Body Dysmorphic Disorder (BDD)

           Body Dysmorphic Disorder (BDD)

     Body Dysmorphic Disorder (BDD) is a mental health condition characterized by an obsessive focus on perceived flaws or defects in one's appearance, which are either minor or not observable to others. People with BDD can spend significant amounts of time worrying about these perceived flaws, and it can severely impact their daily life, relationships, and overall well-being. Here are some key details:

Symptoms:

1. Preoccupation with Appearance: Intense and persistent focus on one or more perceived defects or flaws in physical appearance
2. Excessive Behaviors: Engaging in repetitive behaviors such as mirror checking, excessive grooming, or skin picking. Some may seek constant reassurance from others about their appearance.
3. Avoidance: Avoiding social situations or activities due to embarrassment or anxiety about their appearance.
4. Impaired Functioning: The preoccupation with appearance can cause significant distress or impairment in social, occupational, or other important areas of functioning.

Here are the symptoms of Body Dysmorphic Disorder (BDD) in detail:

1. Preoccupation with Appearance:

   • Persistent and intrusive thoughts about perceived defects or flaws in physical appearance.
   • These flaws are often minor or not noticeable to others.

2. Excessive Behaviors:

   • Mirror Checking: Frequently checking one's appearance in mirrors or reflective surfaces.
   • Grooming: Excessively grooming, such as applying makeup or skin care products in an attempt to fix perceived flaws.
   • Skin Picking: Picking at the skin to try to remove blemishes or imperfections.
   • Seeking Reassurance: Constantly asking others for reassurance about appearance.

3. Avoidance:

   • Social Withdrawal: Avoiding social situations, public places, or activities where appearance might be scrutinized.
   • Avoiding Mirrors: Avoiding mirrors or reflective surfaces due to fear of seeing imperfections.

4. Impaired Functioning:

   • Social Impact: Difficulty maintaining relationships or engaging in social activities due to preoccupation with appearance.
   • Occupational Impact: Difficulty performing work or academic tasks due to distraction or anxiety about appearance.

5. Emotional Distress:

   • Feelings of shame, embarrassment, or depression related to appearance.
   • Intense anxiety or distress when unable to correct or hide perceived flaws.

6. Obsessive Thoughts:

   • Persistent worry or obsession about appearance-related flaws.
   • Difficulty focusing on other tasks or aspects of life due to preoccupation with appearance.

7. Avoidance of Certain Activities:

   • Avoiding activities or situations that involve exposing the body, such as swimming or exercising, due to embarrassment or anxiety about appearance.

If these symptoms are affecting daily life, relationships, or overall functioning, it's important to seek help from a mental health professional.

Common Concerns:

• Skin Flaws: Acne, scars, or perceived blemishes.
• Hair: Thinning hair or perceived hair imperfections.
• Nose: Believing the nose is too big or misshapen.
• Body Size or Shape: Preoccupation with body parts being too large or too small.

Causes:

The exact cause of BDD is not fully understood, but it is believed to result from a combination of genetic, biological, environmental, and psychological factors. Risk factors can include:

• Genetic Predisposition: Family history of BDD or other mental health disorders.
• Biological Factors: Imbalances in brain chemicals or brain function.
• Psychological Factors: Low self-esteem, negative self-image, or past trauma.
• Environmental Influences: Societal pressures, media influence, or bullying.

Diagnosis:

Diagnosis is typically made by a mental health professional through clinical interviews and assessment of symptoms. It's important to differentiate BDD from other conditions like eating disorders or generalized anxiety disorder.

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Role of diet and lifestyle in psoriasis management

                  Role of diet and lifestyle in psoriasis management 

Psoriasis is a chronic skin condition that can have a profound impact on individuals in several ways:

1. Physical Impact:

• Psoriasis can cause red, scaly patches on the skin that can be itchy and painful. Discuss how the physical symptoms of psoriasis, such as dry skin, flaking, and the appearance of these patches, can be uncomfortable and often affect a person's self-esteem.
• Mention that the severity of psoriasis varies from person to person, and some individuals may experience more intense symptoms than others.
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2. Emotional Impact:

• Emphasize the emotional toll that psoriasis can take. Many people with psoriasis may feel self-conscious, embarrassed, or even stigmatized due to the visible nature of the condition.
• Discuss how the emotional impact can extend to issues like anxiety, depression, and decreased quality of life. People with psoriasis may avoid social situations, swimming, or wearing certain clothing because of their condition.
• Note that the emotional impact can vary from mild to severe, and it's important to address these feelings as part of psoriasis management.
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• Diet and lifestyle can play a significant role in managing psoriasis, a chronic skin condition characterized by red, itchy, and scaly patches on the skin. While there is no cure for psoriasis, adopting a healthy diet and making certain lifestyle changes can help alleviate symptoms and potentially reduce the frequency of flare-ups. It's important to note that the impact of diet and lifestyle can vary from person to person, and what works for one individual may not work for another. Always consult with a healthcare professional before making significant changes to your diet or lifestyle for psoriasis management.
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• Here are some key factors to consider in managing psoriasis through diet and lifestyle:
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• Balanced Diet:
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• Anti-inflammatory Foods: Incorporate foods that have anti-inflammatory properties, such as fruits, vegetables, whole grains, and fatty fish (rich in omega-3 fatty acids).
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• Avoid Trigger Foods: Some people with psoriasis find that certain foods can trigger or exacerbate their symptoms. Common triggers include red meat, dairy, gluten, and processed foods. Identify your personal triggers through an elimination diet if necessary.
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• Hydration: Stay well-hydrated to keep your skin moisturized and promote overall health.
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• Maintain a Healthy Weight: Obesity can increase the risk and severity of psoriasis. Losing weight through a balanced diet and regular exercise can help improve symptoms.
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• Alcohol and Smoking:
• Limit alcohol consumption, as excessive alcohol can worsen psoriasis. Avoid smoking, as it's known to increase the risk of developing psoriasis and make symptoms worse.
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• Stress Management: Stress is a known trigger for psoriasis flare-ups. Practicing stress reduction techniques like meditation, yoga, and deep breathing exercises can be beneficial.
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• Sun Exposure: Controlled exposure to sunlight can help some people with psoriasis. UVB therapy is a common treatment prescribed by dermatologists. However, be cautious of overexposure, which can lead to sunburn.
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• Topical Treatments: Over-the-counter or prescription topical treatments, such as corticosteroids and vitamin D analogs, can be used in combination with dietary and lifestyle changes to manage psoriasis.
• In conclusion, while diet and lifestyle can play a role in psoriasis management, they are typically most effective when used in conjunction with medical treatments prescribed by a healthcare provider. Psoriasis is a complex condition, and the right approach may vary from person to person. It's essential to work with a healthcare professional to develop a comprehensive treatment plan that addresses your specific needs and symptoms.
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• Write To Dr. FAROOQ KHAN: Write to Dr. FAROOQ KHAN and get a reply on how homeopathy can help you in treating your disease condition.

Median Arcuate Ligament Syndrome (MALS)

    Median Arcuate Ligament Syndrome (MALS)

Rare condition characterized by abdominal pain attributed to compression of the celiac artery and the celiac ganglia by the median arcute ligament. The abdominal pain may be related to meals, may be accompanied by weight loss, and may be associated with an abdominal bruit herd by a clinician. 

  MALS  may occur in anyone, even children. other names of MALS are:

- Celiac artery compression

- Celica axis syndrome

- Dunbar syndrome

 Symptoms:

  Often, compression of the celiac artery doesn't cause any symptoms. 

 However those with median arcuate ligament syndrome(MALS) can have long-term(chronic) stomach pain. The symptoms may be due to a lack of blood flow through the celaic artery or compression on nerves in the area. 

Symptoms of MALS include: 

- Pain in the upper middle stomcah area, which may go away when leaning forward 

- Stomch pain after eating , exercising or changing body position. 

- Bloting

- Diarrhea: Diarrhea is a common symptoms, some experience constipation. While some experience vomiting, not everyone dose. Exercise or certain postures can aggravate the symptoms. Occasionlly, physical examination reveals an abdominal bruit in the mid-epigastrium. 

- Fear of eating food due to pain, leading to significant weight loss.

 

- Nausea and vomiting. 

 If your stomach pain is severe and activity or movement makes it worse, call your provider immediately. Seek immediate medical help if your stomach pain occurs with:

- Bloody stools

- Fever

- Nausea and vomiting that doesn't go away

- severe tenderness when you touch your belly area

- Swelling of the belly area

- Yellowing of the skin or whites of the eyes(Jaundice). 

 Sometimes upper stomach pain can be confused with chest pin. Sometimes it can be due to a heart attack. Upper stomach pain with or without any of the following symptoms: 

 - pressure, fullness or tightness in your chest

- Crushing or searing pain that spreads to your jaw, neck, shoulders, and one or both arms. 

- Pain that lasts more than a few minutes or gets worse with activity

- Shortness of breath

- cold sweats

- Dizziness or weakness

- Nausea or vomiting.

Risk factors:

- Because the cause of MALS is poorly understood, the risk factors for the syndrome are unclear. MALS has been seen in children, even twins, which might mean genetics plays a role. Some people have developed MALS after pancreatic surgery and blunt injury to the upper stomach area. 

Prognosis:

 

 There are few studies of the long-term outcomes of patients treated for MALS. according to Duncan, the largest and more relevant late outcomes data come from a study of 51 patients who underwent open surgical treatment for MALS, 44 of whom were available for long-term follow-up at an average of nine yers following therapy. 

- The investigators reported that among patients who underwent celiac artey decompression and revascularization, 75% remained asymptomatic at follow-up. In the study, predictors of favorable outcome included

- Age from 40 to 60 years

- Lack of psychiatric condition or alcohol use

- Abdominal pain that was worse after meals

- Weight loss greater than 20 lb. 

 Complications:

 MALS complications include long-term pain, especially after meals. The pain cn led to a fear of eating and significant weight loss. The pain and related depression or anxiety can greatly impact. 

 The pain and related depression or anxiety can greatly impact quality of life. MALS symptoms may be vague and can mimic other conditions. It may take some time to get an accurate diagnosis. 

 

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Ellis-van Creveld syndrome

                            Ellis-van Creveld syndrome

      Ellis-van Creveld syndrome is an autosomal recessive skeletal dysplasia, which is characterized by short stature, retarded growth, polydactyly, and ectodermal and heart defects. The first case of EVC syndrome was reported by Mclntosh in 1933, but Richard W, B, Ellis of Edinburgh, and Simon van Creveld of Amsterdam in 1940, first described this condition and defined it as EVC syndrome. It is also known as chondroectodermal dysplasia and meso-ectodermal dysplasia. 

  The features of Ellis-van Creveld syndrome overlap with those of another, a milder condition called Weyers acrofacial dysostosis. Like Ellis- van Crevelf syndrome, Weyers acrofacial dysostosis involves tooth and nail abnormalities, although affected individuals have less pronounced short stature and typically do not have heart defects. The two conditions are caused by mutations in the same genes. 

Inheritance:

  This condition is inherited in autosomal recessive patterns which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy o the mutated gene, but they typically do not show signs and symptoms of the disease. 

Causes:

  Ellis- van Creveld is passed down through families. it is caused by defects in 1 of 2 Ellis-van Crevel syndrome genes (EVC and EVC2). These genes are positioned next to each other on the same chromosome. The severity of the disease varies from person to person. The rights rate of the condition is seen among the Old Order Amish population of Lancaster County, Pennsylvania. It is fairly rare in the general population. 

Symptoms: Include

- Cleft lip or palate

- Epispdis or undescended testicle (cryptorchidism)

- Extra fingers (polydactyly)

- Limited range of motion

- Nail problems, including missing or deformed nails

- Short arms and legs, especially forearm and lower leg

- Short height, between 3.5 to 5 feet 

- Spares, absent, or fine-textured hair 

- Tooth abnormalities, such as peg teeth, widely-spaced teeth

- Teeth present at birth (natal teeth)

- Delayed or missing teeth

Disorders with similar symptoms:

 Ellis- van Creveld syndrome is in the category of rare skeletal disorders called short rib- polydactyly syndromes, belonging to the ciliopathies group. 

  These disorders are characterized by growth deficiency resulting in short stature, abnormally short ribs, extra fingers and toes, and variable visceral manifestations. These additional findings may include polycystic kidneys, underdevelopment of the lungs, vertebral and genitourinary abnormalities, central nervous system abnormalities, and cleft lip and cleft palate. They are inherited as autosomal recessive genetic conditions. 

 The short rib- polydactyly group includes 4 antenatal lethal types, saldino-Noonan, Majewski, Verma- Naumoff, and Beemer- Langer syndromes, and 2 types compatible with life, EVC, and Asphyxiating Thoracic Dystrophy or Jeune syndrome. 

 ATD is characterized by variable respiratory insufficiency due to thorax narrowness, kidney, liver, and retinal abnormalities, and inconstant short stature. At least two genes are associated with this condition. The neonatal clinical presentation overlap with EVC features, especially in the absence of heart abnormalities. 

 Weyers acrofacial dysostosis is another genetic disorder associated with polydactyly, dental and nail abnormalities, short stature, and abnormal facial features. This condition has been found to be associated with a single mutation in either the EVC or EVC2 gene and follows autosomal dominant inheritance. 

Diagnosis:

 Ellis- Van Creveld syndrome is diagnosed by the observation of short stature, slow growth, and skeletal abnormalities determined by imaging techniques and sometimes teeth present at birth (natal teeth). Molecular genetic testing for the EVC and EVC2 genes is available on a research basis only. Prenatal diagnosis is possible by ultrasound. 

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Reactive attachment disorder(Attachment Disorder in Adult) part- III

                    Reactive attachment disorder

Reactive attachment disorder (RAD) is a psychiatric condition wherein people have difficulty forming attachments with others. It is usually the result of early childhood trauma. 

About Reactive attachment disorder (RAD):

 RAD is a rare condition in which a child or adolescent experiences difficulties forming attachments with others. According to the diagnostic and statistical manual 5th edition, RAD is the result of a trusted source of experiencing neglect or abuse during early childhood. 

Reactive attachment disorder (RAD) can develop in children who do to form a predictable and nurturing bond with a trusted parent or caregiver. This may happen as a result of:

- Growing up in an overcrowded orphanage

- Frequently changing foster homes

- Having a parent or caregiver who has mental or physical health issues.

- Being taken away from a primary caregiver after establishing a bond with them.

- Experiencing long periods of hospitalization. 

     Being unable to form early emotional bonds can cause a child to stop engaging with others emotionally and develop behavioral problems. 

     Reactive attachment disorder (RAD) tends to develop in early childhood and typically affects children and adolescents. However, the symptoms may also extend into adulthood for some people. 

Reactive attachment disorder (RAD) in children: 

   A child can develop RAD following early life trauma that prevents them from forming may consistent emotional bonds with others. 

 Some children may develop RAD as a result of early neglect, such as being left crying, wet, or hungry for hours and having no one to interact with. Others may develop RAD following emotional or physical abuse. 

  Neglect or abuse can cause feelings of isolation, abandonment, and fear. Children who develop RAD tend to stop trying to form consistent emotional bonds with others. 

  This can extend into adolescence and adulthood. For example, some people may have difficulty trusting others and forming close personal relationships. 

Signs and symptoms: 

 Children with RAD may display some or all of the following signs and symptoms trusted source:

- Rarely seeking comfort when distressed

- Not responding to comfort when distressed 

- Minimal emotional or social responses, such as avoiding eye contact and not smiling 

- Persistent low mood and crying 

- Unexplained episodes of irritability, anxiety, or fearfulness

- A lack of interest in interacting or playing with others.

- A lack of social skills

- Cognitive problems

- Hyperactivity 

- Repetitive movements, such as rocking back and forth or hand flapping 

 These symptoms must occur before the age of 5 years in order for the child to receive a diagnosis of RAD. 

Patterns: 

When children with RAD grow a little older, their symptoms usually fall into one of two general patterns: inhibited RAD symptoms or disinhibited RAD symptoms. 

The following sections will discuss these in more detail. 

Inhibited RAD symptoms: 

  With this pattern, children are usually aware of what happens around them, but they do not respond typically to outside stimuli. 

children showing inhibited RD symptoms are often withdrawn and emotionally unresponsive. They may not show or seek affection from caregivers or others, instead preferring to keep to themselves. 

Disinhibited RAD symptoms: 

 With this pattern, children may be overly friendly toward strangers. Also, they may not prefer their primary caregiver over other people. 

In most cases, these children act younger than others' age and may seek affection from others in a potentially unsafe way. 

Reactive attachment disorder (RAD) in adolescents and adults:

 Without treatment, a child who develops RAD may continue to experience issues throughout adolescence and adulthood. 

 These issues may include:

- Avoidance of physical contact

- Difficulty displaying affection or care for others

- A lack of empathy

- Poor social skills

- Difficulty forming stable 

- Relationships with others

- Cognitive problems, such as poor memory or problem-solving skills

- Anger problems

- Control issues

- Academic or workplace problems

- Engaging in risky behaviors, such as substance abuse

- Mental health problems, such as depression or anxiety

Complications:

RAD can cause complications in children, adolescents, and adults. 

Children with RAD may be at increased risk of developmental delays and delayed growth. 

Older children and adolescents may be at increased risk of:

- Anger management issues

- Difficulties in school

- Depression

- Anxiety 

- Eating disorders

- Drug and alcohol abuse

If a person does not receive treatment for RAD during childhood or adolescence, the above complications may occur.

Diagnosis:

 A doctor or therapist will diagnose according to the DSM-5 guidelines. These guidelines trusted source state that a child must meet the following criteria in order to receive a diagnosis of RAD:

- A consistent pattern of emotionally withdrawn behavior toward a parent or caregiver, as evidenced by the child rarely seeking or responding to comfort when distressed

- A consistent emotional or social disturbance, as characterized by at least two of the following behaviors: 

- Minimal social and emotional responsiveness to other people 

- Limited displays of positive emotion.

- Episodes of unexplained irritability, sadness, or fearfulness even during nonthreatening interactions with adult caregivers 

- A traumatic experience that consists of one or more of the following:

- Social neglect or deprivation

- Repeated changes to the child's primary caregiver

- Rearing in a setting that severely limits the child's ability to form selective attachments. 

- Not meeting the diagnostic criteria for an autism spectrum disorder

- Experiencing signs of RAD before the age of 5 years

- Having a developmental age of at least 9 months. 

     Some of the signs and symptoms of RAD overlap with those of other conditions, such as intellectual disabilities or attention deficit disorders. A doctor will want to rule out these conditions before diagnosing RAD.

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