Pica (Disorder)

Pica is a term that refers to cravings for substances that are largely non-nutritive or rather non-foods, such as hair, paper, ice, glue soil, stones, drywall or paint, sharp objects, metal, glass, chalk, etc. The word pica is derived from the Latin word for the bird magpie that feeds on whatever it encounters.

According to the current estimate of the Handbook of Clinical Child Psychology the prevalence rates of pica range from 4% to 26% among institutionalized populations. Pica is more common among children and pregnant women. People with certain mental health conditions such as schizophrenia and obsessive-compulsive disorder may also develop pica as a coping mechanism. It is usually temporary but is often more severe and long-lasting in people with severe developmental disabilities.

There’s no single cause of this eating disorder. In some cases, it may be related to mental retardation or mental illness, while in others, it may be associated with a deficiency in iron, zinc, or another nutrient resulting from malnutrition. Pica has also been found to be associated with decreased activity of the dopamine system in the brain. Dopamine is a neurotransmitter that aids relaying the transmission of nerve impulses from one neuron to another. Due to this association, some researchers think that there may be a connection between abnormally low levels of dopamine in the brain and the development of pica. However, no specific underlying biochemical disorders have been identified.

The following four criteria have been posited by Diagnostic and Statistical Manual of Mental Disorders, 5th edition that must be met to diagnose a person with pica:

1. Person must persist in eating non-nutritive non-foods for at least one month.

2. This eating must be considered abnormal for the person’s stage of development.

3. Eating these substances cannot be associated with a cultural practice that is considered normal in the social context of that person.

4. For people who currently have a medical condition such as pregnancy or a mental disorder like autism spectrum disorder, the action of eating non-nutritive non-foods should only be considered pica if it is dangerous and requires extra medical investigation or treatment on top of what they are already receiving for their pre-existing condition.

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Self-Help Techniques to Manage Anxiety

Anxiety is one of the most common yet most debilitating mental health conditions that can range from worry to full-blown anxiety disorders. There would rarely be anyone who has never worried about anything in his or her life and therefore, occasional worry or fear is rather a part of normal life.  We often worry about the wellbeing of our loved ones or we may fear for our own safety too. Sometimes we worry about our financial situations or our work while at other times we are just concerned about our future. These occasional worries are not always bad; in fact, they are somewhat good for our survival. They help us prepare ourselves to deal with life’s challenges. However, worries can sometimes take acute form and become unbearable, excessive, irrational, or even uncontrollable and are accompanied with physical symptoms such as increased palpitation of heart, sweating, and trembling. If you too are experiencing these symptoms, you might be suffering from full blown anxiety disorder. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) recognizes seven primary types of anxiety disorders: phobic disorders of the “specific” or of the “social” type, panic disorder with or without agoraphobia, generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), and posttraumatic stress disorder (PTSD). GAD is the most common of these anxiety disorders and is characterized by chronic excessive worry about a number of events or activities. The subjective experience of excessive worry in GAD is accompanied by following symptoms:

  • Restlessness or feelings of being keyed up or on edge
  • a sense of being easily fatigued
  • difficulty concentrating or mind going blank
  • irritability
  • muscle tension
  • sleep disturbance

However, an individual who worries a lot does not necessarily suffer from anxiety disorders. Sometimes having an unhealthy lifestyle can make you feel anxious. Following are some self-help techniques that can help you keep anxiety in check and manage symptoms of anxiety, though these must not be considered a substitute for professional help or treatment:

Exercise/Running: Performing regular exercise and going for jogging or brisk walk has been scientifically proven to help allay anxiety symptoms. Exercise releases chemicals, i.e., endorphins in the brain that can counter symptoms of anxiety and improves mood. It also helps in lowering stress hormone cortisol that is secreted when we are anxious. Several studies have shown overall benefits of exercise on mind and body. Exercising for half an hour four times a week has been recommended for those suffering from anxiety.

Socialize: Meet people you trust and share your thoughts and feelings with them. Isolation and loneliness has been shown to increase the symptoms of anxiety. You can also talk to your trusted friends over phone and share your worries with them. Since anxiety is often based on irrational thoughts, talking to others can bring sense to our unwarranted thoughts. Suppressing and keeping your thoughts to yourself, on the other hand, can make them overwhelming and difficult to deal with. You can join some support group also, where other anxiety patients like you share their thoughts, feelings, progress, etc. Make socializing a part of your daily routine no matter how difficult it sometimes may feel.

Muscular relaxation technique: Try Jacobson’s progressive muscle relaxation technique.  Since individuals who experience anxiety symptoms tend to have high arousal, progressive muscle relaxation technique can help release physical tension.

Sleep: Lack of good sleep can aggravate the symptoms. So in order to keep your anxiety symptoms under check, get qualitative 7 – 8 hours of sleep a night.

Deep breathing: Breathing from your gut has been scientifically proven to lower the arousal level of body. Hence, deep breathing exercise can help calm your body and mind. Use deep breathing to relieve immediate symptoms of anxiety like hyperventilation or shortness of breath.

Stay in the present: Anxiety disorders are often future-based, which means, you tend to worry about the things that you feel are going to happen. So in such instances, try to focus on the present. Ask yourself about what is happening at the moment. Mindfulness can help you stay in the moment. Mindfulness is a technique where we are made aware of what is going on around us through our five senses. What do we see, hear, smell, feel, and taste. A regular practice in mindfulness can help you ease anxiety symptoms.

Train your mind: Anxiety is often based on thoughts; therefore, in order to deal with it, one has to work on one’s thoughts. Be accepting to the fact that you cannot actually control everything. Try to do your best instead of striving for perfection. Research studies provide evidence regarding link between perfectionism and mental health disorders like anxiety and depression. Replace negative thoughts with positive ones and try to maintain positive attitude about life.

Challenge your thoughts: Most of the worries and fears in anxiety are irrational and without any base. Identify your apprehensions and challenge each and every single thought that comes to your mind.

Eating healthy: Avoid consuming alcohol and caffeine and focus on eating a well-balanced diet. Eating healthy food helps maintain healthy mind and body. Stay hydrated. It may seem like too simple a remedy but staying hydrated can go a long way in managing anxiety. Whenever you experience anxiety symptoms, drink water as it helps lower the arousal.

Use art as mode of expression: Art therapy has also been found to help relieve anxiety symptoms. Use dance or painting as a mode of giving outlet to your thoughts and feelings. It can also help you take your mind off your worries.

Professional help: If you feel that your anxiety symptoms are interfering with your daily functioning, don’t hesitate to take professional help from a psychiatrist or psychologists or other healthcare provider in your community. Professional treatment mostly includes medications for severe symptoms, along with cognitive behavioral therapy.

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