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Stress, the natural reaction of the body during any moment of danger that requires adaptation or response, can be triggered by both real and perceived threatening situations. The observed situation of danger can be an actual event or a situation perceived as “dangerous” by the mind. The stress response that emerges to protect the individual can disrupt the quality of life and functionality when excessively observed. Read more

Sleep is among the basic physiological needs of living things. The purpose of sleep is to allow the body to rest and renew its energy. Sleep has an important role for the continuation of human life in a healthy way both physically and mentally. A quality night’s sleep helps to regulate the hormonal balance that affects the metabolism and appetite physically, helps the body to renew itself and heart health, as well as to protect mental health.

Sleep is a biological process that repeats every night and consists of cycles. A full sleep cycle takes 70-120 minutes. The four stages of sleep go through cycles. The first three stages are NREM, and the fourth stage is REM sleep. In the first two stages, non-REM sleep is experienced, and in the third stage, Slow Wave Sleep, also known as Delta Sleep, is experienced and deep sleep is entered. In deep sleep, the cells undergo a self-repairing process and the body’s energy is renewed. Memory and learning functions are activated in REM sleep.

There is a complex relationship between sleep and psychology. While sleeping, there is an increase in activity in the amygdala and hippocampus regions, which perform the task of emotion regulation in the brain. With this increase in activity, mental functions and emotional stability are preserved. Poor sleep quality and insufficient sleep affect mental health and cause mood disorders. Poor quality sleep can cause psychological problems, as well as psychological problems can cause poor quality sleep. When sleep quality decreases, it becomes difficult to manage psychological problems. In the literature, the most common psychological problems as a result of poor quality sleep are known as depression and anxiety. In addition, poor quality sleep affects the treatment negatively in individuals receiving psychological treatment.

A quality sleep makes the person feel energetic and ready for the day. When sleep quality is poor, inattention, perception and memory problems, emotional lability, hallucinations and delusions, and excessive stress can be experienced. Accordingly, the social life, working life, physical and mental health of individuals can be affected. According to the theory of brain plasticity, the purpose of sleep is to help neurons reorganize. According to the researches, unnecessary information is deleted during the sleep process, thus contributing to memory. In addition, short-term memories are transformed into long-term memories. It is known that when you are very tired, it becomes difficult to remember things. This is due to the lack of adequate quality sleep. A good night’s sleep not only helps the body rest, but also helps organize and store memories in the brain. Quality sleep is essential for storing newly learned information. Quality and regular sleep helps memory work better.

A good night’s sleep lowers blood pressure, protects heart health, and reduces stress by creating a state of relaxation that helps to stay calm. When the human body cannot rest enough, it can produce high levels of stress hormones as a result of the fast pace of daily life. A quality sleep prevents this. In addition, the increased stress hormone makes it difficult to fall asleep. For this reason, regular quality sleep helps to stay away from stress, and a stress-free life increases sleep quality.

Quality sleep is essential for maintaining mental health. Physical activity, diet, sleep environment and stress level play an important role for quality sleep. Regular exercise during the day has a significant effect on sleep quality. Nutrition and sleep are highly interrelated. Not consuming sugary and processed foods before bedtime and avoiding excessive caffeine consumption increase sleep quality. Like physical activity and diet, the sleep environment is also very important for good sleep. Sleeping and waking up at the same time every day, regulating the sleep time and sleep environment improves sleep quality. It is necessary to stop using electronic devices before going to sleep. The use of electronic devices causes the brain to become active and the mind to rejuvenate, reducing the amount of melatonin and prolonging the time to fall asleep. The hormone melatonin regulates the body’s biological clock. In order for the melatonin hormone to be secreted, a dark environment must be provided. Stress level is also known to affect sleep quality. When the stress level is high, the state of arousal increases and it becomes difficult to fall asleep. This can cause sleep disorders. The emergence of emotions and negative thoughts experienced during the day at the time of sleep affects the quality of sleep negatively. When such situations occur, a mental health professional should be consulted.

Somatoform disorders, or somatoform disorders, are excessive preoccupations with physical symptoms or one’s health, although they do not have any medical equivalent. These disorders have a wide variety of classifications such as somatic symptom disorder (somatization), illness anxiety disorder (hypochondriasis), conversion disorder (conversion), and factitious disorder. Thoughts about bodily symptoms or being sick can be disturbing, as they can harm individuals’ interpersonal relationships as well as their functioning in daily and professional life.

Achieving a psychological integrity and maintaining a state of well-being is related to the harmony between body, thoughts and emotions. The idioms used in daily life such as “staying in the crop of joy, breathing through the nose, jumping into the blood brain, turning pale, knotted in the throat, coming to the mouth of the heart” actually show that emotions such as anger, sadness and fear are experienced through the body. From time to time, emotions that cannot be expressed in the person, some unresolved internal conflicts and exaggerated perception of bodily sensations can be expressed by finding language in the body. What is meant by finding language in the body is that the person suffers from some symptoms and these symptoms do not have a physiological basis as a result of the doctor’s evaluation. In other words, individuals with somatic symptom disorders do have symptoms in their bodies that they really complain about, but there is no evidence to confirm this situation medically.

For example, a person who consults a doctor thinking that a chronic headache is related to a brain tumor and no problem is found in the performed brain imaging tests may experience temporary relief. However, after a short time passes, he repeats his concerns that he has a brain tumor, and in order to resolve these concerns, he can visit the doctor to get an opinion. In somatic symptom disorders, the person verbally says, “I feel sad, so I need some support.” He may say, “I have a headache” to meet this need. Another example might be that a woman who often argues with her husband faints to protect herself from the hurtful words she hears, and these fainting cannot be explained by a neurological finding. Individuals may need a concrete diagnosis that is expected to be made by a doctor, as the situation experienced may be difficult to accept by the person from time to time due to the psychological origin of the situation. Thus, they both avoid the pain of giving voice to suppressed emotions or confronting these emotions, and they can develop a secondary gain with the attention they receive from their environment. Because, unfortunately, in some cultures, emotional needs are generally not listened to much, but when the situation turns into physical/physical health, the needs expected from the environment can be met. Therefore, somatization is used by the person as a coping strategy.

In What Forms Can Somatic Symptom Disorders Occur?

Somatic symptom disorders can occur in various types. The first of these is somatic symptom disorder, which is characterized by physical symptoms such as pain, exhaustion and fatigue. People have intense anxiety that is disproportionate to the importance of the symptoms and their minds are constantly preoccupied with these symptoms. Even if it is proven that these individuals do not experience any problems at different doctor visits, their anxiety levels do not decrease. Another type is illness anxiety disorder, which is manifested by the worry that the person has or will have a serious illness such as cancer. In Illness Anxiety Disorder, the person may display excessive health behaviors such as frequent body scans for disease symptoms or avoiding the hospital because they may be diagnosed with a disease. In this disorder, people generally do not complain of a somatic symptom. In the case of physical symptoms (for example, dizziness on sudden awakening, temporary tinnitus, etc.), these symptoms are generally not a sign of any disease. Another disorder within the scope of somatic symptom disorders is known as conversion disorder. This disorder progresses with symptoms such as fainting, blindness, double vision, numbness in the arms or legs, impaired speech, and gait disturbances. However, these symptoms cannot be explained by a neurological or other medical condition. In another type of factitious disorder, people voluntarily create symptoms of a medical or mental disorder in themselves or in others (such as their children). The person shows himself or another person incapable of work, sick or injured, and for these people, hospitalization has become a way of life.

How does a child and adolescent psychiatrist work?

In recent years, awareness of psychiatric and psychological problems has started to increase in the society, and it has been realized that psychology is one of the most important areas in human life. With the increase in awareness and the expanding scientific literature, it has been understood that children and adolescents are not small states of adults, and knowledge about the mental states of children and adolescents has increased. With these developments and the increase in the number of specialists working in the field, the number of children, youth and families who applied to the child and adolescent psychiatry clinic has accelerated. However, due to the frightening reputation of psychiatry, many families still hesitate to apply to a child and adolescent psychiatrist. Child and adolescent psychiatrists, who have been trained for many years, have the ability to evaluate clients from many perspectives.

When children and families apply to a child and adolescent psychiatry clinic, the process usually proceeds as follows;

In the first interview, unlike other examinations, the child psychiatrist prioritizes establishing a warm, compassionate therapeutic bond with the child and young person.

He listens to the difficulties and problems experienced from many different perspectives and from different sources (family, teachers, experts in other fields) and tries to formulate them in his mind.

He requests tests and analyzes he deems necessary.

After formulating the difficulty, he shares it with the family and the child.

It offers treatment options based on the formulation that everyone agrees with.

Shares the advantages and disadvantages of treatment options with the family and the child. It enables the family and the child to take a role as part of the treatment or change.

Regulates psychopharmacological and/or psychotherapeutic interventions for psychiatric or psychological conditions.

Provides regular follow-up after treatment and interventions are arranged.

After sharing the processes that children and families can carry out with a child psychiatrist, I strongly recommend that they seek the opinion of a child and adolescent psychiatrist who has the ability to evaluate from different perspectives, and include a child and adolescent psychiatrist in the treatment team.

I wish you healthy days.

Posted by:

Dr. Sefa COŞGUN