Self confidence and Self-esteem

Healthy self confidence and self-esteem can enable one live a full and meaningful life. The two terms may overlap but are very different.

Self Confidence:  It is the belief in one’s self and one’s capabilities. Self-confidence is usually not static and can change depending on the situation at hand. Hence, it is normal for one to be confident in one circumstance and not confident in another.

Self-esteem:This refers to whether one appreciates and/or values themselves. It develops over time and changes due to interaction with people or life experiences.

A healthy amount of self-esteem is required to have the self-confidence needed to meet life’s challenges and experiences and to partake in things one finds rewarding and enjoyable.

What is the relevance of self-confidence/esteem?

Many people experience low self-esteem or low self-confidence. For some people it may only be in certain situations whereas for others it may be pervasive, debilitating and affecting their lives in a negative way.

Persons with low self-esteem/confidence tend to develop a self-perpetuating cycle of negative thinking as a result of repeated negative or disappointing life events.

Low self-esteem or self-confidence can result in:

• Shyness
• Poor communication skills
• Social anxiety
• Lack of assertiveness

Low self-esteem can lead to a strong critical internal voice that is an “inner critic” that tends to dominate where an individual is feeling distressed, overwhelmed or judged by others. This inadvertently contributes to feelings of sadness, anxiety and depression.

Some of the consequences of this “inner critic” include:

• Negative thoughts about one’s self
• Believing the negative thoughts are always true
• Ignoring strengths and abilities
• Focusing on mistakes/failures whiles ignoring successes/achievements
• Always expecting the worst
• Believing one does not deserve to be happy

On the other hand, some people may have an extreme self-esteem and self-confidence which is equally as unhealthy as low self-esteem/confidence. Such people are overconfident, overestimate their abilities, attributes and skills. Their self-opinions are often exaggerated and unrealistic.

High or extreme self-esteem and self-confidence can also result in:

• Arrogance
• Self-indulgence
• Express feelings of entitlement
• Overly critical of others

High self-esteem and self confidence can affect one’s life in various ways:

• Relationship problems
• Problems with socializing
• Lack of growth/improvement
• Inability to deal with criticisms.

Self-help strategies to improve self-esteem/confidence:

• Get to know yourself 
• Noting down experiences or thoughts that increase or decrease your confidence and esteem
• Identify your strengths and weaknesses
• Be honest to yourself
• Think about what you would like to change or improve and how to achieve it
• Practice self-acceptance 
• Understand and acknowledge that mistakes happen and are a part of the learning process
• Identify ways of solving problems for a different outcome
• Be critical of the behaviour and not yourself
• Reprogram your thinking 
• Describe yourself to others in positive ways
• Be kind and gentle with yourself
• Practice positive self-talk and affirmations
• Be more assertive 
• Learn to assert your needs
• Don’t feel guilty for asking for what you need and saying no to what you don’t want
• Make changes in your life 
• Identify specific goals
• Break each goal down into achievable steps
• Build on your success after each step
• Surround yourself with positive people
• Reward yourself

If you want some professional help, kindly book an appointment with our mental health professionals.

Schizophrenia is a serious mental illness that affects how a person thinks, feels, and behaves.
People with schizophrenia are usually diagnosed between the ages of 16 and 30. It’s important
to recognize the symptoms of schizophrenia and seek help as early as possible.

What are the symptoms of Schizophrenia?
Schizophrenia symptoms can differ from person to person, but they generally fall into three
main categories: psychotic, negative, and cognitive.

Psychotic Symptoms
They include changes in the way a person thinks, acts, and experiences the world. People with
psychotic symptoms may lose a shared sense of reality with others and experience the world in
a distorted way. For some people, these symptoms come and go. For others, the symptoms
become stable over time.

Psychotic Symptoms include:

• Hallucinations: When a person sees, hears, smells, tastes, or feels things that are not actually there. Hearing voices is common for people with schizophrenia. People who hear voices may hear them for a long time before family or friends notice a problem. 
• Delusions: When a person has strong beliefs that are not true and may seem irrational to others. For example, individuals experiencing delusions may believe that people on the radio and television are sending special messages that require a certain response, or they may believe that they are in danger or that others are trying to hurt them. 
• Thought disorder: When a person has ways of thinking that are unusual or illogical. People with thought disorder may have trouble organizing their thoughts and speech. Sometimes a person will stop talking in the middle of a thought, jump from topic to topic, or make up words that have no meaning. 
• Movement disorder: When a person exhibits abnormal body movements. People with movement disorder may repeat certain motions over and over.

Negative Symptoms
They include loss of motivation, loss of interest or enjoyment in daily activities, withdrawal
from social life, difficulty showing emotions, and difficulty functioning normally.

Negative Symptoms can present as:

• Having trouble planning and sticking with activities, such as grocery shopping
• Having trouble anticipating and feeling pleasure in everyday life
• Talking in a dull voice and showing limited facial expression
• Avoiding social interaction or interacting in socially awkward ways
• Having very low energy and spending a lot of time in passive activities. 

In extreme cases, a person might stop moving or talking for a while, which is a rare condition called catatonia.
These symptoms are sometimes mistaken for symptoms of depression or other mental illnesses.

Cognitive Symptoms
They include problems in attention, concentration, and memory. These symptoms can make it
hard to follow a conversation, learn new things, or remember appointments. A person’s level
of cognitive functioning is one of the best predictors of their day-to-day functioning. Cognitive
functioning is evaluated using specific tests.

Causes/Risk factors of Schizophrenia
There is no known cause of schizophrenia. However, some risk factors have been noted.
Several factors may contribute to a person’s risk of developing schizophrenia, including:

1. Genetics: Schizophrenia sometimes runs in families. However, just because one family member has schizophrenia, it does not mean that other members of the family also will have it. Research suggests that many different genes may increase a person’s chances of developing schizophrenia, but that no single gene causes the disorder by itself. 
2. Environment: A combination of genetic factors and aspects of a person’s environment and life experiences may play a role in the development of schizophrenia. These environmental factors include living in poverty, stressful or dangerous surroundings.
3. Brain structure and function: People with schizophrenia may be more likely to have differences in the size of certain brain areas and in connections between brain areas. Some of these brain differences may develop before birth. Researchers are working to better understand how brain structure and function may relate to schizophrenia.
4. Pregnancy and birth complications: Research has shown people who develop schizophrenia are more likely to have experienced complications before and during their birth, such as:

• a low birthweight
• premature labour
• a lack of oxygen (asphyxia) during birth

Triggers of Schizophrenia
Triggers are things that can cause schizophrenia to develop in people who are at risk.
These include:

Stress: the main psychological triggers of schizophrenia are stressful life events, such as: 

• bereavement
• losing your job or home
• divorce
• the end of a relationship
• physical, sexual or emotional abuse

These kinds of experiences, although stressful, do not cause schizophrenia. However, they can
trigger its development in someone already vulnerable to it.

• Drug abuse: drugs do not directly cause schizophrenia, but drug misuse increases the risk of developing schizophrenia or a similar illness.
• Certain drugs, particularly cannabis, cocaine, LSD or amphetamines, may trigger symptoms of schizophrenia in people who are susceptible.
• Using amphetamines or cocaine can lead to psychosis, and can cause a relapse in people recovering from an earlier episode.
• Teenagers and young adults who use cannabis regularly are more likely to develop schizophrenia in later adulthood.

Treatment of Schizophrenia
Current treatments for schizophrenia focus on helping individuals manage their symptoms,
improve day-to-day functioning, and achieve personal life goals, such as completing education,
pursuing a career, and having fulfilling relationships.
They include:
Antipsychotic medication, Family Education and Support and psychotherapy

Living with Schizophrenia
If schizophrenia is well managed, it's possible to reduce the chance of severe relapses. The
measures to reduce relapses include:

• recognising the signs of an acute episode
• taking medicine as prescribed
• talking to others about the condition

Schizoaffective Disorder is a chronic mental health condition characterized primarily by
symptoms of schizophrenia, such as hallucinations or delusions, and symptoms of a mood
disorder, such as mania and depression.

Many people with schizoaffective disorder are often incorrectly diagnosed at first with bipolar
disorder or schizophrenia. Because schizoaffective disorder is less well-studied than the other
two conditions, many interventions are borrowed from their treatment approaches.

Symptoms of Schizoaffective Disorder
The symptoms of schizoaffective disorder can be severe and include:

1. 1. Hallucinations, which are seeing or hearing things that aren’t there.
2. Delusions, which are false, fixed beliefs that are held regardless of contradictory evidence.
3. Disorganized thinking. A person may switch very quickly from one topic to another or provide answers that are completely unrelated.
4. Depressed mood. If a person has been diagnosed with schizoaffective disorder depressive type they will experience feelings of sadness, emptiness, feelings of worthlessness or other symptoms of depression.
5. Manic behaviour. If a person has been diagnosed with schizoaffective disorder: bipolar type they will experience feelings of euphoria, racing thoughts, increased risky behaviour and other symptoms of mania.

Causes of Schizoaffective Disorder
The exact cause of schizoaffective disorder is unknown. A combination of causes may
contribute to the development of schizoaffective disorder such as:

1.  Genetics: Schizoaffective disorder tends to run in families. This does not mean that if a relative has an illness, you will absolutely get it. But it does mean that there is a greater chance of you developing the illness.
2. Stress: Stressful events such as a death in the family, end of a marriage or loss of a job can trigger symptoms or an onset of the illness.
3. Drug use: Psychoactive drugs such as LSD have been linked to the development of schizoaffective disorder.

Diagnosis of Schizoaffective Disorder
Schizoaffective disorder can be difficult to diagnose because it has symptoms of both
schizophrenia and either depression or bipolar disorder. Nevertheless, clinicians rely on the
diagnostic criteria itemized in the DSM 5 or ICD -10

Treatment of Schizoaffective Disorder
Schizoaffective disorder is treated and managed in several ways:

1. Medications: including mood stabilizers, antipsychotic medications and antidepressants
2. Psychotherapy: such as cognitive behavioural therapy or family-focused therapy
3. ECT (Electroconvulsive Therapy) ECT is usually a last resort treatment. However, not only has it been used in urgent cases and treatment resistance, but it should also merit consideration in augmentation of current pharmacotherapy

Schizotypal Personality Disorder (SPD) is characterized by a pervasive pattern of intense discomfort
with and reduced capacity for close relationships, distorted cognition and perceptions, and
eccentric behaviour. Speech may include digressions, odd use of words, or evidence of magical
thinking, such as a belief in clairvoyance and bizarre fantasies. Patients usually experience
distorted thinking and avoid intimacy. They typically have few, if any, close friends, and feel
nervous around strangers although they may marry and maintain jobs. The disorder, which may
appear more frequently in males, surfaces by early adulthood and can exacerbate anxiety and
depression.

Causes of Schizotypal Personality Disorder (SPD)
The exact cause of SPD is unknown. Many factors may be involved:

1. Genetic: SPD seems to be more common among relatives. Studies have found that some gene defects are found more often in people with SPD.
2. Psychologic: A person's personality, ability to deal with stress, and handle relationships with others may contribute to SPD.
3. Environmental: Emotional trauma as a child and chronic stress may also play roles in developing SPD.

Diagnosis of Schizotypal Personality Disorder (SPD)
Besides a persistent pattern of intense discomfort with close relationships and perceptual
distortions, the presence of the following can aid the diagnosis of schizotypal personality
disorder:

1. Ideas of reference (notions that everyday occurrences have special meaning or significance personally intended for or directed to themselves) but not delusions of reference (which are similar but held with greater conviction)
2. Odd beliefs or magical thinking (eg, believing in clairvoyance, telepathy, or a sixth sense; being preoccupied with paranormal phenomena)
3. Unusual perceptional experiences (eg, hearing a voice whispering their name)
4. Odd thought and speech (eg, that is vague, metaphorical, excessively elaborate, or stereotyped)
5. Suspicions or paranoid thoughts
6. Incongruous or limited affect
7. Odd, eccentric, or peculiar behavior and/or appearance
8. Lack of close friends or confidants, except for 1st-degree relatives
9. Excessive social anxiety that does not lessen with familiarity and is related mainly to paranoid fears

Treatment of Schizotypal Personality Disorder (SPD)
Schizotypal personality disorder is commonly treated with drugs. Atypical antipsychotics
lessen anxiety and psychotic-like symptoms; antidepressants may also help lessen anxiety in
patients with schizotypal personality disorder.

Cognitive-behavioural therapy that focuses on acquiring social skills and managing anxiety can
help. Such therapy can also increase patients' awareness of how their own behavior may be
perceived.

Supportive psychotherapy is also useful. The goal is to establish an emotional, encouraging,
supportive relationship with the patient and thus help the patient develop healthy defense
mechanisms, especially in interpersonal relationships.

Seasonal Affective Disorder (SAD) is a type of depression that occurs during specific seasons, typically in fall and winter months. SAD is more common in countries with long, dark winter seasons.

Causes of Seasonal Affective Disorder (SAD)
The exact causes of SAD are not known, but it is believed to be related to the reduced exposure
to natural sunlight during the winter months. This lack of sunlight can disrupt the body's
internal clock, leading to changes in mood, sleep, and appetite. Additionally, SAD may be
related to imbalances in the brain chemicals that regulate mood, such as serotonin and
melatonin.

Diagnosis of Seasonal Affective Disorder (SAD)
The diagnosis of SAD is typically made by a mental health professional based on the patient's
symptoms, medical history, and a physical exam. The diagnostic criteria for SAD include
experiencing symptoms of depression during specific seasons for at least two consecutive
years.

Treatment of Seasonal Affective Disorder (SAD)
The treatment for SAD may include a combination of medication, light therapy, and
psychotherapy. Antidepressant medications such as selective serotonin reuptake inhibitors
(SSRIs) and bupropion have been found to be effective in treating SAD. Light therapy involves
exposure to a special light box that simulates natural sunlight and can help regulate the body's
internal clock. Psychotherapy, such as cognitive-behavioural therapy (CBT), can also be
beneficial in helping individuals cope with the symptoms of SAD.

Sleep Disorders refer to a range of conditions that affect a person's ability to sleep or stay asleep.
These disorders can have various causes, including medical conditions, lifestyle factors, and
environmental factors. There are several types of sleep disorders, each with its own set of

Causes of Sleep Disorders

1. Medical conditions such as sleep apnea, restless leg syndrome, and narcolepsy
2. Lifestyle factors such as irregular sleep schedule, caffeine and alcohol consumption, and excessive use of electronic devices
3. Environmental factors such as noise, temperature, and light levels in the bedroom
4. Mental health conditions such as anxiety, depression, and post-traumatic stress disorder

Types of Sleep Disorders 
Sleep disorders can manifest in various forms such as:

1. Insomnia: difficulty falling asleep or staying asleep
2. Sleep Apnoea: a disorder characterized by pauses in breathing during sleep
3. Restless Leg Syndrome: an uncomfortable sensation in the legs that can cause a strong urge to move them
4. Narcolepsy: a disorder that causes excessive daytime sleepiness and sudden sleep attacks
5.  Parasomnias: abnormal behaviours during sleep such as sleepwalking, night terrors, and REM sleep behaviour disorder

Symptoms of Sleep Disorders 
They include:

• Difficulty falling or staying asleep
• Excessive daytime sleepiness
• Loud snoring or gasping for air during sleep
• Restless legs or an urge to move them
• Abnormal behaviour during sleep

Diagnosis of Sleep Disorders 
A sleep study, also known as a polysomnogram, is the most common test used to diagnose
sleep disorders. During this test, various sensors are attached to the patient's body to measure
brain activity, heart rate, breathing, and muscle activity during sleep.

Treatment of Sleep Disorders 
Treatment options for sleep disorders vary depending on the type and severity of the disorder.
Some common treatments include:

• Lifestyle changes such as maintaining a regular sleep schedule and avoiding caffeine and alcohol
• Behavioural therapies such as cognitive-behavioural therapy for insomnia
• Medications such as sleeping pills and medications for sleep apnoea and restless leg syndrome
• Continuous Positive Airway Pressure (CPAP) machines for sleep apnoea
• Surgery for certain types of sleep apnoea and other disorders

Social Anxiety Disorder, also known as social phobia, is a type of anxiety disorder characterized
by an intense fear of social situations and being scrutinized or judged by others. People with
social anxiety disorder may experience significant distress and impairment in their daily lives
due to their fears.

Types of Social Anxiety Disorder
There are two main types of social anxiety disorder:

1. Generalized social anxiety disorder: characterized by excessive and persistent fear of most social situations and interactions
2. Performance anxiety: characterized by fear and avoidance of specific situations, such as public speaking or performing in front of others.

Causes of Social Anxiety Disorder
The causes of social anxiety disorder are not fully understood, but several factors may
contribute, including:

• Genetics
• Brain chemistry and function
• Environmental factors (such as childhood experiences or learned behaviours)

Symptoms of Social Anxiety Disorder
The symptoms of social anxiety disorder can vary, but some common symptoms include:

• Intense fear or anxiety in social situations
• Avoidance of social situations or extreme discomfort when faced with them
• Physical symptoms, such as sweating, trembling, or blushing
• Fear of being judged or evaluated by others
• Difficulty making and keeping friends or romantic relationships

Diagnosis of Social Anxiety Disorder
Diagnosing social anxiety disorder typically involves a psychological evaluation by a mental
health professional. This evaluation may include questions about the individual's symptoms,
medical history, and family history, as well as standardized questionnaires or assessments.

Treatment of Social Anxiety Disorder
The treatment for social anxiety disorder can include a combination of medication and therapy.
Some common treatments include:

1. Cognitive-behavioral therapy (CBT): a type of therapy that helps individuals identify and change negative thought patterns and behaviors related to their fears.
2. Medication: such as selective serotonin reuptake inhibitors (SSRIs) or benzodiazepines.
3. Relaxation techniques: such as deep breathing or progressive muscle relaxation.

Stuttering, also known as stammering, is a speech disorder characterized by interruptions or
disruptions in the flow of speech. These interruptions can take the form of repeated sounds,
syllables, or words, prolonged sounds or pauses, or blocking of speech. Stuttering can occur in
individuals of all ages and affects approximately 1% of the population.

Causes of Stuttering
The exact causes of stuttering are not fully understood, but research suggests that a combination
of genetic and environmental factors may play a role. Some of the factors that have been
associated with stuttering include:

1. Genetics: Studies have shown that stuttering tends to run in families, suggesting that there may be a genetic component to the disorder.
2. Neurological factors: Some research has suggested that abnormalities in the brain may contribute to stuttering.
3. Environmental factors: Psychological factors, such as anxiety, stress, or trauma, can also contribute to stuttering.

Types of Stuttering
There are several different types of stuttering, including:

• Developmental stuttering: This is the most common type of stuttering and usually develops in childhood.
• Neurogenic stuttering: This type of stuttering is caused by damage to the brain or nervous system.
• Psychogenic stuttering: This type of stuttering is caused by psychological factors such as anxiety or trauma.

Symptoms of Stuttering
The symptoms of stuttering can vary from person to person but typically include:

• Repetitions of sounds, syllables, or words
• Prolongation of sounds or words
• Blocks or pauses in speech
• Tension or struggle when speaking
• Avoidance of speaking situations

Diagnosis of Stuttering
The diagnosis of stuttering is typically made by a speech-language pathologist (SLP) who will
evaluate the individual's speech and language abilities. The SLP may also conduct additional
assessments to rule out other possible causes of the individual's speech difficulties.

Treatment of Stuttering
There are several different treatment options available for stuttering, including:

1. Speech therapy: This involves working with a speech-language pathologist to improve speech fluency and reduce stuttering.
2. Electronic devices: Some electronic devices, such as speech-aiding devices, can be used to assist with speech fluency.
3. Medications: Certain medications, such as those used to treat anxiety or depression, may be prescribed to help reduce stuttering.
4. Support groups: Joining a support group can provide individuals with stuttering with the opportunity to connect with others who are experiencing similar challenges.

Self-Harm and suicide are serious mental health issues that require immediate attention and
professional intervention.

Definition of Self-Harm
Self-harm refers to intentionally causing physical harm to oneself, without the intention of
committing suicide. Suicide, on the other hand, refers to intentionally ending one's own life.

Causes of Self-Harm
There are several potential causes of self-harm and suicide, including mental health disorders
such as depression, anxiety, and borderline personality disorder, as well as environmental
factors such as trauma, abuse, and bullying.

Symptoms of Self-Harm
Symptoms of self-harm can include cuts, bruises, and burns on the body, as well as wearing
long sleeves or pants to hide injuries. Symptoms of suicide can include talking about death or
suicide, making plans to commit suicide, and withdrawing from social interactions.

Types of Self-Harm
Self-harm can take many forms, including cutting, burning, and hitting oneself. Suicide can
also take various forms, such as overdose, hanging, and self-inflicted gunshot wounds.

Diagnosis of Self-Harm
A mental health professional can diagnose self-harm and suicide by conducting a thorough
assessment of the individual's symptoms, medical history, and family history of mental health
issues.

Treatment of Self-Harm
Treatment for self-harm and suicide typically involves a combination of medication and
therapy. Cognitive-behavioural therapy (CBT) is a common approach used to help individuals
identify and manage triggers that lead to self-harm and suicidal thoughts. Additionally,
medication can be prescribed to help manage symptoms of depression and anxiety. In severe
cases, hospitalization may be necessary to ensure the individual's safety.

Prevention of Self-Harm
Preventing self-harm and suicide involves identifying and addressing underlying mental health
issues, as well as providing individuals with the necessary support and resources to manage
their symptoms. This may include therapy, support groups, and crisis hotlines. Additionally,
educating individuals and communities about the warning signs of self-harm and suicide can
help prevent these behaviours from occurring.

School life can have a significant impact on the mental health of students. Numerous studies
have found that academic pressures, social relationships, and other school-related stressors can
lead to negative mental health outcomes such as anxiety, depression, and burnout.

Here are some common mental health challenges that students may face in school:

• Anxiety: Many students experience anxiety related to school, including test anxiety, social anxiety, and separation anxiety. 
• Depression: Depression is a common mental health challenge that can affect students' academic performance, attendance, and social interactions. 
• Attention Deficit Hyperactivity Disorder (ADHD): ADHD can make it difficult for students to concentrate, stay organized, and complete tasks in a timely manner. 
• Eating disorders: eating disorders, such as anorexia and bulimia, can affect students' physical health and emotional well-being. 
• Substance abuse: Substance abuse is a significant concern for many students, particularly in high school and college.
• Post-traumatic stress disorder (PTSD): Students who have experienced trauma, such as abuse or violence, may develop PTSD, which can affect their academic and social functioning.

In addition to academic and social stressors, other factors such as bullying, discrimination, and
trauma can also have a negative impact on the mental health of students.
It is important for schools to recognize the impact of school-related stressors on student mental
health and to implement strategies to support student well-being.

Some possible strategies include promoting positive relationships among students and between students and teachers, providing mental health resources and support services, and implementing policies to prevent bullying and discrimination.

Somatoform Disorders are a group of mental disorders in which individuals experience physical
symptoms that are not fully explained by a medical condition. These symptoms are often
accompanied by excessive worry and anxiety about their health, which can lead to significant
distress and functional impairment.

Types of Somatoform Disorders

1. Somatization disorder (also known as Briquet's syndrome)
2. Conversion disorder (also known as functional neurological symptom disorder)
3. Hypochondriasis (now known as illness anxiety disorder)
4. Body dysmorphic disorder
5. Pain disorder

Symptoms of Somatoform Disorders
The symptoms of somatoform disorders can vary depending on the specific disorder, but
typically involve physical complaints such as pain, fatigue, digestive problems, or neurological
symptoms such as paralysis or seizures. These symptoms often persist despite medical
treatment and evaluation, leading to frustration and anxiety for the individual experiencing
them.

Causes of Somatoform Disorders
The exact causes of somatoform disorders are not fully understood, but are thought to be related
to a combination of psychological, genetic, and environmental factors. Individuals who have
experienced trauma, abuse, or significant stress may be more likely to develop somatoform
disorders.

Diagnosis of Somatoform Disorders
Diagnosis of somatoform disorders is typically made by a mental health professional, who will
evaluate the individual's symptoms, medical history, and psychological functioning. Medical
tests and evaluations may be used to rule out underlying medical conditions that could be
causing the symptoms.

Treatment of Somatoform Disorders
Treatment for somatoform disorders typically involves a combination of psychotherapy and
medication. Cognitive-behavioral therapy (CBT) has been shown to be effective in helping
individuals to understand and manage their symptoms, as well as addressing underlying
psychological factors that may be contributing to the disorder. Antidepressant medications may
also be prescribed to help alleviate symptoms of anxiety and depression.