Rhabdomyolysis

 Rhabdomyolysis (often called rhabdo) is a serious medical condition that can be fatal or result in permanent disability. Rhabdo occurs when damaged muscle tissue releases its proteins and electrolytes into the blood. These substances can damage the heart and kidneys and cause permanent disability or even death.

https://www.cdc.gov/niosh/topics/rhabdo/default.html#:~:text=Rhabdomyolysis%20(often%20called%20rhabdo)%20is,permanent%20disability%20or%20even%20death.

Treatment

Seek treatment as soon as you suspect rhabdo! If treated early, most rhabdo patients return to work in a few days without any lasting effects. Treatment options depend on how severe the rhabdo is. Only a healthcare provider can determine how severe it is through blood tests, electrocardiograms (also known as EKGs), etc.

Less severe cases can be treated with:

• Drinking fluids
• Getting out of the heat
• Resting

Moderate to severe cases may need intravenous (IV) fluids and hospital admission.

• IV fluids help flush out the muscle proteins and electrolytes. IV fluids can prevent dangerous heart rhythms and loss of kidney function.
• At a hospital, medical professionals can monitor and treat severe cases for:
  • abnormal heart rhythms
  • decreased kidney function
  • seizures
  • elevated compartment pressures
  • high potassium levels

Onychomycosis

 Onychomycosis is a fungal infection of the nail unit. When onychomycosis is caused by dermatophytes, it is called tinea unguium. The term onychomycosis encompasses not only the dermatophytes but the yeasts and saprophytic molds infections as well.

Link : https://www.ncbi.nlm.nih.gov/books/NBK441853/#:~:text=Onychomycosis%20is%20a%20fungal%20infection,saprophytic%20molds%20infections%20as%20well.

A macular pucker

 A macular pucker is scar tissue that has formed on the eye's macula, located in the center of the eye's light-sensitive tissue called the retina. The macula provides the sharp, central vision we need for reading, driving, and seeing fine detail.

 A macular pucker can cause blurred and distorted central vision.

https://www.downstate.edu/patient-care/find-treatment/areas-of-care/ophthalmology/eye-disorders/macular-pucker.html#:~:text=A%20macular%20pucker%20is%20scar,blurred%20and%20distorted%20central%20vision.

High PSA

 High PSA levels can mean you have prostate cancer or a prostate condition that's not cancer, such as an infection (prostatitis) or an enlarged prostate. If your PSA levels are higher than normal, your provider may talk with you about having more tests to diagnose the cause.Aug 31, 2022

What is ASD? What is Autism Spectrum Disorder

 Autism is diagnosed by observing a child’s behavior. There are several well-known diagnostic tools that are used to diagnose or confirm a diagnosis of autism. For example, The Autism Diagnostic Observation Scale (ADOS) and the Childhood Autism Rating Scale (CARS-2). In addition, The American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth Edition (DSM-V) provides standardized criteria to help diagnose ASD and determine the level of support needed. 

 The broad criteria listed in the DSM-V are summarized below: 

Persistent deficits in social communication and social interaction across multiple contexts.

Restricted, repetitive patterns of behavior, interests, or activities. 

Symptoms must be present in the early developmental period.

Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.

These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay.

Autism is considered to be a spectrum disorder; some individuals with autism may also have an intellectual disability, while others are only mildly affected. Although ASD, in most cases, is a life-long disability, early intensive behavioral intervention (EIBI) can result in significant progress, leading to successful, independent participation in learning, social, and community activities. 

If you are concerned about your child’s development, schedule a diagnostic evaluation with our team.

What does PTA mean in charting?

 What does PTA mean in charting?

Inefficiency means losing time, fuel, and money. No one wants that. Projected time of availability (PTA) is a key factor to consider.May 30, 2022

Medical Abbreviations

https://www.urmc.rochester.edu/libraries/miner/resources/abbreviation-glossary.aspx 

75 Must-Know Medical Terms, Abbreviations, and Acronyms

5 min read–Published On: June 22, 2021–Categories: Health Care Trendscopy from Medical school blog

1. Abrasion: A cut or scrape that typically isn’t serious.
2. Abscess: A tender, fluid-filled pocket that forms in tissue, usually due to infection.
3. Acute: Signifies a condition that begins abruptly and is sometimes severe, but the duration is short.
4. Benign: Not cancerous.
5. Biopsy: A small sample of tissue that’s taken for testing.
6. Chronic: Signifies a recurring, persistent condition like heart disease.
7. Contusion: A bruise.
8. Defibrillator: A medical device that uses electric shocks to restore normal heartbeat.
9. Edema: Swelling caused by fluid accumulation.
10. Embolism: An arterial blockage, often caused by a blood clot.
11. Epidermis: The outer layer of the skin.
12. Fracture: Broken bone or cartilage.
13. Gland: An organ or tissue that produces and secretes fluids that serve a specific function.
14. Hypertension: High blood pressure.
15. Inpatient: A patient who requires hospitalization.
16. Intravenous: Indicates medication or fluid that’s delivered by vein.
17. Malignant: Indicates the presence of cancerous cells.
18. Outpatient: A patient who receives care without being admitted to a hospital.
19. Prognosis: The predicated outcome of disease progression and treatment.
20. Relapse: Return of disease or symptoms after a patient has recovered.
21. Sutures: Stitches, which are used to join tissues together as they heal.
22. Transplant: The removal of an organ or tissue from one body that is implanted into another.
23. Vaccine: A substance that stimulates antibody production to provide immunity against disease.
24. Zoonotic disease: A disease that is transmissible from animals to humans.

25. A-, an-: Lack of or without.

26. -ation: Indicates a process.
27. Dys-: Abnormal, difficult, or painful.
28. -ectomy: Surgical removal of something.
29. -ismus: Indicates a spasm or contraction.
30. -itis: Signifies inflammation.
31. -lysis: Decomposition, destruction, or breaking down.
32. Macro-: Large in size.
33. Melan/o-: Black or dark in color.
34. Micro-: Small in size.
35. -ology: The study of a particular concentration.
36. -osis: Indicates something that is abnormal.
37. -otomy: To cut into.
38. -pathy: Disease or disease process.
39. -plasty: Surgical repair.
40. Poly-: Many.
41. Pseudo-: False or deceptive, usually in regard to appearance.
42. Retro-: Behind or backward.

43. Cardi/o: Related to the heart.
44. Derm/a/o, dermat/o: Pertaining to the skin.
45. Encephal/o: Related to the brain.
46. Gastr/o: Related to the stomach.
47. Hemat/o: Pertaining to blood.
48. My/o: Related to muscle.
49. Oste/o: Related to bone.
50. Pulmon/o: Refers to the lungs.
51. Rhin/o: Related to the nose.
52. Sclerosis: Hard or hardening.
53. Stasis: Slowing or stopping the flow of a bodily fluid.
54. Therm/o: Indicates heat.

55. ALS: Advanced life support.
56. Bl wk: Blood work.
57. BMI: Body mass index, a measure of body fat based on height and weight.
58. BP: Blood pressure.
59. CPR: Cardiopulmonary resuscitation, a life-saving technique that’s also called mouth-to-mouth resuscitation.
60. C-spine: Cervical spine.
62. DNR: Do not resuscitate, a medical order indicating providers should not perform CPR.
63. ED/ER: Emergency department or emergency room.
64. EKG: Electrocardiogram, a way of monitoring the heart and testing for problems.
65. HDL-C: High-density lipoprotein cholesterol, often called “good” cholesterol.
66. HR: Heart rate, expressed as beats per minute.
67. LDL-C: Low-density lipoprotein cholesterol, often called “bad” cholesterol.
68. Lytes: Electrolytes.
69. NICU: Neonatal intensive care unit, a specialized unit that cares for premature infants.
70. OR: Operating room where surgeries are performed.
71. Pre-op: Preoperative.
72. Psych: Refers to psychiatry or the psychiatric ward.
73. PT: Physical therapy, a type of treatment to help patients move and feel better.
74. Rx: Prescription, usually for medication but can also signify another treatment.
75. Stat: Immediately.

CNA - Safely Moving Residents - Lifting and Transferring (0.5)

  https://www.youtube.com/watch?embeds_referring_euri=https%3A%2F%2Fwww.snfclinic.com%2F&source_ve_path=Mjg2NjQsMTY0NTA0LDE2NDUwNg&feature=emb_share&v=2gQ_vKJE7yU

CNAs are on their feet all day, lifting and transferring heavy equipment and patients. It's easy to take for granted the danger of improper posture and mechanics in potential injuries. The CNA must be well educated on body mechanics, mechanical lifts, and teamwork to protect themselves and prevent injury to make their job easier and safer.

Good lifting and transferring habits are the best way to protect oneself from a serious back, shoulder, or neck injury. Following your facility's policies will help you protect your back and ensure you work smarter, not harder.

Here are some general lifting and transferring tips to help keep you and your residents safe, which is the most important consideration:

    Plan the move out well and make sure the area is cleared.
    Find out how the resident prefers to be moved, and always make sure to tell them what you are planning to do
    Your weight adds force to pushing, so it's always easier than pulling.
    When you lift or move an object or resident, always face it/them directly.
    The feet should be shoulder-width apart, providing a wide base of support when you lift or move.
    Determine the correct equipment or supplies needed for the move/lift and make sure to have it ready and use it as needed.
    To minimize the effect of a lifted weight on your body, hold the person or object close to you, not at arm's length.
    Use teamwork by asking your teammates for help and talking with them about what you do as you plan and while doing it.
    Moving people or things all at once is much harder than using repeated, small movements. For example, move a person in sections by moving the upper trunk first and then the legs.

·    One of the leading causes of injury during lifting or moving is twisting. Move your torso as one unit and never twist when lifting, transferring or reaching. Pivot your whole body toward the move by picking your feet up.

·         Always maintain correct posture:

o   Less stress is put on your back when bending your knees slightly while lifting. It will put stress on your legs.

o   Knees bent and back straight is the correct posture!

o   If you must bend from the waist, engage your core and tighten your stomach muscles while bending and lifting to help support your back.

Working smarter, not harder, can also include the use of assistive devices to aid us in moving and lifting residents and objects:

    Use the resident's bed as an assistive device. Raise and lower the height as needed to make the position safe for you, the resident, and your teammates. Utilizing rails temporarily for a resident's "handhold" can also help residents assist in their movement.
    Transfers can also be a time when a resident's skin can inadvertently be sheared or torn. Using a slide board can help reduce friction and allows the resident to move from the bed to another surface more easily
    A heavy canvas gait belt placed around a resident's waist is a good tool to assist in moving residents that provides a solid grip for the staff and avoids injury to resident's limbs
    Draw or lift sheets make it easier to move patients in bed. They may interfere with skin-protecting mattresses and shouldn't be left under the resident. Turn the resident to one side to place a draw/lift sheet. Roll half of the sheet up and place it against the resident, smoothing the side closest to the bed. Roll the resident over the roll, back to the other side, and smooth out the sheet. If the resident cannot manage or lift their own head or neck, be sure that the sheet extends high enough to support the head fully while still supporting the hips.
    Residents with upper-body mobility and strength may benefit from a trapeze above their bed, allowing them to lift and assist you in their movement.
    Mechanical lifts and hoists are also very valuable in lifting a heavy resident or one who has fallen to the floor to avoid injuries. Make sure you have completed all training on the appropriate and safe use of the devices in your facility before using them. Use your teammates to assist with these transfers.

Many transfers in our environment involve transferring from the bed to a chair or wheelchair.  Here are safety tips for this type of transfer

    As always, think through the lift and plan the job before beginning to execute it.
    Make sure the bed is in a low and locked position so it will not move.
    If transferring to a chair, place it slightly to the side of the bed.
    If transferring to a wheelchair, remove the footrests, fold up the foot pedals, and ensure the brakes on both wheels are locked.
    Put non-slip footwear on the resident.
    Move the resident to the edge of the bed in stages by first moving the upper trunk and then the legs one at a time and place the resident's legs over the side of the bed.
    Raise the resident to a sitting position on the side of the bed by placing your arms around them and circling their back.
    At this point, a gait belt is recommended.  Place it around the resident's waist.
    Assist the resident in moving forward until their feet are flat on the floor. This can be done by sliding or "walking" them forward. Grasping both legs under the knees, swinging them gently back and forth, and moving the buttocks forward is called "walking."
    Using a wide stance for good support, place your feet on both sides of the resident's feet.
    Do not have the resident put their arms around your neck. This is likely to injure you. Instead, ask the resident to slightly lean forward and place their arms around your shoulders if they can do so.
    Keep your back straight, bend at the hip and knee and allow the resident to reach for the far chair arm.
    Avoid injuring the resident by NOT holding them under the arms. Instead, place your arms around their waist, or grasp the gait belt at the sides of the back with both hands.
    Stabilize the resident's knees by holding your knees against theirs.
    Straighten your hips and knees while pulling the resident up as you both stand, keeping the resident close to your body and your hips and knees slightly bent.
    When the resident is high enough to clear the armrest or chair surface, keep their knees blocked with your own and turn them toward the chair seat by taking small steps together. Once turned, squat by bending your hips and knees to lower the resident to the seat.
    If transferred to a wheelchair, replace the footrests and adjust the pedals, so the resident's hips and knees are at a 90-degree angle. If transferred to a chair, make sure the resident can maintain their feet flat on the floor to avoid sliding.
    Follow the same principles to return the resident to their bed.

Safely repositioning resident in a chair:

    If the resident is in a wheelchair, ensure the brakes are engaged.
    Have the resident fold their arms across their chest.
    Stand behind the chair and wrap your arms around the resident while bending your knees. Fold your arms just under the resident in front, hugging their torso securely.
    Lift the resident's torso up and back in the chair while straightening your legs.

Utilize these safety methods when pulling a resident up in bed:

    Always get help. This seems an easy maneuver but is one that often injures the staff or resident.
    Remove the resident's pillow and place it between their head and the headboard. Place a draw sheet or lift pad under the resident.
    Raise the bed to a height comfortable for you and your teammate
    On either side of the bed, both you and your teammate should bend your knees and push with your feet while grasping the draw or lift sheet firmly, close to the resident's body
    If the resident can, ask them to hold their head up, chin to chest. If they are unable, ensure that the lift sheet supports their head.
    Have the resident assist by pushing backward by bending their knees while you and your teammate lean in the direction you want to move the resident's body.
    Simultaneously on the count of three, have the resident push with their heels while you and your teammate lift the draw or lift the sheet and pull the resident up.

In addition, turning the resident from side to side when in bed should also not be taken for granted as a simple movement.

    Raise the bed to waist height and while standing at one side, place your arms under the resident's shoulders or hips and grasp the draw or lift sheet.
    Moving trunk first and then legs, pull the resident to the edge of the bed and cross the resident's closest leg over the other leg.
    Lean in toward the resident, place your hands on their shoulder and hip, and push the resident's torso away from you.
    Place the top leg in front of the bottom leg.
    Make sure the resident is supported along their hips, back, and shoulders with pillows or bolsters. The resident may also benefit from a pillow between their legs to support the top leg but be sure to adjust for comfort.

Often we have to assist in transferring residents in and out of a car for appointments or discharge.  Here are safety tips to assist you:

    Make sure the front seat of the car is back as far as possible, and the wheelchair is positioned at a 90-degree angle to the seat.
    Using a wide stance for good support, place your feet on both sides of the resident's feet.
    Do not have the resident put their arms around your neck. This is likely to injure you. Instead, ask the resident to slightly lean forward and place their arms around your shoulders if they can do so.
    Keep your back straight, bend at the hip and knee in a squat and grasp the person's upper back. Do not pull under the arms.
    Move your feet to turn, being sure not to twist. Straighten your legs and hips slightly while lifting the resident's torso into the car and placing their buttocks on the seat.
    Before lifting the resident's legs in, ensure their buttocks are back as far as possible toward the driver's side to avoid sliding out.

You may find a resident on the floor.  Perhaps they just slipped to the floor, or perhaps they fell.  Here are some key safety tips for assisting a resident on the floor:

    Make sure to follow all facility policies for falls before assisting the resident up, such as a witnessed lowering to the floor vs. a resident found on the floor with a potential fall-related injury.
    If the resident is not seriously injured, they may be able to assist in getting up, but you should ALWAYS enlist a teammate to help you.
    Enlist as many people as necessary to execute the lift safely. This may be 4 to 6 people or require a mechanical lift.
    Once the resident is cleared for movement, roll them onto a lift sheet or blanket
    With two or more people on each side, get a secure hold on the blanket and have everyone kneel beside the resident. On the count of three, everyone should stand up, lifting the resident to the bed or stretcher.
    Be sure to complete any documentation required by facility policies related to the resident's fall.

Avoiding staff injuries is always the best choice, and the best way to avoid injury is to make sure to:

    Fully understand the task at hand. What or who are we lifting, what is its weight, do I need help to do this, should I use a mechanical lift for this? Can the resident help at all? Is there a potential they are injured?
    Take care of yourself by not getting in a hurry, attempting something you shouldn't because "it's easier to do by myself than wait on someone to help me," or "it takes too long to get the lift on the other unit," etc.  Your employer wants you to be as safe and healthy as you do, and following these safety tips will help you stay that way.

What is a significant number of PVC?

What is a high number of PVCs?

According to one study, experiencing more than 12 PVCs daily increases your risk of sudden cardiac death.Jul 29, 2022

Premature Ventricular Complex (PVC) • LITFL • ECG Library ...

PVHow many PVC are significant?

Premature Ventricular Complex (PVC) • LITFL • ECG Library ...

PVCs are said to be “frequent” if there are more than 5 PVCs per minute on the routine ECG, or more than 10-30 per hour during ambulatory monitoring.

Cs are said to be “frequent” if there are more than 5 PVCs per minute on the routine ECG, or more than 10-30 per hour during ambulatory monitoring.Jun 2, 2021

Premature ventricular contractions (PVCs) are extra heartbeats that begin in one of the heart's two lower pumping chambers (ventricles). These extra beats disrupt the regular heart rhythm, sometimes causing a sensation of a fluttering or a skipped beat in the chest.

Premature ventricular contractions are a common type of irregular heartbeat (arrhythmia). PVCs are also called:

1. Premature ventricular complexes
2. Ventricular premature beats
3. Ventricular extrasystoles

Occasional premature ventricular contractions in people without heart disease usually aren't a concern and likely don't need treatment. You might need treatment if the premature ventricular contractions are very frequent or bothersome, or if you have an underlying heart condition.

Symptoms

Premature ventricular contractions often cause few or no symptoms. But the extra beats can cause unusual sensations in the chest, such as:

1. Fluttering
2. Pounding or jumping
3. Skipped beats or missed beats
4. Increased awareness of the heartbeat

When to see a doctor

If you feel fluttering, pounding or a sensation of skipped heartbeats in your chest, talk to your health care provider. A health care provider can determine if the sensations are due to a heart condition or other health concern. Similar signs and symptoms can be caused by many other conditions such as anxiety, low red blood cell count (anemia), overactive thyroid (hyperthyroidism) and infections.

To understand the cause of premature ventricular contractions (PVCs), it might help to learn more about how the heart typically beats.

The heart is made of four chambers — two upper chambers (atria) and two lower chambers (ventricles).

The heart's rhythm is controlled by a natural pacemaker (the sinus node) in the right upper chamber (atrium). The sinus node sends electrical signals that typically start each heartbeat. These electrical signals move across the atria, causing the heart muscles to squeeze (contract) and pump blood into the ventricles.

Next, the signals arrive at a cluster of cells called the AV node, where they slow down. This slight delay allows the ventricles to fill with blood. When the electrical signals reach the ventricles, the chambers contract and pump blood to the lungs or to the rest of the body.

In a typical heart, this heart signaling process usually goes smoothly, resulting in a resting heart rate of 60 to 100 beats a minute.

PVCs are irregular contractions that start in the ventricles instead of the atria. The contractions usually beat sooner than the next expected heartbeat.

The cause of premature ventricular contractions isn't always clear. Certain things including heart diseases or changes in the body can make cells in the lower heart chambers electrically unstable. Heart disease or scarring may cause the heart's signals to be misrouted.

💜Premature ventricular contractions may be caused by:

1. Certain medications, including decongestants and antihistamines
2. Alcohol or drug misuse
3. Stimulants such as caffeine or tobacco
4. Increased levels of adrenaline in the body due to exercise or anxiety
5. Injury to the heart muscle due to disease

Risk factors

Certain lifestyle choices and health conditions may make a person more likely to develop premature ventricular contractions (PVCs).

💗Risk factors for PVCs include:

1. Caffeine
2. Tobacco
3. Alcohol
4. Stimulants such as cocaine or methamphetamines
5. Exercise — if you have certain types of PVCs
6. Anxiety
7. Heart attack

Heart disease, including congenital heart disease, coronary artery disease, heart failure and a weakened heart muscle (cardiomyopathy)

Complications

💗Having frequent premature ventricular contractions (PVCs) or certain patterns of them might increase the risk of developing irregular heart rhythms (arrhythmias) or weakening of the heart muscle (cardiomyopathy).

Rarely, when accompanied by heart disease, frequent premature contractions can lead to chaotic, dangerous heart rhythms and possibly sudden cardiac death.

How to write the name for H2SO4 (Sulfuric acid)

https://www.medicalnewstoday.com/articles/322627 

Maintaining healthy relationships with age

 Positive relationships can be as important to your health and well-being as nutrition and physical activity. Even though relationships with others may evolve, maintaining a strong social network as you age can contribute to a longer, healthier life.

A social network is simply a group of people close to you. This network — made up of friends, family, co-workers, neighbors and others — is how you give and receive instrumental and emotional support.

Instrumental support is the tangible help you give or receive through acts, such as providing transportation for a neighbor to an appointment or offering child care for friends or family. Emotional support is intended to lift someone's spirits, relieve sadness, give encouragement or offer advice.

Giving relationships direction

Think of your networks and relationships as a convoy traveling down the road of life with you. Some of your relationships are in it for the long haul. Others use the on- or offramps, and some take different roads entirely. Relationships in your convoy change over time, but all provide support and contribute to your well-being along the journey.

As people age, the road can feel lonely. Caring for children or aging parents can make it challenging to maintain friendships. This is normal, and means you must be more intentional about establishing and maintaining relationships, which isn't easy.

Devoting time to relationships

If you're looking to expand your social network, try a few of these ideas:

Take note of current connections.

Do an inventory of who is already in your social network. Are there people you have already met you could reconnect with?

Make the effort to reach out.

In today's connected world, getting in touch with someone is as simple as a phone call, text message or video visit. If you prefer a method involving less technology, send a handwritten card or letter.

Go where people are.

Attend events, church or community activities. Look for classes or groups with people who have interests similar to yours.

Reap the benefits of volunteering.

Join or volunteer for a club or cause that interests you. Volunteering not only improves your physical and mental health, and provides a sense of purpose, but it's also a great way to build new relationships.

Extend and accept invitations.

Don't worry if your social skills feel a bit rusty. An invitation to meet for coffee or go for a walk around the neighborhood may brighten someone else's day as much as it does yours.

Be available.

Relationships take time and effort. Whether connecting with a friend you've known for a long time or someone you just met, be present in the moment, and give your full attention to the person and situation.

In addition to helping provide the necessary support, establishing and maintaining positive relationships also is good for your health. They can boost your happiness, reduce stress, improve confidence and help you cope with traumatic events.

Adults with a strong social network have a reduced risk of depression, lower blood pressure and tend to maintain a healthier body mass index, or BMI. Building new friendships and investing time in maintaining relationships can help you on the highway of life and the path to better health.

Bonnie Betts, Psy.D., is a licensed psychologist in Psychiatry & Psychology in Waseca,https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/maintaining-healthy-relationships-is-important-as-we-age

Living with bipolar disorder

 Your friend recently bought a new car on a whim and announced he was leaving on a cross-country trip without planning a destination or duration. Now you discover he's uninterested in any activity and doesn't want to leave home. The spontaneous actions followed by inactivity could be a sign of a mental health condition called bipolar disorder.

Previously known as manic depression, bipolar disorder causes extreme mood swings of emotional highs and lows called episodes. The highs create a mania or hypomania state with euphoria and energy. A hypomania state is a less extreme mood shift than mania. The lows cause depression, sadness and hopelessness.

Types of bipolar disorder

The type of bipolar disorder is diagnosed based on the occurrence of mania, hypomania and depressive episodes.

People with bipolar I disorder have had at least one manic episode preceded, or followed by hypomanic or major depressive episodes.

Bipolar II disorder is a separate diagnosis and is not a milder form of bipolar I disorder. People with bipolar II disorder have had at least one major depressive episode and at least one hypomanic episode but have not had a manic episode.

For every high, there is a low

Everyone has periods of elevated mood, typically lasting for several hours. For someone with bipolar disorder, that elevated mood can last up to four days. Typical early warning signs include increased activity level and decreased need for sleep, along with an extended elevated mood.

During this time, the person may demonstrate risky behaviors, poor decision-making and an inability to think clearly. Their level of impulsivity is high, particularly with drug or alcohol use.

The body's physical response is raised, causing speech to have a quicker cadence or more force, and movement and actions to be more pronounced.

Usually, a person will spend more time in a depressive state with slowed actions, speech and responses. The person may lose interest in activities, need more sleep and experience intense sadness and hopelessness.

This is different from major depressive disorder, in which people do not experience the highs of bipolar disorder.

Risk factors for bipolar disorder

Certain factors increase the risk of developing the condition or may trigger the first episode of bipolar disorder, including:

Drug or alcohol misuse or abuse

Having a first-degree relative, such as a parent or sibling, with bipolar disorder

Stressful life events paired with latent genes for bipolar disorder

Living with bipolar disorder

Getting treatment early can help prevent bipolar disorder from worsening. Knowledge is power. Learn the symptoms of the disorder to manage them better.

As part of psychotherapy, psychoeducation provides the tools needed to anticipate and control changing moods. It can increase your feelings of empowerment and hope by understanding how treatable the condition is.

These strategies can lessen disruptions in your life due to bipolar disorder:

Avoid drugs and alcohol.

Using alcohol or nonprescription drugs changes the chemicals in the brain. This can worsen symptoms and make them more likely to return.

Watch for early warning signs.

Addressing symptoms early can prevent episodes from getting worse. Over time, you may have identified a pattern to your bipolar episodes and what triggers them.

Involve friends and family.

Share the warning signs and triggers you have identified with family, close friends and your health care team so they can better support you. Develop a specific plan and share how you would like them to cue you into your symptoms when you show signs of mania. They often can identify the behaviors and actions that signal a mania episode first and help you prevent your symptoms from reaching the highest level.

Engage in a purpose.

Explore ways to create a sense of purpose by evaluating your values and beliefs. Identify what is important to you and set goals matching those ideals.

Manage stress and recharge.

The brain and body react similarly to positive or negative stress, which can trigger an episode. Consider keeping a daily journal or record of your feelings, mood and any activities that affect your stress level. Find a creative outlet or physical activity to channel your energy. Yoga or meditation can be helpful relaxation techniques.

Keep a sleep schedule.

Sleep disturbance is a core symptom of bipolar disorder. Maintaining a consistent, scheduled sleep pattern with the same sleep-wake schedule daily is vital. Getting seven to nine hours of sleep per night is important. A work schedule that requires changing shift times can predispose a person with bipolar disorder to episodes.

Take your medications exactly as directed.

You may be tempted to stop treatment — but don't. Stopping your medication or reducing your dose on your own may cause withdrawal effects, or your symptoms may worsen or return. For some people, it can be tempting to stop medication during a manic episode because the symptoms produce a good feeling. This can lead to negative consequences, including taking longer to stabilize when back on medication.

Bipolar disorder is a lifelong condition, but it is treatable. Learn to manage your mood swings and other symptoms with the help of those who love and care for you. Call your health care team if you feel you're falling into an episode of depression or mania.

Janice Schreier is a child and adolescent clinical therapist in Psychiatry & Psychology in La Crosse, Wisconsin.

https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/living-with-bipolar-disorder

Overwhelmed by anxiety?

https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/overwhelmed-by-anxiety Stress and feeling anxious are common and normal. Your body naturally produces these reactions to situations that could lead you to harm's way.

Stress is a normal psychological and physical reaction to the demands of life. It's normal to feel anxious from time to time, especially during times of stress. This can be helpful, as it can help you remain focused and make better decisions.

However, people with anxiety disorders have frequent, sustained and excessive worry that they can't control. They also may feel fear, terror and panic in everyday situations.

There are many types of anxiety. Here are explanations of each, including symptoms and common treatments:

Generalized anxiety disorder

This type of anxiety involves persistent and excessive worry. If you have generalized anxiety disorder, you may have an uneasy feeling about most everything. This worry feels difficult to control and interferes with your daily life. You may overthink plans and solutions to worst-case scenarios. Or you may anticipate disaster and be overly concerned about money, health, family, work and other life events.

Generalized anxiety disorder can lead to worrying more than what seems warranted about situations or expect the worst even then there's no apparent reason to do so. You may feel an inability to relax or enjoy quiet time. You may feel tense all the time and have body aches.

You avoid stressful situations and may have difficulty concentrating. You may find it hard to tolerate uncertainty and may feel a sense of dread or impending doom. This disorder can cause you to struggle with intrusive thoughts about the worst that could happen.

Generalized anxiety disorder can cause you to not sleep well, or feel jumpy or restless. You may have an upset stomach or heart palpitations, shakiness, sweating, a dry mouth, difficulty breathing or a lump in your throat. You could feel dizzy; have cold chills, hot flashes, or numbness and tingling; or may have persistent irritability.

Ongoing generalized anxiety disorder may manifest physically through chronic neck and back pain, headache, irritable bowel syndrome, or stomach and abdominal pain.

There is evidence that biological factors, stressful life experiences, lack of personal security and lack of positive role-modeling of anxious behaviors can lead to generalized anxiety disorder.

Generalized anxiety disorder is treatable, but it takes persistence. A person can find significant relief with psychotherapy, relaxation and mindfulness techniques, or medication. Support groups also help.

Practicing helpful ways of thinking and stress coping skills can lessen the amount of worry. Seek healthy connections with others and a lower-stress lifestyle to find greater freedom from your anxiety. Set healthy boundaries in your life. Use humor and practice to manage your negative anxious tendencies. Exercise can help by relieving the built-up stress and tension.

One of the most important principles of overcoming anxiety is facing your fears. Therapy can help develop a plan, and little by little, you'll grow in self-confidence to manage and cope with anxiety.

Social anxiety

If you struggle with social anxiety, everyday interactions cause significant anxiety, self-consciousness and embarrassment. It is related to the fear of being scrutinized or judged negatively by others. It is intense and affects your work or social life.

You may worry about blushing, trembling, or fear you may look foolish or unintelligent to other people. You may have generalized anxiety disorder symptoms that are mainly associated with social situations. You may fear meeting new people, talking to others at work or school, or speaking in public. Some people with social anxiety fear using a public restroom, being seen eating or drinking in public, or having to perform in front of others.

You may experience feelings of panic or panic attacks, and feel self-conscious or awkward in front of others. You may have difficulty speaking and may avoid situations you feel may trigger anxiety.

Your body may feel rigid and tense while your voice may be soft during social interactions. You may have difficulty making eye contact with others and be sensitive to criticism. You may feel a low self-worth and have a lot of negative self-talk.

Sometimes people with social anxiety may not seek treatment because they feel this uncomfortable way of being is just a part of their personality. However, without treatment for this disorder, these people cannot achieve their potential at school, work or in their personal life.

Social anxiety is treated using the same methods as generalized anxiety disorder.

Panic disorder

A panic attack causes a sudden intense fear or discomfort that peaks within minutes. Other symptoms may include a rapid heart rate, sweating, shakiness, shortness of breath and hot flashes. A person may feel lightheaded, have a sense of impending doom, chills, nausea, abdominal or chest pain, headaches, and numbness or tingling.

Many people feel something is physically wrong when they have a panic attack and that they may be having a heart attack or stroke.

Expected panic attacks occur when there is an obvious cue or trigger, such as with generalized anxiety disorder or a specific phobia. Panic disorder is when a person has frequent, unexpected panic attacks. These panic attacks seem to come out of the blue without a trigger or apparent explanation. If you have panic disorder, you may not be able to stand the thought of experiencing the physical discomfort that has happened when you have panicked before and may always be on guard for another one potentially happening.

Treatment for panic disorder is similar to that of generalized anxiety disorder and social anxiety. Persistence and practice of healthy thinking and coping tools will help develop a better level of confidence in your ability to cope with stress, as well as with the strong feelings of anxiety or panic.

Phobias

Phobias are an overwhelming and unreasonable fear of objects or situations that pose little real danger but provoke anxiety and avoidance. Fear and phobia are different. Fear is a temporary emotion; whereas, a phobia is longstanding. Phobias can create fear that is so strong it becomes debilitating. When this occurs, a phobic fear has become an anxiety disorder.

Your sense of danger or fear is designed to protect you from danger. It can trigger your flight-or-fight instinct so you're ready to take action to protect yourself. A phobia overestimates the threat of a particular situation and triggers intense anxiety leading you to avoid that situation in the future. Avoidance worsens the phobia because it reinforces the brain's exaggerated association between the situation and its threat level.

There are various phobias, including a phobia of animals, insects or spiders; a phobia of natural phenomena like storms or water; and a phobia of blood or injury, blood tests or needles.

Social anxiety can lead to a phobia. Often this comes with agoraphobia, which is a phobia of any place or situation that you fear you can't escape or get help easily. You might avoid travel on public transportation, being in a crowded area or being alone in public. It's rooted in the fear of having intense anxiety or a panic attack in certain places rather than a fear of the place itself.

Health care professionals do not clearly understand why people develop phobias. Often, they begin in childhood — similar to panic disorders.

If you struggle with a phobia, you may notice a racing heart rate, difficulty breathing, trembling, sweating, nausea, dry mouth, and chest pain or tightness. You may feel an overwhelming anxiety or fear. You know your fear is irrational, but you feel powerless to overcome it. You may fear losing control and feel an intense need to escape.

According to research, cognitive therapy and exposure therapy tend to be the best treatment for phobias. Social skills training, mindfulness and medication may help, as well.

Obsessive-compulsive disorder

Obsessive-compulsive disorder, also known as OCD, is a pattern of unwanted thoughts and fears, or obsessions, that lead a person to do repetitive behaviors, or compulsions. The typical onset of OCD is before age 20.

OCD often develops related to a theme. For example, being fearful of germs — an obsession — leads to excessive hand-washing — a compulsion — to reduce the thoughts and fears. If you don't have control over your thoughts, you wash your hands more. This becomes a vicious circle that worsens, and it can become a debilitating lifestyle if not addressed.

Other types of OCD may be needing to have things in perfect symmetrical order; having taboo or other unwanted thoughts; having aggressive thoughts toward yourself or others; and fear of causing harm or danger to self or others by not turning off the stove or not locking the door, so you check and recheck.

Compulsions are the direct result of the obsessive thoughts that lead to repetitive behaviors. These are done in the hope of reducing the anxiety and preventing something bad from happening. Sometimes, actions bring temporary relief but no pleasure. Common compulsions include counting, checking, washing or cleaning; strict routines; orderliness; and a need for reassurance. Symptoms may come and go over time and seem to worsen when a person is under stress.

While adults may recognize their irrational fears and behavior, children may not. Usually, medication and psychotherapy are recommended and can help alleviate many OCD symptoms.

Post-traumatic stress disorder

If you suffer from post-traumatic stress disorder, you have significant anxiety and uncontrolled thoughts triggered by a terrifying or life-threatening event. This could be a terrible accident, a tornado, domestic violence, war, the sudden death of a loved one, critical illness, a near-death experience, kidnapping, terrorist attacks, an assault or a direct threat to your life, or witnessing someone else being attacked.

Some people work through these experiences and learn to cope and adjust with time. Occasionally, people find themselves reliving it, and this affects their ability to function. You may struggle with post-traumatic stress disorder if you get stuck in a state of fear and your symptoms don't improve or worsen.

Symptoms may include avoidance, intrusive memories, changes in emotional reactions, negative changes in thinking and mood, flashbacks, jumpiness and emotional detachment. You may struggle with an overwhelming sense of guilt or shame, sleep disturbances, difficulty concentrating, always being on guard for danger, irritability, angry outbursts, aggressive behavior, and self-destructive behavior. You may feel negative about yourself, have a lack of interest in activities you used to enjoy or have difficulty maintaining your relationships. You could experience memory problems, feelings of hopelessness about the future, and feeling emotionally numb or unable to experience positive emotions.

Having post-traumatic stress disorder increases your risk for depression, anxiety, eating disorders and substance use disorders. It is important to seek treatment if you struggle with intrusive memories, avoid thinking or talking about the trauma, have negative changes to your thinking and mood, and have changes in your physical and emotional reactions to life and others. Treatment may include psychotherapy, exposure therapy called EMDR, medication and other therapies.

For more information, watch this video for ways to combat stress and anxiety: