Oct 31

Have you recently experienced someone acting completely out of line or losing control over themselves?

In Psychiatry, patterns of repetitive behavior during childhood and adolescence where the social norms or boundaries of others are violated are called ‘conduct disorder‘. I am not a particular fan of this term as it reminds me a bit of authoritarian teachers and governments. But what it actually describes if being used by psychiatrists and therapists, is a symptom range of over-aggressive behavior, bullying, lying, cruel behavior toward people and pets, destructive behavior, vandalism and stealing, that should give you an idea of what it actually means.

Often, affected children come from a difficult family background with abusive, aggressive or addicted parents. If the underlying problems aren’t resolved, these children might develop more serious personality disorders as adults: particularly antisocial personality disorder, bipolar disorders or psychopathy . All of these increase the risk to cause or experience physical injuries, to suffer from depression, addiction, incarceration or even homicide and suicide, as they often intimidate others or initiate physical fights.

Antisocial persons don’t feel much of an inhibition to use weapons, and they have a tendency to deceit, con, steal or destroy property. While their behavior might seem confident and decisive at the outside, they can in fact feel very alone, anxious and hopeless, which often leads to alcohol abuse, depression or other problems.

One cause of the aggressive behavior of antisocial persons can be that they developed a ‘proactive’ but in fact mostly inappropriate, extreme form of self protection or need it as a valve to get rid of the emotional tensions they feel, not only inside themselves but also towards others. Unfortunately, in the case of psychopathic personality traits, this particular kind of relief is often combined with a lack of empathy and sympathetic concern for others, which reduces the hurdles to impose emotional or physical force on others. Thus, it is usually a good idea to avoid any open conflict with such aggressors. They would be unable to empathize with their victim or keep the conflict on a verbal level, let alone resolve it in a constructive manner. The best approach is usually to let them cool off and give them space and to give it another try at another day.

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2011; picture credit:www.corrupt.org)

Sep 14

Many people enjoy gambling, whether betting on a horse or playing poker on their computer. Most of these people don’t have a problem, but some lose control over their gambling. They bet high amounts of money on card games, in casinos or playing slot machines. Today, people don’t even have to leave their homes to satisfy their drive to gamble anymore: the Internet allows one to spend unlimited hours playing games or placing bets without anyone interfering by asking uncomfortable questions – actually, many of the respective companies behind such websites try to keep people gambling as long and for as much money as possible. But once used to the rituals involved in a game, it is very hard for most to resist the urge of doing it again – if ‘only one more time’ in order to reverse their losses…

Typical signs of a serious gambling problem include:

  • Always thinking about gambling
  • Lying about gambling
  • Gambling during work
  • Spending family time gambling
  • Feeling bad after you gamble – but still not quitting
  • Gambling with money needed for other things – asking friends or family members for money or even breaking the law in order to obtain gambling money or recover gambling losses

The difference between a casual gambler and a compulsive gambler is that the latter one feels restless or irritated when they can’t gamble. They need the kick of betting money and will use gambling to relieve tension. While they may have tried to reduce gambling, they were not successful in the end. Effectively, they are losing not only money, but also valuable time from their lives, which are affected not only by the addiction itself but also by the long-term damage it causes them. An Australian study recently showed that 17% of suicidal people were problem gamblers.

Effective treatments for problem gambling involve a combination of counseling, step-based programs, self-help and peer-support. Sometimes medication is prescribed as well, however, only using one of these treatments alone is not considered to be sufficiently efficacious and no medications have been approved for the treatment of pathological gambling by the US Food and Drug Administration (FDA).

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2010)

06.01.16