If you are seriously considering studying psychology you are in the right place, because in this article I am going to talk about some important aspects that you should consider before rushing to enroll in your psychology school.

The first thing I would like to say is that Psychology is a beautiful, exciting career, with many different job opportunities and where there is always new information to learn.

You can choose between different specializations of psychology, from clinical to organizational psychology. Psychology is related to many areas of daily life: mental health, work environment, business, legal, social, etc.

But well, without further detours, let's focus on the subject that interests us: what are the most important aspects, in my opinion, to decide to study this career:

• Difficulty of the career: from my experience I would say that the difficulty of this career is medium. It is not one of the most difficult, but you have to study and dedicate time to it.
• Type of subjects: I recommend that before enrolling you take a look at the syllabus of the faculty you are interested in, to get an idea of the type of subjects you will have to study. This aspect is important because there are mathematics subjects, biology subjects, more theoretical subjects and quite difficult subjects with a rather cumbersome and abstract syllabus, such as the dreaded psychology of language and psychology of thought.
• Difficulty of the subjects: as I mentioned before, there are more accessible subjects and subjects to which you will have to dedicate more time. If you want to find out more about this subject, it is a good idea to seek opinions from students who are studying psychology at the faculty you are interested in, because, although the subjects tend to have more or less the same content at all universities, the difficulty of the subject, the depth of the content and, above all, the difficulty of the exams is not the same in all educational centers.

• Career opportunities: this profession has many job opportunities, since a psychologist can work in a private psychology office, have their own office, work as a clinical psychologist in public health (this topic deserves a separate article), work in human resources and organizational psychology, work in social affairs, work in the justice system... As you can see, there is a lot to choose from.
• Specialties: as is usually the case in all degree programs, the first three years you will study subjects related to all the specialties and in the fourth year you will specialize in the mention that interests you most.The specializations offered depend on each university, so they vary from one university to another, but the most common are clinical psychology, social psychology, work and organizational psychology, legal psychology and basic psychology (more oriented towards research and teaching).

• Finally, you should bear in mind that when you finish your degree you will most likely have to study for a master's degree. Whether you want to work in a private psychology office or in public health, it is essential that you have a master's degree in general health psychology and, in addition, to work in public health you must pass the PIR exam (general health psychologist).If your idea is to work in human resources or in another field of psychology, other than mental health, the master's degree is not essential but almost, since companies are increasingly looking for more prepared workers.

I hope you found this article interesting and useful to help you solve some doubts about this beautiful and exciting career.

Positive psychology: the keys to happiness

What is happiness and how can we achieve it? We discover how we can be really happy with Seligman.

Positive psychology, pioneered by Martin Seligman (1990), is a relatively recent approach that studies various positive emotions and human strengths as necessary elements to achieve happiness. In this article you will discover the secret of happiness.

According to positive psychology, there are three main keys to happiness:

• Pleasurable life. It focuses on positive emotions that, although temporary, are necessary to achieve happiness (joy, gratitude, inspiration). These emotions provide us with immediate and subjective gratification and are short-lived, as we quickly become accustomed to them.
• The engaged life. To achieve more lasting happiness we need to keep these emotions in a constant state of flux by engaging in activities that we find highly satisfying and help us achieve our goals.
• Meaningful life. To give meaning to our lives we need to focus on something more than ourselves, which allows us to build a better world.

Seligman's theory of well-being (2011). As we said earlier, happiness is based on experiencing positive emotions and depends on the intrinsic value that each person attaches to these emotions. However, happiness is a highly subjective construct (as it depends on the context of each situation and the mood of the person) and difficult to measure empirically.In this theory, Seligman presents the PRISMA model that includes five essential elements for well-being:

It consists of the ability to recognize positive outcomes and have an optimistic and positive attitude towards the past, present and future.

Positive relationships.

Having positive and healthy social relationships with family, friends and our environment is of great help in achieving wellness.

Involvement or commitment.

Related to the importance of maintaining a commitment in our life to achieve our goals that provides us with a constant flow of positive emotions. To achieve that the fulfillment of our objectives is really satisfactory these must be something challenging and involve some superior ability, which implies passion and concentration in the task that we are developing.

Goals achieved.

Finally, the simple fact of reaching our goals is already satisfactory in itself.However, the achievement of the goals we set ourselves does not work in isolation, but must be accompanied by the other elements mentioned above. We must set different types of short, medium and long-term goals and strive to achieve them.

In short, to be happy it is very important to experience positive emotions on a relatively constant basis, to find meaning in our existence and give it a high value beyond ourselves, to feel useful to improve other people's lives and to build a better world.And, of course, it is also necessary to achieve our goals, whether they are more modest or more ambitious, more immediate or later, always bearing in mind that what costs us a little more effort is much more satisfying than what we achieve very easily.

To be really happy we must give meaning to our life, be aware that our existence is useful for something important.

Burnout syndrome: when work burns you out

Burnout syndrome (BS), also known as work burnout syndrome, was declared in 2000 as an important occupational risk factor by the World Health Organization (WHO) due to its capacity to put the sufferer's mental health at risk and, in severe cases, even his or her life.

BS significantly and prolongedly affects the individual's ability to perform his or her tasks at work and, by extension, to lead a normal and satisfactory life outside the work environment.

The most widely accepted definition of BS is Maslach's, which states that it is “an inadequate way of coping with chronic stress, the main features of which are emotional exhaustion, depersonalization and diminished personal performance”. Another definition of this syndrome comes from Gil-Monte: “a response to chronic work stress made up of negative attitudes and feelings towards the people with whom one works and towards one's own professional role, as well as the experience of being exhausted”. As we can see, both authors consider chronic work stress as the main triggering factor of this syndrome.

However, there are many other factors involved in the development of this syndrome such as: boredom, dissatisfaction with career development, low salaries, work overload, lack of motivation and stimulation at work and, finally, isolation.

On the other hand, in addition to these general factors, other personal factors are also involved that increase the susceptibility of people to suffer from BS: age (related to work experience), being a woman (since women tend to cope better with conflictive situations in the work environment), family environment (family stability is a protective factor against this syndrome), personality type (people with demanding, impatient, competitive and perfectionist personalities tend to suffer from this disorder more frequently).

Environmental factors involving significant changes in the individual's life (death of a family member, marriage, divorce, birth of children, etc.) also contribute significantly to the development of this síndrome.

Symptoms.

The clinical presentation of BS includes three components: emotional exhaustion, depersonalization and loss of the value that work had for the subject. These components, maintained over time, can lead to the development of clinical manifestations such as depression, anxiety, guilt, fear, anger, addictions, personality changes, weight gain or loss, memory loss, difficulty concentrating or sleep disorders. In the most severe cases the individual may even commit suicide.

These symptoms can be classified into different levels of severity:

Mild: minor complaints, tiredness or difficulty getting out of bed.

Moderate: at this level we can already observe cynicism, isolation, suspiciousness or negativism.

Severe: sluggishness, absenteeism, alcohol or drug abuse or self-medication with psychotropic drugs.

Extreme or very severe: excessive isolation, severe psychiatric disorders, suicidal ideation and self-harm (suicide).

Diagnosis.

The most widely used test in the workplace to diagnose this disorder is the Maslach Burnout Inventory, which consists of 22 items that evaluate the components of SB mentioned above (emotional exhaustion, depersonalization and decreased work performance).

Other questionnaires used to diagnose BS are: the Copenhagen Burnout Inventory (CBI), the Oldenburg Burnout Inventory (OLBI) and the Questionnaire for the Assessment of Burnout Syndrome at Work (this is the only scale that includes disillusionment as an important aspect to be assessed in the diagnosis of burnout).

Treatment and prevention.

Treatment and prevention of BS consist of learning different strategies that allow the individual to modify feelings and thoughts related to emotional exhaustion, depersonalization and decreased work performance.

The keys to achieve the objectives are based on:

- Realistic adaptation of expectations to reality.

- Balance between family, work, hobbies, friends, rest, etc.

- Fostering a good working environment.

- Avoiding work overload and excessively long working hours.

- Quality training within the working day.

Conclusions.

In this article we have learned about SB as a disorder framed in the workplace that can become extremely serious and have fatal consequences for the individual, and can even lead to suicide of the person suffering from it.

It is therefore very important that companies and the public health system invest the necessary resources in prevention and in diagnosis and prevention as early as possible to prevent workers from developing the most serious presentations of the disorder, as well as absenteeism and the excessive social security costs associated with long-term sick leave.

Depression: much more than sadness

Depression, or major depressive disorder, is a common mental disorder, affecting approximately 5% of adults worldwide. It is a serious disorder that can even lead to suicide, although there are effective treatments for even the most severe presentations. Women tend to suffer from depression at a higher rate than men.

The causes of depression

Depression is closely related to having suffered adverse life experiences, such as the loss of a job, death of a loved one or divorce. People who go through such situations are more likely to suffer from this disorder. On the other hand, depression significantly affects the functioning of the person in the different areas of his or her life (family, work and social) causing dysfunction and inability to perform daily activities.

The relationship between depression and physical health is also relevant. In this sense, depression can lead to the development of certain physical diseases (cardiovascular, diabetes, cancer) due to the bad habits that these patients tend to maintain, such as sedentary lifestyles, alcohol abuse or stress. In addition, it is very common for people suffering from serious physical illnesses to also develop depression.

Diagnosis and treatment

The most effective and widely used treatments for patients with depression are psychotherapy and psychotropic drugs.

Psychotherapy consists of trying to modify the patient's way of thinking, how he/she faces certain situations and how he/she relates to others.The main psychotherapy treatments are:

• Behavioral activation
• Cognitive-behavioral therapy
• Interpersonal psychotherapy
• Problem solving

On the other hand, the psychotropic drugs used in the first line of treatment of depression are selective serotonin reuptake inhibitors (SSRIs), commonly known as antidepressants.

Self-care in people with depression.

Although psychological and psychopharmacological treatments are necessary to cure depression, these patients can also carry out changes in their habits to increase the effectiveness of the treatments and obtain faster results.

The patient should:

• As far as possible, continue to engage in activities that make him/her enjoy.
• Maintain contact with trusted family and friends with whom he/she can talk about how he/she feels.
• Try to exercise often, as well as maintain a healthy diet and proper sleep hygiene.
• Avoid alcohol and any kind of drugs.

In the most severe cases, the patient may present suicidal ideation. In these cases it is essential that the patient contacts the health services as soon as possible.

Post-holiday syndrome: what is it and why do we suffer from it?

Summer has recently ended and we have enjoyed a well-deserved vacation. But now it is time to get back to work. If these days you feel more tired than usual and do not feel like anything read on, because you may be suffering from post-holiday syndrome.

During the summer vacations we have enjoyed moments of relaxation, peace, rest and disconnection from the daily routine, but returning to work, schedules, rush and traffic jams can be an unpleasant experience. This change, which often occurs suddenly (one day we are lying in the sun on the beach and the next day in the office in front of the computer), can cause us to experience symptoms similar to those of depression such as anhedonia, or the lack of desire to do anything, boredom, tiredness, sadness, anxiety, etc. This adaptive disorder is known as post-vacation syndrome or post-vacation depression which, although in most cases it is a transitory disorder that usually lasts from 3 to 21 days approximately, in some occasions it can derive in a more serious problem.

What can we do to reduce or avoid these symptoms?

The best remedy to overcome post-holiday depression is to adopt a series of preventive and adaptive habits so that the return to routine is as progressive as possible:

• Return to the usual home a few days earlier: although we may feel like stretching the vacations as much as possible to enjoy them to the fullest, the adaptation to the routine will be easier if we return home two or three days earlier.
• Adapt the schedules progressively: it is convenient to abandon the vacation schedules and introduce the schedules of the rest of the year little by little.

• Recover eating habits and physical exercise: during the vacations we tend to relax more both in terms of food and physical exercise, as we usually eat more meals and dinners out, consume less healthy food, more alcohol and do less sport.A few days before the end of the vacations we should try to return to the healthy habits we maintain during the year, with a healthy and balanced diet and regular physical exercise.

• Prioritize work tasks: if you see that you have too many tasks when you return to work, try to prioritize them and carry out the most urgent ones first. This way you will avoid getting overwhelmed.
• Enjoy your free time: try to enjoy the free moments during your working day, and on weekends rest and spend time with your family and friends.

By following these simple tips you can return to work in a smoother way and avoid post-holiday depression or, at least, alleviate its symptoms.

Attention Deficit Hyperactivity Disorder (ADHD)

This mental disorder consists of a combination of three main problems: attention problems, hyperactivity and impulsivity. As we will see below, depending on how these problems are combined, there will be three different types of ADHD with a predominance of attention deficit, hyperactivity or impulsivity.

Symptoms

The main symptoms of this disorder are:

• Frequent daydreaming
• Frequently losing things
• Forgetting important things, such as school books in order to do homework at home.
• Being restless and unable to stop
• Excessive talking
• Being careless, leading you to make mistakes
• Difficulty waiting their turn or interrupting other people's conversations

As mentioned above, the combinations produce three distinct presentations:

• Predominantly inattentive: difficulty completing tasks, paying attention to details, and following instructions.Easily distracted.

• Forgets details of daily routines.
• Predominantly hyperactive: cannot sit still, talks excessively. Difficulty sitting still or sitting in situations where he/she is expected to sit still, such as in class or at mealtimes. Often disturbs classmates in class. The person feels restless.
• Predominantly impulsive: interrupts others a lot, snatches things out of their hands without asking permission, or speaks at inappropriate times. Difficulty waiting their turn or listening to instructions. They tend to get into dangerous situations or have accidents more often than usual.

In some cases the presentation of the disorder occurs as a combination of symptoms without any particular predominance, resulting in a combined presentation.

Diagnosis.

To diagnose this disorder we must take into account the following criteria:

• That the symptoms have been present for more than 6 months.
• Although ADHD symptoms are common in all children, in ADHD they are significantly more pronounced.
• The intensity of the symptoms does not correspond to the child's developmental level.
• Symptoms must be present in at least two different settings, such as at home and at school.
• Symptoms must appear before the age of 12 years.
• Significantly affect functioning at home and at school.

Treatment.

The most common treatment for ADHD is a combination of cognitive-behavioral therapy and psychotropic medication.Psychotropic drug therapy consists of short- and long-term administration of stimulants such as methylphenidate or dextroamphetamine.

The most common adverse effects of these drugs are:

• Headache
• Insomnia
• Stomach pain
• Lack of appetite
• Tachycardia and arterial hypertension.

Emotional intelligence: how emotions influence us

Emotional intelligence (EI) is a construct that is currently very relevant in the field of psychology, since it was popularized by Daniel Goleman in 1995.

But what is emotional intelligence?

We can say that emotional intelligence studies how we can influence our emotions in an intelligent and adaptive way, at the same time it also shows the influence of emotions in making important decisions, such as the work we do or the partner we choose, which are not determined only by logic and purely practical aspects.

The correlation between intelligence, which refers more to our ability to adapt to our environment logically and analytically, and emotional intelligence is rather low. This explains why people with a much higher than average intelligence quotient (IQ) have fewer social skills, tend to be more solitary and are less successful in romantic and social relationships than people whose IQ is more modest but, on the other hand, have an easier time achieving satisfactory romantic and social relationships, including in many cases at work, which provides them with greater well-being in general.

Elements of emotional intelligence.

Goleman points out the main elements of emotional intelligence, which are the following:

•  Emotional self-awareness: this concept refers to the knowledge we have about our own emotions and how they influence us. This aspect can help us to know when we can make important decisions and when we cannot. For example, it can help us to detect in ourselves high intensity emotions, both positive and negative (being excessively happy or sad) and thus postpone our decisions for a few days, as far as possible, until our emotions are more balanced.
• Emotional self-regulation: allows us to know how to recognize, regulate and control our emotions so that they do not dominate us when they are too intense.
• Self-motivation: emotions properly oriented towards objectives and goals allow us to maintain our motivation to achieve these objectives or goals. For this it is essential to be optimistic and have initiative, which allow us to be proactive and act with tenacity and positively.
• Empathy: refers to the recognition of emotions in others. It is a very important skill for maintaining satisfactory and healthy personal relationships, establishing closer and lasting bonds with other people. People who are more empathetic have greater EI-related skills.
• Social skills: social skills are those that allow us to relate to others in an appropriate way, whether they are pleasant, friendly and close to us or not. This concept is closely related to EI, since thanks to it, in addition to basing ourselves on how others make us feel, we also take into account the circumstances that cause others to behave with us in a certain way and thus react with them in a more rational and less visceral way.

Mindfulness

In this article we are going to know the technique of mindfulness, and we will explain its differences with meditation. Basically, mindfulness is a therapy based on focusing attention on breathing, which includes the practice of meditation.

What is mindfulness?

Mindfulness is a 2500 year old technique that we in the West have adopted from Buddhist culture. As we know, Buddhist monks use meditation on a regular basis as a way of getting in touch with their most spiritual side.

Anyway, it is important to emphasize, and this is one of the main differences between mindfulness and meditation, is that mindfulness is not related to any tradition or religion in particular, but it is a tool used to improve the quality of life of people, related to maintaining the attention focused on breathing and the here and now (hence its name, mindfulness).

This technique consists of focusing attention on the present moment, trying to achieve mindfulness. To do this we must focus our attention on the thoughts and feelings that arise without qualifying them as good or bad and without judging them, simply accepting them. It is important to perform this technique correctly to be able to disconnect from noise and distractions.

Mindfulness began to be used in 1979 at the University of Massachusetts Hospital by Dr. Jon Kabatt-Zin as a therapy for stress reduction.

Subsequent studies have shown that this technique performed properly and several times a week is very beneficial for our mental and physical health, as well as presenting other benefits such as improving self-control in children, increasing resilience and coping skills in sick people, to reduce stress and anxiety, to improve concentration and memory, to ignore intrusive thoughts and to improve chronic pain.

How to practice it?

At first the practice of mindfulness can be complicated. Therefore, we should start practicing a few minutes a day and gradually increase to 30 minutes a day. It is possible that at first we do not notice changes, but despite them, we must be constant and not give up the practice.

Tips for performing the technique:

- Find a quiet time of the day, making sure that for a few minutes you can have a place without noise or interruptions. It can be at any time, when you get up, before going to bed, in the afternoon. Any time is good, as long as you are guaranteed a few minutes of quiet.

- Choose a suitable place in a relaxed environment: it is essential to choose a place without noise, without external distractions, with adequate lighting and temperature. A place where you feel completely comfortable and at ease.

- Wear comfortable clothes: this is another very important aspect. You should wear clothes in which you are completely comfortable so that you can focus your attention fully on your thoughts and feelings. Position yourself in a comfortable posture, in which you can stay for about 30 minutes. It can be sitting cross-legged, or leaning against a wall, or lying on the floor on a pilates mat.

- Focus your attention on your breathing: concentrate on how the air enters through your nostrils and reaches your lungs and the rest of your body. And then pay attention to how it leaves your body taking with it all the bad and negative.If your mind is distracted from this task you should refocus it on your breathing.It may be difficult at first, but with practice and perseverance you will get there.

- Let thoughts and feelings appear freely and “observe” them without judgment. Try to deal with it as impersonally as possible.

You can accompany the practice with relaxing music specially designed for mindfulness and meditation. On youtube you will find many videos with this type of music. It is important that you make sure that they do not contain ads.

Here is an example:

Psychology in natural disasters: what role do psychologists play?

Recently we valencians have suffered a terrible natural disaster, the DANA, which according to official sources has left more than 200 dead and thousands of victims who have lost family members, homes, material goods and businesses.

But what role do psychologists play during natural disasters?

Emergency and disaster psychology.

This branch of psychology is in charge of trying to return victims of natural disasters and emergencies to normality, providing psychological support through the techniques that we will see below.

According to Acevedo and Martinez, 2007 “emergency and disaster psychology is the branch of psychology that covers the study of the behavior and reaction mode of individuals, groups or human collectives in the different phases of an emergency or disaster situation”.

The role of the psychologist.

Psychologists in this field work in a multidisciplinary manner with other professionals such as physicians, social workers, engineers, firefighters, volunteers, Red Cross, etc.

The authors mentioned above cite the following as the main intervention techniques in disasters and emergencies:

- Interventions in bereavement situations.

- Psychological demobilization techniques for critical incident management.

- Therapeutic group intervention for evacuees.

- Community intervention techniques oriented to the recovery of social networks and support.

- Integration of first response teams participating in training programs, designing containment programs.

The choice of one type of technique or another will depend on the type of disaster, the behavior of the people affected, the severity and the different circumstances of the particular disaster.

It is important to add that this type of intervention puts a great deal of pressure on the psychologists who work in it, so not everyone is prepared for it. It is necessary to have a great technical and mental preparation, as well as a vocation to intervene in complicated situations. Psychologists during and after natural disasters face high stress and anxiety reactions from the victims, as well as post-traumatic stress disorders, panic attacks and grief. What the psychologist must achieve is to regulate emotions and psychological crises at the individual, group and community levels.

Beltrán, Valero and García (2007), state that according to Puertas (1997) the training and the different competencies essential for an emergency and disaster psychologist should be the following:

- Social skills.

- Communication techniques.

- Knowledge of collective behavior.

- Technical knowledge of emergency intervention.

The psychologist must be able to create an environment of protection and assistance in the midst of chaos, facilitating a climate of trust in individuals and groups and regulating the negative psychological reactions that arise. They must also be prepared to provide this assistance, in addition to the victims, to the other professionals who intervene during and after the disaster, since they may present the same reactions and psychological disorders as the victims themselves.

Perinatal bereavement

What is perinatal bereavement?

Perinatal grief, also known as gestational grief, is the grief suffered by parents who lose a child during pregnancy, during childbirth or a few days after delivery.

It is a type of grief that is not socially recognized and that parents usually face in silence, since the baby has not been born or they have not lived with him/her, added to the absence of memories, people usually minimize and do not understand the pain well. In spite of this, it is necessary for parents to go through the different stages of grief in order to reach acceptance.

It must be taken into account that from the moment we learn of the pregnancy we are already parents and we already feel like parents, and we have already established this bond with the future baby. Therefore, it is necessary to consider this grief as any other grief for the loss of a child.

The phases of grief

The phases to go through in perinatal bereavement are the same as in any other type of bereavement. These phases usually occur in a specific order, but they can also overlap with each other, or even re-experience a phase that was already considered to have been overcome. The ultimate goal is acceptance, which does not mean forgetting the deceased child, but learning to live with the loss.

The phases are:

- Denial: at first the person, as a protective strategy, denies that the loss has occurred. This is considered the most difficult stage to overcome, since due to denial the person may be avoiding grief.

- Anger: when the person recognizes the loss, he/she feels frustrated and angry. It is a stage that is usually very influenced by the circumstances of the death, especially if there have been violent deaths, accidents, sudden deaths, etc.

- Sadness: this is the most common feeling during bereavement. It is at this stage that the person really begins to be aware that the deceased is not coming back. The most common symptoms are sadness and difficulty concentrating and sleeping.

- Acceptance: this is the stage when the person finally accepts the loss and begins to adapt to the new situation. In this phase it is easy that acceptance does not occur completely and there is a regression to previous stages.

How to cope with a perinatal loss?

Parents who are going through a perinatal bereavement can use the following strategies to get through it in the best possible way:

- Do not repress the pain derived from the loss, since it is completely normal.

- Keep mementos of the baby. A good option is to have a keepsake box with clothes, hospital identification bracelet, ultrasound scans, etc. It is also a good idea to name the baby and refer to him/her by the chosen name.

- Seek support from family, friends or groups of people who have experienced the same loss. This provides a sense of understanding, companionship and support. It is also beneficial to seek professional help.

It is important that the environment, friends and relatives of the parents do not minimize their pain, listen to them and accompany them and show their support, let them know that you are willing to help them in whatever they need, and finally be available but respecting that the couple prefers to be alone at certain times, but making it clear that they can count on them at any time.

Psychopathy

Psychopathy, or antisocial personality disorder, is mainly characterized by three components: little respect for established social norms and the law, mistreatment of things, animals or people, and lack of empathy, that is, being insensitive to the feelings of others and not establishing bonds of authentic friendship and love. Psychopathic people establish bonds with other people, they even appear charming in the eyes of others, but it is always to obtain some benefit for themselves even if it is at the cost of harming whoever it may be. They are very manipulative and are capable of distorting the truth or even lying to achieve their goals.

The main traits of psychopathy are:

- Great verbal ability and being superficially charming.

- They have an inordinate self-esteem.

- Tendency to boredom, they need stimuli constantly.

- They lie in a pathological way to manipulate.

- They show a malicious behavior.

- They do not experience any feelings of guilt, compassion or remorse.

Contrary to what many people think, psychopaths' lack of empathy does not mean that they do not understand the emotions of others. They have an understanding of what emotions are but do not experience them on an emotional level, so they are insensitive to them. They know what emotions to simulate in any situation, but they do not genuinely feel the emotion. For example, at a funeral they will appear sad, but they are not really sad. The same goes for joyful situations. They appear congruent to others without experiencing any emotion.

On the other hand, they feel no remorse if they make other people suffer in order to get what they want.

All these traits (manipulation, absence of morality and ethics, insensitivity to the feelings of others) together with cruelty and focusing exclusively on themselves and their own interests are together called machiavellianism.

Lying is an instrument they use to achieve their objectives both in the work environment and in their personal relationships, taking advantage of the good intentions of the people they manipulate. In addition, this way they achieve a more favorable image of themselves and avoid the responsibilities derived from their own actions, since they always try to hold someone else responsible.

The lack of impulse control has serious consequences in the behavior of psychopaths such as the need for immediate gratification, lack of responsibility for their own actions, lack of long-term commitment, dangerous and risky activities, which can lead to legal and economic problems.

They also have an excessive need for control over people and situations and an exaggerated response to frustration, so if they do not get everything under control and get what they want they can have angry and aggressive reactions.

Narcissism at the core of the psychopathic personality.

Perhaps narcissism is the best known and most characteristic trait of people with this disorder.

They have an exaggerated perception of their abilities and skills, as well as of their importance with respect to others, which leads them to be arrogant and egocentric, to belittle others and to have a constant need for admiration. For them the world revolves around themselves, so they are able to get what they want in any way they want, without caring about the consequences of their actions on others or worrying about the feelings of the people they hurt and manipulate.

Narcissism also leads them to keep their self-esteem always at an excessively high level, so they always try to relate to easily manipulated people, whom they can control and feel superior to them.

This need to control and feel superior to others leads them to seek positions of power and dominance both at work, socially and as a couple. 

If you want to know more about this disorder you can watch two videos related to this topic in the youtube section. 

Psychopathy in children

In a previous article we knew about psychopathy in adults. In this article we will describe the appearance of this disorder in children.

Although psychopathy usually appears after the age of fifteen, sometimes its first symptoms can be observed at much earlier ages.

As in the case of adults, the main characteristics of child psychopathy are the lack of empathy and feelings of guilt. Thus, we find children who do not empathize with others and who commit cruel acts without any remorse.

Despite its similarities with the presentation of the disorder in adults, there are also some differences.

Symptoms of psychopathy in children

- Non-compliance with the basic rules of coexistence: such as systematically and intentionally breaking things or hitting other children and even adults.

- Explosions of violence: related to mistreatment and cruelty to people and animals.

- Animal abuse: they often “play” at maiming, hurting and killing animals, from insects to cats and dogs.

- Punishments for their bad actions do not usually work, because even if they know that what they have done is wrong, they do not care at all. Therefore, the best strategy is to avoid situations in which they may engage in undesirable behavior.

- Nocturnal enuresis or encopresis: another characteristic feature that these children usually present is the lack of sphincter control during the night. They usually show enuresis (lack of sphincter control for urine), but sometimes there may also be encopresis (lack of sphincter control for stool).

Causes

Psychopathy is not caused by a single cause. Studies have shown that genetics is very important in its appearance. There are brain lesions that can also lead to the presentation of typical symptoms, such as lesions in the frontal lobe (responsible for functions such as judgment, impulse control, and social and sexual behavior).

It is also closely related to the continuous experience of stressful and traumatic experiences, as occurs in children living in dysfunctional homes where they suffer maltreatment and abuse.

What can parents do?

At present, there is no fully effective treatment for child psychopathy. If parents detect in their children the traits I have mentioned above, they should seek professional help immediately. Child psychologists usually use psychotherapy both individually, with the parents and with the family as a whole. This by no means guarantees that the child will behave normally, nor that he or she will achieve empathy and feelings of guilt. But it may be possible on occasion to control these traits so that the child does not develop full-blown psychopathy in adulthood.

Sleepwalking

This disorder is more common in childhood, up to adolescence, than in adulthood. It is characterized mainly because the person gets out of bed while asleep, being able to perform complex activities.

In cases where it occurs infrequently, it is not considered serious and does not require treatment. But if it happens very frequently it may indicate a sleep disorder.

Symptoms

Sleepwalking episodes usually occur during the first half of the night, about one to two hours after the person falls asleep.

Activities that people usually do during these episodes include:

- Sitting up in bed with their eyes open, getting up, and walking around.

- Not answering when spoken to

- Not waking up easily. In fact, a sleepwalker should not be woken up, it is better to put him/her back to bed.

- In the morning, they usually do not remember the episode

- They can perform activities such as talking, eating, dressing, etc.

- Sometimes these activities can become dangerous if they go out of the house, drive a car, look out of a window or balcony, etc.

- Occasionally they may engage in aggressive behavior

Causes

The causes of this disorder are varied:

- Not enough sleep

- Stress

- Temperature

- Alterations in the sleep schedule

Other factors that can cause sleepwalking episodes include:

- Breathing disorders during sleep, such as obstructive sleep apnea

- Certain medications, such as hypnotics or sedatives

- Drug or alcohol abuse

- Restless legs syndrome

- Gastroesophageal reflux

Two other important factors in the development of sleepwalking are genetics and age. A person will be more at risk if a family member also suffers from sleepwalking. And it is more common in children than in adults, decreasing in incidence after adolescence.

Recommendations for parents or relatives of sleepwalkers
- Do not wake the person during the episode, take him/her back to bed in a calm manner, avoiding scaring him/her.
- Remove obstacles or objects with which the person may hit or fall during the episode.
- Prevent the person from leaving the house or driving a vehicle.
- Prevent the person from leaning out of windows or going to high places such as terraces or balconies.
- Prevent the person from eating, to avoid choking risks.
- In general, avoid any situation that may involve some kind of danger for the person or for those living with him/her.

Oppositional defiant disorder (ODD)

All the children behave in a defiant manner at some time; however, this disorder is characterized by a constant and sustained pattern in which the child presents a defiant behavior towards authority figures, disobedient as well as spiteful and vindictive. That is to say, if for most children this type of behavior is occasional and in angry situations, for oppositional defiant children it is their habitual behavior.

This behavioral disorder causes serious problems both at home and at school, as well as in any social situation.

Symptoms.

In order to diagnose this disorder it is necessary that the child or adolescent presents the following symptoms continuously for a minimum period of six months:

- Irritable mood: easily loses patience and gets angry easily with others.

- He/she has a very sensitive character, is vindictive and resentful.

- Often argues and disobeys parents and authority figures in general.

- He tends to intentionally annoy other people.

- He does not assume his mistakes and blames others for his bad behavior.

- He is cruel with his words.

Three levels of severity can be considered:

- Mild: disruptive behavior is present in only one setting: home, school or friends.

- Moderate: may present several symptoms in two or more settings.

- Severe: presents challenging behavior in all settings.

Causes and risk factors

This disorder usually results from a combination of genetics and temperament and environment.

Children with a strong temperament and difficulty controlling their emotions and frustration are more susceptible to this disorder.

Problems with authority in the home (either by being too strict or the opposite) or living in a dysfunctional family with mentally disturbed or violent family members also predispose the child to this behavioral problem.

Complications

This disorder usually needs a professional psychotherapy intervention to be tackled. But if not remedied in time, it can lead to more serious problems and disorders that can last into adulthood:

- Problems in academic or work performance.

- Antisocial personality disorder (psychopathy).

- Problems with the justice system due to criminal behavior.

- Difficulty controlling impulses.

- Addictions to substances, gambling, etc.

- Suicide.

Comorbid conditions

The following pathologies may occur in combination with ODD:

- Attention deficit hyperactivity disorder.

- Other behavioral disorders

- Depression

- Anxiety

- Communication and learning disorders

For treatment for ODD to be effective, co-occurring disorders, if any, must also be treated.

Borderline personality disorder

This disorder is mainly characterized by producing in the person who suffers from it a great inability to control his emotions, which causes problems of impulsivity, self-esteem and deteriorates relationships with others.

Symptoms

People suffering from this disorder often experience impulsivity, insecurity and lack of self-esteem and rapidly and radically change their feelings towards other people.

The main symptoms are:

- Excessive efforts to avoid abandonment in their relationships, whether real or not.

- Intense and unstable relationships with family or friends.

- Impulsive and risky behaviors such as excessive spending, unprotected sex, reckless driving, etc.

- Use of addictive substances

- Self-destructive behaviors (cutting) or suicidal ideation.

- Feelings of emptiness

- Difficulties in controlling anger.

- Having a feeling of dissociation from one's own body, depersonalization and derealization.

Causes

This disorder usually appears as a result of a combination of predisposing factors:

- Family history: people who have close relatives with borderline personality disorder are more likely to develop it.

- Structural and functional changes in the areas of the brain related to impulse control and emotional control.

- Environmental factors: having suffered situations of mistreatment, abuse or abandonment during childhood. Or in adolescence or adulthood, exposure to major conflicts or having had unstable relationships in which they did not feel valued.

Comorbid conditions

The disorders with which this disorder most frequently co-occurs are:

- Post-traumatic stress disorder

- Major depression

- Bipolar disorder

- Anxiety disorders

- Substance abuse disorders

- Eating disorders

Treatment

The most commonly used intervention to treat borderline personality disorder is psychotherapy, which is mainly based on two techniques:

- Dialectical-behavioral therapy: this technique was developed specifically for the treatment of people with this disorder. It consists of being aware, recognizing and paying attention to the situation and the current emotional state. Strategies for controlling emotions, reducing self-destructive behaviors and improving relationships with others are taught.

- Cognitive-behavioral therapy: it is mainly based on modifying the mistaken beliefs that patients have regarding their perception of themselves, of others and of their relationship problems. This therapy can reduce self-destructive behaviors, mood swings and anxiety symptoms.

Regarding medication, there is no psychotropic drug considered effective for this disorder. But the drugs normally indicated to treat comorbid pathologies, if any, can be used.

Intermittent explosive disorder (IED)

It is a behavioral disorder characterized by intermittent and disproportionate explosions of anger and aggressiveness, sometimes for no apparent reason.

This disorder can cause serious problems in all areas: family, school, work, social and even legal.

Symptoms

Anger attacks usually last about 30 minutes and occur for no apparent reason and without warning. They may occur frequently or may be more widely separated in time.

In these outbreaks the patient may experience:

- Anger and irritability

- Elevated tension

- Tingling and tremors

- Tachycardia

- Tightness in the chest

The patient overreacts and may engage in the following behaviors:

- Tantrums and angry arguments

- Shouting

- Pushing, punching, slapping, etc.

- Fighting

- Breaking objects

- Threats or aggression to people or animals

After these outbreaks the patient may feel calm and tired. Later, he usually feels remorseful and ashamed.

Causes

It appears after the age of 6 years or in adolescence. Risk factors that may be involved in its appearance are:

- Learned behavior: having learned this type of behavior from reference adults at an early age such as, for example, having been raised in a home where the parents behaved this way. Also having suffered verbal or physical abuse or maltreatment during childhood.

- Genetics: there are studies that have concluded that there is a gene that may be responsible for exaggerated reactions of anger and aggression. This gene can be transmitted from parents to children.

- It is possible that there are differences in the structure and functioning of the brain in people who have this disorder compared to people who do not.

- Another important risk factor is having another disorder such as antisocial disorder or borderline personality disorder.

Complications

This disorder can lead to serious complications in many areas:

- Problems in family and couple relationships: due to habitual fights and both physical and verbal abuse that are generated during anger attacks. As a result there may be consequences such as divorce or legal consequences due to abuse complaints.

- Problems at work or at school: it is common for people suffering from TEI to be fired or expelled from school due to their behavior, which can also lead to legal problems.

- Other illnesses may arise from the disorder, such as depression or anxiety disorders.

- It can also have repercussions on physical health, increasing the probability of suffering cardiovascular problems, arterial hypertension, stroke, diabetes, etc.

- Sometimes they may have self-injurious behaviors or suicide attempts.

Treatment

Treatment consists of psychotherapy and medication to help control reactions and impulses.

The adaptive disorder

This disorder occurs when we experience a stressful event (change of city, change of job, change of school) and we are unable to adapt satisfactorily to the new circumstances because we cannot assimilate the stress involved.

Symptoms

The typical symptoms of the adaptive disorder usually have emotional and anxiety components:

- Low mood, sadness and crying.

- Worry, tightness in the chest and shortness of breath

- Insomnia

- Concentration problems

- Low self-esteem, hopelessness, inability to plan activities

- Feelings of loneliness

In children the symptoms are usually different from those of adults, with irritability, insomnia and poor academic performance being predominant.

The diagnosis is made by observing the patient's symptoms, which must significantly affect the patient's functioning and be disproportionate to the stressor.

Types of adaptive disorder

This disorder can present in various forms depending on the combination of the above-mentioned emotional, anxious, cognitive and behavioral symptoms:

- Predominance of depressed mood: with constant urge to cry and feelings of hopelessness.

- Predominance of anxiety: nervousness, worry or separation anxiety

- Combination of anxiety and emotional symptoms: where symptoms of the two previous types are observed.

- Predominance of behavioral disturbance: predominant symptoms are related to behavioral problems.

- Mixed disturbance of emotions and behavior: symptoms typical of depression, anxiety and behavioral disturbances appear.

- Unspecified: this type is used in cases of maladaptive reactions with symptoms that do not fit into any of the above categories.

Treatment

The intervention of choice to treat this disorder is cognitive-behavioral therapy.

The objectives are:

- Reduce and eliminate symptoms by restoring the patient's good functioning.

- Training in problem solving to help reduce or eliminate stressors.

- Reduce the negative consequences experienced by the patient.

- Provide the patient with effective coping skills.

- Using emotional intelligence to help the patient learn to relax, exercise, establish social relationships and manage emotions and stressors appropriately.

Psychosomatic disorders

Psychosomatic disorders are those in which a particular psychological condition causes or worsens a physical illness.

Just as physical illnesses can affect us psychologically, psychological ailments can affect our physical health.

Physical illnesses can be produced by negative coping styles, health-damaging behaviors and stress. Therefore, somatization can be said to be the physical expression of psychological distress.

Physical illnesses that may be influenced by psychological conditions.

- Cardiovascular: hypertension, tachycardia, episodic cardiac arrhythmias, Raynaud's disease, headaches and migraines.

- Respiratory: bronchial asthma, hyperventilation syndrome, allergies, respiratory problems.

- Gastrointestinal: peptic ulcer, irritable bowel syndrome, ulcerative colitis, functional dyspepsia.

- Muscular: tics, contractures, lumbago, tension headaches.

- Dermatological: pruritus, eczema, acne and psoriasis.

- Sexual: impotence, vaginismus, decreased sexual desire.

- Endocrine: Cushing's syndrome, hypothyroidism, hyperthyroidism.

- Immunological: decreased defenses, which can lead to cancer, allergies, rheumatoid arthritis and increased susceptibility to infectious diseases.

Treatment

Intervention in this type of disorders is usually pharmacological and psychological. The objectives are to reduce the patient's levels of anxiety and depression, training in the management of their emotions and learning coping strategies for the physical illness they are suffering from.

An important part of the intervention is to try to eliminate behaviors that can provoke physical illness or worsen it if it already exists (smoking, drinking alcohol, consuming addictive substances).

The aim of all this is to restore the person's functionality so that he/she can return to normal social, work and family life as soon as possible.

High abilities

A person is considered to have high abilities or to be intellectually gifted when his or her intelligence quotient (IQ) is equal to or higher than 130, i.e., higher than that of 98% of the population (98th percentile). However, today in the diagnosis of high ability, not only IQ is taken into account, but also other aspects such as creativity or learning style.

With the development of Gardner's theory of multiple intelligences, the concept evolved, and a person who was above the 75th percentile in all types of intelligence (linguistic-verbal, logical-mathematical, spatial, musical, bodily-kinesthetic, intrapersonal, interpersonal and naturalistic) was considered highly capable or gifted. This theory gives rise to another concept within high abilities, talent, which defines people who stand out in one, two or three of the aforementioned types of intelligence.

The high ability student.

The high ability student is one who has an intellectual capacity well above average and a learning style different from the rest of their peers, which requires a different intervention in their learning process, they are considered students with special learning needs in order to take advantage of their full potential, since, despite their high intellectual ability, these children are more likely to fail academically if an appropriate intervention is not made with them.  

Characteristics of children with high abilities.

- They are very curious children, who ask a multitude of complex questions.

- They are very sensitive, perfectionists and have a high sense of justice.

- They are very creative and like to do things their own way. They tend to have interests that are not typical of children their age.

- In their areas of interest they are able to learn very quickly and spend long hours absorbed in the subject matter, enjoying learning very much.

- Their vocabulary, reasoning skills and understanding of complex and abstract ideas are very advanced for their age.

- Asynchronous development: refers to different development in different domains. In the intellectual area they are above their age, but in the emotional or psychomotor areas they may be at the level of other children of their age or even below.

- Precociousness: they usually learn to read and write before others or do so independently.

Behavioral problems in children with high abilities.

The behavior of children with high abilities is often perceived by adults (parents and teachers) as defiant. They are usually children who talk back more than usual and who refuse or protest more intensely than others to any adult order, no matter how simple it may be (such as putting on their pajamas). They refuse to follow the rules imposed by a purely hierarchical question (you do it because I am your father/mother and you have to obey me). So the best strategy for dealing with these children is negotiation, giving logical and coherent reasons. They also complain a lot when they have to do school work that is not of interest to them. And they are easily frustrated with those they do not like or find difficult.

On many occasions, defiant behavior does not occur at home and at school at the same time. It can be in one setting, the other or both.

New Year's resolutions

It's the beginning of the year and many people make resolutions to make changes in their lives. This custom dates back to the end of the first millennium B.C. when a Babylonian king made a resolution to be a better ruler.

Since then, resolutions have evolved a lot and now the most frequent ones are to go to the gym, quit smoking, eat healthier, learn a language, etc.

In this article we will learn about the main New Year's resolutions and why most people fail to keep them.

Top New Year's resolutions.

In 1987, on New Year's Eve 231 people participated in a telephone survey asking them what they could do to improve their lives for the coming year. Most of the answers were related to eliminating unhealthy habits and changing them for healthier ones.

Normally in the New Year we propose a series of changes to our habits, such as going to the gym, eating healthier, learning a language, saving more, traveling more, etc. These are usually endless lists of 10 or 12 resolutions.

The researchers of the aforementioned study contacted the participants in the following months and found that only 8% (being optimistic) managed to achieve the goals.

Why do we fail so much in our New Year's resolutions?

Precisely the main reason for our failure is the extensive length of the list of resolutions: 10 or 12 habits strongly rooted in our daily routine and we want to change them all at once. It smells of failure. It is better to propose one change at a time and when you have achieved that one, start with the next one. We have a whole year to achieve this, it is not necessary to change all our habits in January.

For example, we can make a list according to an order of priorities. If our resolutions are to quit smoking, go to the gym, save more, learn a language, etc., we can start by quitting smoking. When we have achieved this, we can join a gym. When we have the habit of going to the gym a certain number of days a week we can consider looking for a way to save. Thus, little by little it is much more feasible to achieve our goals.

Another reason for failure is that we set very general goals and do not have a plan to achieve them. For example, the goal of going to the gym. “Going to the gym” is a very general phrase without a defined plan. To achieve this, it is advisable to draw up a concrete and realistic plan. Which gym am I going to go to? What activities am I going to practice? How many times a week can I go? We must think that we must be able to maintain the routine throughout the year.

Something that can help us to be consistent with our resolutions is to know why we set those goals. It is a good idea to write down on a piece of paper not only our goals, but also why we want to achieve them.

E.g. - instead of writing “eat healthier”, we can write “eat healthier, because I want to lose some weight and I want to be healthier”.

Another recommendation is to write down in a diary or keep a record of the days that we have fulfilled our purpose. This can serve as motivation to achieve our goals day by day.

And finally, my last recommendation would be to put the paper where we have written our goal and the reasons why we want to achieve it, in a visible place, such as the fridge, so we see it every day and remember it.

How to inculcate the habit of reading in children.

For most parents, getting their children to read on a regular basis can be a real challenge, as reading is usually not something that excites children.

However, it is very important to instill the habit of reading in our children, as reading has a myriad of benefits:

- Learning to read and improving their reading skills

- Increasing their vocabulary and improving their spelling skills

- Improve concentration, memory and imagination

- Exercise the brain and improve communication

How to get our children to read every day.

- Set an example, a child is more likely to be encouraged to read if he sees his parents or older siblings reading.

- Read with him, so that the reading time is a quality and pleasant moment for the child.

- It is advisable that the child chooses a time of day to read (for example, before bedtime), so it is easier to create a habit.

- He should also choose a place to read that is comfortable for him.

- Let him choose what he wants to read. He is more likely to read more if he reads books that interest him.

- The child should go to buy his books or borrow them from the library, thus increasing his involvement in reading.

- If the child has a favorite book, allow him to reread it as many times as he wants.

Cinema and mental disorders

Throughout its history, cinema has more or less successfully exposed a multitude of mental disorders, from psychotic disorders to anxiety disorders such as agoraphobia.

In this article I will mention 10 disorders that, in my opinion, are best represented in some films.

Contains spoilers from the movies.

Psychotic disorder.

Psychosis (1960). Norman Bates (Anthony Perkins) murders his mother after having suffered physical and psychological abuse since childhood, in addition to the abandonment of his father. As a result of his mother's murder he suffers a break with reality, acting as if she were still alive and having conversations with her that even lead him to commit two murders.

Schizophrenia.

A Beautiful Mind (2001). Based on a true story, it tells the life of John Forbes Nash, winner of the Nobel Prize in Economics, who suffers from paranoid schizophrenia. In this film the main characteristics of paranoid schizophrenia are revealed, such as visual and auditory hallucinations (as he sees and relates to people who do not exist) and the delusion of being persecuted and in danger for being involved in an international conspiracy related to espionage between the United States and Russia.

Obsessive-compulsive disorder.

As Good as It Gets (1997). Melvin Udall (Jack Nicholson) suffers from obsessive-compulsive disorder. This film reflects this disorder very well by showing the main compulsions that these patients usually manifest: obsession with cleanliness (he takes his own disposable cutlery to have breakfast in a cafeteria), not stepping on the lines on the sidewalk, etc. However, falling in love with a waitress played by Helen Hunt and having to take care of his neighbor's dog helps him to control his compulsions and improve his bad temperament.

Borderline personality disorder.

Girl, interrupted (1999), Winona Ryder plays the American writer Susanna Kaysen. Through her memoirs, Susanna recounts her experiences as a patient in a psychiatric hospital where she is admitted due to her pathology.

Anterograde Amnesia.

50 first dates (2004). Lucy Whitmore (Drew Barrymore) suffers from anterograde amnesia due to a cranioencephalic trauma caused by a traffic accident a year ago. Since that day, she is unable to create new memories as she cannot transform short-term memory into long-term memory. Henry Roth (Adam Sandler) falls in love with her and helps her to remind her every day of how they met and the life they have built together.

Dissociative identity disorder.

Black Swan (2010). Nina (Natalie Portman) is chosen to play the white swan and the black swan in the ballet Swan Lake. The interpretation of these two characters with antagonistic personalities causes Nina to begin to show repressed and dissociated aspects of her personality.

Psychopathy (Antisocial personality disorder).

We need to talk about Kevin (2011). In this film we see how this disorder develops from birth to adolescence. Kevin from birth is a difficult child with incessant crying, his mother fails to create an attachment bond with him. He also presents defiant behavior (especially with his mother), animal abuse, encopresis, manipulation (this behavior is seen in his relationship with his father) and lack of empathy and guilt (when he causes an accident in which his sister loses an eye, he does not show any sign of repentance or guilt). Already in adolescence his father gives him a bow with arrows, and he commits a massacre in his high school in addition to murdering his father and sister.

Cognitive disability.

Forrest Gump (1994). Forrest (Tom Hanks) suffers from mental retardation due to which he has a childish mentality even as an adult. However, despite his disability and thanks to his tenacity and good heart, he manages to be the protagonist throughout his life of many crucial events for the United States. The most important people in his life are his mother (Sally Field) and Jenny (Robin Wright), the great love of his life, with whom he has a son (Haley Joel Osment).

Addictions.

Trainspotting (1996). Reflects the heroin addiction in a group of young people and the difficulty of rehabilitation. In this film we can see addiction well represented: showing the routes of administration, the short-term effects of the drug and the long-term consequences.

Posttraumatic stress disorder with agoraphobia.

Copycat (1995). Helen Hudson (Sigourney Weaber) is a psychologist specializing in serial killers who suffers from post-traumatic stress disorder with agoraphobia (she is unable to leave her home) due to the attempted murder at the hands of one of her patients. Together with detective MJ Monagan (Holly Hunter) she must solve a series of murders committed by a serial killer who mimics crimes from the past.

Effects of music on the brain

Music, whether listened to or played, has multiple effects and benefits on the brain. Listening to music or playing an instrument (or singing) not only has benefits on an emotional level, but also on a cognitive level, even several studies have shown its effectiveness both in Alzheimer's patients and in stroke rehabilitation.

Music can improve sleep, memory, decrease stress and anxiety, and stimulate our cognitive and thinking skills. It is also an enjoyable way to improve our level in a language. For example, listening to a song in English while reading the lyrics improves our listening comprehension and pronunciation. To increase the benefits we can also translate the song, which would improve our written comprehension and vocabulary.

As we can see, music has multiple benefits, but what are the effects of music on the brain and why are these benefits achieved?

- Ability to alter breathing and heart rate, which has benefits both at the emotional level, reducing stress and anxiety, and at the cardiovascular level, regulating heart rate.

- Improves mood, reducing levels of depression and anxiety.

- It helps to reduce the perception of pain, which would help patients with diseases with high levels of pain.

- It is a relaxing and pleasant stimulus for our mind.

- Music with fast rhythms stimulates thinking, increasing alertness and concentration levels. On the contrary, music with slow rhythms is associated with relaxation and improvement of moods.

How to apply music therapy at home.

Music therapy, apart from all the benefits we have pointed out, has the great advantage that it can be applied anywhere: at home, going to work, walking down the street, etc.

Tips for practicing music therapy:

- Choose the right type of music for the effect we want to achieve: fast rhythms to stimulate concentration, slow rhythms to relax and music that attracts our attention to relieve pain and unpleasant sensations.

- If our objective is relaxation, we should choose relaxing music, lie down with our eyes closed and concentrate on our breathing.

- To achieve the benefits we are looking for, sessions of 10 to 15 minutes a day are enough, as long as we can dedicate that time to listen to music without interruptions and concentrate on it.

Animal therapy: benefits for mental health.

Animal therapy or zootherapy was first used in a psychiatric hospital in York (England) in the 18th century. Patients were allowed to walk in the garden, where there were domestic animals. It was observed that the company of the animals during the walks of the inmates had benefits for the latter since they were more relaxed and less conflictive.

Therefore, we can affirm that this type of therapy has ample scientific evidence to support its efficacy.

Years later, Freud also observed that the sessions with his patients were more effective if his dog was present during them, especially if the patient was a child or adolescent.

Another area where the efficacy of zootherapy has been demonstrated has been the war (during the two world wars), since this therapy was successfully used in soldiers who had participated in them and had problems of depression, anxiety and post-traumatic stress disorder.

In the last decades this type of therapy has had a great diffusion. There are therapies not only with dogs, but also with horses. They are used especially in patients with autism spectrum disorders, as well as in those suffering from anxiety or depression.

Benefits of therapy with dogs

Dogs have a positive influence on therapy with children or adolescents, especially in the areas of motivation and social skills development. It is easier to achieve the objectives set with the patients since they are calmer thanks to the presence of the dog. A decrease in emotional crises and aggression has also been observed when the dog accompanied the patient in the session.

The presence of dogs calms patients with hyperactivity and improves the social skills of those with autism spectrum disorder.

Benefits of having a pet

The presence of a pet is not only beneficial in cases of patients with serious disorders and in the context of a consultation, but also the simple fact of having a pet at home is also beneficial on a mental and emotional level.

- In the case of elderly people, it breaks the monotony, promotes physical exercise, since they have to walk their pet, and reduces aggression in the case of people with dementia.

- In general, people who live alone and have a pet improve their mental and physical health and motivate them to get out of the house more, which is beneficial to avoid isolation and promote relationships with other people.

- In cases of bereavement due to the death of a loved one, job loss or sentimental breakup, pets have demonstrated their benefits in reducing the risk of depression and suicidal ideation. 

Equine therapy or therapy with horses and its benefits.

This type of therapy is especially effective for people with mental, physical or sensory disabilities, it can be used in early stimulation therapies, as well as for those with social adaptation problems.

Benefits:

- The horse transmits tranquility while stimulating the patient's trust in the animal by allowing himself to be transported by it. Therefore, it is beneficial to promote confidence in people who have problems with social skills and social adaptation.

- On a physiological level the animal transmits warmth, which helps to relax the muscles and stimulate the circulatory system, which has great benefits in people with physical disabilities.

- As for the psychological benefits, equine therapy increases self-esteem and security, improves autonomy, self-control, communication, concentration and attention, in addition to promoting respect for animals.

Equine therapy is especially indicated for people suffering from disorders such as multiple sclerosis, autism, Down syndrome or trauma.

Biology of the pain

Pain is described as an unpleasant experience related to tissue damage, although there can also be pain in the absence of tissue damage or other reason.

We can distinguish three types of pain:

- Physiological: produced by stimulation of nociceptors in the skin or other tissues without tissue damage.

- Acute: is due to tissue damage and lasts until the tissues heal. This type of pain can evolve into chronic pain in the presence of certain physiological factors.

- Chronic: due to constant stimulation of nociceptors due to tissue damage and has serious consequences for the patient. It can be considered a disease in itself.

For pain to be perceived, receptors (nociceptors) and fibers (myelin and amyelin) are necessary to transmit the information to the central nervous system (CNS).

There are two types of nociceptors:

- Those that respond to thermal and mechanical stimuli, transmit the information via myelin fibers.

- The polymodal ones, which respond to pressure, temperature or chemical stimuli, transmit the painful sensation through amyelin fibers.

There are certain chemical substances that are released due to the inflammatory process that act on the nociceptors and regulate the transmission of painful information (bradykinin, histamines, serotonin, substance P, etc.).

The information produced by the painful stimuli that activate the nociceptors is transmitted by the aforementioned fibers to the posterior horn of the spinal cord, from where this information is transmitted to the CNS (mainly to the thalamus, midbrain and hypothalamus, which is the seat of the emotional component of pain).

The final processing of painful information occurs in the cerebral cortex.

Mechanisms that favor the transmission of painful information.

- Interleukins: cytokines are related to pain associated with inflammatory processes. They increase the activity of nociceptive pathways. In addition, they can cause indirect sensitization through the release of other cytokines and mediators of hyperalgesia such as glutamate and cyclooxygenase type 2. However, there are also anti-inflammatory cytokines that are produced during the inflammatory process and reduce the release of proinflammatory cytokines.

- Capsaicin receptor: also favors the transmission of pain information.

- Catecholaminergic system: associated with migraine, by reducing the availability of dopamine receptors.

- Serotonergic system: as in the catecholaminergic system, there is also a polymorphism (related to the 5-HTTLPR protein) that favors a predisposition to migraine, in this case reducing serotonin levels.

- Aminoacidergic system: gamma-aminobutyric acid (GABA) is the main nerve impulse inhibitory neurtransmitter. This inhibitory effect occurs at the postsynaptic level. Therefore, the action of GABA transporters, which act at the presynaptic level and prevent reuptake at the postsynaptic level, i.e. prevent the transmission of the neurotransmitter from one cell to the next, are related to hyperalgesia.

- Transcription factors: the DREAM protein plays an important role in controlling the activation of opioid K receptors by suppressing it. Its absence causes a decrease in pain response related to neuropathic and inflammatory pain.

- Nitric oxide (NO) synthase: NO is synthesized by nitric oxide synthase (NOS). Treatment with selective NOS inhibitors produces analgesia in neuropathic and inflammatory pain conditions.

And this is the process, very briefly, by which we feel pain.

How analgesics act on the nervous system.

In general, the mechanism of action of analgesics is the decrease in nociceptor activity.

Types of analgesics:

- Nonsteroidal anti-inflammatory drugs: they inhibit the production of prostaglandins, responsible for the stimulation of pain nerve endings. They can also relieve fever. E.g. - ibuprofen.

- Minor opioids: act on opioid receptors, which release neurotransmitters responsible for inhibiting the production of substances that stimulate nociceptors. E.g. - codeine

- Major opioids: the mechanism is the same as the previous group, but their target is intense pain. They are the most powerful analgesics and produce a great dependence. E.g.- morphine.

Adjuvant drugs are not analgesics but enhance their action by activating brain areas related to pain relief. These are: antidepressants, anxiolytics, antiepileptic drugs, muscle relaxants, etc.

Biology of addictions

There are a multitude of substances that can lead to addiction. Legal and illegal drugs provide a feeling of pleasure and temporary well-being. This sensation is related to the reward system and its main neurotransmitter: dopamine. When the pleasurable sensation disappears, the body needs this substance again to experience the feeling of well-being. If it does not get it, the person experiences an unpleasant sensation that forces him to desperately look for a way to consume again (we call this craving). This is the beginning of an addiction.

But not only substances can turn us into addicts. Certain foods, especially chocolate, gambling, shopping, any stimulus that gives us a great feeling of immediate pleasure is potentially addictive.

An addiction is a disease that ruins the life of the person who suffers from it, in terms of health, economic, family, social and work life. The consequences of an addiction are not only suffered by the addict, the family and close environment are also victims of the disease.

Many people have lost their families, have gone bankrupt, have had to sell everything they owned in order to continue using or to pay debts, have lost their jobs, friendships and even their lives as a result of addiction.

How the reward system works

The reward system has an evolutionary goal, which is to get what we need to survive. It is related to anticipating, seeking and obtaining pleasure.

It also allows us to distinguish between what is pleasant for us and what is unpleasant.

When we get something we need or that provides us with well-being, the limbic system (related to emotions) increases the production of dopamine. This is the neurotransmitter that produces pleasurable sensations. The continued use of the substance or stimulus that produces the dopamine rush results in intolerance to the lack of this excess dopamine. In addition, the central nervous system becomes accustomed to the substance (tolerance), so to get the same pleasurable effect the person needs to consume more and more, this is dependence. The unpleasant sensation due to the lack of the substance or the addictive stimulus is craving, as mentioned above.

There are different models that explain why some people are more predisposed than others to become addicted. Among the main explanations we find:

- Genetic predisposition, difficulties in the personal maturational process and personal family and social problems, together with exposure to the drug and environmental stress predispose to addiction.

- Sometimes, the person consumes a substance to alleviate the symptoms of a personality disorder or other previous mental illness, which also predisposes him/her to become addicted.

- Some people's reward system is more sensitive to stimuli that give us pleasure or well-being, which also predisposes to addiction.

Main substances or stimuli that cause addiction

- Legal drugs: alcohol and tobacco

- Illegal drugs: cocaine, heroin, fentanyl, cannabis, hallucinogens, etc.

- Medications: benzodiazepines

- Gambling: casinos, slot machines, videogames, etc.

- Shopping

- Stimulant substances present in certain foods: such as caffeine in coffee or theine in tea.

- Certain foods: chocolate, French fries, pizzas, hamburgers, ice cream, etc. 

Treatments for addictions

Addiction therapy is based on a combination of psychological and pharmacological therapy.

- Psychological: they can be both individual and group. They seek to empower the patient and provide skills to avoid relapses as well as to cope with everyday problems without the use of any substance.

- Pharmacological:

1. agonist substances to replace the drug: these are substances that produce the same effect as the drug. The best known is methadone therapy in the treatment of heroin addiction.
2. Antagonist drugs: they prevent the effects of the drug from manifesting themselves. E.g. - use of naltrexone in the case of opioid addiction.
3. Anticraving and antipriming drugs: those that reduce the desire to consume (anticraving), such as acamprosate, and those that prevent the loss of control over consumption (antipriming), such as naltrexone. These drugs are mainly used in cases of alcohol addiction.
4. Psychopharmaceuticals: sometimes it is necessary for the patient to take some type of medication such as antidepressants.

Schizophrenia

Schizophrenia is a serious mental illness characterized by a global affectation of the individual suffering from it in the cognitive, emotional, social and behavioral areas. It involves a rupture of the person's mind with reality.

People are usually diagnosed with this disease between the ages of 16 and 30, usually after a first psychotic episode. However, gradual changes in the thinking, emotions and behavior of affected persons may appear even before the first psychotic break.

This disease is not common in young children.

Starting treatment when the disease has been diagnosed is helpful for recovery.

Symptoms

Schizophrenia is characterized by a wide variety of symptoms. We can differentiate between positive, negative and cognitive symptoms.

• Positive symptoms: these are the symptoms that come to mind when we hear the word “schizophrenia”: hallucinations, delusions and thought disorders.

    - Hallucinations: the person may hear voices or see, taste, smell or touch things that are not real, although the person has the absolute conviction that they are.

   - Delusions are strongly held beliefs that are not true or rational to others.

   - Thought disorders: the person presents unusual or illogical ways of thinking. These thought disorders are manifested in the language that the person emits, characterized by disorganized, strange language, stop talking in the middle of a thought, jump from one topic to another without a logical reason or invent words without meaning.

• Negative symptoms: these are symptoms that affect more the behavioral, social and emotional areas of the person:

  - Loss of motivation, enjoyment or interest in daily activities.

  - Withdrawal from social life

  - Difficulty showing emotions (emotional flattening)

  - Having difficulty planning routine activities

  - Speaking with a muffled voice and lack of facial expression

  - Spending a lot of time in passive, purposeless activities

  - Catatonia: the person stays immobile or stops talking for a period of time. This symptom is rare. A variation of this symptom is waxy flexibility, which consists in the maintenance of a strange or uncomfortable posture imposed by another person on the part of the patient. E.g. In a catatonic state, the physician raises the patient's arm and instead of lowering it, the patient keeps it raised. Both catatonia and waxy flexibility are exclusive symptoms of catatonic schizophrenia.

• Cognitive symptoms:

- Problems processing information for decision making.

- Problems using newly learned information

- Problems with concentration and attention

Schizophrenia and violence

People with schizophrenia are not usually violent; in fact, the risk of violence is higher among people with schizophrenia than among healthy people. However, the risk of being aggressive increases if schizophrenia is accompanied by alcoholism or substance abuse.

Causes of schizophrenia

- Genes: the presence of a member with schizophrenia in the family may increase the probability of suffering from the disease. There are also genes that increase the predisposition to schizophrenia.

- Environment: environmental factors such as living in poverty or stressful environments or exposure to certain viruses or nutritional problems during pregnancy combined with an inherited or genetic predisposition increase the likelihood of schizophrenia.

- Brain structures: many people with schizophrenia have structural and functional differences in some areas of the brain compared to healthy people. Although this topic requires more research.

Treatment of schizophrenia

Schizophrenia requires pharmacological treatment combined with psychosocial interventions.

- Antipsychotic drugs: help relieve psychotic symptoms. They can be taken orally or by injection. The most common side effects of these drugs can be weight gain, dry mouth or drowsiness. An example of an antipsychotic drug is aripiprazole.

- Psychosocial treatments: help the person manage symptoms while continuing with daily activities, such as going to school or work.

- Family education and support: these interventions are aimed at the patient's family members and to learn about the symptoms of the disease, treatment options and ways to help the person with schizophrenia.

Delusional Disorders

A delusion is a belief that the person considers irrefutable and that does not correspond to reality. To be diagnosed it must last at least one month, and is maintained despite attempts by others to prove that the belief is false.

Delusions can be classified into:

- Extravagant: the person has the idea that he/she has been poisoned, is being persecuted or his/her partner is unfaithful. In other words, situations that could be possible but are false in that person.

- Bizarre: the person has a delusional idea about something that is completely impossible. For example, the person believes that his or her organs have been removed, or believes that he or she is rotting from the inside.

Delusional ideas tend to appear especially in psychotic disorders such as schizophrenia, dementia, some cases of depression and bipolar disorder.

Types of delusions

Although some of these delusional ideas could be real in the case of the people who suffer from them, they are false beliefs that do not correspond to reality:

- Erotomanic: the person has the misconception that another person is in love with them. These people can have problems with the law due to the harassment they exert on the person who is the object of the delirium.

- Of grandiosity: the person believes that he/she is very talented in some area or that he/she has made an important discovery.

- Jealousy: the person believes that his or her partner is unfaithful even if it is not true and the falsity of his or her belief is proven to him or her. They may resort to violence.

- Persecution: they believe they are being persecuted, watched, slandered, etc.

- Reference: is the irrational belief that facts, comments, events, television news, etc., are related to the person.

- Somatic: they have a false belief in relation to their body, such as a bad smell or a physical deformity.

- Cotard's syndrome: people who present this delirium think that they are dead and that they are in a plane of reality that corresponds to the dead. They may also think that their organs are rotting.

- Enemy complex: the person believes that everyone around them is their enemy and that they want to harm, hurt or harm them in some way.

- Thought broadcasting: the person believes that their thoughts can be heard by others or that they can be detected by electronic devices.

- Thought reading: it is similar to the previous one. The person thinks that others can read their thoughts through telepathy. They may take protective measures such as wrapping some material around their head.

- Thought stealing: the person believes that other people are stealing his or her ideas.

- Thought insertion: contrary to the previous one, the person believes that the ideas or thoughts he/she has have been implanted in his/her head by other people.

- Capgras Syndrome: the person has the firm conviction that one or more of his relatives have been replaced by an impostor.

- Fregoli Syndrome: similar to the previous one, but in this case the person believes that everyone around him/her is actually a single person who is constantly changing his/her appearance.

- Delusion of control: the person believes that he/she is a puppet controlled by a superior force. The person thinks that someone is possessing his body and managing it at will or that someone else is giving him orders that he has to comply with.

- Delusion of The Truman Show: the person believes that, as in the movie starring Jim Carrey, he is living in a television dish and his life is being broadcast on a prime-time show. The difference is that in the movie this belief was true.

- Ekbom's syndrome or delusional parasitosis: the person believes that he/she is infested by a kind of parasite that lives and grows on his/her skin.

As we can see, the variety of delusional ideas is enormous and some are stranger than others. Although some of these ideas in certain circumstances could be reality, such as the delusion that our partner is being unfaithful or that we are being poisoned, in the case of the person who suffers the delusional idea what he thinks does not correspond to reality. In the case of the most bizarre delusions such as believing that we are rotting inside, which obviously cannot be possible in any case, no matter how strange the belief is, the person does not allow himself to be convinced that his thought is wrong.

What is true is that these ideas, whether they are more or less bizarre, are a great suffering for the person and a detriment to lead a normal life, since believing that they are persecuted, deceived by their partner, that their thoughts can be heard by other people, etc., they may feel in danger, betrayed, manipulated or exposed to others, which sometimes can lead the person to be aggressive or violent.

Treatment of delusional ideas

Antipsychotic drugs, antidepressants or mood stabilizers can be used depending on the disorder that gives rise to the delusional idea.

On the other hand, cognitive behavioral therapy is also proving effective in these cases, since it tries to modify the credibility that the person gives to his or her erroneous thoughts.

Paranoid Personality Disorder

According to the DSM V, paranoid personality disorder is characterized by a pattern of unwarranted distrust and suspicion of others, interpreting their motives as malicious.

The prevalence is between 3.2 and 4.4%, and is more common in men. It is more likely to occur in people who have suffered emotional and/or physical abuse in childhood.

Paranoid personality disorder often has comorbidities with schizophrenia, anxiety disorders, post-traumatic stress disorder, alcohol addiction and other personality disorders (such as borderline personality disorder).

Symptoms

Patients with paranoid personality disorder are characterized by being continually suspicious of other people's evil intentions to deceive, humiliate, or otherwise harm them when there is no evidence that this can happen.

They do not establish close relationships with other people because they think that what they tell may be used against them. They do not trust the loyalty of either their friends or their partner, whom they are always suspecting of being unfaithful.

The main symptoms are:

- Persistent distrust and suspicion of others.

- Suspicion that others are exploiting, harming or disappointing them.

- Unwarranted doubts about the loyalty of friends and coworkers

- Fear that information provided to others may be used against them

- Misinterpretation of other people's words that the individual interprets as belittling or threatening

- Resentment over isolated insults or slights

- Thoughts that he/she has been attacked and a readiness to react with anger

- Unwarranted suspicions of infidelity on the part of a partner

These symptoms begin in early adulthood.

Treatment

Treatment is based on cognitive behavioral therapy and sometimes combined with medication.

The general principles of cognitive behavioral therapy are:

- Reduce the discomfort experienced by the patient.

- To try to make the patient understand that his or her suspicions are unfounded.

- To reduce maladaptive and undesirable behaviors

- Modify problematic personality traits such as distrust or suspicion.

The medications usually prescribed are atypical antipsychotics and antidepressants.