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Psychological Illnesses

Below are a number of Psychological Illneses that could be misidentified as paranormal disturbances or the alien abduction phenomenon. These consist of the following...

■ Narcolepsy.
■ Charles Bonnet Syndrome.
■ Capgra's Syndrome.
■ Temporal Lobe Epilepsy.
■ Sleep Paralysis.

NARCOLEPSY.

The exact cause of narcolepsy is not known. An abnormality in the chemistry regulating sleep and wakefulness in the brain is suspected, but not proven. Both genetic and environmental factors are believed to play a role in the development of this disorder.

All patients experience excessive daytime sleepiness (sleep attacks and persistent daytime drowsiness). Sleep attacks are short periods of sleep that occur many times a day, regardless of the amount or quality of sleep the night before.

They are often described as irresistible and may occur with or without warning when a person is driving, working, eating, talking, or engaging in any other activity. Most patients also experience persistent daytime drowsiness. Excessive daytime sleepiness is usually the first symptom of narcolepsy and often the most difficult symptom to control.

The severity of excessive daytime sleepiness varies; some patients may have many sleep attacks each day and others only one or two sleep attacks per day.

Cataplexy refers to sudden, brief episodes of muscle weakness or paralysis triggered by strong emotions such anger, laughter, surprise or anticipation. Just as nighttime REM (rapid eye movement) sleep is normally accompanied by skeletal muscle paralysis and strong emotions (dreaming); an intense emotion during the waking period can trigger instantaneous muscle weakness or paralysis. Although unable to move, the person remains conscious.

For some people, any strong emotion may trigger cataplexy, while others react to only certain specific emotions. Although most patients experience cataplexy, some patients never develop this symptom.

Hypnagogoic hallucinations are vivid, often frightening, dream-like images that occur when dozing or when falling asleep. Sometimes these images are so vivid that they are difficult to distinguish from reality.

Sleep paralysis refers to a temporary paralysis upon falling asleep or waking up. Episodes may last only a few seconds to minutes.

Frequent awakenings at night are common, but are not the cause of excessive daytime sleepiness in patients with narcolepsy.

How is Narcolepsy Diagnosed?

An overnight stay in a sleep laboratory is necessary to rule out other conditions such as sleep apnea, periodic leg syndrome, and upper airway resistance syndrome that cause can excessive daytime sleepiness.

A daytime nap study will be performed the next day to evaluate the severity of daytime sleepiness. A blood test is neither necessary or sufficient to make the diagnosis of narcolepsy.

How is Narcolepsy Treated?

There is no known cure for narcolepsy, but symptoms can be managed with medications. Stimulant medications are used to control sleep attacks and excessive daytime sleepiness. Since patients respond differently to different stimulants, if one drug causes side effects or fails to relieve excessive daytime sleepiness, a different compound should be tried. Some patients may also find that short, frequent naps help relieve daytime sleepiness, and all patients are encouraged to avoid sleep deprivation. Stimulant medications are no substitute for adequate sleep at night.

At present, there is no evidence that dietary adjustments, nutritional supplements, or exercise will improve daytime alertness. Caffeine and over-the-counter drugs have not been shown to be effective and are not recommended.

Small doses of antidepressant medications and other drugs that suppress REM sleep may be used to control cataplexy. Not all patients with cataplexy require medication. Some have infrequent episodes and others learn to avoid situations that trigger cataplexy. Although disrupted night time sleep is usually not treated, some patients may be treated with short-acting hypnotic medications or sedating antidepressants.

Unfortunately, improving night-time sleep in narcoleptic patients rarely improves their ability to stay awake during the day.

Medications used to manage Excessive Daytime Sleepiness.

Name of Medication Usual Daily Dose Notes dextroamphetamine-sulfate (Dexadrine®, Dextrostat®, Dexadrine-SR®) 5-100 mg Variable duration of action, depending on whether using regular form or SR (sustained release) form of medication. Schedule II medication in the US, limited number of tablets can be prescribed at one time and prescription cannot be refilled.

Methamphetamine-HCl (Desoxyn®) 5-100 mg More potent than dextroamphetamine. Schedule II medication in the US, limited number of tablets can be prescribed at one time and prescription cannot be refilled. Methylphenidate-HCL (Ritalin™, Ritalin-SR®) 10-100 mg Most frequently prescribed stimulant for treatment of narcolepsy in the US. Less potent than dextroamphetamine or methamphetamine.

Variable duration of action, depending on whether using regular form or SR (sustained release) form of medication. Can be used in combination with other stimulants. Schedule II medication in the US, limited number of tablets can be prescribed at one time and prescription cannot be refilled.

Modafinil (Provigil®) 200-800 mg Lower potency than dextroamphetamine or methamphetamine, fewest side effects of stimulant medications. Long duration of action. Schedule IV medication in the US, prescription can be refilled for up to six months without a new prescription. pemoline (Cylert®) 37.5-300 mg Less potent than other medications used to control daytime sleepiness.

Long duration of action. Schedule IV medication in the US, prescription can be refilled for up to six months without a new prescription. Can cause liver damage, patients taking this medication should have blood drawn regularly to evaluate their liver function.

Medications used to manage Cataplexy.

Name of Medication Usual Daily Dose Notes clonipramine (Anafranil®) 25-150 mg Very effective against cataplexy, used more frequently in Europe desimpramine (Norpramin®, Pertofran®) 25-100 mg More anticholinergic effects (dry mouth, blurred vision, constipation) than impramine fluoxetine (Prozac®) 20-60 mg Fewer side effects than other clonipramine, disimpramine, and impramine.

Less weight gain than with other antidepressants. May need higher doses to control cataplexy Impramine (Jaminime®, Tofranil®) 10-100 mg Some anticholinergic effects (dry mouth, blurred vision, constipation) than clonipramine, and desimpramine Protriptyline (Triptil®, Vivactil®) 5-60 mg Anticholinergic effects (dry mouth, blurred vision, and constipation) at high doses. Mild stimulant.

Compiled by Dave Sdaler.

CHARLES BONNET SYNDROME.

Following his wife's death, David Stannard became accustomed to spending quiet evenings alone at his home in Walton-on-Thames, Surrey.

So it came as a surprise to the 73-year-old when he looked up from his television one evening to discover he was sharing his living room with two RAF pilots and a schoolboy.

'The pilots were standing next to the TV, watching it as if they were in the wings of a theatre,' he says.

'The little boy was in a grey, Fifties-style school uniform. He just stood there in the hearth looking puzzled. He was 18 inches high at most.'

Mr Stannard's guests never said a word and vanished after 15 minutes. That night, he says, the walls of his house, which had always been white, looked as though they had been redecorated in patterned wallpaper with a brickwork effect.

The next morning he was caught off-guard again when he found a fair-haired girl standing on his sofa. She also appeared to be from the Fifties, but was life-size, wearing a short skirt and pink cardigan, with chubby knees, white ankle socks and ribbons in her hair.

'I watched her for a while,' he says. 'She didn't move much. Then she was gone.'

Classic case paranormal reports, from not one person but many the world over. But is there an explanation? In the case of Mr Stannard there is, it would be easy to dismiss Mr Stannard's story as the bizarre imaginings of an elderly mind. Fortunately, he knew he wasn't losing his mind; neither was his house haunted.

A few weeks earlier he had been registered blind, though he was still able to watch television if he sat at a certain angle. He'd been warned that as his eyesight deteriorated, he might experience visual hallucinations in the form of Charles Bonnet Syndrome

Charles Bonnet syndrome is a term used to describe the situation when people with sight problems start to see things which they know aren't real. Sometimes called 'visual hallucinations', the things people see can take all kinds of forms from simple patterns of straight lines to detailed pictures of people or buildings.

A Swiss philosopher named Charles Bonnet first described this condition in 1760 when he noticed that his grandfather, who was almost blind, saw patterns, figures, birds and buildings which were not there. Although the condition was described almost 250 years ago, it is still largely unknown by ordinary doctors and nurses. This is partly because of a lack of knowledge about the syndrome and partly because people experiencing it don't talk about their problems from fear of being thought of as mentally ill.

Charles Bonnet syndrome affects people with serious sight loss and usually only people who have lost their sight later in life but can affect people of any age, usually appearing after a period of worsening sight. The visual hallucinations often stop within a year to eighteen months.

At the moment little is known about how the brain stores the information it gets from the eyes and how we use this information to help us create the pictures we see. There is some research which shows that, when we see, the information from the eyes actually stops the brain from creating its own pictures. When people lose their sight, their brains are not receiving as many pictures as they used to, and sometimes, new fantasy pictures or old pictures stored in our brains are released and experienced as though they were seen. These experiences seem to happen when there is not much going on, for example when people are sitting alone, somewhere quiet which is familiar to them or when they are in lying in bed at night.

An estimated 100,000 people in the UK have Charles Bonnet Syndrome, but many won't realise it because the condition remains something of a mystery.

Usually people with Charles Bonnet syndrome are aware that their hallucinations, although vivid, are not real. Charles Bonnet syndrome hallucinations only affect sight and do not involve hearing things or any other sensations. People with Charles Bonnet syndrome do not develop complicated non-medical explanations about the cause of their hallucinations (sometimes called ‘delusions’)..

There seem to be two different kinds of things people see. Both of them can be black and white or in colour, involve movement or stay still, and they can seem real - such as cows in a field, or unreal - such as pictures of dragons.

Firstly, there are the hallucinations of patterns and lines, which can become quite complicated like brickwork, netting, mosaic or tiles.

Secondly, there are more complicated pictures of people or places. Sometimes whole scenes will appear, such as landscapes or groups of people, which are sometimes life-size, and at other times are reduced or enlarged in size. These pictures appear 'out of the blue' and can carry on for a few minutes or sometimes several hours. Many people begin to recognize similar things appearing in their visions such as distorted faces or the same tiny people in particular costumes.

Generally the pictures are pleasant although the effects can be scary.
Sometimes the complicated pictures can make it difficult to get around. For example, streets and rooms may have their shape changed or brickwork and fencing appear directly in front of you making it difficult for you to judge exactly where you are and whether you can walk straight ahead. One gentleman describes how, approaching the top of the stairs, he had a vision of being on top of a mountain, and had considerable problems getting down the stairs. Good knowledge of your surroundings can help overcome this particular problem.

The complicated pictures can sometimes be a little scary. Although the visions themselves may not be of anything frightening, it is disturbing to start seeing strangers in your home or garden. People often overcome this by getting to know the figures in their visions. Another man describes how, when he wakes up in the morning, he says to the figures he is seeing: "Right, what have you got in store for me today?" This allows him to have some control over the way he feels about his seeing things.

So a little affliction, which, if put into the perceptions of UK paranormal reports, and a population of around 60,000,000 divided by the number approximately suffering from Charles Bonnet Syndrome of 100,000. Means that there is a high chance of 1 person in every 600 who may not be aware of their condition and instead, may mistakenly report this as a paranormal event.

Could this be another plausible explanation for medical conditions causing paranormal like events?

Compiled by Dave Sadler.

CAPGRA'S SYNDROME.

Imagine, if you will, that one by one your friends and family– the people closest to you– are being removed and replaced with exact duplicates. Although they are identical in appearance and manner, you are certain that these people are not your loved ones. They are impostors. While most people would become deeply paranoid in such a scenario, there are some individuals who experience such things every day without fear… and just wonder, “why?” Such is the life of people stricken with Capgras’ Syndrome.

A person with Capgras’ Syndrome suffers from the delusion that one or more of their close friends or family members have been replaced with exact duplicates, and they cannot be shaken from this belief in spite of an otherwise clean bill of mental health. In some instances, the person believes that they themselves are, in whole or in part, a duplicate. Unlike the paranoia expected from such a condition, there is never a motive assigned for the appearance of the duplicates – the patients do not believe someone is “out to get them,” but they are at a loss for an explanation why anyone would want to replace their loved ones.

This odd misperception is named after the French psychiatrist Jean Marie Joseph Capgras, who described the case of a Madame M. in 1923. The woman insisted that identical-looking persons had taken the place of her family. Over time her delusion expanded to include neighbors, friends and acquaintances. But Madame M. never bothered to get to know these impostors because it was her belief that each one regularly left to make room for the next double. In all, she eventually claimed to have had more than eighty husbands.

People suffering from Capgras’ Syndrome can sometimes even doubt their own identity after seeing their reflection in a mirror. One man pinched himself on the arm after seeing his reflection at the doctor’s office, and wondered aloud whether he and the man in the reflection were the same person. There was also a woman who flew into a jealous rage every time she caught sight of her own reflection, believing this “other woman” was trying to lure her husband away from her. Her husband eventually covered every reflective surface in the house in an effort to keep her from hurting herself. Oddly enough, she had no problem recognizing herself in the mirror of her makeup compact, but anything larger resulted in an assault on the imaginary impostor. Her doctor tried a novel solution: he gathered a number of mirrors of varying sizes, and had the woman view herself in each one. He started with the smallest and gradually moved to the next larger as soon as she recognized herself. Ultimately she was able to see herself in a full-length mirror, and she was cured from then on.

In some instances, individuals with the Capgras delusion see duplicate objects rather than duplicate people. One doctor reported a patient who believed that his poodle had been replaced with an identical dog, and another reported a patient who believed that during the night his running shoes and many other personal possessions were being replaced.

Capgras’ delusion always centers around just one of the subject’s senses. The most common is the sense of sight; for example, one person readily recognized his wife on the phone when speaking to her, yet when she arrived in the flesh he thought the impostor was actually his sister-in-law. Blind people have also been diagnosed with the disorder, and they believe that the voices of certain loved ones are actually coming from duplicates.

While the causes of Capgras’ syndrome are not specifically known, there is no shortage of theories. It has been shown that many people with the syndrome have brain lesions in the right temporal lobe from traumatic injuries, epilepsy, and other causes, yet there are also significant numbers of patients with no such damage in evidence. Also, there is a somewhat higher incidence of schizophrenia among people with Capgras, and in New Zealand there is a markedly higher incidence of the disorder among the Maori people than in the general population.

Some earlier researchers attempted to draw connections to Prosopagnosia, a condition which prevents some people from being able to recognize faces. By measuring a person’s galvanic skin response– the amount of electrical resistance in the skin– scientists can detect when an individual is experiencing emotions. Patients with Prosopagnosia show an emotional response to familiar faces, though they exhibit no conscious recognition. With a Capgras patient there is no such reaction. Though no emotional connection is present when shown a picture of their father, the patient will remark on the striking resemblance. This test also rules out mental illness as a definitive cause, since the emotional center of the brain would subconsciously react even with impaired perceptions.

Another proposed cause involves some form of damage or impairment in two lobes of the brain: One site of damage affecting the emotional connections with respect to people’s faces, and the other affecting the brain’s consistency-checking abilities.

In at least one case, doctors have successfully cured Capgras’ Syndrome by suspending a prescription of diazepam, yet in other cases symptoms have disappeared after administering anti-psychotic medication. To date, no single treatment has been found to be consistently effective, and so far there is no single theory that can explain all the reported cases of Capgras’ Syndrome. We do know, however, that the human mind uses many interlocking cognitive tricks to fill in the gaps of our observations, essentially building a simulation which allows us to interact with our world and society. When just one or two of those links go awry, the true complexity of that simulation is revealed by the fascinating problems that arise.

In some cases the illness can cause the witness to claim their friends or family members are aliens and are taking over the planet etc... Sound like something straight out of a sci-fi movie, but in fact it can be very difficult to convince those with the illness that everything is as it should be...

Compiled by Gerry Matlack & Steve Mera.

TEMPORAL LOBE EPILEPSY.

A temporal lobe seisure starts in the part of the brain that processes emotions, fight or flight reactions, and short-term memory. Many who have temporal lobe seisures may experience odd feelings ranging from euphoria to fear, deja vu, and hallucinations of taste or smell at the onset of their seisures.

Seisures beginning in the temporal lobes may stem from an anatomical defect or scar. But, it's not always possible to determine the cause of a temporal lobe seisure.

Temporal lobe seisures are often resistant to anti-seisure medications. Surgery may be an option for some people if their seisures consistently begin in only one of their two temporal lobes. Many become free of temporal lobe seisures when the affected portion of the lobe is removed.

An unusual sensation or emotion, known as an aura, may precede a temporal lobe seisure, acting as a warning. Not everyone who has temporal lobe seisures experiences auras, and those who do have auras may not remember them. The aura is actually a small seisure itself one that has not spread into an observable seizure that impairs consciousness and ability to respond. Examples of auras include:

■ A sudden sense of unprovoked fear
■ A deja vu experience
■ The sudden occurrence of a strange odor or taste
■ A rising sensation in the abdomen

People who have temporal lobe seisures usually remain partially conscious during a seisure, but they lose awareness of their surroundings and usually don't remember what happened.

A temporal lobe seisure usually lasts 30 seconds to two minutes. Characteristic signs and symptoms of temporal lobe seisures include:

■ Loss of awareness of surroundings
■ Staring
■ Lip smacking
■ Repeated swallowing or chewing
■ Unusual finger movements, such as picking motions

After a temporal lobe seisure, you may have:

■ A brief period of confusion and difficulty speaking
■ Inability to recall the events that occurred during the seisure
■ Unawareness of having had a seisure until someone else tells you

In extreme cases, what starts as a temporal lobe seisure evolves into a grand mal (tonic-clonic) seisure featuring convulsions and a loss of consciousness. About half of people with temporal lobe seisures never experience a grand mal seisure.

During normal waking and sleeping, your brain cells produce varying electrical activity. If the electrical activity in many brain cells becomes abnormally synchronised, a convulsion or seisure may occur. If this happens in just one area of the brain, the result is a focal or partial seisure. When this occurs in an area of the brain known as the temporal lobe, it's called a temporal lobe seisure.

Temporal lobe seisures can be a result of:

■ Traumatic injury
■ Infections, such as encephalitis or meningitis, or history of such infection
■ A process that causes scarring (gliosis) in a part of the temporal lobe called the hippocampus
■ Injury due to a previous lack of oxygen
■ Blood vessel malformations in the brain
■ Stroke
■ Brain tumors
■ Genetic syndromes

Over time, repeated temporal lobe seisures can cause the part of the brain that's responsible for learning and memory to shrink. This area is called the hippocampus. Brain cell loss in this area may cause memory problems.

People who experience Temporal Lobe Seisures can believe that they are experiencing paranormal disturbances. It is very easy for them to believe that their unusual feelings and hallucinations are somehow attributed to the paranormal or supernatural. Some may even believe that they are psychic in some way due to the seeing of auras.

Compiled by the Mayo Clinic & Steve Mera.

SLEEP PARALYSIS.

Have you ever felt like you were awake but unable to move? You might have even felt afraid but could not call for help? This condition is called sleep paralysis. Sleep paralysis may leave you feeling frightened, especially if you also see or hear things that aren't really there. Sleep paralysis may happen only once, or you may have it frequently - even several times a night.

The good news: sleep paralysis is not considered a dangerous health problem. Read on to find out more about sleep paralysis, its possible causes, and its treatment.

Over the centuries, symptoms of sleep paralysis have been described in many ways and often attributed to "evil" presences: unseen night demons in ancient times, the old hag in Shakespeare's Romeo and Juliet, and alien abductors. Almost every culture throughout history has had stories of shadowy evil creatures that terrify helpless humans at night. People have long sought explanations for this mysterious sleep-time paralysis and the accompanying feelings of terror.

But sleep researchers now know that, in most cases, sleep paralysis is simply a sign that your body is not moving smoothly through the stages of sleep. Rarely is sleep paralysis linked to deep underlying psychiatric problems.

Sleep paralysis is a feeling of being conscious but unable to move. It occurs when a person passes between stages of wakefulness and sleep. During these transitions, you may be unable to move or speak for a few seconds up to a few minutes. Some people may also feel pressure or a sense of choking. Sleep paralysis may accompany other sleep disorders such as narcolepsy. Narcolepsy is an overpowering need to sleep caused by a problem with the brain's ability to regulate sleep.

Sleep paralysis usually occurs at one of two times. If it occurs while you are falling asleep, it's called hypnagogic or predormital sleep paralysis. If it happens as you are waking up, it's called hypnopompic or postdormital sleep paralysis.

As you fall asleep, your body slowly relaxes. Usually you become less aware, so you do not notice the change. However, if you remain or become aware while falling asleep, you may notice that you cannot move or speak.

During sleep, your body alternates between REM (rapid eye movement) and NREM (non-rapid eye movement) sleep. One cycle of REM and NREM sleep lasts about 90 minutes. NREM sleep occurs first and takes up to 75% of your overall sleep time. During NREM sleep, your body relaxes and restores itself. At the end of NREM, your sleep shifts to REM. Your eyes move quickly and dreams occur, but the rest of your body remains very relaxed. Your muscles are "turned off" during REM sleep. If you become aware before the REM cycle has finished, you may notice that you cannot move or speak.

Sleep paralysis brought on by lack of sleep is a more common form and is termed:
SDP - Sleep Deprivation Paralysis.

Many people experiencing sleep paralysis can attribute the condition to paranormal disturbances and the alien abduction phenomenon.

Up to as many as four out of every 10 people may have sleep paralysis. This common condition is often first noticed in the teen years. But men and women of any age can have it. Sleep paralysis may run in families. Other factors that may be linked to sleep paralysis include:

■ A lack of sleep
■ A sleep schedule that changes
■ Mental conditions such as stress or bipolar disorder
■ Sleeping on the back
■ Other sleep problems such as narcolepsy or nighttime leg cramps
■ Use of certain medications
■ Substance abuse
 
If you find yourself unable to move or speak for a few seconds or minutes when falling asleep or waking up, then it is likely you have isolated recurrent sleep paralysis. Often there is no need to treat this condition. However, check with your doctor if you have any of these concerns:

■ You feel anxious about your symptoms
■ Your symptoms leave you very tired during the day
■ Your symptoms keep you up during the night
■ Your doctor may want to gather more information about your sleep health by doing any of these things:

■ Ask you to describe your symptoms and keep a sleep diary for a few weeks.
■ Discuss your health history, including any known sleep disorders or any family history of sleep
  disorders.
■ Refer you to a sleep specialist for further evaluation.
■ Conduct overnight sleep studies or daytime nap studies to make sure you do not have another sleep
  disorder.

Most people need no treatment for sleep paralysis. Treating any underlying conditions such as narcolepsy may help if you are anxious or unable to sleep well. These treatments may include the following:

■ Improving sleep habits -- such as making sure you get 6 to 8 hours of sleep each night.
■ Using antidepressant medication to help regulate sleep cycles.
■ Treating any mental health problems that may contribute to sleep paralysis.
■ Treating any other sleep disorders, such as narcolepsy or leg cramps.

There's no need to fear nighttime demons or alien abductors. If you have occasional sleep paralysis, you can take steps at home to control this disorder. Start by making sure you get enough sleep. Do what you can to relieve stress in your life - especially just before bedtime. Try new sleeping positions if you sleep on your back.; and be sure to see your doctor if sleep paralysis routinely prevents you from getting a good night's sleep.

Compiled by Web MD & Steve Mera.

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