American Medical Association Family Medical Guide - American Medical Association [448]
Treatment
To treat narcolepsy, your doctor will tailor a treatment plan to your individual needs, depending on the severity of your symptoms. Medications called central nervous system stimulants are the recommended treatment for narcolepsy. These drugs promote wakefulness during the day to reduce the effects of excessive daytime sleepiness.
Antidepressant drugs (see page 712) that suppress REM sleep may also be prescribed to control cataplexy. The doctor may recommend taking 10- to 15-minute naps two or three times a day to help relieve daytime sleepiness. It may take several weeks or months of adjustment before your treatment plan is effective; even then, complete control of your symptoms may not be possible. Joining a support group may help you and your family learn to cope with the emotional effects of narcolepsy and learn ways to avoid situations in which you could be injured if you fell asleep unexpectedly.
5
Behavioral, Emotional, and Mental Disorders
A mental disorder is a condition that adversely affects a person’s thoughts, feelings, and behavior. Because they often produce anxiety, mood changes, and disturbances in perception, mental disorders have traditionally been seen as different from physical disorders. However, we now know that, like any other illnesses including heart disease and cancer, mental disorders result from an interaction of biology (such as a chemical imbalance or structural abnormality in the brain), genes, and environment. Mental disorders not only cause psychological symptoms but also can cause a variety of uncomfortable and frightening physical symptoms, including heart palpitations, nausea, and dizziness.
Stressful life events—both positive and negative—can trigger some mental disorders. Others seem to arise spontaneously with no obvious cause. The effects they produce are no less real than the effects of a heart attack or cancer.
Mood Disorders
Mood disorders are mental disorders that affect a person’s emotional state. Occasionally feeling sad, dejected, or elated is a normal part of the human experience. But people with a mood disorder feel these emotions more strongly, and the feelings can persist for months or years. Roughly one in seven people experiences some kind of mood disorder each year. Factors that have been implicated in their development include an inherited susceptibility, an imbalance in brain chemicals that regulate mood, a structural abnormality in a part of the brain that controls emotions, and environmental influences. Often, a combination of these factors comes into play. The most common mood disorders are depression, bipolar disorder (formerly known as manic depression), and seasonal affective disorder (SAD). Mood disorders are among the most treatable of all mental disorders.
Depression
Depression is a disorder of mood regulation, caused by an imbalance of brain chemicals called neurotransmitters, which enable brain cells to communicate with each other. People with depression endure overwhelming feelings of despair and hopelessness that last for long periods. It is normal to feel unhappy when you lose your job or when a loved one dies, but such feelings usually subside with the passage of time. Depression can impair your functioning at home and at work and cause you to withdraw from family and friends.
Women are twice as likely as men to have depression. The disorder can occur at any age, but usually first appears between ages 18 and 44. Depression in childhood and adolescence has been linked to an increased risk of teen suicide. Depression among older people is extremely common and can be worsened by the death of friends and recognition of the physical limitations of aging.
Psychiatric Terms
Many terms used in this section have clearly defined meanings for medical professionals,