudden mood changes due to the sufferer feeling 'high' or at an elevated state one moment, and 'low' or at a very low state the next.

- Postpartum depression can have a prolonged state. The sufferer can exhibit extreme sadness, normally after the woman gives birth and physically undergoes the stress of actual childbirth on top of her other important life stresses. For example, the woman could be overwhelmed with a variety of duties, job 'things to do, family and personal responsibilities, financial woes, past memory- triggered events due to the new baby's arrival and more.

You can see your family physician or other healthcare provider for helpful resources and treatments with depressions. Some main causes of depression are:

- Exaggerated expectation – too many people try to 'do it all' and be like a super-human, working full time plus a part time job and moonlighting, raising children, being a good marriage partner and community supporter, etc.

- Attention Deficit Hyperactivity Disorder (ADHD) and other disorder – can cause people with them to be depressed. It can be difficult facing and handling treatment, thinking others are healthier and better off, which is not so. Group and individual therapy with a qualified psychologist, and / or a good 12-step program can often help people come to terms with their disabilities and go on to success in spite of them – -with them.

- Seasons – Many people find a decrease in daylight, like during winter time months, can and does affect their internal environment, resulting in depression. Light therapy is said to work wonders in these instances.

Overview of Mental Health & War-Related Issues

Sunny — Wed, 02 May 2007 00:30:05 +0000

When a war rages abroad, military personnel, as well as those on the home front, may feel a strain on their emotions and mental stability. With the threat of terrorism and the overwhelming dark cloud of grief, sadness, and anger, more and more individuals are experiencing a blow to their mental health. With each and every affected person, there are varying levels of tolerance and reaction to psychological trauma.

Some people who experience extremely strong emotions due to war-related stress may need to seek help for this inner turmoil. It is quite common to see individuals disconnecting themselves from the world upon returning from battle or displaying an intensely negative attitude when news regarding the war is mentioned. While many common responses involving wartime exist, there are also an equal number of signs that highlight a need to seek professional help.

Common Responses

When it comes to managing the feelings associated with war-related news and terrorism threats, it is normal to encounter difficulty. Individuals may question the state of their future or worry about loved ones in the military. It is common for soldiers to ponder their safety, as well as become shocked or in disbelief. Some people burst into tears for no immediate reason or drop into a pit filled with sadness and depression. They may walk around with a chip on their shoulder, rattled with anger.

At work, the ability to focus and concentrate may become difficult. The body may react with bouts of headaches or stomach irritation. With all of these common responses carrying a heavy load, many falter and turn towards drugs and alcohol to ease the mental pain.

Extreme Responses

For many, the feelings accompanying common responses may fade with time, but for some, they only grow stronger and soon affect their ability to normally function throughout the day. This may also lead to an individual exhibiting signs of a mental disorder. Endless thoughts of war, and nightmares should not threaten daily routines, overall well-being, or happiness.

Reoccurring feelings of guilt, worthlessness, and hopelessness are also signs that one may need help. Additional signs to be on the lookout for, includes feeling jumpy, startling easy; sleepless nights; gloomy outlook on life; and an extreme fear for safety. When these feelings and signs are not attended to, they may snowball into more serious circumstances, such as thoughts of death or suicide.

Coping

To assess your level of coping or to explore some of the signs you might be experiencing, it is highly recommended to take a mental health screening test. This is one of the first steps towards recognizing your need for help, as well as finding appropriate professionals to get you on a healthy track. When coping with war-related subjects, events and people, one of the best ways to relieve stress is to talk about it. Keeping your feelings in will only eat away at your sanity, security, and happiness.

Additional approaches towards coping include taking care of your body through proper eating and exercise; limiting wartime images and news encounters; and asking for help when needed (whether it is a trusted confidant, family member, military advisor, or church).

Warning Signs of Mental Illness and Where to Turn

Sunny — Tue, 17 Apr 2007 17:45:05 +0000

Mental illness is very common in the United States today. The National Mental Health Institute states that about 26.2% of the population in the United States, or about 57.7 million people, has some kind of mental illness. About 6% of the population has severe mental illness. Mental illness is the major disabling factor in the United States today for adults from 18 to 44 years of age.

"Mental health problems" actually strike everyone at some point in his or her life. Whether it's an acute but temporary episode of depression caused by the death of a loved one and eases on its own and without professional intervention, over time or the more lasting clinical depression that needs professional intervention and treatment.

"Mental illness" is defined as a disease that causes detrimental changes in behavior and thought that interfere with an individual's life. Unlike acute episodes of stress or depression brought on by life events (but which nonetheless can themselves benefit from intervention such as a temporary course of medication or work with a therapist, if distressing enough), these changes are prolonged and interfere with an individual's normal functioning.

Before mental illness is diagnosed, physical problems that may cause symptoms should be ruled out and treated, such as an under- or overactive thyroid. Once any physical causes are ruled out, though, mental illness should be considered a possibility and appropriate treatment sought if any of the following symptoms occur in adults:

– Thinking becomes disorganized and not clear
– There is prolonged depression or sadness present (can either be related to a precipitating event such as the death of a loved one or come "out of the blue")
– The person exhibits periods of extreme or worsening depression, followed by periods of increasing and extreme excitability, euphoria, energy and/or engages in impulsive behavior such as excessive and inappropriate spending
– Withdrawing from friends and family
– Sleeping too much or too little
– Eating too much or too little
– Excessive anger out of proportion to the situation at hand
– Excessive worrying or being overly anxious or fearful
– Inability to handle normal daily tasks or to function "as usual"
– Thoughts of suicide
– Denial that there's any problem when confronted
– Physical illnesses or complaints with no medical basis
– Abuse of drugs, alcohol or other mood-altering substances

In children, symptoms can include:

– A drop in grades or other uncharacteristic changes in school performance
– Poor grades even when effort is applied
– Expressing anxiety or worry, such as a refusal to go to bed or unwillingness to go to school
– Having frequent nightmares
– Frequently disobeying or showing anger or aggression
– Having temper tantrums past the appropriate age (i.e., school age)

For adolescents, symptoms can include:

– Drug and alcohol abuse
– Inability to handle "everyday" problems or perform daily activities
– Sleeping too much or too little
– Eating too much or too little
– Physical illnesses or complaints with no medical basis
– Engaging in truancy, theft or vandalism or "excessively" defying authority beyond normal teenaged rebellion
– Obsession with gaining weight
– Protracted moodiness or depressive behavior, perhaps with changes in eating or sleeping and/or with thoughts of death or suicide
– Excessive anger out of proportion to the situation at hand

There is help if you or someone you love is suffering from any of the above symptoms and it's nothing to be ashamed of. The National Alliance on Mental Illness has resources to assist you in finding help local to you.

Visit http://www.nimh.nih.gov/healthinformation/gettinghelp.cfm for more information, and/or http://mentalhealth.samhsa.gov/databases , offered by the federal government's Substance Abuse and Mental Health Services Administration, to find help in your area.

Mental Health and ADD / ADHD

Sunny — Sat, 31 Mar 2007 14:45:09 +0000

Mental health recognizes the seriousness of Attention Deficit Disorder (ADD), the term for clinically diagnosed cases of Attention Deficit Hyperactivity Disorder (ADHD), in both children and adults. Because overall, ADD affects up to 6 percent of the U.S. population, as reported by the Attention Deficit Disorder Association:

- Roughly 2 million children in the United States alone suffer from ADHD. This is the equivalent of about one out of a classroom of around 30 students having ADHD.

- And anywhere from half to 66 percent of these children with ADHD go on to adulthood facing ADHD issues on their jobs, relationships, in person – in life.

Research is still underway to find out mow about ADD, but health and science researchers believe that ADD is probably a genetic issue where biological factors influence the activity of some of the brains neurotransmitters.

Lower glucose levels in some brain areas has helped. It's resulted in controlling the person's attention more, inhibiting impulses; in short less activity happening. Hence, researchers are testing to see whether lower activity levels can help with the reduction, even ceasing, of some ADD symptoms.

ADD Symptoms

Common traits or symptoms demonstrated by adults who have ADD are listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). This list shows that adults with ADD most often:
-Do not seem like they are listening when someone speaks directly to them
-Feel like they cannot relax
-Have a tough time with organizating
-Feel like they are constantly "on the go"
-Do not pay close attention to details
-Mess up at work
-Nervously mess with their hands and / or feet, twisting around in their chairs
-Have short attention spans, especially when handling lengthy tasks
-Do not and often cannot stay seated when it's required long-term
-Do not want to undertake anything that asks for sustained mental effort
-Can and often do talk a lot in a short period of time
-Have a tendency to lose items of importance
-Find it tough to follow through and complete things.
-Find it tough to participate quietly in pursuit of leisure activities
-Like to hurry and supply answers before questions are fully asked

-Can easily become distracted
-Can be a bit impatient
-An be forgetful with everyday things
-Often interrupt others.

An Overview Of Anxiety Disorders

Sunny — Fri, 23 Feb 2007 23:42:56 +0000

In recent years the dialogue about the state of mental health in general and the alarming number of people who suffer from anxiety disorders in particular. This classification includes post traumatic stress, panic attacks, obsessive compulsive disorder and anxiety attacks.

Exactly what causes this condition is not known, however there is an abundance of research that points to brain chemistry imbalance as a main factor and the symptoms are very often confused with depression.

Why should you be concerned about anxiety disorders? Because it is a real medical condition that can severely impact your life and the lives of those around you. In addition, a person can experience an anxiety disorder at any age. There are children receiving treatment as well as adults.

Regardless of the age of the person, anxiety disorders affect their ability to respond to challenges appropriately and suffer with mental confusion, headaches, backaches accompanied by profuse sweating spontaneously without physical cause.

Learning to recognize the symptoms can be the first step in preventing the condition from spiraling out of control. There are reported cases on the evening news daily of the dangerous consequences of leaving this condition untreated.

The common factor between each of these conditions is unwarranted apprehension or excessive fear in situations that don't pose a real or perceived threat and the person remains in this frame of mind for an unusually long time.

Generalized Anxiety Disorder: The person is constantly tired, apprehensive, worried or has morbid thoughts or fear of attack, accompanied by physical distress, shortness of breath and muscle spasms. This condition usually expresses itself as the person moves through normal daily routines in a state of tension and can continue for 6 months or longer.

Anxiety Attack: Unlike Generalized Anxiety Disorder, an anxiety attack is where the feeling of absolute terror strikes suddenly and lasts from a few minutes to several hours. This condition creates havoc in the person's life and can result in a reclusive lifestyle because anxiety attacks can occur at anytime and anyplace. Physical symptoms include mental confusion, nausea and muscle trembling.

Panic Disorder: the person experiences the symptoms of shortness of breath, dizziness, fear of dying, chest pain, abdominal distress and heart palpitations in these sporadic episodes of extreme fear that occur suddenly and without and apparent cause.

Post-Traumatic Stress Disorder: The number of people suffering from this condition rose sharply worldwide after the tragic events of September 11, 2001. It is triggered by experiencing a traumatic event such as an airplane crash, the death of a loved one or a physical assault, emotional abuse or rape. Irritability, extreme mood swings, insomnia, nightmares, flashbacks and feelings of anger or frustration are the most prominent symptoms.

Obsessive/Compulsive Disorder: When this condition is present, the person is plagued by thoughts or certain patterns of behavior that they are compelled to repeat and feel helpless to control or discontinue.

If you or someone you know is showing any of these symptoms, please seek professional assistance. Treating anxiety disorders is accomplished by using a combination of methods, starting with a medical case history and diagnosis of the proper prescription drugs along with behavior modification therapy and diet changes.