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Therapy and Beyond: A Guide to Cognitive Disorders

Cognitive disorders are mental disorders that affect a person’s perception, memory processing, and problem solving abilities, which are cognitive functions of the brain. Some individuals with cognitive disorders will be able to live a healthy, normal, and fulfilling life, such as those with learning disabilities and mild anxiety disorders. People with more serious cognitive disorders including dementia, Alzheimer’s disease, Schizophrenia, amnesia, and delirium may have limited ability to perform everyday tasks. There are treatments for cognitive disorders that may slow down the progression of the diseases, but there is no cure for most of these illnesses. Doctors do not know the all the specific causes of the various cognitive disorders, but they do know that genetics, head trauma, and issues during pregnancy and birth may play a role. 

Amnesia

Amnesia is a condition in which a person is not able to remember information that was previously learned and/or can not commit new information to memory. There are two forms of amnesia, anterograde amnesia and retrograde amnesia. Anterograde amnesia is when a person has lost or impaired their ability to memorize new things. These individuals often forget information within a few seconds to a few minutes. In this situation, information from the short-term memory does not transfer successfully to the long-term memory. Retrograde amnesia is when a person can memorize new things that have happened since the onset of the amnesia, but is not able to remember all or some of their life prior to the start of the condition. People can have both amnesia conditions at once, which is typically the result of head injuries or drug usage.

  • Mayo Clinic: An in-depth look at amnesia, including a detailed definition, symptoms, causes, risk factors, tests and treatments. Contact information is provided for support groups for people with amnesia and their families.
  • Discovery Health: This site provides information on amnesia in easy-to-read language. It goes into detail on how the brain works in regards to memory.
  • Cleveland Clinic: This page provides information on both normal memory and cognitive memory issues. This puts memory into perspective so normal and not-normal memory functions can be differentiated.
  • Health-Cares: Is an online guide that includes information on what causes amnesia and a group of links to follow for more information.
  • Better Health Channel: This website informs readers about symptoms, causes, and diagnosing methods of amnesia. The author also talks the different types of memory and treatment options.


Dementia

Dementia is a syndrome that greatly affects attention, memory, problem solving, and language, that has been present for at least six months. When cognitive ability is seriously lost in a person that has never had issues before, with symptoms that go above and beyond normal aging, dementia is usually the culprit. Dementia can appear as the result of a brain injury or a disease in the body. It can be static, meaning the symptoms do not get worse, but they do not get better. Or it can be progressive, meaning it will get worse over time. There are some instances, less than 10% of cases, in which dementia can be reversed with the proper treatment. Dementia is typically seen in elderly people, but it can occur at any time in an adult’s life. Individuals with dementia are often disoriented in place, time, and person. This means that they often do not know where they are, what day or year it is, or who they are.

  • National Institute of Neurological Disorders and Stroke: An informational page on dementia that includes a section with contact information on various organizations and links to additional resources on the disease.
  • John Hopkins Guide to Understanding Dementia: This is a free electronic guide about dementia that can be downloaded for free and saved to the computer for future use. 
  • Medline Plus: Details on dementia and links to more detailed information, including videos, journal articles, and clinical trials.
  • Family Caregiver Alliance: This article provides a look at caregivers for dementia and Alzheimer’s patients. Tips, techniques, and suggestions on how to stay positive when helping patients are provided, along with resources for support groups.
  • National Institute on Aging: Information on how a family can cope with the behaviors of a person with dementia, especially Alzheimer’s disease. This article breaks down challenging behaviors and family issues with suggestions on how keep things running as smoothly as possible.
  • Dementia Education Online: This is an online course comprised of six modules that can be used alone or with other educational programs. It provides detailed information on dementia recourses at the end of each module.


Delirium

Delirium is a severe neuropsychiatric condition that involves severe behavioral disorganization. Patients with delirium often have perception issues, altered sleep-wake cycles, delusions, hallucinations, and other psychotic disturbances. People with delirium have a very hard time interpreting and processing information, and thus are in a constant confused state of mentality. There are three types of delirium that are based on behavior.  Hypoactive delirium is marked by little to no speech, drowsiness, little to no movement, apathy, and is thus sometimes called quiet delirium. Hyperactive delirium is when the patient is very irritable and agitated, has loud or rapid speech, has hallucinations, and is combative. Patients with mixed delirium will experience both hypoactive and hyperactive delirium at various times. Delirium presents itself in a short period of time, normally within a few days. The majority of people with delirium are elderly patients in a long-term care facility or a hospital. When the brain can not process received and sent signals appropriately, it malfunctions and causes delirium. There are many factors that can cause delirium, such as severe terminal illness, old age, dementia, drug or alcohol abuse. Treatments for delirium include discontinuing the use of medication that may be causing the syndrome, using calendars to help the patient stay orientated, having a comfortable and calm environment for the patient and surrounding them in familiar object, and limited change of caregivers, routine, and surroundings.

  • ICU Delirium and Cognitive Impairment Study Group: This entire website is dedicated to delirium and not only includes basic information about this syndrome, goes into details about treatments and has a huge resource section with links to additional information. This site also has free videos and downloads.
  • Consult Geri RN: This is information about delirium from a nursing perspective. The site provides videos, links, and downloadable content.
  • AARP Health Encyclopedia: This website provides a high level overview on many aspects of delirium, including symptoms, causes, treatments, tests, and prognosis.
  • Aging in the Know: This website provides a look at both delirium and dementia to help decipher between the two. It also provides delirium specific information and links to recourses, new research, and related websites.
  • American Family Physician: This article was written by a medical doctor and provides a detailed look at delirium.
  • National Institute for Health and Clinical Excellence: This page provides insight to the prevention, diagnosis, and the management of delirium. It provides downloadable documents that provide guidelines on caring for adults with delirium, and those who are at risk of becoming delirious.


Depression

Depression is common in individuals with cognitive disorders, especially for those who are still aware of their deteriorating mental condition. Evidence is growing that says dementia is preceded by symptoms of depression, making screening for depression in elderly hospitalized patients very important. Depression occurs in about 1-2 % of all elderly people with up to 20% of elderly people having significant depression symptoms with increased risk for poor medical outcomes and suicide. It is estimated that 25-50% of stroke patients have major depressive disorder and many other illnesses and diseases are associated with a high occurrence of depression. It is treatable with medication which may also help the patient deal with their medical condition in a more positive way.

  • Virtual Mentor: This is a website by the American Medical Association that talks about the differences of depression, dementia and delirium in older people.
  • The British Journal of Psychiatry: Several articles at this website, written by doctors and professors, discuss cognitive deficits in depression. The information contained in these articles are the results from a study that compared multiple studies and articles on cognitive disorders and how depression came into play.
  • Personality Research: This is a paper that reviews existing information about Beck’s Cognitive Theory of Depression, which suggests that cognitive symptoms of depression actually come before mood and affective depression symptoms.
  • Medicine – Psychotherapy: This is a look at various therapy treatments for depression, including interpersonal psychotherapy, psychodynamic therapy, and cognitive-behavioral therapy.
  • Clinical Trials Feeds: This is a detailed look at a study that was completed in 2009 in which the cognitive flexibility of patients with depression were compared to see how neuroplasticity and sleep were effected when using different treatments.


Bipolar Disorder

Bipolar disorder is a mental illness that causes extreme mood swings and drastic changes in behavior, thought, and energy levels. This mood disorder is sometimes called manic depression or manic-depressive illness and it is thought that a chemical imbalance in the brain is the cause. People with bipolar disorder alternate between episodes of severe mania (highs) and depression (lows), which can last for months, weeks, days, or hours. Extreme mania can lead to hallucinations and delusions. It is estimated that about six million American adults have bipolar disorder, which can begin at any stage of life and equally effects women and men of all social classes, ethnic groups, and races. Bipolar disorder does seem to have a genetic link as it runs in families. It is treatable with medication, support groups, and various types of therapy. 

  • Depression and Bipolar Support Alliance: This page provides an overview of bipolar disorder and includes downloadable pamphlets.
  • Family Doctor: In addition to a six minute video on bipolar disorder, this site provides a lot of information on the illness from the basics to more in-depth looks at the different types of bipolar disorder and how it is treated.
  • Help Guide: Provides information to help understand bipolar disorder with easy to read bullet points, graphics, and informational boxes. This site goes into self-help methods, causes, and triggers.
  • National Alliance on Mental Illness: In addition to a basic overview of bipolar disorder, this site provides information on medications that are used to treat the illness.
  • Guide To Bipolar Disorder: This is a complete resource to bipolar disorder, including symptoms, treatment options, and recommendations for books and other websites.
  • Black Dog Institute: This is a website dedicated to bipolar disorder and it includes a self-test to help individuals determine if they may have this disorder.


Schizophrenia

Schizophrenia is a major mental illness that typically affects people between 16 and 30 years old. Schizophrenia is an imbalance of mental functions in which the patient may not be able to decipher between reality and fantasy, has inappropriate emotional responses, has excessive anxiety, has trouble creating and maintaining relationships with other people, may not be able to make sense of what happens to them, and does not have a stable sense of who they are. It is unclear as to what causes Schizophrenia, yet it is believed that it may be caused by a group of conditions and is may be due to structural and/or chemical differences in the brain. Antipsychotic medications are used to treat Schizophrenia, which is a condition that can be improved enough for the patient to live independently and have a career. Other treatments are used, including various forms of therapy and social skills groups.

  • World Fellowship for Schizophrenia: This is a website that is specifically geared towards Schizophrenia, but also includes information on depression and bipolar disorder. It includes a look at the medications used to treat the disorder.
  • The Huxley Institute: This is an online guide to various articles about Schizophrenia.
  • Johns Hopkins Medicine: A look at the history of Schizophrenia, help for family and friends of people with Schizophrenia, and a look at the current treatments available.
  • My Schizophrenia: This entire website is a resource for people living with Schizophrenia and their family and friends. There is a page for breaking news about the disorder, current theories about the etiology of the disorder, tips on getting help and information about the various medicines that are used to treat Schizophrenia.
  • Schizophrenia Research Institute: The institute is based in Australia, but the information is relevant to people in every country that are touched by Schizophrenia. This website provides basic information, current news, and conducts and reports on studies about the disorder.
  • Neuroscience For Kids: This is an educational website geared towards children, to help them understand Schizophrenia in easy to read and understand terms.

Anxiety Disorders

About 40 million American adults a year suffer from anxiety disorders. It is an unpleasant combination of complex emotions and physical symptoms that can affect a person’s daily tasks. The physical symptoms that can accompany the mental anguish of an anxiety disorder include chest pain, nausea, shortness of breath, heart palpitations, nervousness, and headaches. A stressful event can cause brief anxiety, but when a person has an anxiety disorder, it will last at for at least six months or longer and will get worse if not treated. There are several types of anxiety disorders, including obsessive compulsive disorder (OCD), post traumatic stress disorder (PTSD), separation anxiety, social anxiety disorder (SAD), generalized anxiety disorder (GAD), and phobias. People with OCD have recurring thoughts and obsessions that are exaggerated by fears and anxiety. Individuals with PTSD have trouble coping with a traumatic event and often relive the event by having flashbacks and nightmares, trouble sleeping, poor concentration, emotional numbing, and avoidance behaviors. Separation anxiety is a part of child development, but when it interferes with daily tasks or does not stop after a certain age, it is a sign of separation anxiety disorder. SAD is characterized by having extreme anxiety of being judged, ridiculed, or embarrassed by other people, which leads to avoidance behavior. Generalized anxiety disorder is when a person has unrealistic and excessive worries that last six months or longer. A phobia is when a person has an exaggerated or an unrealistic fear of a specific situation, activity, or object. Most types of anxiety disorders can be treated and cured with medication and therapy. Exposure therapy and cognitive behavioral therapy are typically very beneficial to help people control their anxiety and conquer their fears.

  • International OCD Foundation: This website provides detailed information about obsessive compulsive disorder, including information about the disorder, places to reach out to for support, news, and information on how to get involved for the cause.
  • Natural Health and Meditation Resource: This is a descriptive look at post traumatic stress disorder with links at the bottom of the article for more information.
  • Anxiety Disorders Association of America: This page provides information on separation anxiety disorder as well as other anxiety disorders in children.
  • Social-Anxiety: This website provides information about social anxiety disorder, stories from people living with social anxiety disorder, a self-test to see if you have any symptoms of the disorder, and a very good resource section with contact information for support groups and other associations.
  • NARSAD: A 4 page fact sheet on generalized anxiety disorder. This guide provides information on the symptoms and treatments of generalized anxiety disorder and tips on living with the disorder and the types of therapy that works well for people with this disorder.
  • List of Phobias: This is an alphabetical listing of all the phobias, the medical name and what it means. The website also includes general information on phobias and what causes them.

Cognitive disorders can range from mild to moderate, with some disorders affecting a person’s ability to function rationally and independently. But, some of these disorders can be treated so that the affected person can live a happy life, sometimes even being cured. With the proper information, a good support system, and the right treatments, patients and their friends and family will be equipped with the necessary tools to deal with the disorder.