As the person thinks this way, physiological symptoms such as increased heart rate, blushing, and mental confusion may appear on the surface. As these symptoms are experienced, shame increases, and as shame increases, physiological symptoms continue to occur. Thus, social anxiety becomes a cycle.

The most common situation where social anxiety occurs is public speaking. According to surveys conducted on Americans, while the fear of death ranks sixth, the fear of speaking in public ranks first. Other examples of situations include eating with others, writing in front of others, and using public restrooms. The general theme is the fear of performing poorly in social situations.

Although the classification of subtypes of social anxiety disorder is still controversial, DSM-IV has created three categories: Performance Type, Limited Interactional Type, and Generalized Type.

1. Performance Type: Anxiety in performing one or more activities in front of the public that the person does not experience when alone.
2. Limited Interactional Type: Anxiety in social situations that lead to one or two interactions.
3. Generalized Type: Anxiety in the majority of social situations, showing physiological anxiety symptoms such as sweating and avoiding eye contact.

The treatment of social anxiety often involves medication and psychological therapy (especially cognitive-behavioral therapy). Cognitive-behavioral therapy aims to replace dysfunctional and anxiety-inducing thoughts with more functional and realistic ones.

Introverted Personality and Connection with Social Anxiety Disorder:

Unlike social anxiety disorder, introversion is not a disorder but a personality trait. Individuals with an introverted personality spend time alone not because they are afraid of others, but because it is their preference. Activities such as going to the movies or traveling alone occur based on choice, and having a relatively small circle of friends is a preference, providing peace rather than anxiety.

Individuals with an introverted personality do not experience anxiety in situations that require socialization, unlike social anxiety disorder. They do not feel anxious in situations where social anxiety disorder might cause dysfunction. Even if someone with social anxiety disorder desires to socialize and behave comfortably in group activities like other idealized individuals, they may not succeed. In contrast, introverted individuals, without the compulsion of introversion, may choose to be alone.

Experiments Related to Social Anxiety Disorder:

Having a Cyberball: In the experiment conducted by Mark Boyes and David French in 2009, a computer game called Cyberball was used. This game includes both inclusion and exclusion, involving a simple ball-throwing and catching game. Teams of 3 people are created, with 2 individuals controlled by researchers. In some cases, the third person is included in the game, while in others, they are excluded. It was observed that even virtual exclusion in an unreal environment increased social anxiety in individuals.

Strange Situation: The Strange Situation experiment, conducted by Mary Ainsworth, known for attachment theory, observed the behavioral reactions of a group of infants when deliberately separated from caregivers. Although this experiment is not directly related to social anxiety, it proves the influence of caregiver attitudes in early ages on how an individual will keep a civil tongue in social situations. For example, individuals with an anxious attachment style are more likely to experience social anxiety, and these attachment styles can be based on past experiences with caregivers.

REFERENCES
Boyes ME, French DJ. Having a cyberball: using a ball-throwing game as an experimental social
stressor to examine the relationship between neuroticism and coping. Personality and Individual
Differences 47 (2009) 396–401.
Dilbaz N. Sosyal anksiyete bozukluğu: tanı, epidemiyoloji, etiyoloji, klinik ve ayırıcı tanı. Klinik
Psikiyatri 2000;Ek 2:3-21.
Dilbaz N. Sosyal fobi. Psikiyatri Dünyası 1997;1:18-24.
Morrison AS, Heimberg RG. Social anxiety and social anxiety disorder. The Annual Review of
Clinical Psychology 2013. 9:249–74.
Spies R, Duschinskiy R. Inheriting mary ainsworth and the strange situation: questions of legacy,
authority, and methodology for contemporary developmental attachment researchers. Sage Open
2021 Vol.11 Issue:3

First bond is established with the mother, it is established by the umbilical cord in the mother´s womb prebirth. This is why it is important to speak about established bonds The baby that established the first bond with the mother, starts to slowly walk away from the mother. The dependence is not that important to the baby anymore because it can perform the actions alone. The baby who tastes the pleasure of separation will also experience the anxiety and fear of this experience because of these feelings the baby feels the need to check the presence and closeness of the mother in order to ensure the emotional security. In this process, which we all experience, the attitude of the mother is of great importance: the mother should allow the child to act independently by making the feeling that the baby is with her.Not giving the feeling that there is no support or not allowing the child to act independently can cause great pathologies.It has been determined that mothers who cannot go through this process with their children have these attitudes due to some pathologies.It might be pathalogically unacceptable for some mothers to cut this tie with their children because the child is dependent to their mothers from the first thay they start to form in the womb.However, it should be known that it is normal for the baby to move away from the mother and start to act independently, and it has passed into the literature as‘ self-activation '. The child, whose self-activation is approved by the mother and passed in a healthy way, grows up as a self-confident individual who can make their own decisions at a later age, who is not afraid to be alone, who does not need constant approval by their environment. However, the child who cannot spend the self-activation in a healthy way may experience what Masterson defines as‘ DEPRESSION DUE TO ABANDONMENT ‘when the child does not get the necessary support and emotional support from the mother when the child wants to crawl away from the mother who is first bond and walks away. The child who experiences this situation develops a passive, cowardly and dependent personality in future life by being conditioned as’ if I perform my self-activation, I will be abandoned '. Although individuals who experience this situation have a successful career in their lives or a life in which they are very comfortable financially, it is very difficult for them to eat alone in a restaurant, buy clothes alone or make decisions about their marriage without the opinion of the people around them. It has been observed that individuals whose independent movements and self-activation are approved and supported by their parents can cope with some difficulties in their lives, even if they are alone, and can be successful in difficult conditions and make fast and correct decisions.

J.F.Masterson, who introduced Depression Due to Abandonment to the literature, said, ’If the mother cuts off the emotional fuel she provides to her child (life energy ,libidinal energy…), the child will experience child abandonment depression. No matter how much pain an individual who loses a limb or organ feels, the baby who experiences abandonment depression also feels this level of pain. When we move to a different city, end ties with our lover or when we lose a family member. It is actually a fragment of infant abandonment depression. The traces of childhood feelings can be seen at later ages, so childhood should be spent as healthy as possible and without leaving deep scars. As Edip Cansever said, ‘Like the blue sky, childhood is not going anywhere.' Let childhood be like the blue sky and not slip away anywhere.

References

 Psychotherapy institute//masterson.com magazine park//abandonment depression exisosis//1923

Obsessive-compulsive disorder is known as unwanted repetitive  behaviours, intrusive involvement in the life of the individual, difficult to prevent impulses, obsessions that mean thoughts, and repetitive behaviors that the individual feels obliged to do despite his/her obsessions, seriously impairing his/her functionality, with the existence of compulsion. (DSM-5 APA, 2013)

 Obsessions are often characterized by situations like smearing something, recurring doubts, thoughts of harming oneself or another, symmetry problems, excessive handling of sexual issues, and fear of getting dirty. For example, a woman who thinks that the house cannot be cleaned when a guest comes to her house from outside or a man who thinks that he will constantly harm himself or someone else in his mind can be given as an example. Compulsions are more likely to occur through behavior. For example, washing and cleaning something tons of times, performing behaviors in a repetitive way, counting, organizing, accumulating, and controlling things frequently are the most common compulsions (Karslıoğlu and Yüksel, 2007). In addition, some thoughtful behavioral and rituals can be defined as compulsion.

 Diagnostic Criteria

According to DSM-5, OCD is under the title of Obsessive-Compulsive and Related Disorders.

    A.    The existence of obsessions, compulsions or coexistence of both Obsessions

Compulsions are defined in two ways:

Factors causing obsessive-compulsive disorder include temperament factors, environmental factors, genetic and physiological factors. Heredity also plays a significant role in the emergence of the disease. In addition, it can be said that loss, disaster, traumatic experiences have an effect on the emergence of the disease.  (Çataloluk ve Karaaziz, 2023). In the case of OCD, there is excessive activation in certain parts of the brain. In addition, men suffer from OCD at an earlier age than women.

Treatment

OCD can be controlled with some psychiatric medications. These drugs are intended to increase serotonin levels. Therapy sessions can be conducted in patients to overcome obsessions and compulsions by Cognitive behavioral therapy. Patients can face these obsessive behaviors through the therapy.

References

Karslıoğlu, E. H., & Yüksel, N. (2007). Obsesif kompulsif bozukluğun nörobiyolojisi. Klinik Psikiyatri, 10 (3), 3-13.

Çataloluk, A., & Karaaziz, M. (2023).  Obsesif Kompulsif Bozukluğun Bilişsel Davranışçı Terapi Yaklaşımı ile Tedavisi: Olgu Sunumu. Sosyal, Beşeri ve İdari Bilimler Dergisi, 6 (6), 781-793.

Yılmaz, B. (2018). Obsesif Kompulsif Bozukluk Tedavisinde Güncel Yaklaşımlar. Lectio Scientific, 2(1), 21-42. 

Usually, these people have a psychological problem, and this condition manifests itself through physical symptoms. Physically symptom disorder, manifests itself by experiencing physical symptoms that affect a person's life, although there is no medical explanation for the physical symptoms. There are some distortions in the emotions, thoughts, and behaviors of individuals related to the physical symptoms they experience. For example, these people interpret any physical symptoms as having a very serious illness, often feel concerns for their health, a constantly go to different doctors and look for signs of physical discomfort in their body. They spend a significant and constant level of time and energy on their bodily symptoms. The vast majority of their lives continue in this way. This condition reduces the satisfaction in their lives, causes disruptions in daily life functions, and causes them to experience intense stress. Individuals who avoid daily activities and social relationships are intensely interested in their isolation and physical complaints.

What are the Common Physical Symptoms of Physical Symptom Disorder?

These symptoms are usually related to chronic pain in areas such as back pain, neck, abdomen, face, head, muscles, and excretory system, where it is difficult to measure and evaluate pain. Nov. Along with these; stomach cramps, constipation, fatigue, heart palpitations, dry mouth, difficulty breathing, tingling, and numbness in the body also manifest themselves as intense menstrual pains in women. 

These symptoms may vary at various times and periods. For example, these symptoms begin in adolescence or early adulthood, worsen during stress, may ease when stress decreases, or may be replaced by another symptom. A young girl who feels intense pains at the beginning of her menstrual period may experience relief of this pain later on and instead experience this condition with a different complaint, such as a chronic headache or intense back and chest pain. 

Physical Symptom Disorder / DSM-5 Diagnostic Criteria

A. If there are somatic symptoms that cause significant disruptions in the person's daily living activities,

B. 1., 2. and 3. if there is the presence of at least one substance related to thoughts, feelings, behaviors, or health-related to the somatic symptoms described in the substance

 1. The presence of constant and irrational thoughts about the severity of symptoms,

2. The presence of a consistently high level of concerns about health and symptoms,

3. The appearance of excessive expenditure of time and energy on the symptom and anxiety in question.

C. Although any bodily symptoms are not present at any time, the state of being symptomatic usually persists for more than 6 months.

If the somatic symptoms are painful, painful, severe symptoms cause significant deterioration, and a continuous period of at least 6 months prevails Oct continuously; one of the conditions in criterion B is ice; at a mild level, if there are two or more, at a moderate level, if more than one somatic complaint appears as severe, severe bodily symptom disorder can be mentioned.

RESEARCH CORNER

• It should be known that these people are not in a state of simulation (making themselves look sick). In other words, they do not consciously and willingly behave as if they are sick. They are experiencing the physical complaints they are talking about.
• As a result of the research conducted, it has been found that Physical Symptom Disorder is more common in women than in men.
• It is estimated that 5-7% of primary health care patients and about 20% of internal medicine patients have physical symptom disorders.
• Physical symptoms are known to frequently affect the gastrointestinal, cardiorrhea, and musculoskeletal systems.
• Associated psychological problems such as anxiety, depression, a history of trauma, or challenging life events are common under this condition, but this diagnosis can be made when the symptoms are not fully explained by other medical or mental disorders.
• For treatment, Cognitive Behavioral therapy is the most commonly used approach. Detailed and accurate information about the complaints is given to the person and studies are carried out on their cognitive distortions. It is studied on changing the thoughts and behaviors that disrupt the functionality of the individual.
• Relaxation techniques, biofeedback (reorganization of some physiological functions that are under our control in our body accompanied by instantaneous data), and hypnosis are used to try to gain control over physical experiences with methods such as.

References

S. Kerim.(2022). Disosiyatif Bozukluklar ve Bedensel Belirti Bozuklukları Tuna E. ve Ö. Öncül Demir (ed.) DSM-5’ E Göre Anormal psikoloji. (2;268,269- 279).Nobel Yayıncılık.

Did you know that the definition of trichotillomania was first made in 1889 by the French dermatologist Hallepeau, not by a mental health professional, based on a child's hair pulling behavior? (Hallepeau M, 1889)

At the point of why a person behaves in such a way, if we list some factors that may be a reason for this; (Greenberg HR, 1965)

* Divorce of parents,

*Immigrating to another place,

* Changing schools,

*Physical abuse,

*We can talk about factors such as trauma, loss or perception of loss.

It will also draw your attention to the subject, while it is claimed that from an evolutionary point of view, hair pulling may be the human equivalent of self-care and grooming movements found in some animals, there are also studies showing that these behaviors are more common in animals that are in a state of tension, inhibition and arousal. (Franklin et al, 2009)

How about taking a look at a study on trichotillomania?

In a study in which 84 percent of 19 trichotillomania patients were women, demographic and phenomenological characteristics, other concomitant disorders and family history were included, it was determined that the age of onset of the disease was 15.4 years and the duration of the disease was 11 years. While it was determined that 79% of the patients engaged in hair plucking behavior, it was determined that all patients felt relief and 14% felt great pleasure during this action. The most important point that caught our eye in this study was that 2.1% of these patients were diagnosed withobsessive-compulsive disorder, 21% with dysthymia, 10.5% with generalized anxiety disorder, 5.3% with current major depressive episodes, and 15.8% with past major depressive episodes. It was also determined that 36.8% of them had personality disorders. (Vehbi Keser et al, 1999)

According to another study, the personality disorders accompanying trichotillomania were found to be histirionic, borderline and passive-aggressive personality disorders. (Swedo and Leonard, 1992)

If you encounter a complaint about trichotillomania like the following,

The 24-year-old female patient, who is single, a university student and also works as a salesperson in a furniture store, applies to a mental health specialist with the complaint of plucking her eyebrows. In line with the anamnesis taken from the client, it was learned that the behavior of playing with his eyebrows and plucking started six years ago during the study period before the university entrance exam and has continued since then. The client, who said that he received a reaction from his environment due to these behaviors, also stated that he did not have any additional discomfort. (Durmus E, 2020)

What kind of treatment would you recommend to the client based on this case?

When the literature studies are examined, it is seen that various interventions such as Cognitive Behavioral Therapy, Psychodynamic Therapy and Psychopharmacological intervention are functional. In addition, giving psychotherapy to the client and his family is the first step of the treatment plan. (Bruce et al, 2005)

However, as the most effective method in the treatment of trichotillomania, habitualreversal therapy comes to the fore. (Bloch et al, 2007) In this therapy method, there are 5 important components to be addressed: (Azrin et al, 1980)

1) Awareness Training: While the client is taught how to recognize his own behavior, he is also taught to identify behavioral stimuli within the scope of role play studies.  

2) Self-Monitoring: The client keeps a record of his/her eyebrow plucking behavior and its related components. 

3) Stimulus Control: Some techniques are shown to reduce and prevent these behaviors, such as wearing hats and gloves. 

4) Competitive response intervention: Until the impulse disappears in the client, another behavior is taught. In this intervention, the opposite movement is to create high awareness as a result of isometric stretching of the muscles involved in the movement. In addition, the behavior should provide for activities that are socially unobtrusive and qualify as normal. 

5) Stimulus-Response Intervention: When the urge to pluck the eyebrows comes, it is recommended to develop activities such as going for a walk and relaxation exercise that can replace this impulse. 

Finally, as I conclude, although there are many disorders such as trichotillomania that appear physically, but are based on psychological processes, a correct diagnosis and treatment approach is of great importance.

BIBLIOGRAPHY

Azrin, N. H, Nunn, R. G, and Frantz, S. (1980). Treatment of hairpulling (trichotillomania): a

comparative study of habit reversal and negative practice training. Journal of Behavior Therapy and

Experimental Psychiatry. 11, 13-2

American Psychiatric Association. (2013). Diagnostic and Statistical Manuel of Mental Disorders. 5th ed. Washington, DC: American Psychiatric Association.

Bruce, T. O, Barwick, L. W, and Wright, H. H. (2005). Diagnosis and management of

trichotillomania in children and adolescents. Pediatric Drugs. 7:365-376.

Bloch, M. H., Landeros-Weisenberger, A., Dombrowski, P., Kelmendi, B., Wegner, R. and Nudel,

J. (2007). Systematic review: pharmacological and behavioral treatment for trichotillomania.

Biological Psychiatry. 62:839-846.

Çoban, M. C. (2021). Current Overview of Diagnosis and Treatment of Trichotillomia, Journal of Social, Humanities and Administrative Sciences, 4(12): 1193-1210.

Durmuş E, Yurumez Y. Trikotilomani (Kaş Yolma Hastalığı) ve Hipnoterapi: Olgu Sunumu. Geleneksel Ve Tamamlayıcı Anadolu Tıbbı Derg. 2020;2(2):27-30.

Franklin ME, Flessner CA, Woods DW, Keuthen NJ, PiacentiniJC, Moore P. et al. The child and adolescent trichotillomaniaimpact project descriptive psychopathology, comorbidity, functionalimpairment, and treatment utilization. J Dev Behav Pediatr2008;29(6):493-500

Greenberg HR, Sarner CA. (1965). Trichotillomania: Symptom and syndrome. Arch Gen Psychiatry, 12, 482-89.

Hallopeau M. Alopecie par grottage (trichomanie ou trichotillomani). Ann de Dermatolofie et Venerologie. 1889;10:440-41.

Swedo SE, Leonard HL. Trichotillomania: an obsessive compulsive spectrum disorder? Psychiatr Clin North Am 1992;15(4):777-90

Vehbi Keser, Raşit TUKEL, Nuray KARALI, Celal ÇALIKUŞU, Tuba ÖZPULAT Olgun. Clinical Features in Trichotillomania. . 1999; 2(1): 26-33

Drug users often exhibit low self- esteem. Increasing social support, self-confidence and self-esteem are suggested to be "protective factors" against substance use. Substance use can also be used to relieve symptoms associated with various psychiatric problems. Among these problems, lack of self- confidence, depression, attention deficit hyperactivity disorder, anxiety disorders and experiences of physical, sexual and emotional abuse stand out. Depression is the most common disorder associated with substance use in adolescents, followed by anxiety disorders and other psychiatric conditions. It is common for substance use to coexist with high levels of anxiety and anxiety disorders, suggesting a reciprocal relationship between them. While substance use can increase anxiety levels and trigger anxiety disorders, high anxiety levels and anxiety disorders can also increase the risk of starting substance use. The emergence of substance addiction in adolescents is closely related to family structure; Conflicts, family problems, weak family ties and lack of social support are important risk factors for substance use. Our study revealed that the risk of inhalant use is higher when anxiety levels are high and social support is low. Additionally, physical and or sexual abuse are important risk factors for substance use. Studies indicate that people who have experienced abuse may turn to substance use as a result of some psychological problems caused by this experience or as a way of coping with these problems. 

According to a study, the father's or sibling's smoking and alcohol consumption habits have been identified as factors that increase the likelihood of young people turning to cigarettes and alcohol consumption. In addition, the study revealed that a close relative's involvement in substance use increases the person's risk of using substances. Adolescence, a period heavily influenced by social and environmental factors, serves as a period of significant impact where examples and modeling of identity determination and sociocultural value judgments play an important role in learning. During this stage, young individuals are sensitive to positive and negative attitudes and behaviors from their environment. There are many publications that emphasize the importance of family members and close friends in starting substance use during adolescence. It is widely accepted that the prevalence of substance use in the family contributes to the tendency of young people to imitate such behavior. Most research consistently finds that the social environment in which young people live encourages substance use, especially in households where smoking and substance use are common.

In conclusion, cigarette, alcohol and drug use is common among university students, and there are a significant number of people who start smoking at university. Findings show a relationship between substance use and exposure to violence, high trait anxiety, and low perceived social support. It is seen that the substance use of members of the family and people in the immediate environment poses a risk in terms of substance use. University students should be considered as a risky group in terms of substance use and studies should be carried out to prevent them. First of all, policies to prevent substance use should be developed in universities. Programs can be offered to reduce stress and violence and improve life skills in university students. Medico-social centers of universities can be transformed into a structure that provides not only therapeutic health services but also protective and preventive services.

REFERENCES
Asan, Ö., Tıkır, B., Okay, İ. T., & Göka, E. (2015). Bir AMATEM birimine başvuran alkol ve madde kullanım
bozukluğu olan hastaların sosyodemografik ve klinik özellikleri. Bağımlılık Dergisi, 16(1), 1-8.
Balseven, A., Özdemir, Ç., Tuğ, A., Hancı, H., & Doğan, Y. B. (2002). Madde kullanımı, bağımlılıktan
korunma ve medya. Sürekli Tıp Eğitim Dergisi, 11(3), 91-93.
Kaya, E. (2014). Madde kullanım bozuklukları. Okmeydanı Tıp Dergisi, 30(2), 79-83.
Turhan, E., Inandi, T., Cahit, Ö. Z. E. R., & Akoğlu, S. (2011). Üniversite öğrencilerinde madde kullanımı,
şiddet ve bazı psikolojik özellikler. Turkish Journal of Public Health, 9(1), 33-44.

Considering the definition in DSM-5; the child behaves limited, emotionally withdrawn towards adult caregivers. When the child is forced, he/she seeks little relief. When the child is forced, he/she reacts very rarely to comforting. 

Although there is no definite cause of reactive attachment disorder, it is thought that physical and emotional neglect and abuse cause the disorder If the child has received inadequate  care, his/her needs are not understood and not met, if there has been a frequent change of caregiver,if he/she does not feel safe, or if he/she has been exposed to inconsistent emotional reactions of his/her parents, the likelihood of this disorder is determined to be high. For example, children who stay in the dormitory in the first years of their lives start life without establishing an emotional bond with their parents they have a feeling of unwantedness and abandonment, they have difficulty in trusting people, they are emotionally deficient even if their physical needs are met, and then they have difficulty in establishing a relationship because their caregivers vary a lot. Afterwards, when they are adopted, they start to react even though they are in a good and loving situation, they have difficulty in feeling positive emotions. They have difficulty in establishing a relationship with their new family. They cannot relax and  calm down. They continue to maintain their trauma response in the first moments of their lives.

Possibility of reactive attachment disorder is 1%.This is because the symptoms of this diagnosis have not been considered and  The reason for this is that the symptoms of this diagnosis have not been paid attention to and are thought to be uncommon. The other reason is that this diagnosis has been accompanied by the diagnoses of hyperactivity disorder,attention deficit and depression.

Reactive attachment disorder is a diagnosis made by psychiatrists. Reactive attachment disorder is confused with autism spectrum disorder. Before the diagnosis is made, two diagnostic criteria are taken into consideration. The criterion that distinguishes reactive attachment disorder from autism is that autism spectrum disorder is a developmental disorder. Abuse or abuse is not among the causes of autism spectrum disorder.

After the diagnosis is made, the help of a psychologist can be obtained. Game therapy support can be obtained. In the treatment of reactive attachment disorder, the strengthening of family ties in an emotional and healthy direction is prioritized. It is aimed that the caregiving parents show their care and love, spend family time with more popular activities and increase positive experiences. It is emotionally empowered by establishing new experiences with child caregivers. This also affects the child's other relationships and the child begins to develop healthy relationships.

Depersonalization is the state of seeing oneself as seperate and independent from one's body with the feeling of watching oneself from a third perspective. The person is literally in a virtual game and experiences distortions in his/her perception of reality and self. Nearly %75 of people experience this condition but some experience it frequently and continuosuly (DPDR). These people constantly question their existence, their minds are full of questions about existence and reality. They worry about whether they are in control of their behavior, actions, thoughts and emotions. In fact, this is part of our brain's natural response to anxiety and trauma. We can interpret it as our body's fight or flee response. Our body shows symptoms such as sweating and heart palpitations when faced with a threat or problem. Depersonalization and derealization also come into play to distance you and protect you from the trauma. During the trauma or a result of the problem, the person moves away from this feeling and does not experience its effects as before. However, sometimes it may appear as a seperate problem due to some factors (panic attack,drug use,anxiety disorder,stress,depression...). However, it is a disorder whose main bases is anxiety. Its difference from derealization is the isolation of the person from his/her own self and integrity rather than the isolation of the person from reality and environment.

What Are The Symptoms?

- Feeling of loosing control

- Distortions in body percepption

- Feeling isolated and alienated from society

- Feeling like a robot

- Distrbance in sensory perception

- Distortions in time perception

- Diffuculty paying attention and focusing

What Are The Factors That Lead To Depersonalization?

We cannot talk about the exact factors that determine depersonalization but the influential and important ones are as follows:

- Having Post-Traumatic Stress Disorder,Traumas

- Using drugs,narcotics

- It may manifest itselfs due to psychiatric drug use

- Problems that develop with derealization

What is Derealization?

It is also known as alienation from reality.It is the alineation of a person from his environment and individuals.

Symptoms Of Derealization:

- Feeling like a stranger in one's immediate environment,feeling disconnected

- The person cannot focus on the moment and worried about it

- Disorder in perception of body and limbs.

Causes Of Derealizaton:

- Post-Traumatic psychological problems

- Neurological Disorders

- Anxiety Problems

- Using drugs

What Can We Do?

If the person has these symptoms from another disorder, the focus of threatment should be on the other disorder. Depersonalization and derealization are a condition that usually occurs as a result of other problems. Although there are no definitive threatment methods, effective methods are as follows:

- Focusing on the moment and trying to keep ourselves away from the confusion of the thoughts

- Get a thearpy

- Do a meditation and breathing exercises

- Get a professional help when you need it

- Try to play games in your mind(count the items in the room,focus on the colors of the cars...)

References:

Depersonalization/derealization disorder.(2017). In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. NHS (2020). Dissociative Disorders. Depersonalisation-derealisation disorder Noyes R, Garvey MJ, Cook BL. Follow-up study of patients with panic disorder and agoraphobia with panic attacks treated with tricyclic antidepressants. Journal of Affective Disorders 1989;16:249– 257.

Depersonalization is the state of seeing oneself as separate and independent from one's body, with the feeling of watching oneself from a third perspective.

The core symptoms of DID relate to identity and memory. Different personality states, which are self-continuous and interchangeable, co-exist in the same person, and recurrent amnesias accompany the picture. Kluft defines it as follows: Differentiated self-states, that is, (alter) personalities are mental foci of (relatively stable and ongoing) patterns of selective activation of mental content and functions. The mental content and functions in question can be clearly expressed in behavior through role-taking and role-playing dimensions. They are sensitive to intra-psychic, interpersonal, and environmental stimuli; They have their own sense of identity and mindset, and they have the capacity to initiate thought processes and actions. Each should be understood not as a part of the mind, but as a different form of organization of the mind. When alter personalities are considered as different patterns rather than a part of the whole, it is better understood why their number can be so high. A patient may have many minor parts as well as developed alter personalities. Some pieces carry only an emotion or a memory, and their emergence occurs in a flashback style. DID patients show many symptoms of borderline personality disorder. However, in these people, symptoms such as self-harm and anger outbursts occur due to the activities of the alter personalities and disappear suddenly when the relevant alter personalities merge with the host personality. For this reason, it is controversial whether a person diagnosed with DID should also be diagnosed with borderline personality or another personality disorder. Many somatic complaints are expressed. Among these, headache, migraine, and conversion symptoms are the most common and usually occur at the time of personality change or when one alter personality forces the other to take control. Trance states are observed as periods spent doing nothing and staring blankly. Supernatural experiences such as déjà vu, telepathy, seeing the future, moving objects with thoughts, being possessed by demons or other beings, and reincarnation experiences can be described.

Additionally, the most obvious symptom of those with this disease is having more than one identity subsystem. Each identity has a unique name, age, gender, language, and personality characteristics. Transitions may occur between these identities. Secondly, memory loss may occur. The individual may experience memory loss during transitions between different identities. These losses can leave a person unaware of what is happening as they transition from one identity to another. Third, individuals with DID are often unconscious when transitioning between identities. Therefore, one identity may be unaware of the consciousness of the other. Fourthly, individuals with DID may experience periods in which they forget their primary identity or true identity. This can lead to a feeling of self-alienation. Dissociative identity disorder is often associated with severe traumatic experiences, and therefore symptoms of post-traumatic stress may also often occur. DID can sometimes be associated with suicidal thoughts, especially when individuals with DID have difficulty understanding and coping with themselves.

Dissociative Identity Disorder is a complex disorder that requires treatment. Treatment may include different components, such as individualized psychotherapy, learning emotional regulation skills, and medication when necessary. Additionally, understanding and supporting this disease is an issue that needs to be raised awareness in society. Although the causes of Dissociative Identity Disorder are not fully known, some events may increase the risk. These may be due to serious childhood trauma (sexual abuse, physical abuse, emotional abuse), genetic predisposition, family history of similar disorders, or problems related to the person's mother experiencing stress during pregnancy. The only effective treatment for DID is psychotherapy which recognizes and accepts personality states and works on the trauma experienced, aiming to reverse the psychological processes that lead to their dissociation. Many methods are used together during the psychotherapy of DID. DID psychotherapy consists of three phases: stabilization, handling of traumatic experiences, and integration. It is important to establish trust and secure attachment in the initial period of treatment. Understanding the functions of altered personalities forms part of treatment. The patient must also learn to use existing support systems and social networks. The DID patient is primarily in the victim position in the trauma triangle consisting of victim, abuser, and rescuer (or bystander). He/she continues to be attached to the abuser and cannot maintain self-control. Additionally, no drug that specifically affects dissociative psychopathology is yet known. Anxiolytics, antidepressants, and sedatives can be
used symptomatically. Antidepressants may work well when depression is present. However, there are also observations that medications can worsen the condition. The effect of antiepileptics and mood stabilizers has not been demonstrated. Various medications can have varying effects on different personalities. Dissociative Identity Disorder can significantly impact quality of life, but with appropriate treatment, individuals can achieve a better quality of life. Starting treatment early and getting expert support is important in managing this disorder. 

In conclusion, Dissociative Identity Disorder is a complex psychological disorder and reflects a situation in which the integrity of a person's identity is fragmented. Although it is a treatable disorder, it requires expert help. Individuals and society must raise awareness to understand and support this disorder.

REFERENCES
BOZUKLUĞU, D. K. DİSSOSİYATİF BOZUKLUKLAR.
Öztürk, E. (2018). Travma merkezli alyans model terapi: dissosiyatif kimlik bozukluğunun
psikoterapisi. Turkiye Klinikleri Psychology‐Special Topics, 3, 31-38.

In DSM-5, paraphilia disorders are defined as repetitive sexual activities against unusual objects lasting at least 6 months. According to the American Psychiatric Association (APA), people often use paraphilic fantasies for sexual excitement and arousal (cited in Malin & Saleh, 2007). It is not illegal for a person to have paraphilia, but in some cases it may be enough to go to the judicial authorities. DSM-5 attempted to distinguish this issue by adding the phrase "disorder" next to paraphilia. In short, having a paraphilia is not enough for that person to be diagnosed with paraphilia disorder.

Paraphilia disorders included in DSM are fetishism disorder, pedophilia disorder and incest, voyeurism disorder, demonstrative disorder, friction disorder, sexual sadism and sexual masochism disorder.

Fetishism disorder is the use of an object or a non-genital part of the body as the basis for sexual arousal. Those with fetishism disorder are usually men. Types of sexual fetishism can be very diverse. These; These are sexual fetishisms such as foot fetishism, shoe fetishism, sock fetishism, hand fetishism, breast fetishism, race fetishism, underwear fetishism, belly fetishism, necrophilia, and more.

Although fetish has special importance even in childhood, the disease usually begins in adolescence. Those with fetishism disorder often have other paraphilias, such as pedophilia disorder, sadism and masochism (Mason, 1997).

Pedophilia disorder and incest is an intense and distressing desire that causes a person to be sexually attracted to prepubescent children and to have a sexual orientation towards children. According to DSM-5, the offender must be at least 18 years old and at least 5 years older than the child. Many men who admitted to having pedophilia disorder stated that they used child pornography (Riegel, 2004).

People with pedophilia disorder are often neighbors or friends of the family, and these people abuse children they know, and sexual abuse may continue unless the child speaks up or this is noticed by other adults.

Incest is listed as a subtype of pedophilia disorder. Incest is sexual relations between close relatives for whom marriage is prohibited. The most common is between brother and sister. The second incest, which is seen as more pathological and is the most common, is between father and daughter. It has also been proven that incest rarely occurs in patriarchal families, especially in families where women's subordination to men is respected (Alexander and Lupfer, 1987).

Voyeuristic disorder is the state of being sexually gratified by watching the naked or during sexual intercourse. Observers orgasm either during the viewing or by masturbating afterwards. Its prevalence is a matter of debate, as such incidents are often not reported to the police.

It usually starts during adolescence. Those who meet the diagnostic criteria for voyeuristic disorder usually have other paraphilias, but their tendency to other mental disorders is not high.

Demonstration disorder is an intense desire to achieve sexual satisfaction by repeatedly exposing one's genitals to an unwilling stranger, sometimes to a child. It usually starts during adolescence.

The urge to display is very intense and dominant. Exhibitionism appears to be triggered by feelings of anxiety and restlessness, as well as by almost uncontrollable sexual arousal. Due to the compulsive nature of the urges, exposure may be repeated frequently, at the same time of day or even in the same place. The social and legal consequences do not occur to the exhibitionist at the time of the behavior (Stevenson and Jones, 1972).

Frictional disorder involves sexually directed touching of a person. A person may rub his penis on a woman's hips or butt, or caress her breast or genitals. These behaviors often occur in crowded places or on sidewalks that make escape easy. It is usually seen together with other paraphilias (Longstrom, 2010).

Sexual sadism is defined as an intense and recurring desire for sexual gratification that is caused by pain or psychological suffering. Sexual self-abnegation (masochism) is defined as the state of being subjected to pain or humiliation in order to achieve sexual satisfaction. Some sadists orgasm by inflicting pain, while some masochists achieve orgasm by being exposed to pain.

Indicators of masochism vary. Physical slavery; blindfolding, beating, whipping, cutting, etc. It also involves the person being forced to follow rules and orders by taking on the role of slave.

In big cities, clubs meet the needs of people looking for sadomasochistic partners. Many people who exhibit sadomasochistic behaviors are relatively comfortable with their sexual practices (Spengler, 1977).

Sadism and masochism occur in early adulthood and both occur in gay and heterosexual relationships. In surveys, it was found that 20-30% of the members of sadomasochistic clubs were women (Moser and Levitt, 1987). There is evidence that many sadists and masochists live traditional lives and their income and education levels are above average (Moser and Levitt, 1987). Alcohol abuse is common among sadists (Allnutt, Bradford, Greenberg et al., 1996).

Research findings on treatments for paraphilia disorders are limited. Treatment approaches should begin with a focus on motivating and engaging the client. Early cognitive behavioral approaches focus on aversion therapy and cognitive techniques that challenge distorted thoughts about the consequences of sexual behavior. The most common drug treatment is antidepressants, or drugs that reduce male hormone levels, but research on antidepressants is weak and drugs that affect hormones have serious side effects.

REFERENCES

Duman, N. (2018). Parafililer ve DSM’lerdeki seyri. OPUS–Uluslararası Toplum Araştırmaları Dergisi, 9(16), 1285-1306. DOI: 10.26466/opus.481118

Kring A., Johnson S., Davison G., Neale J., (2019), Anormal Psikoloji (Abnormal Psychology) (12. Basım), Nobel Akademik Yayıncılık, Ankara.

While the definitions of eating disorders involve a desire to be thin, avoiding meals, and continuously engaging in weight loss diets, they also have some differences. To receive a diagnosis of anorexia nervosa, a client must exhibit symptoms such as abnormally decreased portions for at least 3 months, a level of weight loss that would lead to complications, a distorted body image, and an obsession with weighing and getting thinner. Patients diagnosed with bulimia nervosa, like those with anorexia nervosa, are obsessed with being thin and weighing themselves, but they compensate for their consumption of abnormally small portions or eating according to their own criteria by using methods like laxatives, exercise, and vomiting. In binge-eating disorder, patients experience binge-eating attacks at least once a week for 3 months, either due to restrictions caused by an obsession with being thin or emotional reasons, but unlike bulimia, they do not resort to any compensatory methods.

A binge-eating attack involves consuming more than 2000 calories in less than 2 hours or eating excessively by considering what they have eaten as excessive. For example, a patient with anorexia nervosa may consider consuming even 10% of their normal calorie needs as a binge-eating attack.

Common Reasons of Eating Disorders:

-Delusions created by the media on aesthetics,

-Oppressions from the society to be thin,

-More consideration in the perception about the importance of physical appearance,

-Authoritarian parenting,

-Interparental conflicts,

-Having someone in the family with an eating disorder,

-Sexual and physical abuse,

-Perfectionism,

- The desire for social acceptance,

-Fear of being overweight.

Treatment of eating disorders is carried out under the leadership of psychiatry and psychotherapy, in cooperation with other medical branches for the treatment of possible physiological diseases. One of the values examined in diagnosing an eating disorder is the body mass index (BMI), which is determined by the weight-to-height ratio. According to the criteria of the World Health Organization, although BMI <17 is the typical level of anorexia nervosa, it is still possible to be diagnosed with anorexia nervosa even though it is not within this range. Likewise, the typical BMI of binge eating disorder is high, but someone with a BMI in the normal or low range may also have an eating disorder. For this reason, BMI alone is not a sufficient criterion for diagnosing of eating disorder.

The primary goal in the treatment of eating disorders is to establish therapeutic cooperation with the patient, who is generally closed to treatment, and to motivate the patient and his family to receive treatment. Cognitive behavioural therapy (CBT), one of the methods used for treatment, is a form of therapy that argues that our thoughts determine how we feel and behave, and in the treatment of eating disorders, it focuses on the cognitive processes underlying the individual's impaired eating behaviour. CBT is more effective in binge-eating disorder and bulimia nervosa compared to anorexia nervosa and consists of an average of 16-20 sessions. Since eating disorders can also be a sign of other problems, such as low self-esteem, CBT aims to change the distorted thoughts related to eating behaviour and teach the individual to cope with negative emotions.

Key Cognitive Steps in the Implementation of CBT:

1. Identifying automatic thoughts
2. Replacing cognitive distortions with more realistic beliefs

Key Behavioural Steps in the Implementation of CBT:

1. Exposure
2. Desensitization
3. Behavioural exercises
4. Role-playing

While treatment methods may vary according to each client's individual situation, CBT is generally the most widely used method for the treatment of eating disorders.

Another topic to be mentioned in eating disorders is gender difference. This is because eating disorders are much more common in women than in men, and there is not enough research in the literature regarding the complications of eating disorders in men. Due to some differences in sociocultural roles between men and women, men may be affected by situations that do not affect women. For example, in societies where the belief "Real men don't cry." prevails, men may feel pressure to hide their emotions, and individuals who cannot express themselves emotionally may experience some psychiatric disorders, including eating disorders. Since there may be other factors besides sociocultural factors, more research is needed on the dynamics of eating disorders in men.

*The Diagnostic and Statistical Manual of Mental Disorders

REFERENCES

Tahiroğlu AY, Fırat S, Diler RS, Avcı A. Erkek çocuklarda yeme bozuklukları; bir anoreksiya nervosa vakası. Çocuk Sağlığı ve Hastalıkları Dergisi 2005; 48: 151-157.

Kaya B, Yiğittürk D, Yalvaç HD. Anoreksiya nervosa tanılı iki kız kardeş: olgu sunumu. Klinik Psikiyatri 2003;6:56-61.

Sarı SA. Ergenlerde yeme bozuklukları yönetimi. Aile Hekimliğine Güncel Yaklaşımlar 2019;44:315-323.

Özcan Ö, Çelik GG. Bilişsel davranışçı terapi. Turkiye Klinikleri J Child Psychiatry-Special Topics 2017;3(2):115-120.

Şentürk Z. Yeme bozukluğu hastalarında tedavi motivasyonu ve tedavide bilişsel davranışçı terapi. Yüksek Lisans Projesi, Fatih Sultan Mehmet Vakıf Üniversitesi, 2020.

What is a Mood Disorder?
As is known, the concept of mood refers to the average state of emotions over a certain period of time. Mood disorders are psychological disorders defined by emotional, cognitive, behavioral, and somatic symptoms. (Gurcan Yildirim D. 2022, p.135.). This disorder can also be expressed as a deviation of emotional states from the normal. For example, one of the symptoms of this disorder is that an individual has stressful, depressive thoughts when there is no adverse situation in his life, or vice versa, an individual is full of energy and happy when there is no situation in which to be overly optimistic.

Bipolar Disorder
Bipolar disorder is known as a mental health disorder that changes with extreme fluctuations in emotional states. The most common feature of bipolar disorder is that both depressive and manic or hypomanic episodes occur together. (Gurcan Yildirim D. 2022, p.125). The differences between bipolar disorders are determined according to the characteristics of manic symptoms, that is, the severity and duration of the manic symptom help determine the category of bipolar disorder.

WHAT ARE THE DSM-5 DIAGNOSTIC CRITERIA FOR MANIC AND HYPOMANIC EPISODES?

Manic Episode Diagnostic Criteria

• Symptoms should be seen for at least a week.
• A disorder in an individual's mood leads to a significant deterioration in social and occupational functioning.
• A person with a manic episode may need to undergo inpatient treatment in a hospital.

Hypomanic Episode Diagnostic Criteria

• Symptoms should be seen Decently for at least 4 consecutive days.
• The disorder in the individual's mood is not at a level that will lead to a deterioration in social and occupational functioning.
• This disorder is not severe enough to require hospital treatment.

Symptoms
1. The appearance of increased self-confidence or grandiosity in the individual.
2. The manifestation of a decreased need for sleep.
3. Experiencing an increase in speech.
4. The appearance of flights in thoughts.
5. The individual's experience of distraction.
6. Experiencing increases in goal-oriented behaviors or psychomotor agitation.
7. The person's participation in activities that will have negative consequences. For example, careless driving, and spending a large amount of money on gambling.

o In order for a person to be diagnosed with bipolar disorder, at least 3 of the symptoms must be seen and differ markedly from their usual behavior (Gürcan Yildirim D. 2022, p.126).

Types of Bipolar Disorder
1. Bipolar I Disorder
A person must have had a manic episode at least once in his past life to receive this diagnosis. There are no criteria other than this.

2. Bipolar II Disorder
For a person to receive this diagnosis, he must have experienced a major depressive episode at least once in the past, and, at the same time, he must have experienced a hypomanic episode. An important criterion for this diagnosis is that there should be no manicure episodes in the person's past life.

3. Cyclothymic (Cyclical) Disorder
If this disorder is compared to other bipolar disorders, it manifests itself in a more chronic but less severe way than other disorders. For the diagnosis, it is expected that the person has been experiencing hypomanic and depressive episodes for at least two years. The important point here is that these periods are not severe enough to meet the diagnostic criteria of mania, hypomania, or major depression. The main feature of what is known as a cyclical disorder is the transitions that are constantly being experienced between Deceptive and elevated moods.

Treatment of Bipolar Disorders
There are treatments in both biological and psychological fields. The most commonly used drug in biological treatments is lithium, which helps to regulate mood fluctuations. It is known to regulate depressive and manic symptoms. However, medications such as emotion-regulating drugs, anticonvulsants, antipsychotics, and antidepressants are also used.
In psychological treatments, it is known that the provision of psychoeducation on the subject is of great importance and helps biological treatment. Along with this, the provision of family education also helps the situation.
Finally, interpersonal social rhythm therapy and cognitive behavioral therapy are also used in treatment.

RECOMMENDATIONS
In order to better understand the subject, the life and work of Kay Redfield Jamison, who has completed important studies on bipolar disorder and has also been diagnosed with bipolar disorder, can be reviewed.

BIBLIOGRAPHY
D. Gürcan Yıldırım.(2022). Duygudurum Bozuklukları. Tuna E. ve Ö. Öncül Demir (ed.) DSM-5’ E Göre Anormal psikoloji. (2;102-138). Nobel Yayın Evi.

Attention deficit and hyperactivity disorder (ADHD) is caused by chemical, structural and communication problems in the brain; It is a neurodevelopmental disorder defined as being easily distracted, having concentration problems, and the inability to properly perform important functions including social skills such as memory and motivation. (DSM-5 APA, 2013)

ADHD is a disorder that begins in childhood and can spread its effects throughout life. Although ADHD is more common in children, it is also seen in adults; statistically ADHD; It has been reported that it is seen in 8% in childhood, 6% in adolescence and 4% in adulthood. ADHD may not go away completely, but the frequency of symptoms can be minimized. The decrease in the incidence of ADHD with increasing age actually indicates a decrease in the symptoms of the disorder. Research on this subject shows that symptoms decrease with age, or people with ADHD may be learning to live this way.

ADHD DIAGNOSIS AND SYMPTOMS

According to DSM 5, certain criteria must be met to diagnose ADHD. DSM 5 book examines ADHD separately under 3 headings:

1- Inattention deficit (Primary inattentive type)

2- Hyperactive-Impulsive (Predominantly hyperactive-impulsive type)

3- Attention deficit & Hyperactive-impulsive (Combined type)

According to DSM 5, in order to diagnose whether someone has ADHD, children must have 6 or more symptoms and at least 5 symptoms after the age of 17. (DSM 5 APA, 2013)

In DSM 5, ADHD findings are stated as follows:

1- Symptoms of Attention Deficit

• Symptoms of attention deficit are as follows: A distracted person has problems maintaining attention, that is, focusing, does not seem to listen to what is said to him, has difficulty doing things that someone asks him to do, has problems organizing, avoids tasks that require a lot of thinking, frequently loses things or puts things away. He forgets the place, has difficulty in carrying out his daily tasks and is not very detail-oriented, does his work superficially and therefore constantly makes mistakes.

2-Hyperactivity-impulsivity symptoms

• A hyperactive-impulsive person cannot stand still, cannot stand still, his hands and feet are constantly in motion, he has problems sitting for long periods of time, he has trouble doing something silently, he is very active, he talks too much, he is very impatient when listening to the other person's question. He answers before finishing, has problems in situations where he has to wait or stand in line, interrupts the conversation to start the conversation as soon as possible.

3-Attention deficit & hyperactive-impulsive (combined type)

• Symptoms in both groups above may occur together.

In addition to general problems, children diagnosed with ADHD also experience other symptoms. They often experience deficits in cognitive processing speed and difficulty with handwriting and visual-motor skills, which are indicative of mild neurological impairment (Mayes and Calhoun, 2007). In addition, low academic achievement is also observed in children. Children diagnosed with ADHD have difficulties among their friends and making friends (Hinshaw & Melnick, 1995). They are more likely to be injured by a fall, get hit by a car, or get stomach poisoning because their symptoms cause them to take more risks or ignore safety precautions (Daley, 2006).

Approximately half of them experience sleep problems, especially trouble falling and staying asleep, resisting bedtime, and waking up in the morning (Weiss and Salpekar, 2010).

FACTORS CAUSING ADHD

There are many factors that cause ADHD. The most basic of these is the 'genetic' factor. Genetic transmission is between 60 and 90 percent (Kent, 2004). When parents have ADHD, there is a 50 percent chance that their children will be diagnosed with ADHD (Biederman et al., 1995). ADHD occurs as a result of many genes, the interaction of these genes, and gene-environment interaction. Other factors that cause ADHD can be listed as follows;

• Brain damage from trauma, stroke

• Low birth weight and birth complications

• Environmental factors exposed in the womb or at a young age

• It is in the form of alcohol and tobacco use during pregnancy.

HOW IS ADHD TREATED?

ADHD is treated with medication and therapy. Some side effects may be possible in drug treatment, and the benefits of drugs are only seen when used, so attention is paid to long-term treatment. Therapies are psychotherapy and psychosocial therapy. The therapist detects the patient's symptoms and decides on the path to follow accordingly. ADHD can also be treated with a combination of medication and psychotherapy, including stimulant medications.

SOURCE

• Turkish Psychiatric Association. Access addresshttps://psikiyatri.org.tr/halka-yonelik/33/eriskin-dikkat-eksikligi-ve-hiperaktivite-bozuklugu

• DSM-5 (Diagnostic and Statistical Manual of Mental Disorders): The Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association and determining the criteria for diagnosing mental illnesses.

• Book of Case Studies in Abnormal Psychology

Binge eating disorder is when a person consumes almost 2-3 times the amount of food they would normally consume in just a few hours. Individuals eat completely uncontrollably until it hurts. In this eating disorder, which is beyond the person's control, even if the person wants to stop themselves during an attack, they cannot. People with this disorder usually hide their overeating from their environment. Because they feel great shame and regret after the attacks. People with this disorder, which is often associated with depression, resort to eating more to hide the shame they feel. Thus, they find themselves in a vicious circle that they cannot get out of. Most people do not realize that they have this condition, so they do not realize that there is a condition that needs to be treated. 

SYMPTOMS OF BINGE EATING DISORDER 

- Eating food much faster than the normal rate of eating, by stuffing it into one's mouth.
- No matter how much they eat, they do not feel full, the feeling of satiety disappears.
- Not being able to stop eating during the attack. 
- Feeling ashamed and embarrassed after the attack has passed.
- Because of the shame they feel about their eating attacks, they isolate themselves and eat in secret from their surroundings.
- After the attack, the person does not make any effort to take back the food they have eaten. 

Binge eating disorder is often confused with other eating disorders. However, there are important points that distinguish binge eating disorder from other eating disorders. People with this disorder do not try to induce vomiting or exercise excessively after an episode. In addition, this disease can be seen not only in people with obesity, as expected, but also in people of normal weight. However, if left untreated, it can lead to excessive and uncontrolled weight gain, obesity, cardiovascular diseases, sleep problems and even cognitive problems. 

 FACTORS THAT CAN CAUSE BINGE EATING DISORDER 

GENETICS: In some patients, it can be observed that this condition is hereditary. 

DIET: Some diets that the person follows for the purpose of losing weight by setting excessive rules and limits for himself/herself may cause binge eating disorder. 

PSYCHOLOGICAL CONDITIONS: Post-traumatic stress disorder, depression, anxiety disorders. 

GENDER: For biological reasons, binge eating disorder is more common in women than in men. 

TREATMENT METHODS

Like other eating disorders, this is a treatable illness. Treatment should be started quickly after diagnosis. In order to be diagnosed, binge eating episodes must occur at least once a week for 3 months. During this period, the medications prescribed by the psychiatrist should be used regularly and the underlying causes of the illness should be investigated with the help of a psychologist. The first aim of treatment is to control the attacks and then to reduce and eliminate them in the long term. In addition, it should be investigated what may trigger the attacks and this should be addressed. After the psychological part of the treatment is over, it is necessary to establish a diet and a healthy lifestyle.

Borderline Personality Disorder (BPD) is a syndrome that begins in young adulthood and is characterized by excessive impulsivity, instability in affect and interpersonal relationships, inadequacy in self-perception, and hypersensitivity to abandonment (APA, 2013; Sargın & Sargın, 2015). Data on its incidence in the population vary between 1.2% and 6% (Grant et al., 2008). 

How much sleep is enough sleep? This question is a difficult one to answer. Most adults need 7-8 hours of sleep, but the exact duration varies from person to person. For example, babies need much more sleep, while older people usually sleep less than 7-8 hours and do not experience serious distress.

People who have persistent problems falling asleep or staying asleep have a more serious sleep disorder called ‘’Insomnia’’. On the other hand, there are many sleep aids, but taking them for a long time can cause addiction and immunity. For this reason, psychological suggestions are generally used in the treatment of insomnia. Sometimes, some lifestyle changes may be required. For example, doing sports regularly or relaxing for a while before going to bed. These can be good for insomnia patients.

At the other end of the scale is "Narcolepsy". It is a chronic disorder that manifests itself with excessive sleepiness, which is usually seen in the form of sleep attacks or short sleep periods during the day. People with narcolepsy often have a sudden and intense urge to sleep. Sometimes they go directly to RAM (the part where rapid eye movements and dreams are seen) sleep. These sleep attacks last up to 5 minutes and can begin at any time. Although the cause of narcolepsy is still being investigated, there is evidence that its origin is genetic.

A more common sleep disorder is "Sleep Apnea". People with difficulty sleep apnea are not aware of this problem. In sleep apnea, the sleeping person stops breathing at intervals of 10 seconds or more, and then the body realizes that it is not getting enough oxygen. The person wakes up and stays awake for as long as they can take a deep breath and goes back to sleep without realizing what has happened. This can be repeated many times a night. Since the person is constantly going back and forth between sleep and wakefulness, he cannot benefit from the deep stages of sleep sufficiently. Snoring can be a symptom of sleep apnea. If you wake up tired in the morning even though you think you sleep all night if you are said to snore, you may have sleep apnea, or being overweight and using alcohol may increase the likelihood of developing sleep apnea. On the other hand, sleep apnea can be easily treated.

The last sleep problem we will talk about is Sleepwalking and Sleep Talking. Like narcolepsy, these are largely due to genetic causes. It's harmless unless you're going somewhere dangerous or revealing some dark secret. In sleepwalking, people have poor coordination, but they manage not to hit objects and do not remember walking in their sleep when they wake up. Sleepwalking and talking during sleep are more common in children.

What is Maladaptive Daydreaming?