#occupational therapy in substance abuse

[mukelaniot]

REFLECTIONS ON MY COMMUNITY BLOCK: A 4TH YEAR OCCUPATIONAL THERAPY STUDENT PERSPECTIVE

As I write what I believe is my last blog of the year, possibly and hopefully the last blog I will ever write as a student, I reflect on my journey in my community block. For the past 5 weeks, I have had the pleasure and the privilege to serve the Cator Manor Community and the people at the Denis Hurley Center. I have to say, I am filled with gratitude to have been exposed to such a community. Not only has it helped shape me as a student, but it has also helped teach me invaluable lessons that I believe will be useful to me as a future health practitioner.

Serving the Cator Manor community, an under-resourced community with most of the people falling in the lower socio-economic status, I encountered and worked with people with various health challenges including, but not limited to hand injuries, strokes, people in need of wheelchairs, and children with ASD. While working in this community, I came to realize that contrary to my preconceived assumptions about community practice, even though the people come from the same community and share similar cultural backgrounds, each of them has their own story. By understanding that, I believe I was then able to fulfill our roles of promoting health and well-being (AOTA,2020), and ensuring people can participate in occupations meaningful to them. Through collaboration with other healthcare practitioners in the clinic, which included, but was not limited to, having joint sessions with physiotherapists, we did our part in fulfilling the aim of holistic care through the Multidisciplinary approach, which optimized outcomes for our clients (Bonder & Dal Santo, 2018). 

Personally, throughout this blog, my favorite task was running group sessions. With the occasional assistance from my colleague, I ran the Women's Support Group, to create a haven for women to share their struggles while creating a community that fosters a sense of universality, and empowerment (Change, 2023). In the Substance Abuse group, I witnessed the power of community support as group members actively supported each other in their recovery journey (Baker, 2024). I learned to utilize the group members who are further along in their recovery road to encourage others by sharing their stories and coping strategies. These 2 projects, I hold dear and am passionate about, as I have personally witnessed a lot of people in need of such groups in my own community, which includes family members of my own.  In a local high school, my colleagues and I ran groups that allowed us to target the youth through mental health promotions, education, and addressing underlying issues at an early age.

However, my journey was not without challenges. At some point during my community block, a colleague and I had a traumatic experience where we were mugged of our personal belongings. It was very hard as we had to go back to that same community. Matters did not get any better when I ran into the of my victimizers in the community at some point, which triggered me as I felt unsafe, frustrated, and frankly, quite vengeful. This led to feelings of PTSD, as I felt unsafe when serving the individuals in the DHC, as I was constantly on edge and in a defensive mode as if someone were to attack me at any time. After realizing how this was impacting how I was serving the community, I started to reconsider the idea of seeking therapy. So, I digest…

Anyway, I am proud to report that throughout this block and academic year, I discovered my ability to be resilient, and to rise above adversity.  As I come a step closer to concluding my training as a student, I plan to take these lessons and acquire the tools I learned along the way to continue to strive to carry the values of Occupational therapy to communities I have yet to serve.

REFERENCES

American Occupational Therapy Association (AOTA). (2020). Occupational therapy practice framework: Domain and process (4th ed.). AOTA Press.

Baker, S. (2024, March 1). The Importance of Building a Community in Addiction Recovery. Iron Bridge Recovery Center. https://ironbridgerecovery.com/articles/the-importance-of-building-a-community-in-addiction-recovery/

Bonder, B. R., & Dal Santo, J. (2018). Occupational therapy in community-based practice settings. Jones & Bartlett Learning

Change, A. of. (2023, October 16). Empowerment in Social Work: Techniques and Importance. Agents of Change Social Work Test Prep. https://agentsofchangeprep.com/blog/empowerment-in-social-work-techniques-and-importance/

[1stproviderchoice]

Why You Need Occupational Therapy Practice Management Software for Your Clinic

Running an occupational therapy clinic involves managing multiple tasks, from scheduling appointments and billing to tracking patient progress and maintaining accurate documentation. To streamline these processes and enhance the efficiency of your clinic, it is essential to invest in Occupational Therapy Practice Management Software. This software provides comprehensive solutions to manage various aspects of your clinic, ensuring smooth operations and improved patient care.

Efficient Appointment Scheduling

One of the key features of Occupational Therapy EMR Software is its ability to streamline appointment scheduling. With this software, you can easily view and manage your clinic's schedule, ensuring that appointments are properly scheduled and allocated according to therapist availability. This helps eliminate scheduling conflicts and reduces the risk of overbooking, ensuring optimal use of resources and maximizing productivity.

Streamlined Billing and Claims Management

Occupational Therapy EMR automates the billing process, making it easier and more efficient for your clinic. The software allows you to generate and send accurate, itemized invoices to patients and insurance providers, reducing the chances of errors and delays in payment. Additionally, the software can automatically process insurance claims, saving time and effort for your staff.

Comprehensive Documentation

Accurate and up-to-date documentation is crucial in occupational therapy clinics. Occupational Therapy Practice Management Software provides a centralized platform to maintain comprehensive patient records, including treatment plans, progress notes, and assessments. This not only ensures easy access to patient information but also helps in generating detailed reports for insurance purposes or audits.

Improved Communication and Collaboration

Effective communication and collaboration are essential in any healthcare setting. Occupational Therapy EMR facilitates seamless communication among therapists, support staff, and patients. The software allows secure messaging, enabling therapists to easily communicate with patients and share important information. Moreover, it provides a platform for therapists to collaborate and share resources, fostering a cohesive and efficient work environment.

Be it Occupational Therapy Practice Management EMR Software, Substance Abuse EMR Software, Urgent Care Practice Management, or Ophthalmology EMR, we at 1st Providers Choice can assist.

Enhanced Data Security and Compliance

The EMR software prioritizes data security and compliance with HIPAA regulations. The software ensures that patient information is securely stored and accessed only by authorized personnel. Additionally, it streamlines the process of maintaining compliance with documentation requirements and audit trails, reducing the risk of legal and regulatory issues.

Conclusion

Investing in occupational therapy EMR is a wise decision for any clinic aiming to enhance its efficiency and provide better patient care. By utilizing this EMR software, you can optimize your clinic's workflow, save time and resources, and ultimately improve patient outcomes.

Occupational therapy EMR is an essential tool for any occupational therapy clinic seeking to streamline its operations and enhance patient care. With its comprehensive features and benefits, this EMR software can revolutionize the way your clinic manages appointments, billing, documentation, communication, and data security. Embracing technology and implementing this software will undoubtedly lead to increased productivity, improved efficiency, and ultimately, better patient outcomes. For quality Occupational Therapy Practice Management Software, you can get in touch with 1st Providers Choice.

[the-fallen-collective]

cw for mentions of abuse, violence, self harm, suicide, substance abuse, etc (none of it goes into detail at all)

Text in images and resources under cut

Dissociative Identity Disorder

Hazy System / Fallen Collective

What is DID?

Dissociative Identity Disorder is a mental disorder where one has two or more identity states. These different parts, or alters, may have different names, genders, ages, mannerisms, behaviours, memories, and opinions. There is also amnesia, or more often, dissociative amnesia, along with struggling or being unable to function in day to day life.

(A picture of a fragmented person with smaller humanoid figures is in the bottom right corner)

Causes of DID

Dissociative Identity Disorder can only form during early childhood, typically from childhood abuse and other trauma. Some of the most common causes is long-term trauma such as physical, emotional, and/or sexual abuse, neglect, medical trauma, and war or terrorism, though there are many other causes, such as vehicle accidents, growing up around abuse, kidnapping, torture, murder, and more.

(A picture that provides a graph titled: Risk Factors of Dissociative

Identity Disorder (DID) then a circle that says: Trauma and Abuse, below it says: Individuals who have experienced severe and repeated trauma, especially during childhood, such as physical, emotional, or sexual abuse, are at a higher risk of developing DID. A second circle says: Early Childhood Trauma, below it says: Trauma occurring before the age of 9, particularly when it involves interpersonal violence, neglect, or unstable caregiving environments, can contribute to the development of DID. A third circle says: Disrupted Attachment, below it says: Lack of consistent, nurturing relationships or attachment figures during early developmental stages can heighten the risk of developing DID.

Symptoms of DID

Symptoms required for a diagnosis are:

A disruption of identity by two or more distinct personality states. The disruption in identity involves marked discontinuity in sense of self and sense of agency, accompanied by other changes in affect, behaviour, consciousness, memory, perception, cognition, and/or sensory-motor functioning.

Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with regular forgetting.

The symptoms cause clinically significant distress or impairment in social, occupational, or important areas of functioning

The disturbance is not a normal part of a broadly accepted cultural or religious practice

The symptoms are not attributable to the psychological

effecte of cubstances.or other medical conditions

An image in the bottom right corner is titled: Dissociative identity disorder

(DID)

The symptoms of DID include: Having at least two identities. Gaps in memory. Daily functioning and socializing challenges.

And then at the bottom it gives the resource name, Cleveland Clinic

Prevalence of DID

Most current studies show dissociative identity disorder is diagnosed to 0.1% to 2% of the global population, though a few give estimates to as high as 3%-5%.

DID is often seen as a very rare disorder, but that's not entirely true. If a prevalence rate of 1.5% is accepted for DID, it is comparable to chronic major depressive disorder (1.5%), bulimia nervosa in women (0.46%-1.5%), and obsessive compulsive disorder (1.1%-1.8%); it is more common than intellectual disability (1%), autism spectrum disorder (1%-2% in the United States but 0.62% globally), schizophrenia (0.3%-0.7%), and persistent depressive disorder (dysthymia) (0.5%); and it is only slightly less common than panic disorder (1.7%-3%), adult ADHD (2.5%), and bipolar 1, bipolar 2, and bipolar disorder not otherwise specified combined (1.8%-2.7%)

Treatment

Common types of treatments are eye movement desensitization and reprocessing (EMDR) therapy, prolonged exposure (PE) therapy, and cognitive behavioral therapy (CBT).

There are two types of goals one may have for recovery and treatment. One may be integration (final fusion), or partial integration (resolution or functional multiplicity).

Integration is when all parts work together to get over the trauma, lower the dissociative amnesia between parts, and take ownership for all thoughts, feelings, memories, urges, skills, and other traits. This is so that the different alters can eventually fuse into one.

Partial Integration is when parts work together to get over the trauma and lower the dissociative amnesia between alters, but they remain separated as different parts for whatever reasons they may have. The end goal for them is really just to work through trauma and learning how to function in day to day life.

Inter-identity amnesia in dissociative identity disorder resolved: A behavioral and neurobiological study - by Lora Dimitrova, Andrew Lawrence, Eline Vissia, Sima Chalavi, Andreana Kakouris, Dick Veltman, and Antje Reinders

DID has subjectively reported inter-identity amnesia, reflecting compromised information transfer between dissociated parts. There have been many conflicting studies regarding memory transfer between parts. Inter-identity amnesia was investigated in people with DID using self-relevant, subject specific stimuli, and behavioral and neural measures. Data included 14 individuals with DID in a trauma-avoidant state, 16 trauma-avoiding DID stimulators, and 16 healthy controls. Reaction times and neural activation patterns were documented with three types of subject specific words: non-self-relevant trauma-related words (NSt), self-relevant trauma-related words from a trauma-avoidant identity state (St), and trauma-related words from a trauma-related identity state (St).

There were no differences in reactions times between XSt and St words, but faster reaction times of XSt over NSt words. Reaction times of the diagnosed DID group were longest, with increased brain activity to XSt words found in the frontal and parietal regions, while decreased brain activity in the anterior cingulate cortex in the diagnosed DID group. This finding of increased cognitive control over self-relevant trauma-related knowledge processing calls for the redirection of "inter-identity amnesia" to "inter-identity avoidance."

Other Information

Quite a few people believe that DID can make someone violent, but that's not entirely true. Horror movies, and most media overall, that feature characters with DID have contributed to this myth and may even be responsible for it. DID is a controversial diagnosis partially because of the fear of criminals avoiding punishment if it is claimed that another alter did the crime; this is also not something that can happen, because if one part commits a crime, the individual as a whole will face punishment. A 2017 study shows that among 173 individuals with DID in treatment had low involvement with criminal justice system. The myth that people with DID are dangerous only further stigmatizes the disorder.

Other Information

The most probable first documentation of DID was in 1584, by Jeanne Fery.

Though convinced it was possession at the time, her recording of her symptoms match up with those with DID today. She had multiple alters, each with their own name, identity, and identifying features. The parts she documented would today be described as an internal self helper (ISH), persecutory protectors, and child alters. Her alters actions ranged from helping her heal to self harm to disordered eating, could be hear in her head, and could take control of her body, and had changes in knowledge and skills. The alters resulted in childhood physical and possible sexual abuse.

Resources: https://my.clevelandclinic.org/health/diseases/9792-dissociative-identity-disorder-multiple-personality-disorder

[dahliaduvide]

I've been digging into the life of Jeremy Wade Delle, beyond just the day of his death that is immortalized in the Pearl Jam song we all know so well.

One thing Jeremy Delle and I have in common is that we both spent time in a psych hospital in our teenage years. We both ended up in adolescent wards of large chain hospitals. My experience wasn't completely negative, but I don't think it helped anyone but my mother.

Jeremy Delle was hospitalized in April of 1990 after what is believed to have been his first suicide attempt.

His parents put him in Timberlawn Psychiatric Hospital where he started seeing a doctor that continued to treat him until his death by suicide on January 8, 1991. He actually had completed a session with his doctor the afternoon before he died.

The redacted police report gives only a small amount of information about the doctor that Jeremy Delle was seeing. His name is given as Dr. Bob H####, and as Dr. Robert H#### on a card that the police found in Mr. Delle's wallet. This card lists two phone numbers for the doctor. The first if the general number for the Timberlawn facility, but the other number is likely a direct line to the doctor's office.

The information given in the July 1990 list of hospitals printed in D Magazine, a local Dallas publication, about Timberlawn is "4600 Samuell Blvd, Dallas. 381-7181. Psychiatric hospital; 232 beds; offers chemical dependency treatment, occupational therapy, and psychiatric unit". That's the same as the first phone number listed on the card on Jeremy Delle's wallet card. The second is 381-6327.

Without a last name, I couldn't search for any other mentions of the doctor in public records (and I didn't find anything relevant using the phone number), but there were certainly a few articles about Timberlawn. More than a few, I had to winnow them down to the ones that seemed most relevant to what Jeremy Delle might have experienced during his stay there.

This article from June 1990 explains the sudden growth in the industry in Texas. The financial motivations behind it have very distinct consequences that the article outlines: patients rarely stay longer than their insurance foots the bill.

When the money runs out everyone- adult, teenager, addict, seems to be miraculously cured.

There are several claims of misconduct by care providers throughout the time surrounding Jeremy Delle's stay at Timberlawn.

May 1988: A Dallas woman is admitted to the substance abuse program at Timberlawn. In February 1996, when she is in her early 30s, she alleges misconduct by her doctor during her stay at Timberlawn.

May 1991: In March 1993, a patient alleges he was pursued by his doctor after seeking treatment at Timberlawn for depression after the end of his marriage. He also alleges that she initiated an inappropriate romantic and sexual relationship which lasted from November 1991 to February 1992.

Obviously, Mr. Delle would have been, or at least should have been, housed in separate adolescent areas from any adult patients, but he might have seen the same doctors. Particularly because he was treated for substance abuse. I have some doubts about whether he was actually using any drugs or not, but I'll put that together in another post with some supporting documents.

I also found these court documents from 2009 relating to a patient that was hospitalized in the Timberlawn facility as a minor. She claims to have been raped by an older male patient due to inadequate supervision of the patients by staff and a lack of private space available to patients. No dates or ages are given, however, so it's impossible to know if this happened within the early 90s. However, if Jeremy Delle had survived until 2009 he would have been in his mid-20s, which is when childhood traumas begin to be understood by a maturing mind.

I'm not a lawyer and couldn't even pretend to be one on the internet, so I won't claim to understand anything about what is happening, but I can read through it and capture other facts about who, where, when, etc. If anybody with a better understanding of USA or Texas state law wants to shed some light on this that would be helpful.

I wasn't able to find any further information about the progress or outcomes of these cases, so I've chosen not to include the names of the staff accused, but they are included in the media coverage if anyone would like to search through news databases that aren't freely available online. I can only research the documents I can find, and unfortunately I don't have access to any academic databases at the moment, either.

My personal opinion is that whatever started Jeremy Delle down a troubled path started before he got to Timberlawn and the care of Dr. H.

I do think this line of research is important for understanding whether or not Mr. Delle received effective or adequate care as his mental illness spiraled out of control.

It strikes me that these stories about Timberlawn confirm and debunk some of the conceptions we have about this particular young man's life from the song written about him in 1991 by Eddie Vedder and Jason Ament. Jeremy Wade Delle was failed by everyone in his life with the power to help him as he started to sink under the waves of his illness. But his parents didn't ignore it completely, they tried to get him help. Maybe not when his illness first manifested, but as soon as his first 'cry for help' came in the form of a suicide attempt, they put him in a hospital that was known to be the best in their area. One with a developing, supposedly cutting edge, program for adolescents and those suffering from substance abuse. They most likely brought him home when the hospital said he was better. Sadly that might have had more to do with how long the hospital knew that insurance would foot the bill and not Mr. Delle's actual mental health.

The story is no less tragic than the story Pearl Jam spins in their song, but it's far more nuanced.

And it's still a great song.

[comorbidityqueen]

Hi! Hello! my name is Taylor and i'm a 31 year old brain injury survivor. I haven't used tumblr since i was a teenager and im not sure if i can pin this post so it comes up first so excuse my lack of tumblr navigation.

I wanted to create this space as a gentle reminder to myself that my writing matters and also as a way for other disabled folk to find some relatability or relief knowing they are not alone. I'm hoping it could also educate others on just the severity of what we go through on a daily basis.

i'm not sure if anything will eventuate from this but if i give one person insight into something they previously knew nothing about then hey, that's cool. So a little bit about me...

i am a scorpio sun, aquarius moon and capricorn rising with a sag merc + venus and cancer mars (oof, right?!). Astrology aside, im a 31 year old living with an acquired brain injury in Adelaide, Australia (Kaurna Land).

When i was 12 years old, 3 days before my 13th birthday, i suffered a right MCA (Middle Cerebral Artery) CVA (Cerebral Vascular Accident). Basically, i had a massive stroke deep in the middle right side of my brain. I was at school at the time and my school didn't call an ambulance straight away. Negligence (sprinkled with ignorance) aside, i was unable to receive medical intervention leaving me permanently disabled for the rest of my life. I suffered with full left side hemiplegia, seizures, cognitive deficits and a substantial amount of teenage angst at the time along with some hysterical laughter. I have now learnt that was something called the pseudobulbar affect and that i wasn't actually losing my mind, that i had just suffered a significant trauma and my brain was like "nah man". My nana died on the same day and i hysterically laughed when my parents told me a few weeks into my 3 month inpatient stay where i had physiotherapy, speech therapy, and occupational therapy. I like to think she was my guardian angel. I learnt to walk and talk again, actually, i had to learn everything again and after numerous tests and scans, the hospital informed me that a genetic mutation was the cause. A compound heterozygous MTHFR (Methylenetetrahydrofolate reductase) which can predispose to thromboembolism to be exact, and yes I still interpret the acronym as motherfu*cker, because it sure was to me and my family at that time.

Over the last almost 19 years i have spent working hard on a body i never signed up to have. I have survived not only an ABI but relentless bullying, substance abuse, trauma's and grief along the way. As i've aged i have regressed, and in 2021 after sustaining a concussion and being diagnosed with concussion syndrome, things got a lot harder and my mobility suffered greatly. With that came debilitating daily migraines, stroke regressions, chronic pain and worsening mental health problems.

I do weekly physiotherapy and have been very fortunate to benefit from NDIS here in Australia. My goal is to eventually become a disability and mental health advocate, while still somehow working on my mobility on a daily basis and trying to survive.

i'm not sure how often this will be used depending on the availability of spoons, but if anyone has any questions about brain injury please don't hesitate to use the ask me anything button ☺️

[feastonkings]

avan jogia / they/them/any  ———  no way is that RIVER PATEL.. they’re a 30-year-old HUMAN notoriously known for being INDULGENT  &  NEEDY but there are some people who have seen them being AFFECTIONATE  &  ENTERTAINING.  if you ask me, they remind me a lot of waxing poetics in everyday conversation, a crystal for every occasion, bohemian but make it sexier, draping over people and furniture like a cat demanding attention, and a rainbow of chaos, but that could just be because they’re considered the SEER around town. just keep an eye on them  &  see if their true colors shine through..

GENERAL.

full name: river celeste halcyon patel nicknames: riv, rivvy, stardust (stage name) classification: enhanced human gender / pronouns: genderqueer, they/them/any age / birthday: 30, february 7th orientations: pansexual, panromantic, polyamorous occupation: co-owner of the broom closet, metaphysical expert, & dancer at the kit-kat club status: open family: luna patel ( mother, deceased ), parthiv patel ( father, deceased ) strengths: affectionate, entertaining, loving, creative, playful weaknesses: indulgent, impulsive, needy, promiscuous, flighty character inspo: ambrose spellman (chilling adventures of sabrina), klaus hargreeves (umbrella academy), eric effiong (sex education), phoebe buffay (friends), mouse (doormouse), nymphadora tonks (harry potter), jules vaughn (euphoria), jesper fahey (shadow & bone), jenny curran (forrest gump), riley blue (sense8), jaskier (witcher), veronica fisher (shameless), ulysses zane (now apocalypse)

BIOGRAPHY.

tw: addiction, death, overdose, abuse, chronic illness

born in new orleans, to two loving and hardworking parents. they lived in the lower ninth ward, in a small two bedroom home. money wasn’t abundant, but there was enough to give them everything they needed.

river was born with type one diabetes and has required insulin to function properly from the start.

their father, worked as a street musician and helped their mother at the metaphysical shop she owned. along with the shop, luna was a well known wiccan and head of one of the many local covens.

with the global environment declining over the years, tropical storm season had become even more dangerous. one particular hurricane hit the city and the big easy didn't stand a chance. over half the city was affected, the lower income areas the worst. hundreds died and among them were river's parents.

they were pushed into the system, foster families that were near capacity with displaced children. river couldn't stand it. hated the clothes they put them in, the way the tried to bring them to church, bringing them to therapy, throwing away their crystals and trying to cut their hair. it didn't take long until they'd run away.

at twelve years old, they were on their own. bouncing from family friend to family friend until their best friend's family got word and took them in as one of their own.

they appreciated everything that family did for them and the strong bond they had with their friend, it was more than they could've asked for. being accepted for who they were and loved made all the difference in helping them survive their teen years.

at the age of seventeen, they decided to get their ged and river said the hardest goodbyes to new orleans and their second hom when they left to go travel the country.

on their own and in their travels, many things were learned. one being how to survive off nothing, as they struggled to find any kind of work. river was not very reliable when it came to day jobs and set schedules, though they attempted to adapt.

the biggest struggle was this constant feeling of emptiness along with rotating periods of random moods that would sometimes come about for no reason at all. it had been there since losing their family and most of the time they just rode it out. in the worst times they turned to substances for help, as they’d done in the past. this lead them down a spiral of abusive relationships, bad run ins with dealers and law enforcement, shady work to keep afloat, etc.

away from home and lacking inhibition, they ended up becoming a garbage disposal for the many options of drugs available in america's underground; using them to fill a void they couldn’t close no matter how hard they tried until it almost killed them.

which is exactly what happened, they ended up overdosing in an all-night diner's bathroom and when they woke up they were in a hospital room with no clue what had happened. it gave them a wake up call for sure, and it was decided that they needed to start over.

after a couple years and many failures, river managed to hitch a ride as far as texas. they had a good feeling about dallas and updated those in new orleans where they were. that was when they were told of the trust money their parents left behind for river to be given to them when they reached the age of twenty-five.

the temptation was there to blow the money on more travels and parties but it was quickly squashed. it was an obvious sign from the stars and they decided to go all in on a new venture, opening up a shop with a close friend called the broom closet.

the new distractions did not shake the vices they picked up on the road but they certainly slowed them down. they are trying their best to kick their many bad habits so that one day they will thrive in the world again.

beyond that they used their natural knack for seduction and flirtatious nature to make money for the shop and meet new people by dancing at the kit-kat club. determined something would come of their life someday.

when they aren’t working at either of their jobs, they can be found writing lyrics or poetry, dancing, partying, or sneaking out of the home of one of their many casual romantic encounters. river is excited for the future and whatever the new start would bring for them in this cyber metropolis.

HEADCANONS.

river has type one diabetes and has a pump to regulate it better. it’s important they are able to see a medical professional regularly. they also wear a medical alert bracelet with this information.

they despise sleeping alone, whether it be from having people around them in close quarters for most of their life or just the loathing of being alone in general, they tend to stick close to people if they can sleep at all.

comparable to a cat they can sleep anywhere and will curl up or drape themselves over people for affection.

they wear their heart on their sleeve and fall in love quite easy, unfortunately their over devotion and wandering eyes have made it difficult to hold any long term relationship except with one person who has always understood the amount of love they have and just because they love someone it does not mean they love another any less.

river has a long history of casual relationships and having a select few they are fully committed to exclusively, however they develop deep feelings for people easily and adore them long after any romance leaves. they are very open with their sexuality and the love of the human body. river has often used casual sex as another coping mechanism and occasional self-destructive tendency.

they love dancing, parties, poetry, and music - they also adore talking to people and will be happy to introduce themselves to anyone and everyone

music has always had a strong place in their life, though they've never had the desire to pursue it professionally. they can play almost any guitar, bass, piano, pan flute, viola, and harmonica.

river can speak spanish, french, creole, american sign language and some hindi besides english

more to come

[cyberneticatoms]

no way is that IKE DUTTON..they’re a 28-year-old SYNTH notoriously known for being SPITEFUL & TEMPERAMENTAL but there are some people who have seen them being TRUTHFUL & LOYAL. if you ask me, they remind me a lot of vodka in a water bottle, sun’s heat on your shoulders, and bleeding knuckles, but that could just be because they’re considered the HOT-BLOODED around town. just keep an eye on them  &  see if their true colors shine through..

↳ 𝚀𝚄𝙸𝙲𝙺 𝙵𝙰𝙲𝚃𝚂

NAME: Iker Matthew Dutton NICKNAMES: Ike, Hates being confused for Ian DATE OF BIRTH: June 30th (28) HEIGHT: 5'11 AFFILIATION: Neutral  OCCUPATION: Bouncer at The Obelisk FACECLAIM: Chay Suede

TW: child abuse, drug abuse, alcohol abuse

↳ 𝙱𝙰𝙲𝙺𝙶𝚁𝙾𝚄𝙽𝙳

❖ Ike came into this world kicking and screaming, over the years not much has changed on that front. They grew up with their twin brother Ian in a trailer park with their parents. A work injury that left the family with too many bills and later substance abuse, Ike grew up with a physically abusive dad and a neglectful mom. The only highlights were when DJ would come pick them up to take them to their grandmother's house. ❖ At least that was the only highlight, until they turned 8 and DJ enlisted for the Coast Guard without telling anyone until the last minute. Up until that point they'd been having behavior issues at school that only increased without guidance from DJ or their grandmother. ❖ This had the school popping into to check at home more and more, whenever they came by Ian cleaned everything up and helped their parents sober up enough to get through the interviews. ❖ Ike felt guilty their twin was doing so much, both scared of the odds of getting separated if they were removed from the house. Still they couldn't stop lashing out and picking fights any moment that they could. When DJ came back on leave was when things changed again. ❖ While they grateful DJ was able to get them to permanently stay with their grandmother, they were still resentful over feeling abandoned. It wasn't until DJ's best friend and future wife, Dahlia, managed to get through to Ike, that they were finally able to forgive him. Seeing the two as their parents in the same way that Ian did. Their cousin Zel had also been living with them, as the three were the same age DJ started calling them the triplets. ❖ After graduating high school, they joined the Coast Guard alongside their two brothers. During one of their leaves they learned DJ and Dahlia had rescued Val, who had come to the club looking for help. Of all their siblings, Val is the one Ike gets along with best, the two quick to shit talk or get into shenanigans. ❖ Currently they work as a bouncer, like DJ they don't trust anyone who works for the Big Three or the Mafia. Having a personal grudge against both, especially with arguing with a corporate drone over them trying to buy out the club.

↳ 𝙼𝙸𝚂𝙲

• In a band with their siblings Ike, Zel, and Val along with their friend Eva. The band is called Three by Five, they usually play drums though occasionally switch with Ian whose on bass. • While in high school was officially diagnosed with intermittent explosive disorder and ADHD. They were afraid of their family trying to have them reprogrammed, instead they were given the choice. They opted for therapy and medication, while they still have their bad days, their mental health is a lot more manageable thanks to a good support system and healthier outlets.

[redwoodwv-hq]

Name: Isaac Apatow Age: 57 Town Occupation: Council Member + Head Raider Previous Occupation: Manager of halfway house Redwood Resident Length: Since creation Faceclaim: Jeffrey Dean Morgan

Bullet Points:

Ike lives in Boneyard Cottage, outside the town walls by the cemetery.

Ike’s still very influenced by his upbringing in Ark but he’s an old white guy and doesn’t have much insight into this despite rehab therapy. He’s a compartmentalizer.

He believes in God and prayer but hates evangelism. Working with a vulnerable population stripped him of most of his bigotry, but his weird beliefs come out in different ways.

He'll get tattooed at the drop of a hat.

Being a raider gives him an outlet for his nervous energy and yen for the unexpected. 

He worked an insane number of random jobs while he was addicted and had no fixed address, so he's got a tiny bit of experience at all sorts of unconnected things.

Biography:

Ike didn’t talk much about how he grew up. How to explain it to people who didn’t live it? There weren’t many people who’d hear him talk about the tiny community in north Washington State that wasn’t even on the maps, housed a total of eight big families, and was a mess of religious nutcases and sovereign citizens, without it changing their opinions of him. So he kept it to himself once he turned twenty and got out, and moved to Brooklyn.

The shift was hard and he found himself indigent for a while, abusing substances, until he pulled himself together (oddly, through the grace of God or at least a street outreach programme) and ended up working there. Eventually becoming the manager of Good Apple Halfway House, making something productive of his life. 

(That’s not to say he didn’t make mistakes along the way. A trail of failed attempted relationships, some kids he never saw. But a man’s more than his mistakes, if the good he does outweighs it, right?)

When the virus hit, well – Ike worked among one of the most vulnerable populations and they got hit *hard*. With social services the first to degrade as the city’s infrastructure crumbled, Ike threw everything he had into keeping his people safe but when you lived in an urban centre with everyone scrabbling to survive? It was a shitshow. He got out. Not without remorse, for the people he abandoned, but Ike was a survivor.

He struck out mostly on his own, using what he’d learned growing up in Ark, and by the time he shored up in Redwood he’d lost little pieces of himself, shaved and nipped off of his conscience with each new desperate act. But nobody knew the things he’d done to stay alive, and in this town, there was the chance to wash himself clean. Right? Right??

[purpledent0]

Rehabilitation Centre in Mumbai: A Comprehensive Guide to Recovery

Mumbai, the bustling financial capital of India, is home to some of the country's finest rehabilitation centres. These facilities provide individuals with the care and support they need to overcome various physical, mental, and emotional challenges. Whether it's addressing substance abuse, mental health disorders, or physical injuries, rehabilitation centre in Mumbai offer tailored programs designed to foster recovery and personal growth.

Why Choose a Rehabilitation Centre in Mumbai?

Rehabilitation centres in Mumbai stand out for their state-of-the-art facilities, highly qualified professionals, and holistic approach to treatment. The city's diverse population ensures access to a wide range of services, catering to people from all walks of life. Mumbai’s rehab centres combine traditional therapeutic practices with modern techniques to create a balanced and effective recovery process.

Services Offered

Substance Abuse Treatment: Addiction to drugs or alcohol can have devastating effects on an individual's health and relationships. Rehabilitation centres in Mumbai offer specialized detoxification programs, counseling sessions, and support groups to help individuals regain control of their lives.

Mental Health Therapy: Mental health is a growing concern in today’s fast-paced world. Rehabs in Mumbai provide therapies for anxiety, depression, PTSD, and other disorders. These centres often employ cognitive-behavioral therapy (CBT), mindfulness exercises, and medication management as part of their treatment plans.

Physical Rehabilitation: For individuals recovering from injuries or surgeries, physiotherapy and occupational therapy are essential. Many rehabilitation centres in Mumbai have advanced equipment and experienced therapists to aid physical recovery and improve mobility.

Holistic Healing: Rehabilitation isn’t limited to physical or mental health. Mumbai's centres often include yoga, meditation, and alternative therapies like acupuncture and aromatherapy to promote overall well-being.

What Makes Mumbai’s Centres Unique?

Mumbai’s rehab centres are unique due to their integration of technology and culture into treatment. Many centres use virtual reality for exposure therapy or online counseling for patients unable to attend sessions in person. The city’s multicultural environment also means that treatment approaches are sensitive to diverse backgrounds and beliefs.

Moreover, Mumbai’s location adds to the healing process. Several centres are nestled in serene environments, away from the city’s chaos, offering patients a peaceful and distraction-free setting for recovery.

Choosing the Right Rehabilitation Centre

Finding the right rehabilitation centre in Mumbai depends on individual needs. Factors such as the type of treatment, cost, and duration of programs play a significant role. It’s advisable to visit the facility, speak with staff, and understand the treatment philosophy before making a decision.

Conclusion

Rehabilitation centres in Mumbai are at the forefront of recovery and healing, providing comprehensive care for a variety of challenges. With their dedication to patient well-being, these centres pave the way for individuals to rebuild their lives and regain a sense of purpose.

For anyone seeking a fresh start, Mumbai's rehabilitation centres offer hope, guidance, and a path to a healthier and more fulfilling life.

[nulifelinecarerehab]

BEST REHABILITATION CENTER IN DEHRADUN, INDIA

NuLifeLineCare Rehab is the best drug de-addiction centre in Dehradun which is built in a prime location with a lush green environment and well-equipped mental health services. It is not a rehab center but a place where you can complete your journey of healing. Our goal is to provide mental health facilities accessible to each and every person in the country.

According to one source, more than 20 million people were in need of substance abuse treatment last year. So, we made sure to construct a de-addiction center that provides an opportunity for addicts to manage their addiction on a long-term basis. It is a safe place that helps addicts recover from various types of substance use, addictions, and associated mental illness.

Our vision is to create awareness about various mental illnesses and substance use disorders among the population. The fact that our well-qualified team of Psychiatrists and Psychologists customize treatment plans for every individual makes us special. NuLifeLineCare is the best rehabilitation center in India as thousands of patients were able to return to their normal lives with our treatment approaches.

HOW THE BEST REHABILITATION CENTER IN INDIA TREAT

NuLifeLineCare Rehab is a well-known and best Rehabilitation Centre for Drug and Alcohol Addiction. Our team considers themselves as your healing partners who work day and night to give you a healthy lifestyle. This state-of-the-art Rehabilitation Center works with unique treatment approaches customized for every individual. Apart from treatment, we have dieticians and gym instructors who curate the meals and activities for the patients.

WHY CHOOSE ONLY NuLifeLineCare Rehab

NuLifeLineCare Rehab is built in a lush green environment away from the traffic of the city. NuLifeLineCare is committed to giving the best rehabilitation center standards to help every patient with any kind of addiction. It is indeed India’s best centre for alcohol and drug treatment in Dehradn, Uttarakhand. Our services include such as physical, occupational, speech, and recreational therapies. We work not only on the illness but on the holistic development of the patients. Our team believes in maintaining the confidentiality of the patients as well as in providing safe and effective treatment to the patients.

NuLifeLineCare Rehab provides a safe and secure environment for people. Our team provides 24-hour assistance to people all over India. We are motivated to give personalized care and treatment of NABH standards to the people. NuLifeLineCare Rehab strives to deliver the best results to the people. Our practical approach to managing addiction has helped thousands of patients who are suffering from addiction. We ensure that you have a comfortable stay during your journey of recovery. Our well-qualified dietician along with in-the-house kitchen curates the best meal for the patients according to their needs. Our Psychiatrists make sure that patients are on regular follow-ups to assess their condition from time to time.

If you or someone you know is struggling eith drug or alcohol addiction, reach out us at NuLifeLineCare Rehab for effective addiction treatment.

Call us on: 8958305058

Or visit: https://www.nulifelinecare.org/

Location: https://maps.app.goo.gl/LRhxT1zLwVERANAm8

[healthexpert12]

Comprehensive Guide to Finding the Best Bangalore Rehabilitation Centre for Effective Recovery

Introduction

Bangalore is known for its vibrant culture, booming economy, and diverse healthcare offerings. Among the most crucial sectors of healthcare in the city is rehabilitation. Whether recovering from an injury, surgery, addiction, or mental health challenges, the right rehabilitation centre in Bangalore can make all the difference. This article will guide you through what to look for in a rehabilitation centre, the types of services offered, and how to choose the best one for your needs.

What is a Rehabilitation Centre?

A rehabilitation centre is a healthcare facility that provides specialized treatment and therapy to individuals recovering from a range of physical, emotional, and mental health issues. These centres focus on improving a patient’s quality of life by helping them regain strength, function, and independence.

In Bangalore, these rehabilitation centres cater to a variety of needs, from physical rehabilitation to drug and alcohol recovery programs.

Types of Rehabilitation Centres in Bangalore

Physical Rehabilitation Centres

These centres help individuals recovering from physical injuries or surgeries. Treatment might include physiotherapy, occupational therapy, pain management, and rehabilitation after strokes or surgeries.

Addiction Rehabilitation Centres

Addiction recovery is a crucial service in Bangalore’s rehabilitation sector. These centres offer detoxification programs, psychological therapy, group counseling, and support to individuals battling substance abuse.

Mental Health Rehabilitation

Mental health rehab centres focus on individuals dealing with anxiety, depression, bipolar disorder, and other psychiatric conditions. Therapy, counseling, and medication management are often offered.

Neuro-Rehabilitation Centres

For those dealing with neurological disorders like Parkinson’s, Multiple Sclerosis, or recovery from a brain injury, neuro-rehabilitation centres provide specialized services for motor skills, cognitive functioning, and overall wellness.

Choosing the Right Rehabilitation Centre in Bangalore

When looking for the best rehabilitation centre in Bangalore, consider these factors:

Reputation and Reviews

It’s essential to check online reviews and testimonials to ensure that the facility has a good track record of successful treatments.

Qualified Staff

Ensure the centre is staffed with licensed medical professionals, including physiotherapists, psychologists, and addiction counselors.

Range of Services

The best rehabilitation centres offer a range of services, including one-on-one therapy, group sessions, holistic treatment options, and aftercare support.

Accreditations and Licensing

Confirm that the centre adheres to local regulations and is licensed by relevant health authorities. This ensures high standards of care and safety.

Location and Accessibility

Choose a centre that is conveniently located and easily accessible for regular visits, especially if family support is needed.

Benefits of Rehabilitation Centres in Bangalore

Comprehensive Care

Rehabilitation centres offer holistic care that addresses both the physical and mental aspects of recovery.

Personalized Treatment Plans

Centres create tailored treatment plans based on individual assessments, ensuring that each patient receives the most effective care.

Support Systems

Many centres provide support groups for family members and friends, creating a network of care for the patient’s recovery journey.

Experienced Healthcare Professionals

Bangalore’s rehabilitation centres are staffed with experienced professionals who specialize in different areas of rehabilitation, ensuring patients get the best care.

Conclusion

Finding the right Bangalore rehabilitation centre can be the key to a successful and smooth recovery. Whether you're recovering from an injury, illness, or addiction, you deserve the best treatment. By considering the reputation, staff qualifications, services offered, and patient reviews, you can choose a centre that best meets your needs.

Start your journey towards recovery today, and take the first step by choosing a reliable and effective rehabilitation centre in Bangalore.

[many-to-mention10001]

What is a rehabilitation center?

What is a rehabilitation center? A facility that provides therapy and treatment for people recovering from physical injuries, illnesses, or substance abuse.

What types of rehabilitation centers exist? Centers for physical therapy, occupational therapy, speech therapy, addiction recovery, mental health, and specialized conditions like spinal injuries.

What services do rehabilitation centers provide? Physical therapy, psychological counseling, medical care, skill development, group therapy, and aftercare planning.

Who can benefit from rehabilitation centers? Individuals recovering from surgery, injuries, chronic illnesses, substance abuse, or mental health disorders.

How long does rehabilitation typically last? Duration varies; it can range from a few weeks to several months, depending on the condition and progress.

[treatnow]

Suicide Statistics and Brain Wound Insights: PART 2

"In the past 18 months, three experienced Super Hornet pilots have died by suicide. According to their families, all had symptoms consistent with brain injuries." NYT Dave Philipps PRESS SUMMARY ON SUICIDES Dave Philipps of the New York Times continues his reporting on brain wounds inflicted on US service members using their own technology, in this case Top Gun pilots. Previously, he has looked at artillery and mortar crews, grenade instructors and Navy SEALs. In this case, Top-Gun Navy Pilots Fly at the Extremes. Their Brains May Suffer, he reports on Project Odin's Eye, which extends a study already underway with SEALs to assess the impact of Operator Syndrome. Operator Syndrome is a unique pattern of interrelated medical and behavioral health-care needs, typically experienced by Special Operations warriors, to include pilots flying high-G fighters. The symptoms closely parallel polytrauma, including "traumatic brain injury effects; endocrine dysfunction; sleep disturbance; obstructive sleep apnea; chronic joint/back pain, orthopedic problems, and headaches; substance abuse; depression and suicide; anger; worry, rumination, and stress reactivity; marital, family, and community dysfunction; problems with sexual health and intimacy; being "on guard" or hypervigilant; memory, concentration, and cognitive impairments; vestibular and vision impairments; challenges of the transition from military to civilian life; and common existential issues." Readers of this space know that many of the above symptoms can be addressed using Hyperbaric Oxygen Therapy (HBOT) for alleviation and healing of many of those brain and other bodily wounds, including behavioral and cognitive damage. Military Medicine published a piece, Cumulative Blast Impulse Is Predictive for Changes in Chronic Neurobehavioral Symptoms Following Low Level Blast Exposure during Military Training looking for predictors of long term brain health. The research looked at peak blast overpressure, impulse, total number of blasts, Time in Low-Level Blast Occupation, and Time in Service all showed strong evidence of influence on Neurobehavioral System Inventory (NSI) scores after blast exposure. In simple terms, repeated blast exposure correlates with negative brain health outcomes. Reinforcing the negative consequences of thousands of high-G-force insults to the brain, Special Warfare Combat Crewmen (SWCC) boat Veteran Anthony Smith writes in the Havok Journal: "At 65 mph, the boat slams into a wave about once every second. 3,600 impacts happen in an hour. The impacts can be as hard and severe as 125 rotational g-forces on the head and neck, producing severe whiplash and sub-concussive impact. Often, it’s only about 35 or 40 g. Pretty typical." Increasing numbers of SWCC boat operators are coming to TreatNOW for help with Allostatic Overload (Operator) Syndrome. Smith's survey of 1000 led to 314 responses. 299 of the 314 were verified SWCC operators, representing 3,584 years of SWCC experience. Of the fifteen (15) who were not SWCC, two (2) were SEALs, two (2) were fleet officers who had served in the Special Boat Teams, one (1) was a USCG Warrant Officer, and nine (9) were NSW combat service support personnel.  The median age was fifty (50), and median number of years served as SWCC was eleven (11), while most completed five (5) deployments. 100% of respondents had service time on SWCC fast boats and are now living with long-term effects of traumatic brain injury (TBI), whiplash-associated disorders (WAD), and musculoskeletal disorders (MSD), including cognitive impairment, neuroendocrine dysfunction, sleep disorders, chronic pain, and psychological disorders. To summarise: A constellation of symptoms related to insults to the brain from a variety of forces in various service categories leads to brain wounding that can be addressed with Hyperbaric Oxygenation. HBOT is used safely, effectively and infrequently across the DoD. Donations and volunteers are helping the brain wounded, without national government funding, get into HBOT treatment across the US. Ten states know better and have collectively appropriated over $32 Million to treat TBI/PTSD using HBOT. The USG has to wake up and pay for HBOT treatments. The suicide epidemic needs ACTION to heal brain wounds, not only more research and public service announcements, call centers, cooperative agreements, and "lethal means safety." The continuing diagnosis and treatments aimed at "mental health" have to be expanded -- perhaps even expanded -- into "healing brain wounds." Final Note: A deep-dive into HBOT for COVID and PTSD is in the The Empowering Neurologist Podcast, Dec 09, 2024. Dr. Amir Hadanny is interviewed by Dr. David Perlmutter in "Hyperbaric Medicine Revolution." The discussion focuses on enhancing the oxygen availability to the brain for mitochondrial dysfunction, a powerful therapeutic tool across a wide variety of neurological issues like head injury/TBI/PTSD, concussion, Operator Syndrome, dementia, stroke and even long COVID. As Congressman Greg Murphy, MD (R-NC) recently put it to CBS NEWS, ” I believe it is medical malpractice not to offer this to our Veterans.” Heal Brains. Stop Suicides. Restore Lives. TreatNOW ****************************** The TreatNOW Mission is ending service member suicides. Along the way, we have learned that we can end suicidal ideation, help end symptoms of PTSD, get patients off most of their drugs, and heal brain wounds to end the effects of BLAST injury, mild TBI Persistent Post Concussive Syndrome, and polytrauma from AHI and Burn Pits. Diabetic Foot Ulcers have become a major emphasis. www.treatnow.org Information provided by TreatNOW.org does not constitute a medical recommendation. It is intended for informational purposes only, and no claims, either real or implied, are being made. Read the full article

[ceruleanatmospheric]

Depression

4 types: 1. Major Depression: mild, moderate, severe 2. Dysthymia: chronic long-standing low intensity depression. Occupational and social function may be normal 3. Depression of Bipolar mood disorder: swing between elation and low mood 4. Post-partum Depression: few days or months after childbirth, not pertaining to the first child, often keeps the mother from doing daily activities.

Patient's Story #1 Premorbid: active, outgoing, sporting person During pregnancy: swing between extremely happy and feeling totally miserable. Postpartum: feel very burdened by child, intense feeling of guilt, unreasonable inability to accept baby with joy. Tensed relationship with husband, constantly in argument, never met eye to eye. Extremely high expectations, suffering from workload, alone, difficulty in home, work and baby. Rarely slept well, low blood pressure. Attitude worsen: angry, screaming, throwing stuff, suicidal thoughts, attempted suicide a few times, failed to execute due to fear, knew that something was very off. 5 months post-partum: psychiatric help. Diagnosed post-partum depression, take a break from work, concentrate on recovery, started on lowest dosage possible, improvement after a few weeks, learnt techniques of relaxation and sleep better. Encouragement and advice to improve close relationships.

Outcome: optimistic, no longer a shy person, open communication, full recovery to no medication required.

Men may self-medicate depression with alcohol or druhs.

Signs and Symptoms: low mood, lack of pleasure. significant change in appetite or weight, insomnia/hypersomnia nearly every day, psychomotor agitation/retardation, fatigue/loss of energy nearly every day, feeling uselessness/ inappropriate guilt, decreased ability to think, concentrate or to make decision nearly everyda, recurrent thoughts of death/suicidal ideas/suicidal plans/attempt.

Minimum 5 of the above symptoms for at least 2 weeks.

Rule out: hypothyroidism, Parkinson

and must have caused significant impairment in social and occupational functioning of individual.

Negative thoughts are caused by neurochemical change, often unshakeable.

Physical symptoms: tiredness, memory difficulties, heart symptoms, sensation of hot and cold, muscle aches and pain, dizziness, stomach ache, nausea. ECG and angiograms are normal.

Suicide: higher risk in male, substance abuse, recurring episode of depression.

Depression develops from physical illnesses: chronic heart disease, stroke, cancer, Parkinson disease, dementia, elderly. Pseudodementia in elderly improved with depression treatment.

Admission for cases with suicidal thoughts, refusal to eat, psychosis.

Electroconvulsive therapy given under anaesthesia in a specialised setting.

Antidepressants: not addictive, does not change personality, aggression/danger to others, duration is not dependent on number of depressive episodes.

Cognitive Behavioural Therapy: analyse mind and body, react better in critical scenario, change negative and destructive thoughts into more positive ones, problem solving and building self-worth.

Patient's Story #2

Premorbid: 30 years of marriage, 3 grown-up children. Part timer, homemaker, wife, mother, studied pottery and art. Enjoyed travelling, meeting people, etc.

The Change: Husband suspected having affair, insisted patient to move out of condo, felt lost, empty, betrayed, foolish, ashamed.

Difficulty in daily activities, confused, couldn't focus on future prospects, tired, restless, negative thoughts, self doubt, rarely prioritised herself.

Developing and maintaining positive attitude.

Rest and support: Stress relaxation techniques: breathing, progressive muscular relaxation, yoga.

Depression is a relapsing illness which can be prevented.

What to Eat: limit fats, sweets, alcohol. Eat plenty of fresh fruits and vegetables, drinking lots of water, reducing salty snacks, soft drinks, avoid deep-fried foods.

Exercise: to raise energy level, reduce tension, relieve tiredness/fatigue. Walk, jog a few times a week, to release endorphins, to decrease pain. Focus on exercise activity, forget day-to-day worries.

Have a mental break.

Talking to others: family, friends, religion, healthcare provider.

Patient's Story #3:

Premorbid: 63 years old father, disease-free, active working until retirement, without any time to seek the simplest pleasures in life or cultivate hobby.

Signs and symptoms: feel light, drifting when walking about, anxious, palpitations. Experienced slight difficulty in breathing, worsen when alone, 'Empty nest syndrome', difficulty visiting busy or brightly lit places, can't look at the floor when sweeping, wavy water from taps feel shaky, toss and turn in bed, restless, unstable, dizzy, afraid, anxious when queuing, waiting for someone to arrive.

Physician noticed sad, cheerless, depressed countenance, with fright and anxiety in heartbeat.

Given antidepressants, symptoms improved over next month, developed guidelines for daily existence, abstain from stress and overexcitement, unhappiness, idling.

Refrain from gambling, walking under hot sun, don't rush to complete any work.

Take Pitman shorthand course to activate the brain. Retreat to rural areas to visit relatives, go for short vacation abroad.

Screening:

Think of the last 2 weeks...

have you been feeling sad, down in the dumps?

do you still enjoy job, sports, hobbies?

do you often feel tired?

do you have much trouble sleeping or sleep too much?

gained or lost weight?

often feel down on yourself, or that most things is your fault?

trouble making decisions or concentrating on your work?

often feel agitated or can barely move?

felt that life isn't worth living?

5 and above, and includes first or second question, will benefit from consultation with doctor.

Sleep hygiene

Set the time to sleep and wake everyday, no daytime naps.

Conducive sleep: bedroom, temperature, noise, lighting

Light dinner at least 3 hours before sleep

avoid caffeine after 5 pm

avoid alcohol/cig

exercise 5 hours before sleep

hot water bath 2 hours before sleep

hot milk-based drink before sleep

develop ritual: brush teeth, activity with less concentration or effort, change into sleep attire, read a book

don't lie in bed, read or watch TV till you feel sleepy again. Associate your bed with sleep.

[magimark1]

The Role of Rehabilitation Centers in Transforming Lives

What Is a Rehabilitation Center? A rehabilitation center is a specialized facility designed to help individuals recover from various conditions, including physical injuries, chronic illnesses, addictions, and mental health disorders. The primary goal is to enable patients to restore their independence, improve their quality of life, and reintegrate into society with confidence.

Types of Rehabilitation Centers Physical Rehabilitation Centers These focus on helping individuals recover from injuries, surgeries, or illnesses that affect their mobility. Through physical therapy, occupational therapy, and other specialized treatments, patients regain strength, flexibility, and functionality.

Substance Abuse Rehabilitation Centers These facilities provide a structured environment for individuals struggling with drug or alcohol addiction. They offer detoxification programs, counseling, therapy, and education to help patients overcome dependency and build healthier habits.

Mental Health Rehabilitation Centers Designed for individuals facing challenges like depression, anxiety, or post-traumatic stress disorder (PTSD), these centers offer therapy, counseling, and coping strategies to improve mental well-being.

Specialized Rehabilitation Centers Some centers cater to specific needs, such as stroke recovery, pediatric rehabilitation, or neuro-rehabilitation for conditions like traumatic brain injuries.

Key Components of a Rehabilitation Program Personalized Treatment Plans: Each patient receives a customized plan tailored to their specific needs and goals. Multidisciplinary Approach: Teams of professionals, including doctors, therapists, counselors, and social workers, collaborate to provide holistic care. Therapeutic Interventions: Depending on the condition, these may include physical therapy, cognitive behavioral therapy, or group sessions. Family Involvement: Families often play a crucial role in supporting the patient’s recovery journey. Many centers include family therapy and education. The Journey to Recovery Recovery is not a linear process, and every individual’s journey is unique. Rehabilitation centers create a supportive environment where patients feel empowered to overcome challenges at their own pace. Success is measured not just by physical or mental improvement but also by the patient’s ability to lead a fulfilling and independent life.

Why Choose a Rehabilitation Center? Opting for professional help ensures access to expert care, evidence-based treatments, and a structured environment. Rehabilitation centers provide the tools and resources needed for lasting recovery, reducing the likelihood of relapse or long-term complications.

Conclusion Rehabilitation centers are beacons of transformation and renewal. They guide individuals from a place of struggle to a state of empowerment and healing. By addressing the physical, emotional, and social aspects of recovery, these centers pave the way for brighter, healthier futures.

[iikciim]

Psychotherapeutic Drugs

Anatomy, Physiology, and Pathophysiology Overview

The treatment of mental disorders is called psychotherapeutics.

Long-term pharmacotherapy in conjunction with psychotherapy is recommended when emotions or behaviors compromise the quality of life, ability to carry out normal activities of daily living, social functioning, or occupational functioning over a prolonged period.

In the biochemical imbalance theory, mental disorders are thought to arise as the result of abnormal levels of endogenous chemicals in the brain known as

Drugs used to treat mental illnesses, including anxiety, affective disorders, and psychoses, work by blocking or stimulating the release of various endogenous neurotransmitters.

Patients with mental illness are at greater risk for physical illnesses associated with obesity, including diabetes, hypertension, and heart disease.

Economic, educational, and psychosocial issues may preclude a mentally ill person from seeking psychiatric health care, resulting in self-medication with substances of abuse, including alcohol, tobacco, and illegal or unauthorized prescription drugs.

Ideal mental health care involves many components, including a carefully detailed patient interview and carefully chosen and regularly monitored drug therapy.

Nonpharmacologic treatments include psychotherapy, support groups, social and family support systems, and often spiritual support systems.

There are three common types of mental illness: anxiety, affective, and psychotic disorders. The drugs used to treat anxiety are anxiolytics. Mood stabilizers and antidepressants are used to treat affective disorders, while antipsychotics are used to treat psychotic disorders.

Psychosis is a major emotional disorder that impairs mental function. A person experiencing psychosis cannot participate in everyday life and shows a loss of contact with reality.

Affective disorders are emotional disorders characterized by changes in mood. They range from mania to depression and include anxiety, a normal emotion that may be a healthy reaction but becomes pathologic when it is life-altering.

Anxiety disorders occur in approximately 18.1% of the adult population in the US.

Obsessive-compulsive disorder is twice as common as schizophrenia or panic disorders in the general population.

Situational anxiety arises in response to specific life events, and nursing assessment is key to identifying patients at risk.

https://bb-csuohio.blackboard.com/bbcswebdav/pid-7116321-dt-content-rid-80385689_1/xid-80385689_1

Pharmacology Overview

Psychotropic drugs are among the most commonly prescribed drugs in the United States.

The effectiveness of drug therapy is often measured by verbal reports from patients regarding the level of improvement (if any) in their social and occupational functioning.

Nonadherence to the prescribed regimen is common as patients may remain in denial about the reality of their mental illness, including the need to take psychotropic medications.

Anxiolytic Drugs

Primary anxiolytic drugs include the benzodiazepine drug class and the miscellaneous drug buspirone. The benzodiazepines are commonly used as first-line drug therapy for both acute and chronic anxiety disorders.

Other drugs that are effective as anxiolytics include selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), antipsychotics, and the antihistamine hydroxyzine.

All anxiolytic drugs decrease anxiety by reducing overactivity in the central nervous system (CNS).

Benzodiazepines are the largest and most commonly prescribed anxiolytic drug class because they offer several advantages over other drugs used to treat anxiety.

Benzodiazepines exert their effect by depressing activity in areas of the brain when they increase the action of gamma-aminobutyric acid (GABA), which is an inhibitory neurotransmitter in the brain that blocks nerve transmission in the CNS.

The most common undesirable effect is overexpression of their therapeutic effects, in particular CNS depression. Benzodiazepines can also cause hypotension.

Elderly patients tend to be more sensitive to the sedating effects of benzodiazepines, which can increase their risk for falls; lower doses are usually needed.

When benzodiazepines are taken alone, an overdose is generally not life-threatening. When they are combined with alcohol or other CNS depressants, the outcome is much more severe.

Buspirone (BuSpar) is an anxiolytic drug that is different from benzodiazepines; it appears to have agonist activity at both serotonin and dopamine receptors.

https://bb-csuohio.blackboard.com/bbcswebdav/pid-7116321-dt-content-rid-80385687_1/xid-80385687_1

Affective Disorders

Mood-Stabilizing Drugs

Mood stabilizers are drugs used to treat bipolar illness. Catecholamines play an important role in the development of mania; serotonin also appears to be involved.

Lithium has been in use for many years and is still used to effectively alleviate the symptoms of acute mania in bipolar disorder as well as for maintenance therapy to prevent episodes.

When taking lithium, patients need to maintain their sodium intake and not change it dramatically.

A new antipsychotic, cariprazine (Vraylar), was approved in 2016 for the treatment of bipolar disorder.

A variety of medications may be used in conjunction with lithium to regulate mood or achieve stability, including benzodiazepines, antipsychotic drugs, antiepileptic drugs, and dopamine receptor agonists.

Antidepressant Drugs

Antidepressants are the pharmacologic treatment of choice for major depressive disorders. They are also useful in treating other disorders, such as dysthymia, schizophrenia, eating disorders, and personality disorders.

Some of the antidepressants are also used in the treatment of various medical conditions, including migraine headaches, chronic pain syndromes, sleep disorders, premenstrual syndrome, and hot flashes associated with menopause.

Many drugs used to treat affective disorders increase the levels of neurotransmitter concentrations in the CNS, including serotonin, dopamine, and norepinephrine.

The permissive hypothesis led to the creation of the selective SSRI drug class. The permissive theory postulates that reduced concentrations of serotonin are the predisposing factor in patients with affective disorders. Depression results from decreases in both the serotonin and catecholamine levels, whereas mania results from increased dopamine and norepinephrine levels but decreased serotonin.

Anxiety and depression commonly occur together, so there is much crossover in symptom control between antidepressant and anxiolytic drugs.

A nonresponse to antidepressant drug therapy is defined as failure to respond to at least 6 weeks of therapy with adequate drug dosages. Twenty percent to 30% of patients who do not respond to the usual dosage of an antidepressant will respond to higher dosages.

In 2005, the Food and Drug Administration (FDA) issued special black box warnings for all classes of antidepressants in both adult and pediatric patient populations; data indicated a higher risk for suicide in patients receiving these medications.

Current recommendations for all patients receiving antidepressants include regular monitoring for signs of worsening depressive symptoms, especially when the medication is started or the dosage is changed.

Tricyclic Antidepressants

TCAs were the original first-generation antidepressants; their use has largely been replaced with SSRIs and serotonin-norepinephrine reuptake inhibitors.

The TCAs are considered second-line drug therapy in patients for whom the SSRIs are ineffective or as adjunct therapy with newer drugs.

Originally used to treat depression, currently, TCAs are most commonly used to treat neuropathic pain syndromes and insomnia.

Undesirable effects of TCAs are a result of their effects on various receptors.

Blockade of cholinergic receptors results in undesirable anticholinergic adverse effects, the most common being constipation and urinary retention.

TCA overdoses are notoriously lethal. It is estimated that 70% to 80% of patients who die of TCA overdose do so before reaching the hospital, especially if the drugs are taken with alcohol. The systems affected are the CNS and cardiovascular system.

Most TCAs are rated as pregnancy category D drugs, which makes their use by pregnant women relatively more hazardous than that of most of the newer drugs.

Monoamine Oxidase Inhibitors

MAOIs, along with TCAs, represent the first generation of antidepressant drug therapy; they are rarely used as antidepressants but are used to treat Parkinson’s disease.

MAOI use may cause a hypertensive crisis when taken with stimulant medications or with a substance containing tyramine, which is found in many common foods and beverages.

Clinical symptoms of MAOI overdose generally do not appear until about 12 hours after ingestion. The primary signs and symptoms are cardiovascular and neurologic. 

Second-Generation Antidepressants

The second-generation antidepressants include trazodone, bupropion, SSRIs (e.g., fluoxetine, sertraline, paroxetine), serotonin-norepinephrine reuptake inhibitors (e.g., venlafaxine), and miscellaneous drugs, nefazodone, and mirtazapine.

The inhibition of serotonin reuptake is the primary mechanism of action of the selective serotonin reuptake inhibitor (SSRIs).

SSRIs and SNRIs are often prescribed because of their superiority to older antidepressants.

The adverse effect profiles of second-generation antidepressants are associated with significantly fewer and less severe effects than TCAs and MAOIs.

Second-generation antidepressants take the same amount of time to reach maximum clinical effectiveness as do the TCAs and MAOIs—typically 4 to 6 weeks.

Although depression is the primary indication, the drugs have shown benefit in treating other mental and physical disorders, such as bipolar disorder, obesity, eating disorders, obsessive-compulsive disorder, panic attacks or disorders, social anxiety disorder, posttraumatic stress disorder, premenstrual dysphoric disorder, the neurologic disorder myoclonus, and various substance abuse problems such as alcoholism.

Some of the most common adverse effects are insomnia, weight gain, and sexual dysfunction, primarily related to the inability to achieve orgasm.

One potentially hazardous adverse effect of any drug or combination of drugs that have serotoninergic activity is known as serotonin syndrome.

SSRIs are associated with a discontinuation syndrome or withdrawal syndrome, and the drugs must be very slowly tapered. SSRIs with the shortest half-lives (citalopram, escitalopram, sertraline, paroxetine) are most commonly associated with discontinuation syndrome. Symptoms include flulike feeling, difficulty concentrating, faintness, and GI symptoms. While most commonly associated with SSRIs, it can occur with the SNRIs: venlafaxine, desvenlafaxine, duloxetine, milnacipran, and levomilnacipran.

To prevent potentially fatal pharmacodynamic interactions with the MAOIs, a 2- to 5-week washout period is recommended between the use of SSRIs and MAOIs.

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Nursing Process

Nursing considerations related to psychotherapeutic drugs include the need for skillful patient assessment with an emphasis on past and present medical history, physical examination, and a thorough medication history and profile as a comparative baseline for the patient during and after initiation of therapy.

Thoroughly assess the patient’s neurologic functioning, including level of consciousness, mental alertness, and level of motor and cognitive functioning.

The Mini-Mental State Examination (MMSE) is one tool that you may use to assess cognitive status and help identify impairments often found in mental illnesses.

Constantly assess the patient for any suicidal ideations or tendencies because of the potential for suicide, with or without the concurrent use of other medications or alcohol.

If an assessment reveals any concerns and/or the patient acknowledges suicidal thoughts, it is critical to share assessment findings with nursing staff so that an appropriate referral for immediate assessment and/or treatment may be initiated.

It is important to assess sleep habits and nutritional intake and to perform a head-to-toe physical examination for baseline and comparative purposes. Note any drug allergies as well as any contraindications, cautions, and potential drug interactions.

With psychotherapeutic drug therapy, assess the patient’s mouth and oral cavity to make sure the patient has swallowed the entire oral dosage. This helps to prevent hoarding or “cheeking” of medications, and noncompliance that may lead to drug toxicity or overdose.

All psychotherapeutic drugs are to be taken exactly as prescribed and at the same time every day and without failure. If omission occurs, contact the prescriber immediately. Abrupt withdrawal may have negative effects on the patient’s physical and mental status.

Patients taking psychotherapeutic drugs who have a history of cardiac disease may be at a greater risk for experiencing dysrhythmias, tachycardia, stroke, myocardial infarction, and/or heart failure.

Always provide a medication guide and instructions upon dispensing all psychotherapeutic medications.

Monitor the therapeutic effects of psychotherapeutic medications and the patient’s progress before and during drug therapy. Mental alertness, cognition, affect, mood, ability to carry out activities of daily living, appetite, and sleep patterns are all areas that need to be closely monitored and documented.