Understanding Elderly Persons Mental Health Disorders:

Understanding Elderly Persons Mental Health Disorders:

Understanding mental health disorders in elderly persons is crucial for providing appropriate care, improving quality of life, and ensuring early detection and treatment.

Here’s a clear overview of the key aspects:

Common Mental Health Disorders in the Elderly:

Depression

Often underdiagnosed in older adults.

Symptoms: persistent sadness, fatigue, sleep disturbances, loss of interest, weight changes.

May be triggered by isolation, loss, illness, or medication side effects.

Anxiety Disorders

Includes generalized anxiety disorder, phobias, panic disorder.

Often co-occurs with depression.

Symptoms: excessive worry, restlessness, tension, sleep issues.

Dementia

Includes Alzheimer’s disease and other types (vascular, Lewy body, etc.).

Progressive cognitive decline: memory loss, confusion, personality changes, impaired judgment.

Early detection is key for care planning.

Delirium

Acute and sudden onset of confusion.

Often caused by medical illness, medications, or surgery.

Reversible with timely treatment.

Substance Use Disorders (“Please Seek Medical Advice”)

Includes alcohol or prescription drug misuse (especially benzodiazepines or opioids).

May be overlooked due to stigma or misattributed to aging.

Late-Onset Psychosis

Can include schizophrenia-like symptoms or delusional disorder.

May be related to neurodegenerative diseases or underlying medical conditions. (“Please Seek Medical Advice”)

Contributing Factors to Mental Health Issues in the Elderly:

Biological: Chronic illness, pain, neurodegenerative conditions, medication side effects.

Psychological: Grief, trauma, fear of death, loss of autonomy.

Social: Isolation, loneliness, lack of social support, elder abuse.

Environmental: Institutionalization, poor housing, or inadequate caregiving.

Diagnosis and Assessment:

Comprehensive assessments should include:

Medical history and current medications

Mental status exams (e.g., MMSE, MoCA)

Functional assessments (daily living skills)

Family and caregiver input

Treatment Approaches:

Psychotherapy

Cognitive Behavioral Therapy (CBT), reminiscence therapy, supportive counseling.

Medication (“Please Seek Medical Advice”)

Antidepressants, anxiolytics, antipsychotics — but with caution due to sensitivity and side effects.

Social Support

Day programs, community involvement, family therapy, support groups.

Lifestyle Modifications

Physical activity, good nutrition, sleep hygiene, cognitive stimulation.

Integrated Care

Collaboration between primary care, mental health professionals, and caregivers.

Prevention and Early Intervention:

Promote social engagement and meaningful activity.

Regular screenings during routine medical visits.

Educate families and caregivers on warning signs.

Encourage open conversations about mental health.

Shervan K Shahhian

Neurodivergent Individuals, who are they:

Neurodivergent Individuals, who are they:

“It is important to seek advice from a Psychiatrist”

Neurodivergent individuals are people whose neurological development and functioning differ from what is typically expected by societal norms. The term neurodivergent is part of the broader concept of neurodiversity, which recognizes that brain differences are natural variations of the human experience.

Who Falls Under the Neurodivergent Umbrella?

Neurodivergence can include (but is not limited to) people with:

Autism Spectrum Disorder (ASD)
Attention-Deficit/Hyperactivity Disorder (ADHD)
Dyslexia
Dyspraxia
Dyscalculia
Tourette Syndrome
Obsessive-Compulsive Disorder (OCD)
Bipolar disorder or other mood-related differences (sometimes included depending on context)
Sensory Processing Disorder

Some also include people with traumatic brain injuries or those experiencing complex PTSD under certain definitions of neurodivergence.

Key Points:

Being neurodivergent is not inherently a disorder or deficit — it’s a different way of experiencing and interacting with the world.
Neurodivergent people may face challenges in traditional systems (e.g., schools, workplaces) that are designed for neurotypical brains.
They often have unique strengths — such as pattern recognition, creativity, hyperfocus, or alternative problem-solving approaches.

Shervan K Shahhian

Bipolar 1 & Bipolar 2, what is the difference:

Bipolar 1 & Bipolar 2, what is the difference:

ASK YOUR PSYCHIATRIST/MEDICAL DOCTOR

The main difference between Bipolar I and Bipolar II disorder lies in the severity and type of mood episodes experienced:

Bipolar I Disorder

Manic episodes are the hallmark. These are severe, often requiring hospitalization, and can include psychosis (delusions, hallucinations).
The person may also experience major depressive episodes, but depression is not required for a diagnosis.
Manic episodes Might last at least 7 days, or are so severe that immediate medical care is needed.

Example: A person may go days without sleep, have grandiose ideas, and engage in risky behaviors—followed (or preceded) by deep depression.

Bipolar II Disorder

Characterized by hypomanic episodes (a milder form of mania) and major depressive episodes.
No full manic episodes occur.
Hypomania Might lasts at least 4 days and doesn’t usually cause significant disruption or require hospitalization.

Example: A person may feel unusually energetic, talkative, and productive for a few days, but not out of control—then experience weeks or months of debilitating depression.

Summary Table:

Feature	Bipolar I	Bipolar II
Mania	Full mania (severe)	Hypomania (mild/moderate)
Depression	May occur, not required	Required for diagnosis
Hospitalization	Common during mania	Rare
Psychosis	Possible in mania	Absent

Here’s a comparison of Bipolar I vs Bipolar II including their core features and typical treatment options:

Bipolar I vs. Bipolar II: Full Comparison

Feature	Bipolar I	Bipolar II
Type of Elevated Mood	Full mania	Hypomania (less intense than mania)
Depressive Episodes	Common, but not required for diagnosis	Required for diagnosis
Mania Duration	≥ 7 days, or any duration if hospitalization needed	≥ 4 days, not severe enough for hospitalization
Psychosis	Can occur during manic episodes	Not typical
Functioning Impairment	Often severe, may lead to hospitalization	Impairment usually mild during hypomania
Diagnosis Requirement	At least 1 manic episode	At least 1 hypomanic + 1 major depressive episode
Suicide Risk	High (especially with mixed episodes or depression)	Higher than Bipolar I due to more time spent in depression
Course of Illness	May have rapid cycling or mixed episodes	Often more time spent depressed than elevated

Treatment Options

1. Mood Stabilizers

ASK YOUR PSYCHITRIAST/MEDICAL DOCTOR

2. Antipsychotics (especially for mania or psychosis)

ASK YOUR PSYCHITRIAST/MEDICAL DOCTOR

3. Antidepressants

ASK YOUR PSYCHITRIAST/MEDICAL DOCTOR.

4. Psychotherapy

Cognitive Behavioral Therapy (CBT) – For managing depressive symptoms and negative thinking patterns.
Psychoeducation – Teaching about the illness to improve treatment adherence.
Family-focused therapy – Helps stabilize the environment and support systems.

5. Lifestyle and Monitoring

Sleep regulation is critical — disturbed sleep can trigger episodes.
Mood tracking apps or journals help identify early warning signs.
Avoiding alcohol and drugs — these can destabilize mood.

Summary:

Bipolar I: More severe, needs stronger antimanic treatment, often antipsychotics. ASK YOUR PSYCHIATRIST/MEDICAL DOCTOR
Bipolar II: More chronic depression, focus often on lamotrigine and psychotherapy.
Shervan K Shahhian

Dark Thoughts, how to cope:

Dark Thoughts, how to cope:

Struggling with dark thoughts can feel isolating and overwhelming, but you don’t have to face them alone.

Here’s a grounded, layered approach to coping:

1. Don’t Face It Alone

Talk to someone you trust. A friend, family member, or a therapist.

If it’s intense or persistent, seek professional help — a psychologist or psychiatrist can offer real support and perspective.

You can also contact a crisis line if things feel urgent (let me know your location, and I can help find one near you).

2. Understand the Nature of the Thought

Dark thoughts often aren’t truths — they’re mental weather, not your identity.

Try journaling them without judgment. Write what the thought says, how it feels, and what might have triggered it.

3. Grounding Techniques

5–4–3–2–1 Technique: Name 5 things you see, 4 things you feel, 3 things you hear, 2 you smell, and 1 you taste.

Cold water on your face or holding ice can help shift mental gears.

4. Creative or Spiritual Outlets

Art, music, or writing can help channel those energies safely.

Meditation or prayer — not to escape, but to connect with a higher awareness or intelligence.

5. Shift the Inner Dialogue

Ask yourself:

Whose voice is this?

Would I say this to a friend? Try to counter with gentle truths, even if they feel small: “This is hard, but I am still here. I don’t have to believe every thought I think.”

You’re not alone in having dark moments — but what you do with them defines your strength, not the fact that they’re there.

Shervan K Shahhian

Concussion Symptoms, what are they:

Concussion Symptoms, what are they:

Concussion symptoms can vary from person to person but generally fall into four main categories: physical, cognitive, emotional, and sleep-related.

Here’s a breakdown of the most common symptoms:

Physical Symptoms

Headache

Dizziness or balance problems

Nausea or vomiting

Blurred or double vision

Sensitivity to light or noise

Fatigue or drowsiness

Ringing in the ears (tinnitus)

Temporary loss of consciousness (not always present)

Cognitive Symptoms

Confusion or feeling “foggy”

Difficulty concentrating or remembering

Slowed thinking or response times

Disorientation (not knowing where you are or what time it is)

Emotional and Mood Symptoms

Irritability

Sadness or depression

Anxiety or nervousness

Mood swings

Sleep-Related Symptoms

Sleeping more or less than usual

Difficulty falling asleep

Trouble staying asleep

Symptoms may appear immediately or take hours to days to show up. In some cases, people may not even realize they have a concussion right away.

Shervan K Shahhian

How can we protect our Memory:

How can we protect our Memory:

Protecting memory involves a combination of lifestyle choices, mental stimulation, physical health, and sometimes targeted interventions.

Here are key strategies to help preserve and enhance memory:

1. Mental Stimulation

Keep learning: Engage in new skills, puzzles, languages, reading, or hobbies.

Challenge your brain: Strategy games, chess, or memory games build cognitive resilience.

2. Nutrition for Brain Health

Eat a brain-healthy diet: Focus on the Mediterranean or MIND diet — rich in vegetables, fruits, whole grains, nuts, and healthy fats (like olive oil).

Stay hydrated: Even mild dehydration can affect memory.

3. Prioritize Sleep

7–9 hours per night: Memory consolidation occurs during deep sleep stages.

Good sleep hygiene: Regular schedule, no screens before bed, and a calm environment.

4. Physical Activity

Exercise regularly: Aerobic activity increases blood flow to the brain and stimulates growth factors that aid memory.

Even walking helps: 30 minutes a day can make a difference.

5. Manage Stress and Emotions

Chronic stress harms memory: Cortisol interferes with memory consolidation and retrieval.

Practice relaxation techniques: Meditation, yoga, breathing exercises.

6. Avoid Brain Hazards

Limit alcohol and avoid smoking: Both can accelerate memory decline.

Watch medications: CONSULT YOUR MEDICAL DOCTOR.

7. Stay Socially Active

Engage with people: Conversations, shared activities, and emotional bonds help maintain cognitive function.

8. Monitor Health Conditions

Control blood pressure, cholesterol, and diabetes: These affect brain health. CONSULT YOUR MEDICAL DOCTOR.

Treat depression: Untreated depression often mimics or worsens memory loss.

Shervan K Shahhian

Understanding Self-Harm or Self-Mutilation:

Understanding Self-Harm or Self-Mutilation:

Understanding self-harm or self-mutilation requires compassion, psychological insight, and awareness of the deeper emotional pain driving these behaviors.

Definition
Self-harm (also known as non-suicidal self-injury, or NSSI) refers to the deliberate infliction of physical harm on one’s own body, often without suicidal intent. Common methods include cutting, burning, hitting, or scratching oneself.

Why People Self-Harm
Self-harm is typically a coping mechanism for intense emotional distress. People may hurt themselves to:

Regain a sense of control when they feel overwhelmed.

Release emotional pain that feels unmanageable.

Punish themselves due to feelings of guilt or self-loathing.

Feel something physical when they are emotionally numb or dissociated.

Communicate distress when words feel inadequate or unavailable.

Underlying Psychological Factors
Self-harming behaviors are not a diagnosis on their own, but they often co-occur with:

Depression

Anxiety disorders

Post-traumatic stress disorder (PTSD)

Borderline personality disorder (BPD)

Dissociation or trauma histories

Low self-esteem or self-hatred

Warning Signs
Unexplained cuts, bruises, or burns

Wearing long sleeves in hot weather

Frequent isolation or withdrawal

Emotional volatility or numbness

A preoccupation with self-punishment or self-hatred

What Self-Harm Is Not
It’s not just attention-seeking—it’s often a silent cry for help.

It’s not a suicide attempt, though the two can be related.

It’s not limited to teens or one gender—people of all ages and backgrounds can be affected.

Support and Healing
Helping someone who self-harms involves:

Listening without judgment

Encouraging professional help (psychotherapy, especially DBT or CBT)

Providing emotional safety and understanding

Helping them find healthier coping strategies (journaling, exercise, art, mindfulness, etc.)

Therapeutic Approaches
Dialectical Behavior Therapy (DBT): Especially effective for those with BPD or emotional regulation issues.

Cognitive Behavioral Therapy (CBT): Helps reframe harmful thoughts and develop new coping mechanisms.

Trauma-informed care: Vital for those with abuse or PTSD backgrounds.

Shervan K Shahhian

Understanding Non-Suicidal Self-Injury or NSSI:

Understanding non-suicidal self-injury or NSSI:

Non-suicidal Self-Injury (NSSI) refers to the intentional, direct harm to one’s own body tissue without suicidal intent. It’s a psychological behavior often used as a coping mechanism, not an attempt to end life. Understanding it involves examining emotional, psychological, and social dimensions.

Key Aspects of NSSI:

1. Common Forms:

Cutting (most prevalent)

Burning

Scratching

Hitting or banging body parts

Interfering with wound healing

Hair pulling (can overlap with trichotillomania)

2. Psychological Function:

People may engage in NSSI for various emotional reasons, including:

Emotion regulation: Relief from intense emotions like anger, sadness, anxiety, or emptiness.

Self-punishment: Due to guilt, shame, or low self-esteem.

To feel something: Counteracting emotional numbness or dissociation.

Communication or expression: As a cry for help or a way to express internal pain non-verbally.

Control: Gaining a sense of control in chaotic situations.

3. Risk Factors:

Childhood trauma or abuse

Emotional dysregulation (often seen in borderline personality disorder)

Depression or anxiety disorders

Bullying, social rejection, or peer pressure

Lack of social support or emotional expression tools

4. Who Is Affected?

Most common among adolescents and young adults

Can occur in any gender, though females often report cutting more and males report hitting or burning more

Increasingly seen across cultural and socio-economic groups

5. Clinical Recognition:

Included in the DSM-5 as a condition requiring further study

Often co-occurs with other mental health issues like depression, PTSD, eating disorders, or BPD

6. Treatment Approaches:

Cognitive Behavioral Therapy (CBT): Helps restructure negative thought patterns and develop healthy coping skills.

Dialectical Behavior Therapy (DBT): Particularly effective for emotion regulation and interpersonal effectiveness.

Trauma-informed care: When history of abuse or trauma is involved.

Medication: If there’s a co-occurring mood or anxiety disorder.

Family therapy or support groups: To address relational dynamics and isolation.

Important Distinctions:

NSSI ≠ Suicide Attempt: NSSI is not intended to be fatal, though it can increase the risk of future suicide attempts if underlying issues remain untreated.

It is a signal of distress, not attention-seeking behavior — compassionate, nonjudgmental support is key to helping those who engage in it.

Supporting someone who engages in non-suicidal self-injury (NSSI) and understanding how it is assessed clinically are both critical for effective care and intervention. Here’s a breakdown of both:

How to Support Someone Engaging in NSSI

1. Respond with Empathy, Not Judgment

Avoid saying things like “Why would you do that?” or “You just want attention.”

Instead: “That must be really hard for you. I’m here if you want to talk.”

2. Stay Calm and Grounded

Seeing injuries can be shocking, but reacting with panic may make the person feel ashamed or retreat.

Keep your voice calm, and focus on understanding rather than controlling.

3. Open Non-Confrontational Conversations

Ask gently: “I noticed you’ve been hurting yourself. Do you want to talk about what’s been going on?”

Validate their pain even if you don’t understand the behavior: “I can’t imagine what you’re going through, but I want to help.”

4. Encourage Professional Help

Suggest they speak with a therapist or counselor trained in trauma, emotion regulation, or adolescent mental health.

Offer to help them find resources or go with them if they’re afraid.

5. Promote Safe Alternatives

Help them identify replacement behaviors like:

Snapping a rubber band on the wrist

Drawing on skin with red markers

Holding ice cubes

Journaling or art

Exercise or grounding techniques

These don’t solve the core issue but can reduce harm as they transition to healthier coping.

6. Be Patient

Stopping NSSI is a process, not a single decision.

Relapses can happen; continue offering nonjudgmental support.

How NSSI is Assessed Clinically

1. Clinical Interviews

Mental health professionals conduct structured or semi-structured interviews that cover:

Frequency, methods, and severity of self-injury

Triggers and emotional states before and after

Intent (e.g., suicidal vs. non-suicidal)

History of trauma, abuse, or neglect

Co-occurring symptoms: depression, anxiety, dissociation

2. Assessment Tools and Questionnaires

Some standardized tools used include:

Functional Assessment of Self-Mutilation (FASM)

Deliberate Self-Harm Inventory (DSHI)

Self-Injurious Thoughts and Behaviors Interview (SITBI)

3. Differential Diagnosis

Clinicians assess whether NSSI is:

A symptom of a broader condition (e.g., Borderline Personality Disorder, Depression, PTSD)

Occurring independently, possibly as a primary coping mechanism.

4. Risk Assessment

Even though NSSI isn’t suicidal, it’s linked to higher suicide risk over time.

Clinicians assess for suicidal ideation, hopelessness, and impulsivity.

5. Treatment Planning

Based on the assessment, the clinician develops a personalized care plan that may involve:

Therapy (DBT, CBT, EMDR)

Medication SEEK MEDICAL ADVICE FROM A MEDICAL DOCTOR.

Family involvement, if appropriate

Shervan K Shahhian

Self-Injury, why:

Self-Injury, why:

Self-injury (also known as non-suicidal self-injury or NSSI) is the act of deliberately harming one’s body without suicidal intent. It’s usually a way for someone to cope with intense emotional pain, stress, or psychological distress.

The reasons people self-injure vary, but common motivations include:

Emotional Regulation: To relieve overwhelming negative emotions like sadness, anger, anxiety, or numbness. The physical pain can momentarily distract from emotional suffering or provide a sense of control.

Self-Punishment: For some, self-injury serves as a form of self-directed anger or guilt. They may feel they “deserve” pain due to low self-esteem or unresolved trauma.

Feeling Real or Grounded: People who feel dissociated or emotionally numb may use pain to reconnect with their body and emotions.

Communication: Although not always conscious, some use self-injury as a way to signal distress or get help when they struggle to express it verbally.

Relief from Tension: The act of self-injury can cause the release of endorphins, which temporarily reduce stress or anxiety.

It’s important to note that self-injury is a sign of underlying emotional pain — not always attention-seeking or manipulation, as is sometimes misperceived. Compassion, understanding, and professional support are essential in helping someone who self-injures.

Shervan K Shahhian

Cutters and those who Self-Harm, why:

Cutters and those who Self-Harm, why:

Self-harm, including cutting, is a complex and often misunderstood behavior. People who engage in self-harm are usually not trying to end their lives but are instead trying to cope with overwhelming emotional pain, regulate intense feelings, or feel something when feeling numb. It’s a maladaptive coping mechanism that can temporarily relieve distress but often leads to shame, isolation, and increased suffering.

Common Reasons People Self-Harm:

Emotional regulation: To release feelings of anger, sadness, or frustration.
Self-punishment: Due to feelings of guilt, shame, or self-hatred.
Numbness or dissociation: To feel real or break through emotional numbness.
A cry for help or communication: When words feel insufficient to express inner turmoil.
Sense of control: When life feels chaotic or out of their hands.

Important Points:

It affects people across all ages, genders, and backgrounds.
It is not necessarily linked to suicidal intent, though it does increase risk.
Shame and stigma often keep people from seeking help.
Therapy (especially Dialectical Behavior Therapy or Cognitive Behavioral Therapy) can be very effective.
Supportive relationships and environments are critical for healing.

Would you like insights on how to support someone who self-harms or explore psychological approaches to treatment?

Explore Psychological approaches to treatment:

Psychological approaches to treating self-harm focus on understanding the underlying emotional drivers and helping individuals build healthier coping strategies.

Here’s an overview of the most effective evidence-based treatments:

1. Dialectical Behavior Therapy (DBT)

Best for: Individuals with emotional dysregulation, especially those with Borderline Personality Disorder (BPD), though it’s helpful beyond that.

Core Skills Taught:

Mindfulness: Staying present and aware of emotions.

Distress Tolerance: Surviving emotional crises without self-harming.

Emotion Regulation: Identifying and managing intense emotions.

Interpersonal Effectiveness: Navigating relationships in a healthy way.

Why it works: DBT teaches concrete skills to replace self-harm with more adaptive behaviors.

2. Cognitive Behavioral Therapy (CBT)

Best for: Understanding and challenging the thoughts and beliefs that lead to self-harming behaviors.

Focuses on the cognitive distortions (e.g., “I deserve pain”) and maladaptive behavior patterns.

Encourages behavioral experiments to try safer alternatives.

Teaches problem-solving and coping skills.

3. Mentalization-Based Therapy (MBT)

Best for: People who struggle to understand their own and others’ mental states (common in BPD or attachment trauma).

Helps the person recognize the thoughts and feelings behind their actions.

Builds the capacity to reflect rather than react.

4. Compassion-Focused Therapy (CFT)

Best for: Individuals with high self-criticism or shame.

Aims to increase self-compassion and soothe the inner critic.

Replaces self-harm used as self-punishment with nurturing internal dialogues.

5. Psychodynamic Therapy

Best for: Exploring unresolved emotional conflicts, early attachment issues, or trauma.

Uncovers the root psychological causes behind the need to self-harm.

Can be helpful for those who want to understand the deeper meaning of their behavior.

6. Trauma-Informed Therapy (e.g., EMDR, Somatic Experiencing)

Best for: Those with a history of abuse, neglect, or PTSD.

Recognizes self-harm as a survival response to trauma.

Helps process traumatic memories and reduce dysregulation at the nervous system level.

Additional Support Approaches:

Art therapy or music therapy to express pain non-verbally.

Group therapy for peer support and skill-building.

Medication may be helpful for co-occurring depression, anxiety, or mood disorders.

Treatment is most effective when non-judgmental, empathetic, and collaborative, focusing on safety planning, trust, and empowerment.

Shervan K Shahhian