The DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text-Revised) is considered the standard diagnostic manual for establishing diagnosis of numerous mental disorders. Of note, in its introduction, several caveats are outlined.
First, mental disorder implies a distinction from physical disorders that is a relic of mind/body dualism. Second, "‘mental disorder' lacks a regular operational definition that covers all situations." Third, the categorical approach has limitations in that discrete entities are assumed when in fact there are no absolute boundaries dividing one disorder from another. Fourth, the criteria for each disorder function as guidelines only and should not be applied in either a "cookbook fashion" or in an "excessively flexible" manner. Finally, the objective of the manual is primarily to enhance agreement among clinicians and investigators and is not to imply that any "condition meets legal or other non-medical criteria for which constitutes mental disease, mental disorder, or mental disability" (see Introduction and Cautionary Statement of DSM-IV-TR).
It is critical to keep these caveats in mind, as it is easy to get caught in a physician's diagnosis, believing that it's set in stone, which it isn't. As new details are acquired in treatment, the diagnosis and treatment plan may change. Additionally, it's not uncommon for clinicians to disagree on the diagnosis because of the earlier mentioned caveats. When reading the different criteria individually, it is easy to recognize many of them and jump towards the conclusion that one has the described condition.
Only some time and the guidance of a skilled clinician who's probing and comprehensive in his or her questioning will help to establish an analysis that results in a highly effective treatment plan. A chance to begin a diagnosis is important in developing a treatment plan that restores one's health, and if the treatment plan fails, the first order of business is to reconsider diagnosing.
The mind is really a complex organ that is composed of gray matter and white matter. Gray matter consists of the cell bodies of neurons along with other support cells, and also the white matter consists of long tracts of axons that run between the neurons. Different regions of the mind have somewhat specific functions. For example, the motor cortex controls voluntary movements of the body, and the sensory cortex processes information to the senses.
Different regions of the brain contact other areas nearby as well as more distantly. Information travels through the axons of the neurons inside the white matter areas of the brain.
The mind contains vast amounts of neurons, which connect to each other electrochemically. What this means is that whenever a nerve is stimulated, a number of chemical events occur that in turn create an electrical impulse. The resulting impulse propagates down the nerve length known as the axon and causes a release of chemicals called neurotransmitters into a space between the stimulated nerve and also the nerve that it wishes to communicate with, known as the synaptic cleft.
The neurotransmitters connect to receptors on the second nerve, either stimulating or inhibiting them. The interaction between the neurotransmitters and receptors could be likened to a key interacting with a lock where the neurotransmitter or "key" engages the receptor or "lock," causing it to "open." This opening can be a number of chemical changes inside the second nerve that either causes that nerve to "fire" or "not fire." Thus, brain activity is the result of an orchestrated number of nerves firing or not firing in a binary fashion. In that sense, it's much like a computer where very complicated processes begin their lives like a series of 1s or 0s (on or off, fire or don't fire).
After the nerve fires, thereby releasing neurotransmitters into the synaptic cleft, the neurotransmitters should be taken off the region in order to show the signal off. There's two ways that these chemicals can be taken off in order to turn the signal off. The first is as simple as destroying the chemical through the use of another chemical referred to as an enzyme with that specific purpose in mind. The second reason is by pumping caffeine back to the nerve that released it by using another special chemical known as the transporter or transport pump.
The process of pumping chemicals back to the nerve is known as reuptake. It is important to understand these basic principals of neurophysiology because all psychoactive compounds, whether neurotransmitters, hormones, medications, or addictive drugs, involve one or more of these simple mechanisms.
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Note: This article was sent to us by: Elaine Brenten at 02102011
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