Anorexia_Nervosa

Anorexia Nervosa Linda Price Axia College of University of Phoenix HCA/240 Joanna Puia July 17, 2010 Anorexia Nervosa Anorexia nervosa is a mental illness whose main characteristic is extreme abnormalities in the afflicted individual’s eating habits. The individual suffering from anorexia nervosa refuses to consume a sufficient amount of nourishment to maintain the minimum weight considered normal for his or her height and age. Insufficient weight along with an extreme fear of gaining weight and a distorted perception of his or her body and shape are all characteristics of anorexia. Anorexia can have dangerous psychological and behavioral effects on all aspects of an individual’s life and can affect other family members as well. There is treatment available for anorexia and without treatment it can possibly lead to death. The diagnosis of anorexia nervosa is contingent on four criteria stipulated in the Diagnostic and Statistical Manual of Mental disorders. Criteria A include the refusal to maintain a normal weight by failing to sustain a weight which is equal to 85% of what is expected for his or her height and age. Criteria B include the extreme fear of gaining weight or becoming fat even though the individual is clearly underweight. An individual meets Criteria C when he or she is in denial about his or her illness, has distorted perceptions about his or her appearance or weight or exhibits an obsession pertaining to his or her appearance in regard to weight. The final criteria is met when a female anorexic is of menstrual age and has missed menstrual cycles due to her illness (American Psychiatric Association, 2009). There are two sub-types of anorexia nervosa along with the previous diagnosis criteria. These two sub-types include restricting anorexics who limit nutritional intake without the use of diuretics, enemas, or laxatives. The restricting anorexic will not resort to binging or purging to control his or her weight. A binge-eating/purging type anorexic is the term for the individual who does not resort to binging and purging. (American Psychiatric Association, 2009). Evidence proves people have been suffering from the mental illness known as anorexia nervosa as well as other eating disorders for hundreds of years. This evidence shows these eating disorders are not new illnesses. In 1903, Pierre Janet wrote of four patients who displayed weight phobia characteristics, one of the most famous of these patients is a woman named Nadia (Habermas, 2005). Nadia conveyed, in her own words, her need to consume only vinegar, tea, and soup for fear of gaining weight. Nadia spent numerous hours reading and thinking about food though denying herself the comfort of food and nutrition which clearly showed an obsession with food. Janet while working with Nadia proceeds to write his thoughts about her disorder indicating “her refusal of food to be consequence of idea, a delusion” (Habermas, 2005). Additionally, Janet conveys Nadia’s fears to originate from her view of having a bloated figure or overstuffed appearance due to her extreme fear of being overweight like her mother (Habermas, 2005). Janet’s work with his patients provided insight indicating that anorexia nervosa has been a problem for at least a thousand years, maybe even longer. While Janet’s study of his patients offers awareness into the continuing presence of the illness, more present studies indicate the prevalence of anorexia nervosa to have steadily increased over time. A distinct picture is provided by one such study which examined cases during the time periods from 1958 to 1962, 1968 to 1972 and 1978 to 1982. The occurrence of anorexia nervosa patients admitted for treatment more than quadrupled during this time (George et al., 1987). This increase can possibly be attributed to the continuous lack of understanding regarding the underlying cause of this illness. Theory insinuated the cause of anorexia nervosa to be organic even though the illness was originally thought to be primarily a psychological disorder. In current times the origin of the disorder has reverted back to psychological in nature (George et al., 1987). Two neurotransmitters struggle concerning regulation in the presence of eating disorders. Individuals afflicted with anorexia nervosa are commonly plagued with unregulated dopamine levels. Dopamine assists in regulating thought processes as well as mood and behavior. Furthermore dopamine assists in regulating appetite and eating patterns. Serotonin, a neurotransmitter which is responsible for regulating feeding, the awareness of pain, motor activity, sexual behaviors, temperature regulation in the body and sleeping cycles is also associated with anorexia nervosa (Mulvihill et al., 2006). Various symptoms and signs become apparent when these regulatory actions become impaired in anorexia nervosa cases. The urgency of the illness stems from the overabundance of potential complications to malnutrition. Lowered blood pressure, bloating, or swelling and a decreased heart rate will often be experienced by the individual diagnosed with anorexia nervosa (Mulvihill et al., 2006). Cardiac arrest, abnormal heart rhythm or sudden death can be caused as a result of lost electrolytes and possible dehydration due to the affected metabolic process (Mulvihill et al., 2006). Loss of calcium which is crucial to bone health is a complication that may be experienced in later years. The anorexic is at an increased risk of developing osteoporosis due to this insufficient calcium intake (National Alliance on Mental Illness, 2008). Because of the anorexic individual’s distorted self image and flawed thought processes’ concerning eating habits and weight the illness goes from a psychological concern to a legitimate medical concern which requires a varied method of treatment. One’s medical doctor who recognizes specific symptoms and signs associated with anorexia nervosa such as: dryness or yellow tone to the skin, emaciation, a downy-type growth of body hair and significantly low blood pressure will prompt him or her to give a diagnosis of anorexia nervosa (Frey, 2005). Additionally, complaints of abdominal upset such as: pain, vomiting, or constipation may be noted by the doctor. Female anorexics may have stopped menstruation and may be experiencing decreased energy levels. As a result of temperature regulation being compromised, the patient may routinely complain of feeling cold. Moreover, the doctor may notice signs of tooth decay or reduced tooth enamel if vomiting is a complaint of the patient. Additional measures including a weight loss history will be taken to come to a definitive diagnosis. A definitive anorexia nervosa diagnosis will normally result in the individual being at or below 85% of their standard weight (Frey, 2005). Other medical conditions which can cause metabolic disorders induced weight loss, including digestive disease and tumors will need to be ruled out. Furthermore the possibility of other mental illness including social phobia, body dysmorphic disorder and obsessive compulsive disorder will need to be ruled out by either a psychologist or the doctor. It is important to be aware that many individuals diagnosed with this illness will frequently have numerous mental illness diagnoses even though these disorders can frequently be ruled out as the cause of the anorexia nervosa symptoms and signs (American Psychiatric Association, 2009). Anorexia nervosa treatment has changed over the years as much as the hypothesis of anorexia nervosa’s origin. The illness is currently dealt with through multiple angles though it was originally dealt with almost completely through psychotherapy in the late fifties through the early sixties. Current treatment includes family therapy as well as group therapy, even though individual psychotherapy is still vital to successful treatment. Occasional antipsychotic medications are prescribed along with antidepressants which are commonly prescribed as well (George et al., 1987). In order for the patient to realize more positive eating habits, nutritional education is also crucial. Admission to a hospital is necessary in severe cases of anorexia nervosa. Patients having a weight below or equal to 60% of the standard weight for height and age require hospitalization. Additionally, there may be cumulative signs of depression, suicidal risk or psychosis in patients binging and purging uncontrollably. Extended consequences are likely regarding people close to the patient in these severe occurrences. The family living with and caring for the anorexic may feel they are in the midst of a crisis (Frey, 2005). The patient’s environmental circumstances can either hinder or aid his or her treatment. The patient may try to hide his or her disease from friends and family. Due to the frequent occurrences of denial in those suffering from this illness, diagnosis and treatment may be difficult if not virtually impossible. The people close to the individual suffering from anorexia nervosa may be oblivious to the serious battle going on inside of their loved one’s mind; this is because many individual’s with anorexia nervosa are commonly “overachievers” (Mulvihill et al., 2006). Success is significantly increased, if, instead, family and friends recognize the related signs and symptoms of the illness and voice concern or encourage medical or psychological evaluation, diagnosis and treatment. The anorexic will be more likely to adhere to treatment plans with a support system of educated individuals. Anorexia nervosa is a complicated illness which extends back throughout history. The agreement holds true the illness is the unequivocal result of psychological disruption even though the cause has been hypothesized from numerous perspectives. The individual experiences a condition of malnutrition from this complex disease which regularly leads to secondary health problems due to the body’s inability to function correctly. Severe health complications or death may be experienced as a result of these malfunctions. Immediate diagnosis is critical in order to combat long-term health problems. In order to retrain the individual regarding healthy eating habits and nutritional intake, psychotherapy on the individual, group and family levels as well as medical intervention must be used. Additionally, to deal with compulsions and negative thought processes anti anxiety or anti depressants medications may be necessary. Compliance with treatment plans by the anorexia nervosa diagnosed individual will ensure a low risk of relapse and an excellent prognosis. References American Psychiatric Association, (2009). Diagnostic and statistical manual of mental disorders (4th ed.). Arlington, Va: American Psychiatric Association.Retrieved on July 15, 2011 from Gale database. Frey, R.J. (2005). Anorexia Nervosa. The Gale Encyclopedia of medicine, 3rd ed.. Retrieved on July 15, 2011 from Gale database. George, D.T., Weiss, S.H., Gwirtsman, H.E., & Blazer, D.(1987). Hospital treatment of anorexia nervosa: A 25 years retrospective study from 1958 to 1982. International Journal of Eating Disorders, 6 (2), 321-330. Retrieved on July 15, 2011 from EBSCOhost database. Habermas, T. (2005). On the uses of history in psychiatry: Diagnostic implications for Anorexia nervosa. International Journal of Eating Disorders, 38 (2), 167-182. Retrieved July 15, 2011 from EBSCOhost database. National Alliance on Mental Illness. (2008). Anorexia nervosa. Retrieved on July 15, 2011 from Google database. Mulvihill, M. L., Zelman, M., Holdaway, P., Tompary, E., & Raymond, J. (2006). Human diseases: A systemic approach (6th ed.). Upper Saddle River,NJ: Pearson Prentice Hall. Retrieved on July 15, 2011 from Google database.