Tag Archives: Abuse

Forgiveness: Letting Go Of Grudges And Bitterness

When someone you care about hurts you, you can hold on to anger, resentment and thoughts of revenge — or embrace forgiveness and move forward.

Nearly everyone has been hurt by the actions or words of another. Perhaps your mother criticized your parenting skills, your colleague sabotaged a project or your partner had an affair. These wounds can leave you with lasting feelings of anger, bitterness or even vengeance — but if you don’t practice forgiveness, you might be the one who pays most dearly. By embracing forgiveness, you can also embrace peace, hope, gratitude and joy. Consider how forgiveness can lead you down the path of physical, emotional and spiritual well-being.

What is forgiveness?

Generally, forgiveness is a decision to let go of resentment and thoughts of revenge. The act that hurt or offended you might always remain a part of your life, but forgiveness can lessen its grip on you and help you focus on other, positive parts of your life. Forgiveness can even lead to feelings of understanding, empathy and compassion for the one who hurt you.

Forgiveness doesn’t mean that you deny the other person’s responsibility for hurting you, and it doesn’t minimize or justify the wrong. You can forgive the person without excusing the act. Forgiveness brings a kind of peace that helps you go on with life.

What are the benefits of forgiving someone?

Letting go of grudges and bitterness can make way for compassion, kindness and peace. Forgiveness can lead to:

• Healthier relationships
• Greater spiritual and psychological well-being
• Less anxiety, stress, and hostility
• Lower blood pressure
• Fewer symptoms of depression
• Lower risk of alcohol and substance abuse

Why is it so easy to hold a grudge?

When you’re hurt by someone you love and trust, you might become angry, sad or confused. If you dwell on hurtful events or situations, grudges filled with resentment, vengeance and hostility can take root. If you allow negative feelings to crowd out positive feelings, you might find yourself swallowed up by your own bitterness or sense of injustice.

What are the effects of holding a grudge?

If you’re unforgiving, you might pay the price repeatedly by bringing anger and bitterness into every relationship and new experience. Your life might become so wrapped up in the wrong that you can’t enjoy the present. You might become depressed or anxious. You might feel that your life lacks meaning or purpose, or that you’re at odds with your spiritual beliefs. You might lose valuable and enriching connectedness with others.

How do I reach a state of forgiveness?

Forgiveness is a commitment to a process of change. To begin, you might:

• Consider the value of forgiveness and its importance in your life at a given time
• Reflect on the facts of the situation, how you’ve reacted, and how this combination has affected your life, health and well-being
• When you’re ready, actively choose to forgive the person who’s offended you
• Move away from your role as victim and release the control and power the offending person and situation have had in your life

As you let go of grudges, you’ll no longer define your life by how you’ve been hurt. You might even find compassion and understanding.

What if I have to interact with the person who hurt me but I don’t want to?

If you haven’t reached a state of forgiveness, being near the person who hurts you might be tense and stressful. To handle these situations, remember that you can choose to attend or avoid specific functions and gatherings. Respect yourself and do what seems best. If you choose to attend, don’t be surprised by a certain amount of awkwardness and perhaps even more intense feelings. Do your best to keep an open heart and mind. You might find that the experience helps you to move forward with forgiveness.

What if the person I’m forgiving doesn’t change?

Getting another person to change his or her actions, behavior or words isn’t the point of forgiveness. Think of forgiveness more about how it can change your life — by bringing you peace, happiness, and emotional and spiritual healing. Forgiveness can take away the power the other person continues to wield in your life.

What if I’m the one who needs forgiveness?

The first step is to honestly assess and acknowledge the wrongs you’ve done and how those wrongs have affected others. At the same time, avoid judging yourself too harshly. You’re human, and you’ll make mistakes. If you’re truly sorry for something you’ve said or done, consider admitting it to those you’ve harmed. Speak of your sincere sorrow or regret, and specifically, ask for forgiveness — without making excuses. Remember, however, you can’t force someone to forgive you. Others need to move to forgiveness in their own time. Whatever the outcome, commit to treating others with compassion, empathy and respect.

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How To Deal With A Cheater?

Do you suspect (or know) that a supposedly monogamous partner has cheated on you? You are not alone. Between a fourth and half of all attached partners will cheat (or have cheated) at one time or another. Knowing others are affected too, however, does not lessen the hurt. Take a look at these steps and use them to help you get through the trauma. This can be an exceptional painful issue and the emotions are very intense so use this as a checklist to help yourself get through the event.

1. First and foremost – take a deep breath and some time. Do not let yourself have a knee-jerk response. Think! This is especially important in long-term relationships. Sudden reactions without thought can lead to consequences you might regret. Give yourself some mental space before you take any action.

2. Talk to someone. You are not alone. Statistics are sketchy and vary widely, but many surveys have been done on cheating and they indicate that between a fourth and half of all married people will or have cheated at one time or another.

3. Do not blame yourself. It’s easy for people to start looking at themselves for reasons why their partner cheated… nothing good will come of that. Issues that lead to cheating sometimes involve both people, but that’s certainly not always the case. However, it would help, at a later date look inwards too to find out why your partner looked elsewhere for comfort. There could be certain gray areas in your behavior which could have led to such actions. You have to remember that most humans like a monogamous lifestyle, as it brings about so much of happiness & security. However, there are a few who would not conform to this.

4. Determine whether you were actually cheated on. Ask yourself these questions: Were you officially boyfriend and girlfriend at the time this “cheating” occurred? Were you officially monogamous? If not, you cannot be sure that your significant other knew what he or she was doing would offend you, in which case you might want to consider less confrontational options.

5. Talk to your partner. Let your concerns and fears be known. It might come out that nothing at all happened, or perhaps something did happen and coercion was involved (workplace sexual harassment, for example, which needs to be discussed openly and immediately to ward off future occurrences). There could be a substance abuse or psychological issue that needs to be addressed (sex addiction is very real). If help is warranted, you might want to support your partner in getting help – that could prove therapeutic for both of you. However, substance abuse is not a valid “excuse” for inappropriate behavior and you absolutely must not permit the “yeah but I was drunk so it doesn’t matter” argument – stand very firm on that.

6. Ask yourself if you will ever be able to look at your partner the same way. Infidelity doesn’t mean much for some, and some people have more than one physical relationship and it doesn’t suggest a shortcoming in their relationship with their steady partner, but this is rare. Infidelity often indicates boredom and dissatisfaction with the present relationships. Dealing with a partner who doesn’t want you in the first place, or one who doesn’t mind hurting you, is ridiculous. Dump him/her if this is the case.

7. If you decide this is irreconcilable, don’t break up with your partner and later take him/her back. This will only give you more emotional stress. If you break up, make it a clean break. However, a trial separation is a valid option. If you do make a break of any kind (permanent or trial) don’t talk to your ex after breaking up with him/her immediately. Give yourself some cooling off time first. If there are children or critical financial issues this might not be possible. In that case, set specific ground rules (time frames, meeting places, etc). This can be difficult, but it’s important.

8. If you are married and pretty sure a more-than-casual relationship is happening, you might need to consider an attorney or a reputable detective in the area that specializes in domestic cases.

9. If you do use an investigator, do not confront or accuse your partner. Let the investigator do his/her job first (if you confront them they may continue in an even more cautious way, which will make the investigation more expensive).

10. Get tested for STD’s as soon as possible. Not knowing will cause you extreme stress. Early treatment is critical.

11. If you can, collect evidence (receipts, emails, photographs, etc.) of the paramour. Keep this information at a friend or family member’s house. This will be less work the investigator will need to do later on your dollar.

12. Don’t start rumors. Share your suspicions with more than one close friend is likely to create gossip that can have very negative results in many areas. If there is an investigation underway, that kind of talk can hamper the case.

13. Look at your own personal actions, too. If you are also cheating, then it might be time to have an open discussion with your partner and clear the air. Perhaps couples counseling is in order. If divorce is the chosen option, remember it can get very ugly, very quickly, and your indiscretions will be brought into the limelight as well.

14. Turnabout is not fair play. Don’t start a relationship just because your spouse has done so. This is pure revenge and nothing good will come of it.

Tips :

• Get out if the incident has hurt you too much.

• Being honest with yourself is important. If you don’t end the relationship, can you live with the thought that it might happen again?

• Get counseling! It’s not a particularly bad idea to do this even if there’s nothing wrong in your life, but when you are hurt it can definitely help to talk to someone professional.

• It always helps to forgive and put it behind you and not dwell on the past if you want to move forward.

• Do you want to invest the energy to “monitor” the relationship?

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Improved Mental Health Tied to Quitting Smoking

In a new study from Washington University, researchers find that quitting smoking does more than improve physical health as stopping the habit also improves mental health.

Typically, health professionals who treat people with psychiatric problems often overlook their patients’ smoking habits, assuming it’s best to tackle depression, anxiety, or substance abuse problems first.

However, the new study shows that people who struggle with mood problems, or addiction can safely quit smoking and that kicking the habit is associated with improved mental health.

The study is published online in the journal Psychological Medicine.

“Clinicians tend to treat the depression, alcohol dependence or drug problem first and allow patients to ‘self-medicate’ with cigarettes if necessary,” said lead investigator Patricia A. Cavazos-Rehg, Ph.D.

“The assumption is that psychiatric problems are more challenging to treat and that quitting smoking may interfere with treatment.”

In the study, Cavazos-Rehg discovered that quitting, or significantly cutting back on cigarette smoking was linked to improved mental health outcomes.

Specifically, quitting altogether or reducing by half the number of cigarettes smoked daily was associated with lower risk for mood disorders like depression, as well as a lower likelihood of alcohol and drug problems.

“We don’t know if their mental health improves first and then they are more motivated to quit smoking or if quitting smoking leads to an improvement in mental health,” Cavazos-Rehg said.

“But either way, our findings show a strong link between quitting and a better psychiatric outlook.”

Naturally, the serious health risks associated with smoking make it important for doctors to work with their patients to quit, regardless of other psychiatric problems.

“About half of all smokers die from emphysema, cancer, or other problems related to smoking, so we need to remember that as complicated as it can be to treat mental health issues, smoking cigarettes also causes very serious illnesses that can lead to death,” she said.

Researchers analyzed questionnaires gathered as part of the National Epidemiologic Study on Alcohol and Related Conditions.

This survey was administered in the early 2000’s and just under 35,000 people were surveyed. As part of the study, participants answered questions about drinking, smoking, and mental health in two interviews conducted three years apart.

The researchers focused on data from 4,800 daily smokers. Those who had an addiction or other psychiatric problems at the time of the first survey were less likely to have those same problems three years later if they had quit smoking.

And those who hadn’t had psychiatric problems at the initial survey were less likely to develop those problems later if they already had quit.

At the time of the first interview, about 40 percent of daily smokers suffered mood or anxiety disorders or had a history of these problems. In addition, about 50 percent of daily smokers had alcohol problems, and some 24 percent had drug problems.

Forty-two percent of those who had continued smoking during the years between the two surveys suffered mood disorders, compared with 29 percent of those who quit smoking.

Alcohol problems affected 18 percent of those who had quit smoking versus 28 percent who had continued smoking.

And drug abuse problems affected only 5 percent of those who had quit smoking compared with 16 percent of those who had continued smoking.

“We really need to spread the word and encourage doctors and patients to tackle these problems,” Cavazos-Rehg said.

“When a patient is ready to focus on other mental health issues, it may be an ideal time to address smoking cessation, too.”

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Being Yourself; Knowing Who You Are.

It is quite a simple statement really, to say “Just be yourself” – but when faced with the tough situations in life you ask yourself

• Who am I?

• What does it involve being myself?

• How can I be myself if I really don’t know who I am right now?

• How do I find out who I really am? Who can tell me this?

The answer is YOU. You need to unveil what it is that “fulfills” you. When I say “fulfill” I mean what “completes you” as a person. What truly makes you happy and at peace with life? You were born totally unique and began growing up on the path devoted totally to you.

Then some time, some where we are influenced by the outside world and start becoming or trying to become somebody else. Society pushes us to have “her hair” or “her body” or “their marriage” or car or house or career.

We are bombarded with choices and fail to make decisions based on our best interests. We get confused and off track and suddenly we don’t know where to turn.

Don’t worry. The solutions are in “you”. Take stock of your personality. Write down all the positive things about yourself, about who you are. Note all the negative things that you could probably work on improving (don’t dwell too much on these points at the moment). But where I am headed with this is to acknowledge a few attributes about you that make you – You.

Ask a close friend, relative or colleague to also write down some positive things about you and some negative things that they believe you could change. Are you seeing the same qualities in yourself as how others see you? You don’t really have to do this activity to benefit from it – but just merely thinking about the outcome might give you the starting point for expressing who you truly are.

Identifying your strengths and weaknesses.

Are whether you are honest with yourself?

I say it’s a mental thing. An obsession. A control issue and a very deceiving condition. 

Lies. Lying to yourself, your husband, your mum, your friends. Everybody close to you. But mostly damaging yourself. When you lie to yourself you are breaking the biggest form of trust one can tamper with and that itself will destroy you.

For whatever you are facing right now, I want to assure you it’s okay. You don’t have to be a victim. Just because you’ve lied, or feel the need to lie, it doesn’t mean you are a bad person and should be banished. You simply need to forgive. Think of yourself as a small child looking for approval. All that child wants is some guidance, hope, encouragement, love and acceptance. If you deny a child those things they are going to feel scared. They are going to be frightened of the world and they are going to hold back on striving to be the best they can be because of self doubt. So forgive your mistakes, accept you have done wrong, learn the lesson being taught and move on with encouragement that things will get better.

You are only human, you are allowed to make mistakes. The true spirit comes from allowing these mistakes to act as stepping stones into the pathway of your success. You can leave them behind so long as you continue to keep paving that road ahead of you. With every situation you are faced in life, you can ask yourself “Am I being genuine, real, authentic, sincere and true to myself?”.

Making decisions in your life that choke you with the guilt are not in your best interests. You are only hurting yourself. Until you realize you are a total victim of yourself. You are your own worst enemy. You are abusing yourself in the highest form of abuse. You are sick of being treated this way and the only one who can change this is you. You have to learn to love yourself, appreciate yourself and accept yourself for all that you are. That makes you decide that you didn’t like the person you had become and you had to change.

We all have flaws. We all have battles. We all have room for improvement. Don’t see perfections around you. Not all are perfect. All misbehave in their own time. It takes a while, but accept who you are. Accept your journey as necessary to bring you where you are right now. Sure you have regrets – everybody has, but choose not to dwell on them because they are part of your past.

They are all necessary to bring you to where you are right now. You should look into your future and knowing that whatever obstacles are presented to you now – you have the strength to handle them. You might not get it at first go, you might not follow a direct line, but ultimately you will get there. And you will get there with honesty, optimism and a full heart – because being empty is nobody’s desire.

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Seven Reasons To Seek Marriage Counseling

Marriage rates supposedly are on the decline. While it’s an oft-repeated statistic that 50 percent of first marriages end in divorce, that number has remained unchanged for the past 30 years. Divorce rates also vary with the partners’ level of education, religious beliefs, and many other factors.

But when divorce does happen, it results in difficulties for adults as well as children. For adults, divorce can be one of life’s most stressful life events. The decision to divorce often is met with ambivalence and uncertainty about the future. If children are involved, they may experience negative effects such as denial, feelings of abandonment, anger, blame, guilt, preoccupation with reconciliation, and acting out.

While divorce may be necessary and the healthiest choice for some, others may wish to try to salvage whatever is left of the union. When couples encounter problems or issues, they may wonder when it is appropriate to seek marriage counseling. Here are seven good reasons.

1. Communication has become negative. 

Once communication has deteriorated, often it is hard to get it going back in the right direction. Negative communication can include anything that leaves one partner feeling depressed, insecure, disregarded, or wanting to withdraw from the conversation. This can also include the tone of the conversation. It is important to remember that it’s not always what you say, but how you say it.

Negative communication can also include any communication that not only leads to hurt feelings, but emotional or physical abuse, as well as nonverbal communication.

2. When one or both partners consider having an affair, or one partner has had an affair. 

Recovering from an affair is not impossible, but it takes a lot of work. It takes commitment and a willingness to forgive and move forward. There is no magic formula for recovering from an affair. But if both individuals are committed to the therapy process and are being honest, the marriage may be salvaged. At the very least, it may be determined that it is healthier for both individuals to move on.

3. When the couple seems to be “just occupying the same space.” 

When couples become more like roommates than a married couple, this may indicate a need for counseling. This does not mean if the couple isn’t doing everything together they are in trouble. If there is a lack of communication, conversation and intimacy or any other elements the couple feels are important and they feel they just “co-exist,” this may be an indication that a skilled clinician can help sort out what is missing and how to get it back.

4. When the partners do not know how to resolve their differences. 

When a couple begins to experience discord and they are aware of the discord, knowing is only half the battle. Many times I have heard couples say, “We know what’s wrong, but we just don’t know how to fix it.” This is a perfect time to get a third party involved. If a couple is stuck, a skilled clinician may be able to get them moving in the right direction.

5. When one partner begins to act out on negative feelings. 

I believe what we feel on the inside shows on the outside. Even if we are able to mask these feelings for a while, they are bound to surface. Negative feelings such as resentment or disappointment can turn into hurtful, sometimes harmful behaviors. I can recall a couple where the wife was very hurt by her husband’s indiscretions. Although she agreed to stay in the relationship and work things out, she became very spiteful. The wife would purposefully do things to make her husband think she was being unfaithful even though she wasn’t. She wanted her husband to feel the same pain she felt, which was counterproductive. A skilled clinician can help the couple sort out negative feelings and find better ways to express them.

6. When the only resolution appears to be separation

When a couple disagrees or argues, a break often is very helpful. However, when a timeout turns into an overnight stay away from home or eventually leads to a temporary separation, this may indicate a need for counseling. Spending time away from home does not usually resolve the situation. Instead, it reinforces the thought that time away is helpful, often leading to more absences. When the absent partner returns, the problem is still there, but often avoided because time has passed.

7. When a couple is staying together for the sake of the children. 

If a couple feels it is wise to stay together for the sake of the children, it may help to involve an objective third party. Often couples believe that they are doing the right thing when staying together actually is detrimental to the children. On the contrary, if the couple is able to resolve issue and move toward a positive, healthy relationship, this may be the best decision for all involved.

In my opinion, children should never be the deciding factor when couples are determining whether to stay together. I recall working with an adolescent who was having trouble in school. She was acting out and her grades were declining. After a few sessions she stated, “I know my parents really don’t like each other.” When I asked her why, she replied, “They are nice to each other, but they never smile or laugh like my friends’ parents.”

Children are generally very intuitive and intelligent. No matter how couples may think they are able to fake their happiness, most children are able to tell.

All marriages are not salvageable. In the process of marriage counseling, some couples may discover it is healthier for them to be apart. However, for those relationships that can be salvaged, and for those couples willing to commit to the process, marriage counseling may be able to remind them why they fell in love and keep them that way.

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ANXIOUS ADDICTS: The Relationship Between Anxiety and Addiction.

Almost everyone at some point in their lives struggles with a form of anxiety. Feelings produced from anxiety can be misleading and are perpetuated by reinforcing thoughts. Most people do not recognize that they are anxious until they feel the physical symptoms of anxiety. Substance abuse is a quick remedy for uncomfortable feelings produced by anxiety. An addict who suffers from anxiety will often be reluctant to enter substance abuse treatment, fearful that his or her anxiety issue will not be addressed.

Anxiety Characteristics, Thoughts, Feelings and Behaviors:

Anxiety consists of thoughts, feelings, and behaviors. Thoughts will perpetuate feelings which create a behavioral response in an individual. Anxiety is rooted in fear and not wanting to feel fearful creates an intense distressed behavioral response. An addict who suffers from anxiety will use substances to escape from feeling anxious. Addicts who also struggle with anxiety will appear irritable, pre-occupied and apprehensive. Four common characteristics of anxiety found in an individual are:

1. The excessive need for control.
2. Ignoring psychological and physical signs of stress.
3. The excessive need for approval.
4. Perfectionism.

These characteristics are an individual’s belief system which perpetuates anxiety. Thoughts that are identified as should, would or could statements reinforce the belief system of the addict. These statements reflect thinking in the past and desire to change the chain of events. Example statements are:

  • I could have set an alarm last night, before I started drinking, to wake me up for school. I’m so stupid.
  • It would have been better if I didn’t spend the holidays with my parents. They drive me to use drugs.

Other anxiety related thoughts are based on future events and create frequent worrying or obsessing. For example “If I get this job then I will stop using drugs.” Focusing on events that we cannot change (past) or that are not in our control (future) increases anxiety symptoms. This disturbance of mood contributes to the addict’s desire to escape through substance abuse.

Anxiety Symptoms and Addiction:

Anxiety produces strong intense reactions within the body and mind. Anxiety responses are not always recognizable and may go untreated. Anxiety will manifest in two ways, physical and psychological. 

The physical and psychological symptoms of anxiety are similar to withdrawal symptoms from drugs and alcohol. An addict will automatically look for substances to calm an anxious state. The avoidance of uncomfortable physical agitation and painful emotions are some of the components that maintain addiction and anxiety. Both anxiety and addiction will become stronger the more the addict continues using drugs and/or alcohol. Addiction enables the addict to avoid confronting and challenging anxious thoughts and feelings.

Exercises for Decreasing Anxiety:
Self-help techniques for mild anxiety management are:

  • Stay in the present. Don’t get stuck thinking about the past or future.
  • Recognize what you can control verses what you cannot.
  • Learn to be aware of your stress and incorporate relaxation exercises.
  • Don’t be so critical of yourself. Mistakes are not failures and nobody is perfect.
  • While these exercises are helpful, anxiety is made worse with drug and alcohol abuse. An addict that suffers from addiction and anxiety may not be able to resolve anxiety issues alone.

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Schizophrenia. It’s Causes and Symptoms.

Schizophrenia is a disorder that directly impacts the brain and what it interprets as reality. Schizophrenia evidences itself usually sometime between the ages of 18 and 35, though it can happen at other ages as well. Schizophrenia occurs more in males than in females and at the time of diagnosis, it can be devastating to the person experiencing it–and to the family or loved ones trying to understand the disease process. There are many theories as to the origins or causes of schizophrenia but to date, there are no real “cures.”Can psychotherapy be used to treat the different types of schizophrenia? The answer is yes, but not alone.

The standard of treatment for schizophrenia is a medication regime to dilute the dangerous symptoms of the mind disorder and get the person suffering back to square one. However, psychotherapy is a positive (and often necessary and recommended) adjunct to medical treatment for the disorder.

It should be emphasized though that medication is the first line of treatment and the most immediately effective.

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What is Schizophrenia?
In all of its different forms, schizophrenia is a severely disabling brain disorder that is never cured. If patients remain faithful to their medication routine, they can and will usually live a fairly normal and well-ordered life. It is a chronic condition and as stated, there is no known cure.However, usually relapses occur because patients with schizophrenia feel better or are doing well. They think that the disease has been cured and inevitably go off their medication–or cut back on it. Without chemical stabilization of their thought processes, most schizophrenics relapse fairly quickly and the relapses can have serious consequences.A girl in her late teens who decided that God had healed her. She was so full of life and so excited to embrace her life without medication. She very quickly decompensated and had to be emergently hospitalized because she became suicidal right in front of me. It was like watching a horror movie play out to see her change so quickly.Another guy who was diagnosed with schizophrenia in his late 20s. He decided to go off his medications one day unbeknowst to anyone and just “disappeared” rather than arriving home one night. He was in his early 30s by then. He boarded a train and traveled some 2000 miles before his family found him–on the street, living out of trashcans and high on drugs–whereas he had 2 weeks before been working at a prestigious law office in the Seattle area.

This illustrates how quickly a schizophrenic without medication can decompensate.

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Symptoms of Schizophrenia :

  • Delusions–misinterpretation or misconception of reality.
  • Hallucinations–seeing people, hearing voices that do not exist–in some cases, the voices tell the person to harm themselves–or others.
  • Derangement of thoughts–unable to think clearly or speak clearly–speaking in gibberish or word salad.
  • Behavioral disruptions–extremely provocative behaviors, violence or extreme agitation.
  • Repercussions of Schizophrenia :
  • Loss of motivation–to do anything.
  • Loss of interest in everyday activities.
  • Lack of emotions or heightened emotions.
  • Neglect of personal hygiene.
  • Social withdrawal or isolation.
  • Reduced or impaired ability to plan or complete tasks.

Worst Outcomes for Schizophrenics :

  • Homelessness.
  • Unemployment–or inability to keep a job long.
  • Devaluation of self.
  • Substance abuse.
  • Suicidal or homicidal.
  • Institutionalization.
  • Loss of family and friends.

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Why Do Some People Get Schizophrenia?
There are many theories as to why some people get it and some don’t… from what part of the continent you live on to what nationality a person is. Some of the current thoughts on causes:

  • Family history puts someone at much higher risk (I worry about this a lot!)
  • Babies who did not get adequate nutrition in uterus.
  • Exposure to high levels of stress or violence
  • African American descent but other nationalities as well
  • Older paternal age
  • Substance abuse at an early age
  • Exposure to viruses or toxins while in uterus.
  • Genetic disposition
  • Environmental influences

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