Binge Eating Disorder

Binge Eating disorder (BED) is a common eating disorder that affects millions of people worldwide. It is characterized by episodes of excessive food intake, typically involving a sense of loss of control of eating. This behavior is often followed by feelings of intense guilt, shame, and distress. Binge eating can have a significant impact on a person's physical and emotional health.

It can affect people of any age, gender, or ethnicity, but it is most commonly seen in women and typically begins in adolescence or early adulthood. Binge eating episodes often occur in secret and can be triggered by emotional stress, anxiety, or depression. People with BED may feel a sense of relief or numbness during the binge, but afterward feel intense guilt, shame, or disgust. BED is usually associated with obesity, but it can also occur in people who are of normal weight or even underweight.

The exact causes of BED are not fully understood, but it is thought to be a complex interplay of genetic, environmental, and psychological factors. Research has shown that people with BED may have abnormalities in the areas of the brain that regulate appetite, and they may also have a higher sensitivity to food-related cues. Other factors that increase your risk include:

• Having a someone in your immediate family (especially female relatives) who has an eating disorder
• Having other mental health conditions like as depression, anxiety, or a substance use disorder
• Having a negative body image and a history of dieting or overeating. People who work or have worked in occupations that emphasis a restrictive body size or ‘thinness’ are at risk.

Some of the common triggers for binge eating include stress, boredom, negative emotions, and social pressure. People with BED may also use food as a way to cope with underlying emotional issues, such as depression or anxiety. Unfortunately, binge eating can quickly become a vicious cycle, with the behavior leading to feelings of guilt and shame, which in turn can trigger more episodes of binge eating.

The signs and symptoms of BED can vary from person to person, but some common indicators include:

• Eating larger than normal amounts of food in a short period of time
• Feeling a sense of loss of control during the binge
• Eating when not hungry
• Eating faster than normal
• Eating until feeling uncomfortably full
• Eating alone/ in secret due to shame or embarrassment
• Feeling a sense of guilt or shame after binge eating
• Hiding or hoarding “binge” food

Some people with this disorder plan their binges and may buy large amounts of certain foods (usually unhealthy foods e.g. chips) which they hide to binge on in secret.

Some complications resulting from BED include:

• Overweight and Obesity
• Increased risk of diabetes, high blood pressure, high cholesterol, heart disease and stroke
• It affects your sleep and sexual health
• May worsen body image issues
• Increased risk of depressed mood, anxiety and substance use

If you recognize that your eating habits may be problematic, it’s important to seek professional help early. Treatment for BED is often very effective and most people do well on them. It involves a combination of psychotherapy, medication, nutrition counselling and lifestyle changes. Cognitive-behavioral therapy (CBT) is used to help patients identify and change the thoughts and behaviors that contribute to binge eating. Other types of therapy, such as interpersonal therapy or dialectical behavior therapy, may also be helpful in addressing underlying emotional issues.

Medications such as antidepressants or anti-anxiety drugs may also be prescribed when appropriate. Lifestyle changes such as regular exercise, healthy eating habits, and stress reduction techniques can also be beneficial in managing the disorder. People can also do the following to help them cope with the edge to binge;

• Avoid buying foods that may trigger you to binge and remove them from your home; and avoid keeping reminders of them in your house.
• Be mindful of the signs you feel when you’re hungry and avoid getting too hungry, as this can lead to binge eating. Eat healthy meals on time with healthy snacks in between.
• Keeping a food journal and tracking emotions can also be helpful in identifying patterns and triggers for overeating or binge eating.
• During mealtime, try to focus solely on eating and avoid distractions such as television, books or other activities. This may help you recognize when you’re getting full so you stop eating.
• Engage in productive and enjoyable activities since you are more likely to overeat when you are feeling bored. This avoids mindless eating.

In conclusion, binge eating disorder can have significant physical and psychological consequences. If you or someone you know is struggling with binge eating, it is important to seek help from a healthcare professional as soon as possible. With the right treatment and support, it is possible to overcome binge eating disorder and achieve a healthier and happier life.

Binge Drinking

Binge drinking is a problematic pattern of alcohol misuse that involves consuming large amounts of alcohol within a short period of time. This behavior can occur at any age but is commonest among teenagers and young adults (18-34 years) and can lead to serious health problems and social consequences.

Binge drinking can be defined as consuming five or more alcoholic drinks for men, or four or more for women, within two hours, for most adults this brings blood alcohol concentration (BAC) levels to 0.08 g/dL or more. This type of drinking is often associated with social events such as after work events, parties, concerts, and sporting events, where alcohol is readily available and consumed in large quantities. Binge drinkers have a high rate of injuries compared to nondrinkers and even those who are chronic heavy drinkers and is the fourth leading cause of death in the United States.

People may binge drink as a way to relieve stress especially work related stress, to fit in within a social group, to relieve boredom and as a coping mechanism in times of anxiety or sadness. It may also signal a relapse in people who are recovering from an alcohol use disorder.

One of the main risks associated with binge drinking is alcohol poisoning, which can result in coma or death. This occurs when the amount of alcohol in the bloodstream reaches toxic levels, impairing breathing and heart function sometimes leading to seizures, vomiting and choking. This is a medical emergency. Additionally, binge drinking can lead to accidents and injuries, including falls, car accidents and fights.

Binge drinking can also have long-term effects on health. Regular binge drinking can lead to liver disease, high blood pressure, and an increased risk of certain cancers like breast and colon cancer. It can also contribute to mental health problems such as depression, anxiety, psychosis (i.e. hallucinations, etc.) and increases the risk of suicide. It may also trigger alcohol use disorder in people who are predisposed to it and leads to memory, attention and learning problems especially in students.

The social consequences of binge drinking can also be severe because it leads to impaired judgment and decision-making, which can have serious consequences. Binge drinking is often associated with risky behaviors such as unprotected sex, which can lead to unintended pregnancy or babies with fetal alcohol syndrome and sexually transmitted infections. Also violence including homicide, intimate partner violence, and sexual assault and doing or saying embarrassing things, poor academic or work performance (due to the hangovers), legal problems, and strained relationships. Additionally, if you observe any of the following signs, it is possible that you have a binge drinking problem:

• Consuming excessive amounts of alcohol during social events or weekends
• Experiencing blackouts due to excessive alcohol consumption
• Drinking four or five alcoholic beverages within a period of two hours or less
• Drinking more than intended
• Regretting behaviors that you engaged in while under the influence of alcohol
• Feeling exhausted or experiencing a hangover after a night of drinking
• Experiencing worry or guilty about your excessive drinking habits.

To prevent binge drinking, it is important to encourage responsible drinking habits. This includes setting limits on the amount of alcohol consumed and planning ahead on the amount you intend to drink in a social setting, inform a trusted friend to stop you if you go above that. Avoiding drinking games and competitions. Alternating alcoholic drinks with non-alcoholic beverages or opt for a smaller bottle or one with less alcohol content and drink slowly.

Engage in healthier and safer ways to socialize and have fun with your friends without resorting to excessive alcohol consumption. For example, physical activities, exploring new hobbies, or volunteering for a good cause can be rewarding and beneficial for both physical and mental health. On a larger scale, education campaigns, such as school-based programs and community events, can provide young adults with the information and skills they need to make informed decisions about alcohol consumption. Parents and guardians can also play a crucial role in preventing binge drinking by talking to their children about responsible drinking, avoiding peer pressure and modeling healthy behaviors. Finally, if you or someone you know has a problem with alcohol it’s important to seek professional help.

In conclusion, binge drinking is a dangerous and harmful behavior that can have serious health and social consequences. It is important to be aware of the risks associated with binge drinking and to encourage responsible drinking habits to prevent long-term problems.

Borderline Personality Disorder (BPD), also called Emotionally Unstable Personality Disorder is a disorder that affects approximately 1.5-2% of the population, with a higher prevalence among women (75%). People with BPD experience intense emotions difficult to regulate emotions, marked impulsivity, unstable self-image and relationships. This disorder can be challenging to diagnose and treat, but with the right support, individuals with BPD can manage their symptoms and live fulfilling lives.

Signs of BPD include

• Emotional instability- People with BPD may experience intense mood swings, including feelings of emptiness, anxiety, outbursts of anger and violence and sadness, often in response to criticism from others. They can also suddenly shift from being smothering, fun, exciting and passionate to becoming aloof and withdrawn in a relationship. The result is a constant back-and-forth between demands for love and attention and sudden withdrawal and self-isolation.
• Impulsivity- Lack of impulse control and a tendency to engage in impulsive behaviors, such as substance abuse, binge eating, overspending, reckless driving, or unsafe sex.
• Distorted self-image- Have an unstable sense of self, experiencing rapid changes in their values, goals, careers, preferences (including sexual) and interests. They also tend to self-sabotage, feel guilt, shame or have a negative view of themselves.
• Unstable relationships- often have a history of tumultuous relationships with friends, family members, or romantic partners, characterized by idealization and devaluation. Their romantic relationships often go through a ‘honeymoon phase’ where they have great admiration for/ pedestalization of a loved one (idealization), this can rapidly shift to intense anger toward or dislike of that person (devaluation) when they don’t meet certain perceived standards. This is because people with this disorder tend to use a coping mechanism called splitting where they tend to see people and situations as black and white with no middle ground or room for them to make mistakes. In response to devaluation, the person with BPD may have outbursts of anger, aggression or ask for a break up causing repeated emotional crises and accounting for their many intense but unstable relationships.
• Fear of Abandonment- in an obviously unhealthy relationship or even when they do request for a breakup, people with this disorder have difficulty letting relationships go. This is due to a deep seated fear of abandonment they have this can lead to constantly watching out for signs that someone may leave them and to interpret even a minor event as a sign that abandonment is imminent. They would often go to excessive lengths to avoid abandonment. These may result in desperate efforts, such as pleading, making public scenes, physically preventing the other person from leaving, or threatening self-harm.
• May have a history of suicidal threats or gestures and acts of self-harm (cutting or burning) as a reaction to abandonment, rejection, disappointment or for no apparent reason at all. These acts may frighten their partners and relations and result in they being a danger to themselves or others. People with BPD are up to 40% more likely to attempt suicide than the general population so these should be taken seriously. (NB. All suicidal thoughts, threats and attempts are emergencies which need immediate medical evaluation and psychiatric care.)
• Persistent feelings of emptiness: Many people with BPD feel sad, bored, unfulfilled or “empty.” Feelings of worthlessness and self-loathing are also common.
• Dissociative episodes, paranoid thoughts and sometimes hallucinations may be triggered by extreme stress, usually fear of abandonment. These symptoms are temporary and usually not severe enough to be considered a separate disorder.
• Angry outbursts
• Sexual impulsivity. Sexual identity is often a confusing subject for people with this disorder especially since large percentage of them experienced childhood sexual abuse. Sexual impulsivity is often demonstrated by having earlier sexual encounters, more casual sexual experiences, and more partners.
• Lying

The development of this disorder is thought to result from a complex interplay between biological, genetic, and environmental factors. Evidence points to a strong link between distressing childhood experiences, particularly involving parents and caregivers, and the development of BPD. These negative childhood experiences include: early separation from mother or other supportive caregivers, emotional invalidation, physical neglect, parental insensitivity and physical and sexual abuse. Genetically, studies show that the disorder tends to run in families. Also, people with BPD have differences in both the structure of their brain and brain function. BPD has been associated with excessive activity in parts of the brain that control the experience and expression of emotion.

BPD can be difficult to diagnose because many of its symptoms overlap with other mental illnesses, such as depression, anxiety, bipolar disorder, PTSD and substance use disorders (Salters-Pedneault, 2023). Moreover, people with BPD may hide their symptoms or deny that they need help, out of fear of being stigmatized or rejected. However, with proper screening and assessment, mental health professionals can identify BPD and offer evidence-based treatments.

The most effective treatments for BPD are psychotherapy and medication. Psychotherapy can help people with BPD learn new coping skills, improve their relationships, and regulate their emotions. Some of the most common types of psychotherapy for BPD are Dialectical Behavior Therapy (DBT), Cognitive Behavioral Therapy (CBT), and Schema Therapy. DBT is a specific form of therapy that teaches individuals how to manage their emotions, tolerate distress, and communicate effectively. CBT focuses on changing negative thought patterns and behaviors. Schema Therapy addresses the underlying beliefs and assumptions that contribute to BPD symptoms.

Medication can also be useful in managing specific symptoms of BPD, such as anxiety, depression, or impulsivity. However, medication alone is not a sufficient treatment for BPD and should be used in conjunction with psychotherapy.

Living with BPD can be challenging, but it is possible to manage symptoms and achieve recovery. People with BPD and their loved ones should seek professional help, build a supportive network, and practice self-care. They should also educate themselves about BPD and learn to recognize their triggers and warning signs. With persistence and dedication, individuals with BPD can improve their quality of life and reach their full potential.

Bipolar Affective Disorder

Bipolar affective disorder, commonly known as bipolar disorder, is a mental health condition characterized by periods/ episodes of extreme shifts in mood, energy, and activity levels. It is a chronic and lifelong condition that affects millions of people worldwide.

The disorder is characterized by repeated (i.e. at least two) episodes in which the patient's mood and activity levels are significantly disturbed. This disturbance consists of some occasions of elevated mood, increased energy and activity (mania or hypomania), and other occasions of a low mood and decreased energy and activity (depression).

Recovery is usually complete between episodes. Manic episodes usually begin abruptly and last for between 2 weeks and 4-5 months (without treatment), depressions tend to last longer about 6 months- 1year. Episodes of both kinds often follow stressful life events or other mental trauma, but this is not always the case. The frequency of episodes tends to increase and the length of recovery time tends to get shorter as time goes on and depressions become commoner and longer lasting after middle age.

Bipolar disorder affects approximately 1- 2% of the global population, with the age of onset typically occurring in adolescence (around 15years) or early adulthood. It affects men and women equally and is more likely to occur in individuals with a family history of the disorder or those who have experienced traumatic life events.

The commonest subtypes of bipolar disorder are Bipolar I and Bipolar II. Cyclothymic Disorder and Unspecified Bipolar and Related Disorders are added places that use the DSM-5.

Bipolar I disorder involves periods of manic episodes, which are often severe, last for at least one week and usually require hospitalization. Depressive episodes may also occur, but they are not required for a diagnosis of Bipolar I.

Bipolar II disorder involves periods of hypomanic episodes, which are less severe than manic episodes, but still result in significant changes in mood, behavior, and energy levels. These episodes must last for at least four days and be accompanied by depressive episodes that last for at least two weeks.

Symptoms of a manic episode include

• Elevated or Irritable mood. When someone has an elevated mood due to bipolar disorder, it is often different from their usual behavior. They may seem very happy and excited, or even out of control. They can also become easily annoyed and act rude or arrogant instead of being friendly.
• Increased energy, activity levels, and restlessness
• Increased goal directed activities (e.g. tirelessly working on several projects at once)
• Decreased need for sleep (feeling energetic despite getting less sleep than usual)
• Racing thoughts, rapid speech and quickly changing ideas or topics when speaking.
• Easily distracted
• Grandiosity or inflated self-esteem
• Poor judgment or risky behavior, such as spending sprees or impulsive sexual behavior
• Hallucinations or delusions

Hypomania is a milder form of mania that is characterized by a noticeable change in behavior and mood, but it does not typically interfere with daily life, work and social interactions in the same way as a full-blown manic episode. There is a persistent mild elevation of mood with noticeable feelings of well-being, physical and mental efficiency. People experiencing hypomania may feel more energetic, talkative, and confident than usual, and they may engage in impulsive behaviors, such as spending money excessively or engaging in risky sexual behavior. They may also feel more creative and productive and have decreased need for sleep. Hypomania can be difficult to recognize as a symptom of bipolar disorder because the changes in mood and behavior can be subtle and even enjoyable for the individual. However, if left untreated, hypomania can progress to full-blown mania or lead to a depressive episode.

Symptoms of a depressive episode include

• Persistent sadness, emptiness, or hopelessness
• Loss of interest or pleasure in activities
• Significant changes in appetite and weight
• Fatigue or loss of energy
• Difficulty sleeping or oversleeping
• Feelings of worthlessness or guilt
• Difficulty concentrating or making decisions
• Thoughts of death or suicide (NB. All suicidal thoughts, threats and attempts are emergencies which need immediate medical evaluation and psychiatric care.)

Several risk factors have been identified that can increase the likelihood of developing bipolar disorder. These include genetic factors, as the disorder tends to run in families. Environmental factors, such as stress, trauma, and substance abuse, can also trigger bipolar disorder in those with a genetic predisposition. Other factors that can increase the risk of developing bipolar disorder include a history of substance abuse, traumatic life events, and sleep disturbances. Additionally, certain medical conditions, such as thyroid disorders and multiple sclerosis, have been linked to an increased risk of bipolar disorder.

Although bipolar disorder is a lifelong condition, its symptoms can be well managed, and with the right treatment, individuals with bipolar disorder can live fulfilling lives. Treatment typically involves a combination of medication, psychotherapy, and lifestyle changes.

Medications used to treat bipolar disorder include mood stabilizers, such as lithium and valproic acid, antipsychotics, and antidepressants. Psychotherapy, such as cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT), can also be beneficial in managing bipolar disorder symptoms.

Like other mental health conditions, stigma in bipolar is a very real problem and adds to making living with bipolar disorder challenging, but there are several coping tips that can help manage symptoms and improve quality of life:

• Educate yourself and loved ones about the disorder and work with your healthcare provider to develop a treatment plan that works for you.
• If you’re on medication be consistent with the regime and attend regular reviews with your psychiatrist and psychologist.
• Stick to a routine, including regular sleep, exercise and meal times.
• Identify and avoid triggers that can cause mood swings, such as stress, alcohol, and drugs.
• Learn relaxation techniques, such as deep breathing and meditation, to reduce stress and anxiety.
• Stay connected with friends and family for social support.
• Consider joining a support group to connect with others who are also living with bipolar disorder.

In conclusion, bipolar affective disorder is a complex condition. If you are concerned about yourself or someone you care about experiencing bipolar symptoms, it is important to seek medical help to receive an accurate diagnosis. While bipolar disorder cannot be cured, it can be effectively managed with the appropriate medication and support. By managing symptoms, individuals with bipolar disorder can achieve a better quality of life and minimize the impact of the disorder on their daily functioning, work and relationships.