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 The founder of phenomenology, German philosopher Edmund Husserl, introduced the term in his book Ideen zu einer reinen Phänomenolgie und phänomenologischen Philosophie (1913; Ideas: A General Introduction to Pure Phenomenology, 1931). Early followers of Husserl such as the German philosopher Max Scheler, influenced by his previous book, Logische Untersuchungen (two volumes, 1900 and 1901, Logical Investigations, 1970), claimed that the task of phenomenology is to study essences, such as the essence of emotions. Although Husserl himself never gave up his early interest in essences, he later held that only the essences of certain special conscious structures are the proper objects of phenomenology. As formulated by Husserl after 1910, phenomenology is the study of the structures of consciousness that enable consciousness to refer to objects outside itself. This study requires reflection on the content of the mind to the exclusion of everything else. Husserl called this type of reflection the phenomenological reduction. Because the mind can be directed toward nonexistent plus real objects, Husserl noted that phenomenological reflection does not presuppose that anything that has recently come into existence, but rather amounts to a “bracketing of existence” - that is, setting aside the question of the real existence of the contemplated object.
 Freud’s first published work, “On Aphasia,” appeared in 1891, it was a study of the neurological disorder in which the ability to pronounce words or to name common objects is lost because of organic brain disease. His final work in neurology, an article, “Infantile Cerebral Paralysis,” was written in 1897 for an encyclopaedia only at the insistence of the editor, since by this time Freud was occupied largely with psychological rather than physiological explanations for mental illnesses. His subsequent writings were devoted entirely to that field, which he had named psychoanalysis in 1896.
 Pierre Janet (1859-1947), the French psychologist, born and educated in Paris, he taught philosophy (1881-98) but was also interested in neurology and psychology, which he studied under Jean Martin Charcot. Janet did important pioneer work on the scientific treatment of neuroses and hysteria; his investigations of hypnosis as an aid to understanding the mind and the diagnosis of its disorders greatly influenced the early work of another pupil of Charcot, Sigmund Freud. Among Janet's works are “Neuroses” (1898; trans. 1909), “Major Symptoms of Hysteria” (1907; trans. 1920), and “Principles of Psychotherapy” (1924).
 Freud’s new orientation was heralded by his collaborative work on hysteria with the Viennese physician Josef Breuer. The work was presented in 1893 in a preliminary paper and two years later in an expanded form under the title “Studies on Hysteria.” In this work the symptoms of hysteria were ascribed to manifestations of undischarged emotional energy associated with forgotten psychic traumas. The therapeutic procedure involved the use of a hypnotic state in which the patient was led to recall and reenact the traumatic experience, thus discharging by catharsis the emotions causing the symptoms. The publication of this work marked the beginning of psychoanalytic theory formulated based on clinical observations.
 During the periods from 1895 to 1900 Freud developed many concepts that were later incorporated into psychoanalytic practice and doctrine. Soon after publishing the studies on hysteria he abandoned the use of hypnosis as a cathartic procedure and substituted the investigation of the patient’s spontaneous flow of thoughts, called ‘free association’, to reveal the unconscious mental processes at the root of the neurotic disturbance.
 In his clinical observations Freud found evidence for the mental mechanisms of repression and resistance. He described repression as a device operating unconsciously to make the memory of painful or threatening events inaccessible to the conscious mind. Resistance is defined as the unconscious defence against awareness of repressed experiences in order to avoid the resulting anxiety. That to probe the unconscious mind, Freud developed the psychotherapy technique of free association. In free association, the patient reclines and talks about thoughts, wishes, memories, and whatever else comes to mind. The analyst tries to interpret these verbalizations to determine their psychological significance. In particular, Freud encouraged patients to free associate about their dreams, which he believed were the ‘royal road to the unconscious’. According to Freud, dreams are disguised expressions of deep, hidden impulses. Thus, as patients recount the conscious manifest content of dreams, the psychoanalyst tries to unmask the underlying latent content - what the dreams carries or attemptively communicates (as an idea) that something is held of a measurable understanding to mean and give to expression of something potentially understood in the mind.
 He traced the operation of unconscious processes, using the free associations of the patient to guide him in the interpretation of dreams and slips of speech. Dream analysis led to his discoveries of infantile sexuality and of the so-called Oedipus complex, which constitutes the erotic attachment of the child for the parent of the opposite sex, together with hostile feelings toward the other parent. In these years he also developed the ‘theory of transference’, the processes by which emotional attitudes, established originally toward parental figures in childhood, are transferred in later life to others. The end of this period was marked by the appearance of Freud’s most important work, “The Interpretation of Dreams” (1899). Here Freud analysed many of his own dreams recorded in the 3-year period of his self-analysis, begun in 1897. This work expounds all the fundamental concepts underlying psychoanalytic technique and doctrine.
 Freud introduced his new theory in The Interpretation of Dreams (1889), the first of 24 books he would write. The theory is summarized in Freud’s last book “An Outline of Psychoanalysis” published in 1940, after his death. In contrast to Wundt and James, for whom psychology was the study of conscious experience, Freud believed that people are motivated largely by unconscious forces, including strong sexual and aggressive drives. He likened the human mind to an iceberg: The small tip that floats on the water is the conscious part, and the vast region beneath the surface comprises the unconscious. Freud believed that although unconscious motives can be temporarily suppressed, they must find a suitable outlet in order for a person to maintain a healthy personality.
 In 1902 Freud was appointed a full professor at Vienna University. This honour was granted not in recognition of his contributions but as a result of the efforts of a highly influential patient. The medical world still regarded his work with hostility, and his next writings, “The Psychopathology of Everyday Life” (1904) and “Three Contributions to the Sexual Theory” (1905), only increased this antagonism. As a result Freud continued to work virtually alone in what he termed ‘splendid isolation’.
 By 1906, however, a small number of pupils and followers had gathered around Freud, including the Austrian psychiatrists William Stekel and Alfred Adler, the Austrian psychologist Otto Rank, the American psychiatrist Abraham Brill, and the Swiss psychiatrist’s Eugen Bleuler and Carl Jung. Other notable associates, joined the circle in 1908, as well, the Hungarian psychiatrist Sándor Ferenczi and the British psychiatrist Ernest Jones.
 Austrian doctor Sigmund Freud spent many hours refining his theories in this study within his home in Vienna, Austria. Freud pioneered the use of clinical observation to treat mental disease. The publication of The Interpretation of Dreams in 1899 detailed his technique of isolating the source of psychological problems by examining a patient’s spontaneous stream of thought.
 Increasing recognition of the psychoanalytic movement made possibly the formation in 1910 of a worldwide organization called the International Psychoanalytic Association. As the movement spread, gaining new adherents through Europe and the US, Freud was troubled by the dissension that arose among members of his original circle. Most disturbing was the defection from the group of Adler and Jung, each of whom developed a different theoretical basis for disagreement with Freud’s emphasis on the sexual origin of neurosis. Freud met these setbacks by developing further his basic concepts and by elaborating his own views in many publications and lectures.
 After the onset of World War I Freud devoted little time to clinical observation and concentrated on the application of his theories to the interpretation of religion, mythology, art, and literature. In 1923 he was stricken with cancer of the jaw, which necessitated constant, painful treatment in addition to many surgical operations. Despite his physical suffering he continued his literary activity for the next 16 years, writing mostly on cultural and philosophical problems.
 When the Germans occupied Austria in 1938, Freud, a Jew, was persuaded by friends to escape with his family to England. He died in London on September 23, 1939.
 Freud created an entirely new approach to the understanding of human personality by his demonstration of the existence and force of the unconscious. In addition, he founded a new medical discipline and formulated basic therapeutic procedures that in modified form are applied widely in the present-day treatment of neuroses and psychoses. Although never accorded full recognition during his lifetime, Freud is generally acknowledged as one of the great creative minds of modern times.
 Among his other works are Totem and Taboo (1913), Ego and the Id (1923), New Introductory Lectures on Psychoanalysis (1933), and Moses and Monotheism (1939).
 The ego, the term occurring in psychoanalysis, that designates its term as denoting the central part of the personality structure that deals with reality and is influenced by social forces. According to the psychoanalytic theories developed by Sigmund Freud, the ego constitutes one of the three basic provinces of the mind, the other two, being the id and the superego. Formation of the ego begins at birth in the first encounters with the external world of people and things. The ego learns to modify behaviour by controlling those impulses that are socially unacceptable. Its role is that of a mediator between unconscious impulses and acquired social and personal standards.
 In philosophy, ego means the conscious self or “I.” It was viewed by some philosophers, notably the 17th-century Frenchman René Descartes and the 18th-century German Johann Gottlieb Fichte, as the sole basis of reality; they saw the universe as existing only in the individual's knowledge and experience of it. Other philosophers, such as the 18th-century German Immanuel Kant, proposed two forms of the ego, one perceiving and the other thinking.
 As well, the term Id was oriented into psychoanalytic theory, one of the three basic elements of personality, the others being the ego and the superego. The id can be equated with the unconscious of common usage, which is the reservoir of the instinctual drives of the individual, including biological urges, wishes, and affective motives. The id is dominated by the pleasure principle, through which the individual is pressed for immediate gratification of his or her desires. In strict Freudian theory the energy behind the instinctual drives of the id is known as the libido, a generalized force, basically sexual in nature, through which the sexual and psychosexual nature of the individual finds expression.
 Also, the Superego, in psychoanalytic theory is one of the three basic and most fundamental constituents of the mind, the others being the id and the ego. As postulated by Sigmund Freud, the term designates the element of the mind that, in normal personalities, automatically modifies and inhibits those instinctual impulses or drives of the id that tend to produce antisocial actions and thoughts.
 According to psychoanalytic theory, the superego develops as the child gradually and unconsciously adopts the values and standards, first of his or her parents, and later of the social environment. According to modern Freudian psychoanalysts, the superego includes the positive ego, or conscious self-image, or ego ideal, that each individual develops.
 Psychoanalysis, is the name applied to a specific method of investigating unconscious mental processes and to a form of psychotherapy. The term refers, as well, to the systematic structure of psychoanalytic theory, which is based on the relation of conscious and unconscious psychological processes.
 The techniques of psychoanalysis and much of the psychoanalytic theory based on its application were developed by Sigmund Freud. His work concerning the structure and the functioning of the human mind had influential significance, both practically and scientifically, and it continues to influence contemporary thought.
 Of Freud’s three basic personality structures - id, ego, and superego - only the id is totally unconscious. The first of Freud's innovations was his recognition of unconscious psychiatric processes that follow laws different from those that govern conscious experience. Under the influence of the unconscious, thoughts and feelings that belong together may be shifted or displaced out of context; two disparate ideas or images may be condensed into one; thoughts may be dramatized in the form of images rather than expressed as abstract concepts; and certain objects may be represented symbolically by images of other objects, although the resemblance between the symbol and the original object may be vague or farfetched. The laws of logic, indispensable for conscious thinking, do not apply to these unconscious mental productions.
 Recognition of these modes of operation in unconscious mental processes made possibly the understanding of such previously incomprehensible psychological phenomena as dreaming. Through analysis of unconscious processes, Freud saw dreams as serving to protect sleep against disturbing impulses arising from within and related to early life experiences. Thus, unacceptable impulses and thoughts, called the latent dream content, are transformed into a conscious, although no longer immediately comprehensible, experience called the manifest dream. Knowledge of these unconscious mechanisms permits the analyst to reverse the so-called dream work, that is, the process by which the latent dream is transformed into the manifest dream, and through dream interpretation, to recognize its underlying meaning.
 A basic assumption of Freudian theory is that the unconscious conflicts involve instinctual impulses, or drives, that originate in childhood. As these unconscious conflicts are recognized by the patient through analysis, his or her adult mind can find solutions that were unattainable to the immature mind of the child. This depiction of the role of instinctual drives in human life is a unique feature of Freudian theory.
 According to Freud's doctrine of infantile sexuality, adult sexuality is an end-product of a complex process of development, beginning in childhood, involving a variety of body functions or areas (oral, anal, and genital zones), and corresponding to various stages in the relation of the child to adults, especially to parents. This distinguishes the oedipus Complex, in psychoanalysis, a son’s largely unconscious sexual attraction toward his mother accompanied by jealousy toward his father. The terminological distinction of the oedipus complex, derived from the Greek legend of Oedipus, was first used in the late 1800's by Austrian psychiatrist Sigmund Freud, the founder of psychoanalysis. Freud thought that the Oedipus complex was the most important event of a boy’s childhood and had a great effect on his subsequent adult life. Freud claimed that in nearly all cases the boy represses the desire for his mother and the jealousy toward his father. As a result of this unconscious experience, Freud believed, a boy with an Oedipus complex feels guilt and experiences strong emotional conflicts. Freud thought that young women went through a similar experience, in which they are attracted to their father and surmount the disconfirming antagonistic attitude toward their mother. He called this the Electra complex. According to Freud, if a woman remains under the influence of the Electra complex, she is likely to choose a husband with characteristics similar to those of her father.
 Of crucial importance is the so-called Oedipal period, occurring at about four to six years of age, because at this stage of development the child for the first time becomes capable of an emotional attachment to the parent of the opposite sex that is similar to the adult's relationship to a mate; the child simultaneously reacts as a rival to the parent of the same sex. Physical immaturity dooms the child's desires to frustration and his or her first step toward adulthood to failure. Intellectual immaturity further complicates the situation because it makes children afraid of their own fantasies. The extent to which the child overcomes these emotional upheavals and to which these attachments, fears, and fantasies continue to live on in the unconscious greatly influences later life, especially ‘loves’ relationships.
 The conflicts occurring in the earlier developmental stages are no less significant as a formative influence, because these problems represent the earliest prototypes of such basic human situations as dependency on others and relationship to authority. Also, basic in moulding the personality of the individual is the behaviour of the parents toward the child during these stages of development. The fact that the child reacts, not only to objective reality, but also to fantasy distortions of reality, however, greatly complicates even the best-intentioned educational efforts.
 The effort to clarify the bewildering number of interrelated observations uncovered by psychoanalytic exploration led to the development of a model of the structure of the psychic system. Three functional systems are distinguished that are conveniently designated as the id, ego, and superego.
 The first system refers to the sexual and aggressive tendencies that arise from the body, as distinguished from the mind. Freud called these tendencies Triebe, which literally means “drives,” but which is often inaccurately translated as “instincts” to indicate their innate character. These inherent drives claim immediate satisfaction, which is experienced as pleasurable; the id thus is dominated by the pleasure principle. In his later writings, Freud tended more toward psychological rather than biological conceptualization of the drives.
 How the conditions for satisfaction are to be brought about is the task of the second system, the ego, which is the domain of such functions as perception, thinking, and motor control that can accurately assess environmental conditions. In order to fulfill its function of adaptation, or reality testing, the ego must be capable of enforcing the postponement of satisfaction of the instinctual impulses originating in the id. To defend itself against unacceptable impulses, the ego develops specific psychic means, known as defence mechanisms. These include repression, the exclusion of impulses from conscious awareness; projection, the process of ascribing to others one's own unacknowledged desires; and reaction formation, the establishments of a pattern of behaviour directly opposed to a strong unconscious imperative necessarily in need for or required to employ of its relief. Such defence mechanisms are put into operation whenever anxiety signals a danger that the original unacceptable impulses may reemerge.
 An id impulse becomes unacceptable, not only as a result of a temporary need for postponing its satisfaction until suitable reality conditions can be found, but more often because of a prohibition imposed on the individual by others, originally the parents. The totality of these demands and prohibitions constitutes the major content of the third system, the superego, the function of which is to control the ego in accordance with the internalized standards of parental figures. If the demands of the superego are not fulfilled, the person may feel shame or guilt. Because the superego, in Freudian theory, originates in the struggle to overcome the Oedipal conflict, it has a power akin to an instinctual drive, is in part unconscious, and can give rise to feelings of guilt not justified by any conscious transgression. The ego, having to mediate among the demands of the id, the superego, and the outside world, may not be strong enough to reconcile these conflicting forces. The more the ego is impeded in its development because of being enmeshed in its earlier conflicts, called fixations or complexes, or the more it reverts to earlier satisfactions and archaic modes of functioning, known as regression, the greater is the likelihood of succumbing to these pressures. Unable to function normally, it can maintain its limited control and integrity only at the price of symptom formation, in which the tensions are expressed in neurotic symptoms.
 A cornerstone of modern psychoanalytic theory and practice is the concept of anxiety, which institutes appropriate mechanisms of defence against certain danger situations. These danger situations, as described by Freud, are the fear of abandonment by or the loss of the loved one (the object), the risk of losing the object's love, the danger of retaliation and punishment, and, finally, the hazard of reproach by the superego. Thus, symptom formation, character and impulse disorders, and perversions, as well as sublimations, represent compromise formations - different forms of an adaptive integration that the ego tries to achieve through more or less successfully reconciling the different conflicting forces in the mind.
 Various psychoanalytic schools have adopted other names for their doctrines to indicate deviations from Freudian theory.
 Swiss psychiatrist Carl Jung began his studies of human motivation in the early 1900's and created the school of psychoanalysis known as analytical psychology. A contemporary of Austrian psychoanalyst Sigmund Freud, Jung at first collaborated closely with Freud but eventually moved on to pursue his own theories, including the exploration of personality types. According to Jung, there are two basic personality types, extroverted and introverted, which alternate equally in the completely normal individual. Jung also believed that the unconscious mind is formed by the personal unconscious (the repressed feelings and thoughts developed during an individual’s life) and the collective unconscious (those feelings, thoughts, and memories shared by all humanity).
 Carl Gustav Jung, one of the earliest pupils of Freud, eventually created a school that he preferred to call analytical psychology. Like Freud, Jung used the concept of the libido; however, to him it meant not only sexual drives, but a composite of all creative instincts and impulses and the entire motivating force of human conduct. According to his theories, the unconscious is composed of two parts, as the personal unconscious, which contains the results of the individual's entire experience, and the collective unconscious, the reservoir of the experience of the human race. In the collective unconscious exist a number of primordial images, or archetypes, common to all individuals of a given country or historical era. Archetypes take the form of bits of intuitive knowledge or apprehension and normally exist only in the collective unconscious of the individual. When the conscious mind contains no images, however, as in sleep, or when the consciousness is caught off guard, the archetypes commence to function. Archetypes are primitive modes of thought and tend to personify natural processes in terms of such mythological concepts as good and evil spirits, fairies, and dragons. The mother and the father also serve as prominent archetypes.
 An important concept in Jung's theory is the existence of two basically different types of personality, mental attitude, and function. When the libido and the individual's general interest are turned outward toward people and objects of the external world, he or she is said to be extroverted. When the reverse is true, and libido and interest are centred on the individual, he or she is said to be introverted. In a completely normal individual, these two particular directions and involving character alternatives, dominating a motion course of underestimate potential of what is the dispositional  inclinations in the possession or manifesting usually wide determinants’ as to acquire knowledge of o r skill by stud y and experience, but usually the libido is directed mainly neither in one direction nor of the other; as a result, two personality types are recognizable.
 The Jungian concepts in the term ‘complex’, was an acceptable group of repressed ideas that shape an individual’s response to think, feel, and act in a certain habitual pattern. Swiss psychiatrist Carl Jung, who originally coined the term complex, derived it from the Latin word complexus, meaning interweaving or braiding. Jung stated that a complex is a "grouping of psychic elements about emotionally toned contents," adding that it "consists of a nuclear element and a great number of secondarily constellated associations." The components of a complex may be present in consciousness or in the unconscious. Conflicts, frustrations, and threats to personal security encountered during infancy are then repressed into the unconscious, where they remain dormant, but not forgotten. These unconscious memories will govern an individual’s response to emotional conflict even into adult life, as the original trauma and its associated effect patterns thinking and behaviour to meet the new conflict.
 Further, complex, group of repressed ideas existing in the mind as representations or a formulation that construct of consuming interests to bring to an end by or as by the action of force, the form and the shape that an individual’s responses to think, feel, and act in a certain habitual pattern. Swiss psychiatrist Carl Jung, who originally coined the term complex, derived it from the Latin word complexus, meaning interweaving or braiding. Jung stated that a complex is a "grouping of psychic elements about emotionally toned contents," adding that it "consists of a nuclear element and a great number of secondarily constellated associations." The components of a complex may be present in consciousness or in the unconscious. Conflicts, frustrations, and threats to personal security encountered during infancy are then repressed into the unconscious, where they remain dormant, but not forgotten. These unconscious memories will govern an individual’s response to emotional conflict even into adult life, as the original trauma and its associated effect patterns thinking and behavior to meet the new conflict.
 The Oedipus and Electra complexes as described by Sigmund Freud, and the inferiority complex as described by Alfred Adler, have correctly been influential concepts within the context of psychoanalytic experience.
 The Oedipus and Electra complexes as described by Sigmund Freud, and the inferiority complex as described by Alfred Adler, have been influential concepts within the context of psychoanalytic theory
 Jung rejected Freud's distinction between the ego and superego and recognized a portion of the personality, somewhat similar to the superego, that he called the persona. The persona consists of what a person appears to be to others, in contrast to what he or she actually is. The persona is the role the individual chooses to play in life, the total impression he or she wishes to make on the outside world.
 Austrian psychologist and psychiatrist Alfred Adler, after leaving the university he studied and was associated with Sigmund Freud, the founder of psychoanalysis. In 1911 Adler left the orthodox psychoanalytic school to found a neo-Freudian school of psychoanalysis. After 1926 he was a visiting professor at Columbia University, and in 1935 he and his family moved to the United States.
 In his analysis of individual development, Adler stressed the sense of inferiority, rather than sexual drives, as the motivating force in human life. According to Adler, conscious or subconscious feelings of inferiority (to which he gave the name inferiority complex), combined with compensatory defence mechanisms, is the basic cause of psychopathological behaviour. The function of the psychoanalyst, furthermore, is to discover and rationalize such feelings and break down the compensatory, neurotic will for power that they engender in the patient. Adler's works include “The Theory and Practice of Individual Psychology” (1918) and “The Pattern of Life” (1930).
 Adler’s analysis of individual development stressed the sense of inferiority, rather than sexual drives, as the motivating force in human life. According to Adler, conscious or subconscious feelings of inferiority (to which he gave the name inferiority complex), combined with compensatory defence mechanisms, is the basic cause of psychopathological behaviour. The function of the psychoanalyst, furthermore, is to discover and rationalize such feelings and break down the compensatory, neurotic will for power that they engender in the patient. Adler's works include “The Theory and Practice of Individual Psychology” (1918) and “The Pattern of Life” (1930).
 Alfred Adler, another of Freud's pupils, differed from both Freud and Jung in stressing that the motivating force in human life is the sense of inferiority, which begins as soon as an infant is able to comprehend the existence of other people who are better able to care for themselves and cope with their environment. From the moment the feeling of inferiority is established, the child strives to overcome it. Because inferiority is intolerable, the compensatory mechanisms set up by the mind may get out of hand, resulting in self-centred neurotic attitudes, overcompensations, and a retreat from the real world and its problems.
 Adler laid particular stress on inferiority feelings arising from what he regarded as the three most important relationships: those between the individual and work, friends, and loved ones. The avoidance of inferiority feelings in these relationships leads the individual to adopt a life goal that is often not realistic and is frequently expressed as an unreasoning will to power and to all others are influenced by the dominant ascendancy leading to every type of antisocial behaviour from bullying and boasting to political tyranny. Adler believed that analysis can foster a sane and rational “community feeling” that is constructive rather than destructive.
 Austrian psychologist and psychotherapist Otto Rank worked with Sigmund Freud, the founder of psychoanalysis, before developing his own theories about mental and emotional disorders. Rank believed that an individual’s neurotic tendencies could be linked to the traumatic experience of birth.
 Another student of Freud, Dr. Otto Rank, introduced a new theory of neurosis, attributing all neurotic disturbances to the primary trauma of birth. In his later writings he described individual development as a progression from complete dependence on the mother and family, to a physical independence coupled with intellectual dependence on society, and finally to complete intellectual and psychological emancipation. Rank also laid great importance on the will, defined as “a positive guiding organization and integration of self, implementing its use in the constant critical creativites as well as that it inhabits and controls the instinctual drives.”
 American psychoanalyst and social philosopher Erich Fromm stressed the importance of social and economic factors on human behaviour. His focus was a departure from a traditional psychoanalysis, which emphasized the role of the subconscious. In the 1969 essay for Collier’s Year Book, Fromm presents various explanations for human violence. He argues that violence cannot be controlled by imposing stronger legal penalties, but rather by creating a more just society in which people connect with other as humans and are able to control their own lives.
 Later noteworthy modifications of psychoanalytic theory include those of the American psychoanalyst’s Erich Fromm, Karen Horney, and Harry Stack Sullivan. The theories of Fromm lay particular emphasis on the concept that society and the individual is not separate and opposing forces, that the nature of society is determined by its historic background, and that the needs and desires of individuals are largely formed by their society. As a result, Fromm believed, the fundamental problem of psychoanalysis and psychology is not to resolve conflicts between fixed and unchanging instinctive drives in the individual and the fixed demands and laws of society, but to bring about harmony and an understanding of the relationship between the individual and society. Fromm also stressed the importance to the individual of developing the ability to fully use his or her mental, emotional, and sensory powers.
 Horney worked primarily in the field of therapy and the nature of neuroses, which she defined as of two types: situation neuroses and character neuroses. Situation neuroses arise from the anxiety attendant on a single conflict, such for being faced with a difficult decision. Although they may paralyse the individual temporarily, making it impossible to think or act efficiently, such neuroses are not deeply rooted. Character neuroses are characterized by a basic anxiety and a basic hostility resulting from a lack of love and affection in childhood.
 Sullivan believed that all development can be described exclusively in terms of interpersonal relations. Character types as well as neurotic symptoms are explained as results of the struggle against anxiety arising from the individual's relations with others, including security measures of which a system is maintained for the purpose of allaying anxiety.
 An important school of thought is based on the teachings of the British psychoanalyst Melanie Klein. Because most of Klein's followers worked with her in England, this has come to be known as the English school. Its influence, nevertheless, is very strong throughout the European continent and in South America. Its principal theories were derived from observations made in the psychoanalysis of children. Klein posited the existence of complex unconscious fantasies in children under the age of six months. The principal source of anxiety arises from the threat to existence posed by the death instinct. Depending on how concrete representations of the destructive forces are dealt within the unconscious fantasy life of the child, two basic early mental attitudes result that Klein characterized as a “depressive position” and a “paranoid position.” In the paranoid position, the ego's defence consists of projecting the dangerous internal object onto some external representative, which is treated as a genuine threat emanating from the external world. In the depressive position, the threatening object is introjected and treated in fantasy as concretely retained within the person. Depressive and hypochondriacal symptoms result. Although considerable doubt exists that such complex unconscious fantasies operate in the minds of infants, these observations have been of the utmost importance to the psychology of unconscious fantasies, paranoid delusions, and theory concerning early object relations.
 Scottish physician William Cullen coined the term neurosis near the end of the 18th century to describe a wide variety of nervous behaviours with no apparent physical cause. Austrian psychoanalyst Sigmund Freud and his followers popularized the word in the late 19th and early 20th centuries. Freud defined neurosis as one class of mental illnesses. In his view, people became neurotic when their conscious mind repressed inappropriate fantasies of the unconscious mind.
 Until 1980 neuroses appeared as a specific diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders, a handbook for mental health professionals. Neurosis encompassed a variety of mental illnesses, including Dissociative disorders, anxiety disorders, and phobias.
 In the psychoanalytic model, neurosis differs from a psychosis, another general term used to describe mental illnesses. Individuals with neuroses can function at work and in social situations, whereas people with psychoses find it quite difficult to function adequately. People with neuroses do not grossly distort or misinterpret reality as those with psychoses do. In addition, neurotic individuals recognize that their mental functioning is disturbed while psychotic individuals usually do not. Most mental health professionals now use the term psychosis to refer to symptoms such as hallucinations, delusions, and bizarre behaviour.
 Psychosis, the mental illness in which a person loses contact with reality and has difficulty functioning in daily life. Psychotic symptoms can indicate severe mental illnesses, such as schizophrenia and bipolar disorder (manic-depressive illness). Unlike people with fewer severe psychological problems, psychotic individuals do not usually recognize that their mental functioning is disturbed.
 Once, again, a psychosis, is categorized as a mental illness in which a person loses contact with reality and has difficulty functioning in daily life. Psychotic symptoms can indicate severe mental illnesses, such as schizophrenia and bipolar disorder (manic-depressive illness). Unlike people with fewer severe psychological problems, psychotic individuals do not usually recognize that their mental functioning is disturbed.
 Mental health professionals generally divide psychotic symptoms into three broad types: hallucinations, delusions, and bizarre behaviour. Hallucinations refer to hearing, seeing, smelling, feeling, or tasting something when nothing in the environment actually caused that sensation. For example, a person experiencing an auditory hallucination might hear a voice calling their name even though no one else is actually present. A delusion is a false belief held by a person that appears obviously untrue to other people in that person’s culture. For example, a man may believe that Martians have implanted a microchip in his brain that controls his thoughts. Bizarre behaviour refers to behaviour in a person that is strange or incomprehensible to others who know the person. For example, hoarding unused scraps of tin because of their ‘magical properties’ would be a type of bizarre behaviour.
 Psychosis can occur in a number of mental illnesses. These include schizophrenia and schizophrenia-related disorders, bipolar disorder, paranoid personality disorder, and delusional disorder. Less common, psychotic symptoms occur in major depression Dissociative disorders, and post-traumatic stress disorder.
 Psychotic symptoms can also result from substance abuse. Stimulants, such as cocaine and amphetamines, can cause psychotic symptoms, especially if taken in high doses or over long periods of time. Hallucinogenic substances, such as lysergic acid diethylamide (LSD), mescaline and phencyclidine (PCP), can cause psychosis. Alcohol and marijuana can occasionally cause psychotic symptoms as well. Individuals with alcoholism may experience psychotic symptoms, especially hallucinations, as they withdraw from alcohol use. Alcohol dependence over a long period of time can result in Korsakoff’s psychosis, a syndrome that may include psychotic symptoms and an inability to form new memories. Certain medical conditions can also cause psychosis. Syphilis, especially if untreated for many years, can lead to psychosis. Brain tumours can also lead to psychotic symptoms.
 Treatment of psychotic symptoms usually involved taking antipsychotic drugs, and called neuroleptics. Common Antipsychotic drugs include chlorpromazine (Thorazine), fluphenazine (Prolixin), thioridazine (Mellaril), trifluoperazine (Stelazine), clozapine (Clozaril), haloperidol (Haldol), olanzapine (Zyprexa), and risperidone (Risperdal). These medications can help reduce psychotic symptoms and prevent symptoms from returning. However, they can also cause severe side effects, such as muscle spasms, tremors, and tardive dyskinesia, a permanent condition marked by uncontrollable lip smacking, grimacing, and tongue movements. Psychotic symptoms in individuals with bipolar disorder may respond to other types of medication, including lithium, carbamazepine (Tegretol), and valproate (Depakene).
 Psychotic symptoms that occur as a result of substance abuse usually disappear gradually after the person stops using the substances. Physicians sometimes use Antipsychotic medications temporarily to treat these individuals. Physicians have not discovered any effective treatments for Korsakoff’s psychosis. Psychotic symptoms resulting from medical conditions often disappear after treatment of the underlying medical problem.
 Neurophysiology, speaking seriously is the study of how nerve cells, or neurons, receives and transmits information. Two types of phenomena are involved in processing nerve signals: electrical and chemical. Electrical events propagate a signal within a neuron, and chemical processes transmit the signal from one neuron to another neuron or to a muscle cell.
 A neuron is a long cell that has a thick central area containing the nucleus; it also has one long process called an ‘axon’ and one or more short, bushy processes called ‘dendrites’. Dendrites receive impulses from other neurons. (The exceptions are sensory neurons, such as those that transmit information about temperature or touch, in which the signal is generated by specialized receptors in the skin.) These impulses are propagated electrically along the cell membrane to the end of the axon. At the tip of the axon the signal is chemically transmitted to an adjacent neuron or muscle cell.
 Like all other cells, neurons contain charged ions, potassium and sodium (positively charged) and chlorine (negatively charged). Neurons differ from other cells in that they are able to produce a nerve impulse. A neuron is polarized - that is, it has an overall negative charge inside the cell membrane because of the high concentration of chlorine ions and low concentration of potassium and sodium ions. The concentration of these same ions is exactly reversed outside the cell. This charge differential represents stored electrical energy, sometimes referred to as membrane potential or resting potential. The negative charge inside the cell is maintained by two features. The first is the selective permeability of the cell membrane, which is more permeable to potassium than sodium. The second feature is sodium pumps within the cell membrane that actively pump sodium out of the cell. When depolarization occurs, this charge differential across the membrane is reversed, and a nerve impulse is produced.
 Depolarization is a rapid change in the permeability of the cell membrane. When sensory ideas or any other kind of stimulating current is received by the neuron, the membrane permeability is changed, allowing a sudden influx of sodium ions into the cell. The high concentration of sodium, or action potential, changes the overall charges within the cell from negative too irrefutable positivity, and charged to ion concentrations, for triggering similar reactions along the membrane, propagating the nerve impulse. After a brief period called the refractory period, during which the ionic concentration returned to resting potential, the neuron can repeat this process.
 Nerve impulses travel at different speeds, depending on the cellular composition of a neuron. Where speed of impulse is important, as in the nervous system, axons are insulated with a membranous substance called ‘myelin’. The insulation provided by myelin maintains the ionic charge over long distances. Nerve impulses are propagated at specific points along the myelin sheath; these points are called the nodes of Ranvier. Examples of myelinated axons are those in sensory nerve fibres and nerves connected to skeletal muscles. In non-myelinated cells, the nerve impulse is propagated more diffusely.
 When the electrical signal reaches the tip of an axon, it stimulates small presynaptic vesicles in the cell. These vesicles contain chemicals called neurotransmitters, which are released into the microscopic space between neurons (the synaptic cleft). The neurotransmitters subjoin of abounding deliberations to particularly specific receptors on the surface of the adjacent neuron their adherence of fastening or affix by a state of being firmly attached to the receptor or something that causes the adjacent cell to depolarize and propagate an action potential of its own. The duration of a stimulus from a neurotransmitter is limited by the breakdown of the chemicals in the synaptic cleft and the reuptake by the neuron that produced them. Formerly, each neuron was thought to make only one transmitter, but recent studies have shown that some cells progress of two or more.
 The signals conveying everything that human beings sense and think, and every motion they make, follows nerve pathways in the human body as waves of ions (atoms or groups of atoms that carries electric charges). Australian physiologist Sir John Eccles discovered many of the intricacies of this electrochemical signalling process, particularly the pivotal step in which a signal is conveyed from one nerve cell to another. He shared the 1963 Nobel Prize in physiology or medicine for this work, which he described in the 1965 Scientific American article.
 A neuron is a long cell that has a thick central area containing the nucleus, it also has one long process called an axon and one or more short, bushy processes called dendrites. Dendrites receive impulses from other neurons. (The exceptions are sensory neurons, such as those that transmit information about temperature or touch, in which the signal is generated by specialized receptors in the skin.) These impulses are propagated electrically along the cell membrane to the end of the axon. At the tip of the axon the signal is chemically transmitted to an adjacent neuron or muscle cell.
 Like all other cells, neurons contain charged ions: potassium and sodium (positively charged) and chlorine (negatively charged). Neurons differ from other cells in that they are able to produce a nerve impulse. A neuron is polarized - that is, it has an overall negative charge inside the cell membrane because of the high concentration of chlorine ions and low concentration of potassium and sodium ions. The concentration of these same ions is exactly reversed outside the cell. This charge differential represents stored electrical energy, sometimes referred to as membrane potential or resting potential. The negative charge inside the cell is maintained by two features. The first is the selective permeability of the cell membrane, which is more permeable to potassium than sodium. The second feature is sodium pumps within the cell membrane that actively pump sodium out of the cell. When depolarization occurs, this charge differential across the membrane is reversed, and a nerve impulse is produced.
 Depolarization is a rapid change in the permeability of the cell membrane. When sensory ideas or any other kind of stimulating current is received by the neuron, the membrane permeability is changed, allowing a sudden influx of sodium ions into the cell. The high concentration of sodium, or action potential, changes the overall charges within the cell from negative too positively in finding the local change in ion concentration, which triggers similar reactions along the membrane, propagating the nerve impulse. After a brief period called the ‘refractory period’, during which the ionic concentration returned to resting potential, the neuron can repeat this process.
 When the electrical signal reaches the tip of an axon, it stimulates small presynaptic vesicles in the cell. These vesicles contain chemicals called neurotransmitters, which are released into the microscopic space between the synaptic cleft. The neurotransmitters attach to specialized or specific receptors on the surface of the adjacent neuron. This stimulus causes the adjacent cell to depolarize and propagate an action potential of its own. The duration of a stimulus from a neurotransmitter is limited by the breakdown of the chemicals in the synaptic cleft and the reuptake by the neuron that produced them.
 If to say, that Roderick MacKinnon, born in 1956, is the American biomedical researcher and co-winner of the 2003 Nobel Prize in chemistry for his discoveries involving ion channels. The pores that govern the passage of molecules into and out of cells, in that of every second in each of the billions of cells in the human body, millions of ions, such as potassium and sodium, shuttles back and forth through these special portals in the cellular membrane. This action underlies a range of physiological processes, including muscle contraction and the communication of impulses between nerve cells. MacKinnon and his colleagues were the first to show the detailed structure of one type of ion channel.
 Born in 1956, MacKinnon grew up in Burlington, Massachusetts, outside Boston. He earned his bachelor’s degree in biochemistry from Brandeis University in Waltham, Massachusetts, in 1978, and his medical degree from Tufts University School of Medicine in Boston in 1982. After beginning a career in medicine, MacKinnon turned to biomedical research. Postdoctoral fellowships at Harvard University in Cambridge, Massachusetts, and Brandeis ultimately led to a professorship in the Department of Neurobiology at Harvard Medical School in 1989. In 1996 MacKinnon moved to Rockefeller University in New York City, where he became a professor of molecular Neurobiology and biophysics.
 To study an ion channel - in this case, a particular cellular protein involved in the transport of potassium - MacKinnon chose a difficult method known as X-ray crystallography. This method involves forming the protein into a crystal and then using X rays to determine the protein’s structure. Many scientists doubted that the approach would work, but in 1998 MacKinnon and his team achieved success, presenting a detailed three-dimensional picture of the potassium channel.
 In subsequent research, MacKinnon and his colleagues discovered more about the chemical workings of ion channels. This work helped to explain, for example, how such a pore permits the passage of millions of potassium ions per second while largely blocking the passage of sodium ions. Increased knowledge of these protein pores will be important for the design of future drugs because the malfunctioning of ion channels has been linked to heart disease and cystic fibrosis, among other illnesses.
 In addition to the Nobel Prize, MacKinnon has been honoured with the 1999 Albert Lasker Basic Medical Research Award. He shared the Nobel Prize with American biologist Peter Agre, who, in separate research, discovered the molecular channel through which cells transport water.
 When a neuron is in its resting state, its voltage is about -70 millivolts. An excitatory neurotransmitter alters the membrane of the postsynaptic neuron, making it possible for ions (electrically charged molecules) to move back and forth across the neuron’s membranes. This flow of ions makes the neuron’s voltage rise toward zero. If enough excitatory receptors have been activated, the postsynaptic neuron responds by firing, generating a nerve impulse that causes its own neurotransmitter to be released into the next synapse. An inhibitory neurotransmitter causes different ions to pass back and forth across the postsynaptic neuron’s membrane, lowering the nerve cell’s voltage to -80 or -90 millivolts. The drop in voltage makes it less likely that the postsynaptic cell will fire.
 If the postsynaptic cell is a muscle cell rather than a neuron, an excitatory neurotransmitter will cause the muscle to contract. If the postsynaptic cell is a gland cell, an excitatory neurotransmitter will cause the cell to secrete its contents.
 While most neurotransmitters interact with their receptors to create new electrical nerve impulses that energize or inhibit the adjoining cell, some neurotransmitter interactions do not generate or suppress nerve impulses. Instead, they interact with a second type of receptor that changes the internal chemistry of the postsynaptic cell by either causing or blocking the formation of chemicals called second messenger molecules. These second messengers regulate the postsynaptic cell’s biochemical processes and enable it to conduct the maintenance necessary to continue synthesizing neurotransmitters and conducting nerve impulses. Examples of second messengers, which are formed and entirely contained within the postsynaptic cell, include cyclic adenosine monophosphate, diacylglycerol, and inositol phosphates.
 Once neurotransmitters have been secreted into synapses and have passed on their chemical signals, the presynaptic neuron clears the synapse of neurotransmitter molecules. For example, acetylcholine is broken down by the enzyme acetylcholinesterase into choline and acetate. Neurotransmitters like dopamine, serotonin, and GABA is removed by a physical process called reuptake. In reuptake, a protein in the presynaptic membrane acts as a sort of sponge, causing the neurotransmitters to reenter the presynaptic neuron, where they can be broken down by enzymes or repackaged for reuse.
 Neurotransmitters are known to be involved in a number of disorders, including Alzheimer’s disease. Victims of Alzheimer’s disease suffer from loss of intellectual capacity, disintegration of personality, mental confusion, hallucinations, and aggressive - even violent - behaviour. These symptoms are the result of progressive degeneration in many types of neurons in the brain. Forgetfulness, one of the earliest symptoms of Alzheimer’s disease, is partly caused by the destruction of neurons that normally release the neurotransmitter acetylcholine. Medications that increase brain levels of acetylcholine have helped restore short-term memory and reduce mood swings in some Alzheimer’s patients.
 Neurotransmitters also play a role in Parkinson disease, which slowly attacks the nervous system, causing symptoms that worsen over time. Fatigue, mental confusion, a mask-like facial expression, stooping posture, shuffling gait, and problems with and speaking is among the difficulties suffered by Parkinson victims. These symptoms have been partly linked to the deterioration and eventual death of neurons that run from the base of the brain to the basal ganglia, a collection of nerve cells that manufacture the neurotransmitter dopamine. The reasons why such neurons die are yet to be understood, but the related symptoms can be alleviated. L-dopa, or levodopa, widely used to treat Parkinson disease, acts as a supplementary precursor for dopamine. It causes the surviving neurons in the basal ganglia to increase their production of dopamine, thereby compensating to some extent for the disabled neurons.
 Many other effective drugs have been shown to act by influencing neurotransmitter behaviour. Some drugs work by interfering with the interactions between neurotransmitters and intestinal receptors. For example, belladonna decreases intestinal cramps in such disorders as irritable bowel syndrome by blocking acetylcholine from combining with receptors. This process reduces nerve signals to the bowel wall, which prevents painful spasms.
 Other drugs block the reuptake process. One well-known example is the drug Fluoxetine (Prozac), which blocks the reuptake of serotonin. Serotonin then remains in the synapse for a longer time, and its ability to act as a signal is prolonged, which contributes to the relief of depression and the control of obsessive-compulsive behaviours.
 Neurotransmitters are released into a microscopic gap, called a synapse, that separates the transmitting neuron from the cell receiving the chemical signal. The cell that generates the signal is called the presynaptic cell, while the receiving cell is termed the postsynaptic cell.
 After their release into the synapse, neurotransmitters combine chemically with highly specific protein molecules, termed receptors, that are embedded in the surface membranes of the postsynaptic cell. When this combination occurs, the voltage, or electrical force, of the postsynaptic cell is either increased (excited) or decreased (inhibited).
 When a neuron is in its resting state, its voltage is about -70 millivolts. An excitatory neurotransmitter alters the membrane of the postsynaptic neuron, making it possible for ions (electrically charged molecules) to move back and forth across the neuron’s membranes. This flow of ions makes the neuron’s voltage rise toward zero. If enough excitatory receptors have been activated, the postsynaptic neuron responds by firing, generating a nerve impulse that causes its own neurotransmitter to be released into the next synapse. An inhibitory neurotransmitter causes different ions to pass back and forth across the postsynaptic neuron’s membrane, lowering the nerve cell’s voltage to -80 or -90 millivolts. The drop in voltage makes it less likely that the postsynaptic cell will fire.
 If the postsynaptic cell is a muscle cell rather than a neuron, an excitatory neurotransmitter will cause the muscle to contract. If the postsynaptic cell is a gland cell, an excitatory neurotransmitter will cause the cell to secrete its contents.
 While most neurotransmitters interact with their receptors to create new electrical nerve impulses that energize or inhibit the adjoining cell, some neurotransmitter interactions do not generate or suppress nerve impulses. Instead, they interact with a second type of receptor that changes the internal chemistry of the postsynaptic cell by either causing or blocking the formation of chemicals called second messenger molecules. These second messengers regulate the postsynaptic cell’s biochemical processes and enable it to conduct the maintenance necessary to continue synthesizing neurotransmitters and conducting nerve impulses. Examples of second messengers, which are formed and entirely contained within the postsynaptic cell, include cyclic adenosine monophosphate, diacylglycerol, and inositol phosphates.
 Once neurotransmitters have been secreted into synapses and have passed on their chemical signals, the presynaptic neuron clears the synapse of neurotransmitter molecules. For example, acetylcholine is broken down by the enzyme acetylcholinesterase into choline and acetate. Neurotransmitters like dopamine, serotonin, and GABA is removed by a physical process called reuptake. In reuptake, a protein in the presynaptic membrane acts as a sort of sponge, causing the neurotransmitters to reenter the presynaptic neuron, where they can be broken down by enzymes or repackaged for reuse.
 Severe mental illness almost always alters a person’s life dramatically. People with severe mental illnesses experience disturbing symptoms that can make it difficult in holding down a job, or go to school, relate to others, or cope with ordinary life demands. Some individuals require hospitalization because they become unable to care for themselves or because they are at risk of committing suicide.
 The symptoms of mental illness can be very distressing. People who develop schizophrenia may hear voices inside their head that say nasty things about them or command them to act in strange or unpredictable ways. Or they may be paralysed by paranoia - the deep conviction that everyone, including their closest family members, wants to injure or destroy them. People with major depression may feel that nothing brings pleasure and that life is so dreary and unhappy that it is better to be dead. People with panic disorder may experience heart palpitations, rapid breathing, and anxiety so extreme that they may not be able to leave home. People whom experience episodes of mania may engage in reckless sexual behaviour or may spend money indiscriminately, acts that later cause them to feel guilt, shame, and desperation.
 Other mental illnesses, while not always debilitating, create certain problems in living. People with personality disorders may experience loneliness and isolation because their personality style interferes with social relations. People with an eating disorder may become so preoccupied with their weight and appearance that they force themselves to vomit or refuse to eat. Individuals who develop post-traumatic stress disorder may become angry easily, experience disturbing memories, and have trouble concentrating.
 Experiences of mental illness often differ to be unlike or distinct in nature as it depends on one’s culture or social group, sometimes greatly so. For example, in most of the non-Western world, people with depression complain principally of physical ailments, such as lack of energy, poor sleep, loss of appetite, and various kinds of physical pain. And yet, even in North America these complaints are commonplace. But in the United States and other Western societies, depressed people and mental health professionals who treat them tend to emphasize psychological problems, such as feelings of sadness, worthlessness, and despair. The experience of schizophrenia also differs by culture. In India, one-third of the new cases of schizophrenia involve catatonia, a behavioural condition in which a person maintains a bizarre statue-like posture for hours or days. This condition is rare in Europe and North America.
 Schizophrenia, is a very severe mental illness characterized by a variety of symptoms, including loss of contact with reality, bizarre behaviour, disorganized thinking and speech, decreased emotional expressiveness, and social withdrawal. Usually only some of these symptoms occur in any one person. The term schizophrenia comes from Greek words meaning “split mind.” However, contrary to common belief, schizophrenia does not refer to a person with a split personality or multiple personality. For a description of a mental illness in which a person has multiple personalities, to observers, schizophrenia may seem like madness or insanity, but persons with schizophrenia have disturbed, frightening thoughts and may have trouble telling the difference between real and unreal experiences.
 Perhaps more than any other mental illness, schizophrenia has a debilitating effect on the lives of the people who suffer from it. A person with schizophrenia may have difficulty telling the difference between real and unreal experiences, logical and illogical thoughts, or appropriate and inappropriate behavioural interactions whose appropriations are to  express of the  objectifying descriptions upon the cases to act of having or having to carry of a definite direction, resisting  upon those forms that exploit the contribution in weights of others, or sustain without the adequate issues for which exists or going together without conflict or incongruity, which are accorded to the agreeing conditions, that are disinherently limited. Schizophrenia seriously impairs a person’s ability to work, go to school, enjoy relationships with others, or take care of oneself. In addition, people with schizophrenia frequently require hospitalization because they pose a danger to themselves. About 10 percent of people with schizophrenia commit suicide, and many others attempt suicide. Once people develop schizophrenia, they usually suffer from the illness for the rest of their lives. Although there is no cure, treatment can help many people with schizophrenia lead productive lives.
 Schizophrenia also carries an enormous cost to society. People with schizophrenia occupy about one-third of all beds in psychiatric hospitals in the United States. In addition, people with schizophrenia account for at least 10 percent of the homeless population in the United States. The National Institute of Mental Health has estimated that schizophrenia costs the United States tens of billions of dollars each year in direct treatment, social services, and lost productivity.
 Approximately 1 percent of people develop schizophrenia at some time during their lives. Experts estimate that about 1.8 million people in the United States have schizophrenia. The prevalence of schizophrenia is rather being one than another or more, regardless of sex, race, and culture. Although women are just as likely as men to develop schizophrenia, women tend to experience the illness to a lesser extent than is severely, with fewer hospitalizations and better social functioning in the community.
 Schizophrenia usually develops in late adolescence or early adulthood, between the ages of 15 and 30. Much less common, schizophrenia develops later in life. The illness may begin abruptly, but it usually develops slowly over months or years. Mental health professionals diagnose schizophrenia based on an interview with the patient in which they determine whether the person has experienced specific symptoms of the illness.
 Symptoms and functioning in people with schizophrenia tend to vary over time, sometimes worsening and other times improving. For many patients the symptoms gradually become less severe as they grow older. About 25 percent of people with schizophrenia become symptom-free later in their lives.
 A variety of symptoms characterize schizophrenia. The most prominent include symptoms of psychosis - such as delusions and hallucinations - as well as bizarre behaviour, strange movements, and disorganized thinking and speech. Many people with schizophrenia do not recognize that their mental functioning is disturbed.
 Delusions are false beliefs that appear obviously untrue to other people. For example, a person with schizophrenia may believe that he is the king of England when he is not. People with schizophrenia may have delusions that others, such as the local police or the FBI are plotting against them or spying on them. They may believe that aliens are controlling their thoughts or that their own thoughts are being broadcast to the world so that other people can hear them.
 People with schizophrenia may also experience hallucinations (false sensory perceptions). People with hallucinations see, hear, smell, feel, or taste things that are not really there. Auditory hallucinations, such as hearing voices when no one else is around, are especially common in schizophrenia. These hallucinations may include, in and around two or more voices conversing with other, voices that continually comment on the person’s life, or voices that command the person to do something.
 People with schizophrenia often behave bizarrely. They may talk to themselves, walk backward, laugh suddenly without explanation, make funny faces, or masturbate in public. In rare cases, they maintain a rigid, bizarre pose for hours on end. Alternately, they may engage in constant random or repetitive movement, such that the actions justified, the dynamical situation has proven current to the motional services in moderation that include the primary presence of its operateness.
 People with schizophrenia sometimes talk in incoherent or nonsensical ways, which may commonly suggest of an impounding distinction the impact to cause confused or disorganized thinking? In conversation they may eradicably jump from subject to subject or string together loosely associated phrases. They may combine words and phrases in meaningless ways or make up new words. In addition, they may show poverty of speech, in which they talk less and more slowly than other people, fail to answer questions or reply only briefly, or suddenly stop talking in the middle of speech.
 Another common characteristic of schizophrenia is social withdrawal. People with schizophrenia may avoid others or act as though others do not exist. They often show decreased emotional expressiveness. For example, they may talk in a low, monotonous voice, avoid eye contact with others, and display a blank facial expression. They may also have difficulties experiencing pleasure and may lack interest in participating in activities.
 Other symptoms of schizophrenia include difficulties with memory, attention span, abstract thinking, and planning ahead. People with schizophrenia commonly have problems with anxiety, depression, and suicidal thoughts. In addition, people with schizophrenia are much more likely to abuse or become dependent upon drugs or alcohol than other people. The use of alcohol and drugs often worsens the symptoms of schizophrenia, resulting in relapses and hospitalizations.
 Schizophrenia appears to result not from a single cause, but from a variety of factors. Most scientists believe that schizophrenia is a biological disease caused by genetic factors, an imbalance of chemicals in the brain, structural brain abnormalities, or abnormalities in the prenatal environment. In addition, stressful life events may contribute to the development of schizophrenia in those who are predisposed to the illness.
 Research shows that the more genetically related a person is to someone with schizophrenia, the greater the risk that person has of developing the illness. For example, children of one parent with schizophrenia have a 13 percent chance of developing the illness, whereas children of two parents with schizophrenia have a 46 percent chance of developing the disorder.
 Mental health professionals do not rely on psychotherapy to treat schizophrenia, a severe mental illness. Drugs are used to treat this disorder. However, some psychotherapeutic techniques may help people with schizophrenia learn appropriate social skills and skills for managing anxiety. Another severe mental illness, bipolar disorder (popularly called manic depression), is treated with drugs or a combination of drugs and psychotherapy.
 Some evidence suggests that schizophrenia may result from an imbalance of chemicals in the brain called neurotransmitters. These chemicals enable neurons (brain cells) to communicate with other. Some scientists suggest that schizophrenia result from excess activity of the neurotransmitter dopamine in certain parts of the brain or from an abnormal sensitivity to dopamine. Support for this hypothesis comes from Antipsychotic drugs, which reduce psychotic symptoms in schizophrenia by blocking brain receptors for dopamine. In addition, amphetamines, which increase dopamine activity, intensify psychotic symptoms in people with schizophrenia. Despite these findings, many experts believe that excess dopamine activity alone cannot account for schizophrenia. Other neurotransmitters, such as serotonin and norepinephrine, may play important roles as well.
 Brain imaging techniques, such as magnetic resonance imaging and positron-emission tomography, have led researchers to discover specific structural abnormalities in the brains of people with schizophrenia. For example, people with chronic schizophrenia tend to have enlarged brain ventricles (cavities in the brain that contains cerebrospinal fluid). They also have a smaller overall volume of brain tissue compared to mentally healthy people. Other people with schizophrenia show abnormally low activity in the frontal lobe of the brain, which governs abstract thought, planning, and judgment. Research has identified possible abnormalities in many other parts of the brain, including the temporal lobes, basal ganglia, thalamus, hippocampus, and superior temporal gyrus. These defects may partially explain the abnormal thoughts, perceptions, and behaviours that characterize schizophrenia.
 Evidence suggests those factors in the prenatal environment and during birth can increase the risk of a person later developing schizophrenia. These events are believed to affect the brain development of the fetus during a critical period. For example, pregnant women who have been exposed to the influenza virus or who have poor nutrition have a slightly increased chance of giving birth to a child who later develops schizophrenia. In addition, obstetric complications during the birth of a child - for example, delivery with forceps - can slightly increase the chances of the child later developing schizophrenia.
 Although scientists favour a biological cause of schizophrenia, stress in the environment may affect the onset and course of the illness. Stressful life circumstances - such as growing up and living in poverty, the death of a loved one, an important change in jobs or relationships, or chronic tension and hostility at home - can increase the chances of schizophrenia in a person biologically predisposed to the disease. In addition, stressful events can trigger a relapse of symptoms in a person who already has the illness. Individuals who have effective skills for managing stress may be less susceptible to its negative effects. Psychological and social rehabilitation can help patients develop more effective skills for dealing with stress.
 Although there is no cure for schizophrenia, effective treatment exists that can improve the long-term course of the illness. With many years of treatment and rehabilitation, significant numbers of people with schizophrenia experience partial or full remission of their symptoms.
 Treatment of schizophrenia usually involves a combination of medication, rehabilitation, and treatment of other problems the person may have. Antipsychotic drugs (also called neuroleptics) are the most frequently used medications for treatment of schizophrenia. Psychological and social rehabilitation programs may help people with schizophrenia function in the community and reduce stress related to their symptoms. Treatment of secondary problems, such as substance abuse and infectious diseases, is also an important part of an overall treatment program.
 Serotonin, neurotransmitter, or chemical that transmits messages across the synapses, or gaps, between adjacent cells, in among the many functions, serotonin is released from blood cells called platelets to activate blood vessel constriction and blood clotting. In the gastrointestinal tract, serotonin inhibits gastric acid production and stimulates muscle contraction in the intestinal wall. Its functions in the central nervous system and effects on human behaviour - including mood, memory, and appetite control - have been the subject of a great deal of research. This intensive study of serotonin has revealed important knowledge about the serotonin-related cause and treatment of many illnesses.
 Serotonin is produced in the brain from the amino acid tryptophan, which is derived from foods high in protein, such as meat and dairy products. Tryptophan is transported to the brain, where it is broken down by enzymes to produce serotonin. In the process of neurotransmission, serotonin is transferred from one nerve cell, or neuron, to another, triggering an electrical impulse that stimulates or inhibits cell activity as needed. Serotonin is then reabsorbed by the first neuron, in a process known as reuptake, where it is recycled and used again or converted into an inactive chemical form and excreted.
 While the complete picture of serotonin’s function in the body is still being investigated, many disorders are known to be associated with an imbalance of serotonin in the brain. Drugs that manipulate serotonin levels have been used to alleviate the symptoms of serotonin imbalances. Some of these drugs, known as selective serotonin reuptake inhibitors (SSRIs), block or inhibit the reuptake of serotonin into neurons, enabling serotonin to remain active in the synapses for a longer period of time. These medications are used to treat such psychiatric disorders as depression; obsessive-compulsive disorder, in which repetitive and disturbing thoughts trigger bizarre, ritualistic behaviours; and impulsive aggressive behaviours. Fluoxetine (more commonly known by the brand name Prozac), is a widely prescribed SSRI used to treat depression, and more recently, obsessive-compulsive disorder.
 Drugs that affect serotonin levels may prove beneficial in the treatment of nonpsychiatric disorders as well, including diabetic neuropathy (degeneration of nerves outside the central nervous system in diabetics) and premenstrual syndrome. Recently the serotonin-releasing agent dexfenfluramine has been approved for patients who are 30 percent or more over their ideal body weight. By preventing serotonin reuptake, dexfenfluramine promotes satiety, or fullness, after eating less food.
 Other drugs serve as agonists that react with neurons to produce effects similar to those of serotonin. Serotonin agonists have been used to treat migraine headaches, in which low levels of serotonin cause arteries in the brain to swell, resulting in a headache. Sumatriptan is an agonist drug that mimics the effects of serotonin in the brain, constricting blood vessels and alleviating pain.
 Drugs known as antagonists bind with neurons to prevent serotonin neurotransmission. Some antagonists have been found effective in treating the nausea that typically accompanies radiation and chemotherapy in cancer treatment. Antagonists are also being tested to treat high blood pressure and other cardiovascular disorders by blocking serotonin’s ability to constrict blood vessels. Other antagonists may produce an effect on learning and memory in age-associated memory impairment.
 Antipsychotic medications, developed in the mid-1950's, can dramatically improve the quality of life for people with schizophrenia. The drugs reduce or eliminate psychotic symptoms such as hallucinations and delusions. The medications can also help prevent these symptoms from returning. Common Antipsychotic drugs include risperidone (Risperdal), olanzapine (Zyprexa), clozapine (Clozaril), quetiapine (Seroquel), haloperidol (Haldol), thioridazine (Mellaril), chlorpromazine (Thorazine), fluphenazine (Prolixin), and trifluoperazine (Stelazine). People with schizophrenia must usually take medication for the rest of their lives to control psychotic symptoms. Antipsychotic medications appear to be less effective at treating other symptoms of schizophrenia, such as social withdrawal and apathy.
 Antipsychotic drugs help reduce symptoms in 80 to 90 percent of people with schizophrenia. However, those who benefit often stop taking medication because they do not understand that they are ill or because of unpleasant side effects. Minor side effects include weight gain, dry mouth, blurred vision, restlessness, constipation, dizziness, and drowsiness. Other side effects are more serious and debilitating. These may include muscle spasms or cramps, tremors, and tardive dyskinesia. Newer drugs, such as clozapine, olanzapine, risperidone, and quetiapine, tend to produce fewer of these side effects. However, clozapine can cause agranulocytosis, a significant reduction in white blood cells necessary to fight infections. This condition can be fatal if not detected early enough. For this reason, people taking clozapine must have weekly tests to monitor their blood.
 Because many patients with schizophrenia continue to experience difficulties despite taking medication, psychological and social rehabilitation is often necessary. A variety of methods can be effective. Social skills training help people with schizophrenia learn specific behaviours for functioning in society, such as making friends, purchasing items at a store, or initiating conversations. Behavioural training methods can also help them learn self-care skills such as personal hygiene, money management, and proper nutrition. In addition, cognitive-behavioural therapy, a type of psychotherapy, can help reduce persistent symptoms such as hallucinations, delusions, and social withdrawal.
 Family intervention programs can also benefit people with schizophrenia. These programs focus on helping family members understand the nature and treatment of schizophrenia, how to monitor the illness, and how to help the patient make progress toward personal goals and greater independence. They can also lower the stress experienced by everyone in the family and help prevent the patient from relapsing or being rehospitalized.
 Because many patients have difficulty obtaining or keeping jobs, supported employment programs that help patients find and maintain jobs are a helpful part of rehabilitation. In these programs, the patient works alongside people without disabilities and earns competitive wages. An employment specialist (or a vocational specialist) helps the person maintain their job by, for example, training the person in specific skills, helping the employer accommodate the person, arranging transportation, and monitoring performance. These programs are most effective when the supported employment is closely integrated with other aspects of treatment, such as medication and monitoring of symptoms.
 Some people with schizophrenia are vulnerable to frequent crises because they do not regularly go to mental health centres to receive the treatment they need. These individuals often relapse and face rehospitalization. To ensure that such patients take their medication and receive appropriate psychological and social rehabilitation, assertive community treatment (ACT) programs have been developed that deliver treatment to patients in natural settings, such as in their homes, in restaurants, or on the street.
 People with schizophrenia often have other medical problems, so an effective treatment program must attend to these as well. One of the most commonly associated problems is substance abuse. Successful treatment of substance abuse in patients with schizophrenia requires careful coordination with their mental health care, so that the same clinicians are treating both disorders at the same time.
 The high rate of substance abuse in patients with schizophrenia contributes to a high prevalence of infectious diseases, including hepatitis B and C and the human immunodeficiency virus (HIV). Assessment, education, and treatment or management of these illnesses is critical for the long-term health of patients.
 Other problems frequently associated with schizophrenia include housing instability and homelessness, legal problems, violence, trauma and post-traumatic stress disorder, anxiety, depression, and suicide attempts. Close monitoring and psychotherapeutic interventions are often helpful in addressing these problems.
 Certain personality traits may also directively lead to stress-related disorders. The so-called Type A personality, characterized by competitive, hard-driving intensity, is common in American society. Although early studies suggested a link between Type A behaviour and coronary heart disease, most studies since the 1980s have failed to find such a relationship. However, research has consistently demonstrated that people who show a high level of hostility, anger, and cynicism - often components of Type A behaviour - have a higher risk of coronary heart disease than people without these traits.
 Several other psychiatric disorders are closely related to schizophrenia. In schizoaffective disorder, a person shows symptoms of schizophrenia combined whether mania or severe depression. Schizophreniform disorder refers to an illness in which a person experiences schizophrenic symptoms for more than one month but fewer than six months. In schizotypal personality disorder, a person engages in odd thinking, speech, and behaviour, but usually does not lose contact with reality
 The occurring personality disorders, disorders in which one’s personality results in personal state of being agitated with doubt or mental conflict as unconcerning a crazed derangement or significantly inflicting something that gives rise to the defragmentation of the social or working function, such that of every person has a personality — that is to say, a characteristic way of thinking, feeling, behaving, and relating to others. Most people experience at least some difficulties and problems that result from their personality. The specific point at which those problems justify the diagnosis of a personality disorder is controversial. To some extent the definition of a personality disorder is arbitrary, reflecting  as well as professional judgments about the person’s degree of dysfunction, needs for change, and motivation for change.
 The occurring personality disorders involve behaviour that deviates from the norms or expectations of one’s culture. However, people who digress from cultural norms are not necessarily dysfunctional, nor are people who conform to cultural norms necessarily healthy. Many personality disorders represent extreme variants of behaviour patterns that people usually value and encourage. For example, most people value confidence but not arrogance, agreeableness but not submissiveness, and conscientiousness but not perfectionism.
 Because no clear line exists between healthy and unhealthy functioning, critics question the reliability of personality disorder diagnoses. A behaviour that seems deviant to one person may seem normal to another depending on one’s gender, ethnicity, and cultural background. The personal and cultural biases of mental health professionals may influence their diagnoses of personality disorders.
 An estimated 20 percent of people in the general population have one or more personality disorders. Some people with personality disorders have other mental illnesses as well. About 50 percent of people who are treated for any psychiatric disorder have a personality disorder.
 Mental health professionals rarely diagnose personality disorders in children because their manner of thinking, feeling, and relating to others does not usually stabilize until young adulthood. Thereafter, personality traits usually remain stable. Personality disorders often decrease in severity as some person ages.
 People with antisocial personality disorder act in a way that disregards the feelings and rights of other people. Antisocial personalities often break the law, and they may use or exploit other people for their own gain. They may lie repeatedly, act impulsively, and get into physical fights. They may mistreat their spouses, neglect or abuse their children, and exploit their employees. They may even kill other people. People with this disorder are also sometimes called sociopaths or psychopaths. Antisocial behaviour in people less than 18 years old is called conduct disorder.
 Antisocial personalities usually fail to understand that their behaviour is dysfunctional because their ability to feel guilty, remorseful, and anxious is impaired. Guilt, remorse, shame, and anxiety are unpleasant feelings, but they are also necessary for social functioning and even physical survival. For example, people who are found in their deficiency, such as their ability to feel anxious will often fail to anticipate actual dangers and risks. They may take chances that other people would not take.
 Antisocial personality disorder affects about 3 percent of males and 1 percent of females. This is the most heavily researched personality disorder, in part because it costs society the most. People with this disorder are at high risk for premature and violent death, injury, imprisonment, loss of employment, bankruptcy, alcoholism, drug dependence, and failed personal relationships.
 People with borderline personality disorder experience intense emotional instability, particularly in relationships with others. They may make frantic efforts to avoid real or imagined abandonment by others. They may experience minor problems as major crises. They may also express their anger, frustration, and dismay through suicidal gestures, self-mutilation, and other self-destructive acts. They tend to have an unstable self-image or sense of self.
 As children, most people with this disorder were emotionally unstable, impulsive, and often bitter or angry, although their chaotic impulsiveness and intense emotions may have made them popular at school. At first they may impress people as stimulating and exciting, but their relationships tend to be unstable and explosive.
 About 2 percent of all people have borderline personality disorder. About 75 percent of people with this disorder are female. Borderline personalities are at high risk for developing depression, alcoholism, drug dependence, bulimia, Dissociative disorders, and post-traumatic stress disorder. As many as 10 percent of people with this disorder commit suicide by the age of 30. People with borderline personality disorder are among the most difficult to treat with psychotherapy, in part because their relationship with their therapist may become as intense and unstable as their other personal relationships.
 Avoidant personality disorder is social withdrawal due to intense, anxious shyness. People with Avoidant personalities are reluctant to interact with others unless they feel certain of the likened impact, which they fear for being criticized or rejected. Often they view themselves as socially inept and inferior to others.
 Many psychiatrists and psychologists use two additional diagnoses. Depressive personality disorder is characterized by chronic pessimism, gloominess, and cheerlessness. In passive-aggressive personality disorder, a person passively resists completing tasks and chores, criticizes and scorns authority figures, and seems negative and sullen.
 Personality disorders result from a complex interaction of inherited traits and life experience, not from a single cause. For example, some cases of antisocial personality disorder may result from a combination of a genetic predisposition to impulsiveness and violence, very inconsistent or erratic parenting, and a harsh environment that discourage feelings of empathy and warmth but rewards exploitation and aggressiveness. Borderline personality disorder may result from a genetic predisposition to impulsiveness and emotional instability combined with parental neglect, intense marital conflicts between parents, and repeated episodes of severe emotional or sexual abuse. Dependent personality disorder may result from genetically based anxiety, an inhibited temperament, and overly protective, clinging, or neglectful parenting.
 The pervasive and chronic nature of personality disorders makes them difficult to treat. People with these disorders often fail to recognize that their personality has contributed to their social, occupational, and personal problems. They may not think they have any real problems despite a history of drug abuse, failed relationships, and irregular employment. Thus, therapists must first focuses on helping the person understand and become aware of the significance of their personality traits.
 People with personality disorders sometimes feel that they can never change their dysfunctional behaviour because they have always acted the same way. Although personality change is exceedingly difficult, sometimes people can change the most dysfunctional aspects of their feelings and behaviour.
 Therapists use a variety of methods to treat personality disorders, depending on the specific disorder. For example, cognitive and behavioural techniques, such as role playing and logical argument, may help alter a person’s irrational perceptions and assumptions about himself or herself. Certain psychoactive drugs may help control feelings of anxiety, depression, or severe distortions of thought. Psychotherapy may help people to understand the impact of experiences and  responsibilities. These programs appear to help some people, but it is unclear how long their beneficial effects last.
 The appropriate treatment, most people can recover from mental illness and return to normal life. Even those with persistent, long-term mental illnesses can usually learn to manage their symptoms and live productive lives.
 In most societies mental illness carries a substantial stigma, or mark of shame. The mentally ill, were at most, blamed for their own ill’s, blamed for bringing it upon their own illnesses, and others may see them as victims of bad fate, religious and moral transgression, or witchcraft. Such stigmas may keep families from acknowledging that a family member is ill. Some families may hide or overprotect a member with mental illness - keeping the person from receiving potentially effective care - or they may reject the person from the family. When magnified from individuals to a whole society, such attitudes lead to underfunding of mental health services and terribly inadequate care. In much of the world, even today, the mentally ill, were chained, shackled and caged, or hospitalized in filthy, brutal institutions. Yet attitudes toward mental illness have improved in many areas, especially owing to a heralded breed and advocacy for the mentally ill.
 Mental illness creates enormous social and economic costs. Depression, for example, affects some 500 million people in the world and results in more time lost to disability than such chronic diseases as diabetes mellitus and arthritis. Estimating the economic cost of mental illness is complex because there are direct costs (actual medical expenditures), indirect costs (the cost to individuals and society due to reduced or lost productivity, for example), and support costs (time lost to care of family members with mental illnesses).
 Another method of estimating the cost of mental illness to society measures the impact of premature deaths and disablements. Research by the World Health Organization and the World Bank estimated that in 1990, among the world’s population aged 15 to 44 years, depression accounted for more than 10 percent of the total burden attributable to all diseases. Two other illnesses, bipolar disorder and schizophrenia, accounted for another 6 percent of the burden. This research has helped governments recognize that mental illnesses constitute a far greater challenge to public health systems than previously realized.
 No universally accepted definition of mental illness exists. Usually, the definition of mental illness depends on a society’s norms, or rules of behaviour. Behaviours that violate these norms are considered signs of deviance or, in some cases, of mental illness.
 The variation in behavioural norms does not mean, however, that definitions of mental illness are necessarily incompatible across cultures. Many behaviours are recognized throughout the world for being indicative of mental illness. These include extreme social withdrawal, violence to oneself, hallucinations (false sensory perceptions), and delusions (fixed, false ideas).
 Another way of defining mental illness is based on whether a person’s behaviours are maladaptive - that is, whether they cause a person to experience problems in coping with common life demands. For example, people with social phobias may avoid interacting with other people and experience problems at work as a result. Critics note that under this definition, political dissidents could be considered mentally ill for refusing to accept the dictates of their government.
 Mental illness affects people of all ages, races, cultures, and socioeconomic classes. The prevalence of mental illness refers to what degree or to the greater extent do peoples experience of a mental illness during a specified period.
 Psychosomatic Illness, illness that has no basic physical or organic cause but appears to be the result of psychological conditions, such as stress, anxiety, and depression. Such illnesses reflect the general belief that the mind is capable of strongly affecting bodily reactions, and that a person’s mental condition can actually cause changes in the chemistry of the body, thereby creating physical illness. In cases of psychosomatic illness, a marked change in the body can often be readily detected.
 The most effective treatment for psychosomatic disorders takes account into  both the physical and the emotional aspects of the disease. The physical symptoms cannot usually be cured until the person’s psychological environment has improved. For instance, a business executive working under severe pressure may develop ulcers. Although medicine and a special diet can improve this condition, if the person fails to cut down on work or learn relaxation techniques, he or she will probably continue to suffer from the disease and may even develop additional psychosomatic illnesses. In more serious cases of psychosomatic illness, doctors may recommend that the patient undergo some form of psychotherapy in addition to treatment for the physical aspects of the illness.
 Depression can take several other forms. In bipolar disorder, sometimes called manic-depressive illness, a person’s mood swings back and forth between depression and mania. People with seasonal affective disorder typically suffer from depression only during autumn and winter, when there are fewer hours of daylight. In dysthymia, people feel depressed, have low self-esteem, and concentrate poorly most of the time - often for a period of years - but their symptoms are milder than in major depression. Some people with dysthymia experience occasional episodes of major depression. Mental health professionals use the term clinical depression to refer to any of the above forms of depression.
 Major depression, the most severe form of depression, affects from 1 to 2 percent of people aged 65 or older who are living in the community (rather than in nursing homes or other institutions). The prevalence of depression and other mental illnesses is much higher among elderly residents of nursing homes. Although most older people with depression respond to treatment, many cases of depression among the elderly go undetected or untreated. Research indicates that depression is a major risk factor for suicide among the elderly in the United States. People over age 65 in the United States have the highest suicide rate of any age group.
 Generally, the overall prevalence rates of mental illnesses between men and women are similar. However, men have much higher rates of antisocial personality disorder and substance abuse. In the United States, women suffer from depression and anxiety disorders at about twice the rate of men. The gender gap is even wider in some countries. For example, in China, women suffer from depression at nine times the rate of men.
 Mental illness is becoming an increasing problem for two reasons. First, increases in life expectancy have brought increased numbers of certain chronic mental illnesses. For example, because more people are living into old age, more people are suffering from dementia. Second, a number of studies provide evidence that rates of depression are rising throughout the world. The reasons may be related to such factors as economic change, political and social violence, and cultural disruptions. While some have questioned these findings, dramatic increases in the numbers of refugees and people dislocated from their homes by economic forces or civil strife are associated with great increases in a variety of mental illnesses for those populations. According to the United Nations High Commissioner for Refugees, the number of refugees worldwide increased from 2.5 million in 1971 to 13.2 million in 1996, peaking at 17 million in 1991.
 A number of mental illnesses - such as depression, anxiety disorders, schizophrenia, and bipolar disorder - occur worldwide. Others seem to occur only in particular cultures. For example, eating disorders, such as anorexia nervosa (compulsive dieting associated with unrealistic fears of fatness), occurs mostly between girls and women in Europe, North America, and Westernized areas of Asia, whose cultures view thinness as an essential component of female beauty. In Latin America, people who are met with directly (as through participation or observation) in having known the intimacy or inward practices that are acquainted or familiar with or versed of something based on the personal exposure seem as been awarded of an experience, perhaps, an experience overwhelming of some causal reason to fright after a dangerous or traumatic event is said to have sustained (fright), an illness in which their soul has been frightened away. In some societies of West Africa and elsewhere, brain fatigue describes individuals (usually students) who experience difficulties in concentrating and thinking, as well as physical symptoms of pain and wearing out.
 Most mental health professionals in the United States use the Diagnostic and Statistical Manual of Mental Disorders(DSM), a reference book published by the American Psychiatric Association, as a guide to the different kinds of mental illnesses. The foundation, known as DSM-IV, describes more than 300 mental disorders, behavioural disorders, addictive disorders, and other psychological problems and groups them into broad categories. This describes some of the major categories, including anxiety disorders, mood disorders, schizophrenia and other psychotic disorders, personality disorders, cognitive disorders, Dissociative disorders, somatoform disorders, factitious disorders, substance-related disorders, eating disorders, and impulse-control disorders. Mental health professionals in many other parts of the world use a different classification system, the International Classification of Diseases (ICD), published by the World Health Organization.
 The DSM and ICD are both categorical systems of classification, in which each mental illness is defined by its own unique set of symptoms and characteristics. In theory, each disorder should possess diagnostic criteria that are independent of from each one and another, just as tuberculosis and lung cancer are discrete diseases. Yet symptoms of many mental disorders overlap, and many people - such as those who experience both depression and severe anxiety - show symptoms of more than one disorder at the same time. For these reasons, some mental health professionals advocate a dimensional system of classification. In contrast to the categorical approach, which sees mental disorders as qualitatively distinct from normal behaviour, a dimensional system views behaviour as falling along a continuum of normality, with some behaviours considered more abnormally than others. In a dimensional system, diagnoses do not describe discrete diseases but rather portray the relative importance of an array of symptoms.
 Mood disorders, also called affective disorders, create disturbances in a person’s emotional life. Depression, mania, and bipolar disorder are examples of mood disorders. Symptoms of depression may include feelings of sadness, hopelessness, and worthlessness, as well as complaints of physical pain and changes in appetite, sleep patterns, and energy level. In mania, on the other hand, an individual experiences an abnormally elevated mood, often marked by exaggerated self-importance, irritability, agitation, and a decreased need for sleep. In bipolar disorder, also called manic-depressive illness, a person’s mood alternates between extremes of mania and depression.
 Bipolar disorder is a mental illness that causes mood swings. In the manic phase, a person might feel ecstatic, self-important, and energetic. But when the person becomes depressed, the mood shifts to extreme sadness, negative thinking, and apathy. Some studies indicate that the disease occurs at unusually high rates in creative people, such as artists, writers, and musicians. But some researchers contend that the methodology of these studies was flawed and their results were misleading. In the October 1996 Discover Magazine article, anthropologist Jo Ann C. Gutin presents the results of several studies that explore the link between creativity and mental illness.
 People with schizophrenia and other psychotic disorders lose contact with reality. Symptoms may include delusions and hallucinations, disorganized thinking and speech, bizarre behaviour, a diminished range of emotional responsiveness, and social withdrawal. In addition, people who suffer from these illnesses experience and inability function operates in one or more important areas of life, such as social relations, work, or school.
 Personality disorders are mental illnesses in which one’s personality results in personal distress or a significant impairment in social or work functioning. Overall, people with personality disorders have poor perceptions of themselves or others. They may have low self-esteem or overwhelming narcissism, poor impulse control, troubled social relationships, and inappropriate emotional responses. Considerable controversy exists over where to draw the distinction between a normal personality and a personality disorder.
 Cognitive disorders, such as delirium and dementia, involve a significant loss of mental functioning. Dementia, for example, is characterized by impaired memory and difficulties in such functions as speaking, abstract thinking, and the ability to identify familiar objects. The conditions in this category usually result from a medical condition, substance abuse, or adverse reactions to medication or poisonous substances.
 Dissociative disorders involve disturbances in a person’s consciousness, memories, identity, and perception of the environment. Dissociative disorders include amnesia that has no physical cause; Dissociative identity disorders, in which a person has what more is less, such are the considerations in having two or more distinct personalities that alternate in their control of the person’s behaviour; depersonalization disorder, characterized by a chronic feeling of being detached from one’s body or mental processes; and Dissociative fatigue, an episode of sudden departure from home or work with an accompanying loss of memory. In some parts of the world people experience Dissociative states as ‘possession’, is that by a god or ghost instead of separate personalities, insofar as  many societies, a trance and possession states are normal parts of cultural and religious practices, as well as, to what they are, and not too considered for Dissociative disorders.
 Somatoform disorders are characterized by the presence of physical symptoms that cannot be explained by a medical condition or another mental illness. Thus, physicians often judge that such symptoms result from psychological conflicts or distress. For example, in conversion disorder, also called hysteria, a person may experience blindness, deafness, or seizures, but a physician cannot find anything wrong with the person. People with another somatoform disorder, hypochondriasis, constantly fear that they will develop a serious disease and misinterpret minor physical symptoms as evidence of illness.
 Substance-related disorders result from the abuse of drugs, side effects of medications, or exposure to toxic substances. Many mental health professionals regard these disorders as behavioural or addictive disorders rather than as mental illnesses, although substance-related disorders commonly occur in people with mental illnesses. Common substance-related disorders include alcoholism and other forms of drug dependence. In addition, drug use can contribute to symptoms of other mental disorders, such as depression, anxiety, and psychosis. Drugs associated with substance-related disorders include alcohol, caffeine, nicotine, cocaine, heroin, amphetamines, hallucinogens, and sedatives.
 Eating disorders are conditions in which an individual experience severe disturbances in eating behaviours. People with anorexia nervosa have an intense fear about gaining weight and refuse to eat adequately or maintain a normal body weight. People with bulimia nervosa repeatedly engage in episodes of binge eating, usually followed by self-induced vomiting or the use of laxatives, diuretics, or other medications to prevent weight gain. Eating disorders occur mostly among young women in Western societies and certain parts of Asia.
 People with impulse-control disorders cannot control an impulse to engage in harmful behaviours, such as explosive anger, stealing (kleptomania), setting fires (pyromania), gambling, or pulling out their own hair (trichotillomania). Some mental illnesses - such as mania, schizophrenia, and antisocial personality disorder - may include symptoms of impulsive behaviour.
 People have tried to understand the causes of mental illness for thousands of years. The modern era of psychiatry, which began in the late 19th and early 20th centuries, has witnessed a sharp debate between biological and psychological perspectives of mental illness. The biological perspective views mental illness in terms of bodily processes, whereas psychological perspectives emphasize the roles of a person’s upbringing and environment.
 These two perspectives are exemplified in the work of German psychiatrist Emil Kraepelin and Austrian psychoanalyst Sigmund Freud. Kraepelin, influenced by the work in the mid-1800's of German psychiatrist Wilhelm Griesinger, believed that psychiatric disorders were disease entities that could be classified like physical illnesses. That is, Kraepelin believed that the fundamental causes of mental illness lay in the physiology and biochemistry of the human brain. His classification system of mental disorders, first published in 1883, formed the basis for later diagnostic systems. Freud, on the other hand, argued that the source of mental illness lay in unconscious conflicts originating in early childhood experiences. Freud found evidence for this idea through the analysis of dreams, free association, and slips of speech.
 This debate has continued into the late 20th century. Beginning in the 1960's, the biological perspective became dominant, supported by numerous breakthroughs in psychopharmacology, genetics, neurophysiology, and brain research. For example, scientists discovered many medications that helped to relieve symptoms of certain mental illnesses and demonstrated that people can inherit a vulnerability to some mental illnesses. Psychological perspectives also remain influential, including the Psychodynamics perspective, the humanistic and existential perspectives, the behavioural perspective, the cognitive perspective, and the Sociocultural perspective.
 Psychiatry has increasingly emphasized a biological basis for the causes of mental illness. Studies suggest a genetic influence in some mental illnesses, such as schizophrenia and bipolar disorder, although the evidence is not conclusive.
 Clinical depression is one of the most common forms of mental illness. Although depression can be treated with psychotherapy, many scientists believe there are biological causes for the disease. In the June 1998 Scientific American article, neurobiologist Charles B. Nemeroff reports upon the connection between biochemical changes in the brain and depression.
 Scientists have identified a number of neurotransmitters, or chemical substances that enable brain cells to communicate with other, that appears important in regulating a person’s emotions and behaviour. These include dopamine, serotonin, norepinephrine, gamma-amino butyric acid (GABA), and acetylcholine. Excesses and deficiencies in levels of these neurotransmitters have been associated with depression, anxiety, and schizophrenia, but scientists have yet to determine the exact mechanisms involved.
 Research shows that the more genetically related a person is to someone with schizophrenia, the greater the risk that person has of developing the illness. For example, children of one parent with schizophrenia have a 13 percent chance of developing the illness, whereas children of two parents with schizophrenia have a 46 percent chance of developing the disorder.
 Advances in brain imaging techniques, such as magnetic resonance imaging (MRI) and positron emission tomography (PET), have enabled scientists to study the role of brain structure in mental illness. Some studies have revealed structural brain abnormalities in certain mental illnesses. For example, some people with schizophrenia have enlarged brain ventricles (cavities in the brain that contains cerebrospinal fluid). However, this may be a result of schizophrenia rather than a cause, and not all people with schizophrenia show this abnormality.
 A variety of medical conditions can cause mental illness. Brain damage and strokes can cause loss of memory, impaired concentration and speech, and unusual changes in behaviour. In addition, brain tumours, if left to grow, can cause psychosis and personality changes. Other possible biological factors in mental illness include an imbalance of hormones, deficiencies in diet, and infections from viruses.
 In the late 19th century Viennese neurologist Sigmund Freud developed a theory of personality and a system of psychotherapy known as psychoanalysis. According to this theory, people are strongly influenced by unconscious forces, including innate sexual and aggressive drives.
 The Psychodynamics perspective views mental illness as caused by unconscious and unresolved conflicts in the mind. As stated by Freud, these conflicts arise in early childhood and may cause mental illness by impeding the balanced development of the three systems that constitute the human psyche: the id, which comprises innate sexual and aggressive drives; the ego, the conscious portion of the mind that mediates between the unconscious and reality; and the superego, which controls the primitive impulses of the id and represents moral ideals. In this view, generalized anxiety disorder stems from a signal of unconscious danger whose source can only be identified through a thorough analysis of the person’s personality and life experiences. Modern Psychodynamics theorists tend to emphasize sexuality less than Freud did and focus more on problems in the individual’s relationships with others.
 Both the humanistic and existential perspectives view abnormal behaviour as resulting from a person’s failure to find meaning in life and fulfill his or her potential. The humanistic school of psychology, as represented in the work of American psychologist Carl Rogers, views mental health and personal growth as the natural conditions of human life. In Rogers’s view, every person possesses a drive toward self-actualization, the fulfilment of one’s greatest potential. Mental illness develops when a person’s condition by some circumstantial environment interferes with this drive. The existential perspective sees emotional disturbances as the result of a person’s failure to act authentically - that is, to behave in accordance with one’s own goals and values, rather than the goals and values of others.
 The pioneers of behaviourism, American psychologists’ John B. Watson and B. F. Skinner, maintained that psychology should confine itself to the study of observable behaviour, rather than explore a person’s unconscious feelings. The behavioural perspective explains mental illness, as well as all of human behaviour, as a learned response to, malaria, and infection’s stimuli. In this view, rewards and punishments in a person’s environment shape that person’s behaviour, for example, a person involved in a serious car accident may develop a phobia of cars or the generalized fear to all forms of transportation.
 The cognitive perspective holds that mental illness result from problems in cognition - that is, problems in how a person reasons, perceives events, and solves problems. American psychiatrist Aaron Beck proposed that some mental illnesses - such as depression, anxiety disorders, and personality disorders - result from a way of thinking learned in childhood that is not consistent with reality. For example, people with depression tend to see themselves in a negative light, exaggerate the importance of minor flaws or failures, and misinterpret the behaviour of others in negative ways. It remains unclear, however, whether these kinds of cognitive problems actually cause mental illness or merely represent symptoms of the illnesses themselves.
 The Sociocultural perspective regards mental illness as the result of social, economic, and cultural factors. Evidence for this view comes from research that has demonstrated an increased risk of mental illness among people living in poverty. In addition, the incidence of mental illness rises in times of high unemployment. The shift in the world population from rural areas to cities - with their crowding, noise, pollution, decay, and social isolation - and, has also, been implicated in causing relatively high rates of mental illness. Furthermore, rapid social change, which has particularly affected indigenous peoples throughout the world, brings about high rates of suicide and alcoholism. Refugees and victims of social disasters - warfare, displacement, genocide, violence - have a higher risk of mental illness, especially depression, anxiety, and post-traumatic stress disorder.
 Social scientists emphasize that the link between social ills and mental illness is correlational rather than causal. For example, although societies undergoing rapid social change often have high rates of suicide the specific causes have not been identified. Social and cultural factors may create relative risks for a population or class of people, but it is unclear how such factors raise the risk of mental illness for an individual.
 There are no blood tests, imaging techniques, or other laboratory procedures that can reliably diagnose a mental illness. Thus, the diagnosis of mental illness is always a judgment or an interpretation by an observer based on the spoken exchange, ideas, behaviours, and experiences of the patient.
 For the most part, mental health professionals determine the presence of mental illness in an individual by conducting an interview intended to reveal symptoms of abnormal behaviour. That is, the professional asks the patient questions about their mental state: “Do you hear voices of people who are not with you?” “Have you felt depressed or lost interest in most activities?” “Have you experienced a marked increase or decrease in your appetite?” “Have you been sleeping less than normal?” “Are you easily distracted?” The answers to these questions will suggest other questions. Eventually, the clinician will feel that he or she has enough information to determine whether the patient is suffering from a mental illness and, if so, to make a diagnosis.
 The process of diagnosis is not as simple as it might seem. Patients often have difficulty remembering symptoms or feel reluctant to talk about their fantasies, sex life, or use of drugs and alcohol. Many patients suffer in forms that are more than there is one disorder at a time - for example, depression and anxiety, or schizophrenia and depression - and determining which symptoms constitute the primary problem is complex. In addition, symptoms may not be specific to mental illnesses. For example, brain tumours of the central nervous system can produce symptoms that mimic those of the Psychotic disorders.
 Another problem in diagnosis is that mental health professionals may interpret symptoms differently based on their personal or cultural biases. One study examined this effect by showing 300 American and British psychiatrists videotaped interviews of eight patients with mental illnesses. Although the psychiatrists’ diagnoses substantially agreed for patients with “textbook” cases of schizophrenia, their diagnoses varied widely for patients who had symptoms of both schizophrenia and other disorders, depending on whether the psychiatrist was American or British. The risk of misdiagnosis is even greater when the mental health professional and the patient come from different cultural groups.
 Mental health professionals use a number of methods to treat people with mental illnesses. The two most common treatments by far are drug therapy and psychotherapy. In drug therapy, a person takes regular doses of a prescription medication intended to reduce symptoms of mental illness. Psychotherapy is the treatment of mental illness through verbal and nonverbal communication between the patient and a trained professional. A person can receive psychotherapy individually or in a group setting.
 The type of treatment administered depends on the type and severity of the disorder. For example, doctors usually treat schizophrenia primarily with drugs, but specialized forms of psychotherapy may more effectively relieve phobias. For some mental illnesses, such as depression, the most effective treatment seems to be a combination of drug therapy and psychotherapy. Although some people with severe mental illnesses may never fully recover, most people with mental illnesses improve with treatment and can resume normal lives. Despite the availability of effective treatments, only about 40 percent of people with mental illnesses ever seek professional help.
 A variety of mental health professionals offer treatment for mental illness. These include psychiatrists, psychologists, psychotherapists, psychiatric social workers, and psychiatric nurses.
 Drugs introduced by the mid-1950's had enabled many people who otherwise would have spent years in mental institutions to return to the community and live productive lives. Since then, advances in psychopharmacology have led to the development of drugs of even greater effectiveness. These drugs often relieve symptoms of schizophrenia, depression, anxiety, and other disorders. However, they may produce undesirable and sometimes serious side effects. In addition, relapses may occur when they are discontinued, so long-term use may be required. Drugs that control symptoms of mental illness are called psychotherapeutic substance or preparation, in that a substance used by itself or in a mixture in the treatment of or the dependence on drugs, if only to make it bearable. The major categories of psychotherapeutic drugs include Antipsychotic drugs, Antianxiety drugs, antidepressant drugs, and antimanic drugs.
 Antipsychotic drugs, also called neuroleptics and major tranquillizers, control symptoms of psychosis, such as hallucinations and delusions, which characterize schizophrenia and related disorders. They can also prevent such symptoms from returning. Antipsychotic drugs may produce side effects ranging from dry mouth and blurred vision to a tardive dyskinesia. The occasioning of Panic Disorders, is a mental illness in which a person experiences repeated, unexpected panic attacks and persistent anxiety about the possibility that the panic attacks will recur. A panic attack is a period of intense fear, apprehension, or discomfort. In panic disorder, the attacks usually occur without warning. Symptoms include a racing heart, shortness of breath, trembling, choking or smothering sensations, and fears of “going crazy,” losing control, or dying from a heart attack. Panic attacks may last from a few seconds to several hours. Most peak within 10 minutes and render of their potentialities or peak, within 20 or 30 minutes.
 About 2 percent of people in the United States suffer from panic disorder during any given year, and the condition affects more than twice as many women as men. People with panic disorder may experience panic attacks frequently, such as daily or weekly, or more sporadically. Additionally, panic attacks may occur as part of other anxiety disorders, such as phobias - in which a specific object or situation triggers the attack - and, more rarely, post-traumatic stress disorder.
 People with panic disorder frequently develop agoraphobia, a fear of being in places or situations from which escape might be difficult if a panic attack occurs. People with agoraphobia typically fear situations such as travelling in a bus, train, car, or aeroplane, shopping at malls, going to theatres, crossing over bridges or through tunnels, and being alone in unfamiliar places. Therefore, they avoid these situations and may eventually become reluctant to leave their home. In addition, people with panic disorder appear to have an increased risk of alcoholism and drug dependence. Some studies indicate they also have a higher risk of depression and suicide.
 Panic disorder, and both with and without agoraphobia, result from a combination of biological and psychological factors. Some individuals may inherit a vulnerability to accentuation and the availing of anxiety and an increased risk of experiencing panic attacks. In addition, certain physiological cues may trigger a panic attack. For example, if a person experiences a racing heart during a panic attack, he or she may begin to associate this sensation with panic attacks. An accelerated heart beat can be addictive and may impair movement and concentration in some people. Some antidepressant drugs, such as imipramine (Tofranil), also reduce panic symptoms in some people but can produce side effects such as dizziness or dry mouth. Another class of drugs, selective serotonin reuptake inhibitors (SSRIs), appears to reduce panic symptoms with fewer side effects. SSRIs used to treat panic disorder, would remedially need paroxetine (Paxil) and fluvoxamine (Luvox). Medication eliminates panic symptoms in 50 to 60 percent of patients. For many patients, however, panic attacks return when they stop taking the medication.
 Research has shown that cognitive-behavioural therapy, a type of psychotherapy, eliminates panic attacks in 80 to 100 percent of patients. In this method, therapists help patients re-create the physical symptoms of a panic attack, teach them coping skills, and help them to alter their beliefs about the danger of these sensations. Patients with agoraphobia face their feared situations under the therapist’s supervision, using coping skills to overcome their strong anxiety. These coping skills may include physical relaxation techniques, such as deep breathing and muscle relaxation, as well as cognitive techniques that help people think rationally about anxiety-provoking situations. About 70 percent of panic disorders patients who also have moderate to severe agoraphobia benefit from this type of treatment.
 Antianxiety drugs, also called minor tranquillizers, reduce high levels of anxiety. They may help people with generalized anxiety disorder, panic disorder, and other anxiety disorders. Benzodiazepines, a class of drugs that includes diazepam (Valium), are the most widely prescribed Antianxiety drugs. Benzodiazepines can be addictive and may cause drowsiness and impaired coordination during the day.
 Antidepressant drugs help relieve symptoms of depression. Some antidepressant drugs can relieve symptoms of other disorders as well, such as panic disorder and obsessive-compulsive disorder.
Antidepressant drugs comprise three major classes: tricyclics, Monoamine oxidase inhibitors (MAO inhibitors), and selective serotonin reuptake inhibitors (SSRIs). Side effects of tricyclics may include dizziness upon standing, blurred vision, dry mouth, difficulty urinating, constipation, and drowsiness. People who take MAO inhibitors may experience some of the same side effects, and must follow a special diet that excludes certain foods. SSRIs generally produce fewer side effects, although these may include anxiety, drowsiness, and sexual dysfunction. One type of SSRI, Fluoxetine (Prozac), is the most widely prescribed antidepressant drug.
 Antimanic drugs help control the mania that occurs as part of bipolar disorder. One of the most effective antimanic drugs is lithium carbonate, a natural mineral salt. Common side effects include nausea, stomach upset, vertigo, and increased thirst and urination. In addition, long-term use of lithium can damage the kidneys.
 Psychotherapy can be an effective treatment for many mental illnesses. Unlike drug therapy, psychotherapy produces no physical side effects, although it can cause psychological damage when improperly administered. On the other hand, psychotherapy may take longer than drugs to produce benefits. In addition, sessions may be expensive and time-consuming. In response to this complaint and demands from insurance companies to reduce the costs of mental health treatment, many therapists have started providing therapy of shorter duration.
 Psychotherapy encompasses a wide range of techniques and practices. Some forms of psychotherapy, such as Psychodynamics therapy and humanistic therapy, focus on helping people understand the internal motivations for their problematic behaviour. Other forms of therapy, such as behavioural therapy and cognitive therapy, focus one’s actions in general or on a particular occasion, should,  in the manner of recognizing the controversial behaviour communicative impact, which to cause to acquire knowledge for which of people skills are essential to set right in that as wrong must be  corrected. The majority of therapists today incorporate treatment techniques from a number of theoretical perspectives. For example, cognitive-behavioural therapy combines aspects of cognitive therapy and behavioural therapy.
 Psychodynamics therapy is one of the most common forms of psychotherapy. The therapist focuses on a person’s experiences as a source of internal, unconscious conflicts and tries to help the person resolve those conflicts. Some therapists may use hypnosis to uncover repressed memories. Psychoanalysis, a technique developed by Freud, is one kind of Psychodynamics therapy. In psychoanalysis, the person lies on a couch and says whatever comes to mind, a process called free association. The therapist interprets these thoughts along with the person’s dreams and memories. Classical psychoanalysis, which require years of intensive treatment, is not as widely practised today as in previous years.
 Both humanistic therapy and existential therapy treat mental illnesses by helping people achieve personal growth and attain meaning in life. The best-known humanistic therapy is client-centred therapy, developed by Carl Rogers in the 1950's. In this technique, the therapist provides no advice but restates the observations and insights of the client (the person in treatment) in nonjudgmental terms. In addition, the therapist offers the person unconditional empathy and acceptance. Existential therapists help people confront basic questions about the meaning of their lives and guide them toward discovery of their own uniqueness.
 Psychotherapists whom practice behavioural therapies do not focus on a person’s experiences or inner life, instead, they help the person to change their conduct behavioural, and patterns of abnormal behaviour by applying established principles of conditioning and of learning. Behavioural therapy has proven effective in the treatment of phobias, obsessive-compulsive disorder, and other disorders.
 The Obsessive-Compulsive Disorder categorized the mental illness in which a person experiences recurrent, intrusive thoughts (obsessions) and feels compelled to perform certain behaviours (compulsions) again and again. Most people have experienced bizarre or inappropriate thoughts and have engaged in repetitive behaviours at times. However, people with obsessive-compulsive disorder find that their disturbing thoughts and behaviours consume large amounts of time, cause them anxiety and distress, and interfere with their ability to function at work and in social activities. Most people with this disorder recognize that their obsessions and compulsions are irrational but cannot suppress them.
 Obsessive-compulsive disorder usually begins in adolescence or early adulthood. It effects from 1.5 to 2 percent of people in the United States, as the disorder affects that are slightly more prominent in women than men.
 Obsessions can include a variety of thoughts, images, and impulses. Common obsessions include fears of contamination from germs, doubts about whether doors are locked or appliances are turned off, nonsensical impulses such as shouting in public, sexual thoughts that are disturbing to the individual, and thoughts of accidentally and unknowingly harming someone. People with obsessions may avoid shaking hands with other people because they fear contamination, or they may avoid driving because they fear they will injure someone in a traffic accident.
 People usually perform compulsions to relieve the anxiety produced by their obsessions, although not all people with obsessions perform compulsions. The most common compulsions involve cleaning rituals and checking rituals. For example, people with obsessions about germs may wash their hand’s dozens of times each day until their skin becomes raw. People with obsessions about neatness and symmetry may constantly rearrange or straighten objects on their desk. People with checking compulsions must repeatedly check to make sure they locked doors and windows or turned off water faucets. Other compulsions include counting objects, hoarding vast amounts of useless materials, and repeating words or prayers internally.
 Obsessive-compulsive disorder can have disabling effects on people’s lives. People with severe cases of this disorder may need hospitalization to help treat the compulsions. In fewer extreme instances, individuals with compulsions must often allow a great deal of extra time to complete seemingly routine tasks, such as preparing to leave the house in the morning. Individuals may avoid going to certain places or engaging in certain activities because they feel embarrassed about their behaviour.
 In addition, family members of someone with this disorder may feel angry with the person because the compulsive behaviours intrude on their time together or interfere with the family’s functioning. For instance, some individuals hoard things, such as newspapers or magazines, because they believe they may someday need certain pieces of information. The piles of newspapers may cover the living areas and make other family members feel embarrassed to have guests in the home.
 Like many other mental illnesses, obsessive-compulsive disorder appears to result from a combination of biological and psychological influences. Some people may have a biological predisposition to experience anxiety. Research also suggests that abnormal levels of the neurotransmitter serotonin may play a role in obsessive-compulsive disorder. Brain scans of people with obsessive-compulsive disorder have revealed abnormalities in the activity level of the orbital cortex, cingulate cortex, and caudate nucleus, a brain circuit that helps control movements of the limbs.
 The disorder may develop when these biological influences combine with a psychological vulnerability to anxiety. Some people may develop a psychological vulnerability to anxiety in childhood. They may come to believe that the world is a potentially dangerous place over which one has little control. People seem to develop obsessive-compulsive disorder specifically when they learn that some thoughts are dangerous or unacceptable and, while attempting to suppress these thoughts, develop anxiety about the recurrence of the thoughts and about the perceived dangerousness and intrusiveness of the thoughts.
 Treatment for obsessive-compulsive disorder includes psychotherapy, psychoactive drugs, or both. Mental health professionals consider exposure and response prevention, a type of cognitive-behavioural therapy, to be the most effective form of psychotherapy for this disorder. In this technique, the therapist exposes the patient to feared thoughts or situations and prevents the patient from acting on their own compulsion. For example, a therapist might have patients with cleaning compulsions touch something dirty and then prevent them from washing their hands. This technique helps 60 to 70 percent of people with obsessive-compulsive disorder.
 Medications to treat obsessive-compulsive disorder are made up of selective serotonin reuptake inhibitors, such as Fluoxetine (Prozac) and fluvoxamine (Luvox). A tricyclic antidepressant, clomipramine (Anafranil), also helps relieve symptoms of the disorder. About 80 percent of people with the disorder show some improvement with a combined treatment of medication and behavioural therapy. However, many patients relapse when they stop taking the medication.
 The goal of cognitive therapy is to identify patterns of irrational thinking that cause a person to behave abnormally. The therapist teaches skills that enable the person to recognize the irrationality of the thoughts. The person eventually learns to perceive people, situations, and himself or herself in a more realistic way and develops improved problem-solving and coping skills. Psychotherapists use cognitive therapy to treat depression, panic disorder, and some personality disorders.
 Rehabilitation programs assist people with severe mental illnesses in learning independent living skills and in obtaining community services. Counsellors may teach them personal hygiene skills, home cleaning and maintenance, meal preparation, social skills, and employment skills. In addition, case managers or social workers may help people with mental illnesses obtain employment, medical care, housing, education, and social services. Some intensive rehabilitation programs strive to provide active follow-up and social support to prevent hospitalization.
 Therapists often use play therapy to treat young children with depression, anxiety disorders, and problems stemming from child abuse and neglect. The therapist spends time with the child in a playroom filled with dolls, puppets, and drawing materials, which the child may use to act out personal and family conflicts. The therapist helps the child recognize and confront their own feelings.
 In group therapy, a number of people gather to discuss problems under the guidance of a therapist. By sharing their feelings and experiences with others, group members learn their problems are not unique, receive emotional support, and learn ways to cope with their problems. Psychodrama is a type of group therapy in which participants act out emotional conflicts, often on a stage, with the goals of increasing their understanding of their behaviours and resolving conflicts. Group therapy generally costs less per person than individual psychotherapy.
 Family intervention programs help families learn to cope with and manage a family member’s chronic mental illness, such as schizophrenia. Family members learn to monitor the illness, help with daily life problems, ensure adherence to medication, and cope with stigma.
 Electroconvulsive therapy (ECT) is a treatment for severe depression in which an electrical current is passed through the patient’s brain for one or two seconds to induce a controlled seizure. The treatments conducted towardly, did by or repeated over a period of several weeks. For unknown reasons, ECT often relieves severe depression even when drug therapy and psychotherapy have failed. The treatment has created controversy because its side effects may include confusion and memory loss. Both of these effects, however, are usually temporary.
 Seeking a treatment for extreme cases of mental illness, Portuguese neurologist António Egas Moniz invented the lobotomy, a surgical technique that destroys tissue in the frontal lobe of the brain. The procedures, widely performed in the 1940s and 1950s, often leaving the person in a vegetative state or caused drastic changes in personality and behaviour.
 Even more controversial than ECT is Psychosurgery, the surgical removal or destruction of sections of the brain in order to reduce severe and chronic psychiatric symptoms. The best-known example of Psychosurgery is the lobotomy, a procedure developed by Portuguese neurologist António Egas Moniz that was widely performed in the 1940's and early 1950's. Psychosurgery is now rarely performed because no research has proven it effective and because it can produce drastic changes in personality and behaviour.
 A significant portion of the homeless population in the United States suffers from a chronic mental illness, such as schizophrenia. The shortage of mental health treatment centres in many cities may partly account for the large number of mentally ill people who are homeless or in jail.
 Treatment for mental illness takes places in a number of settings. Mental hospitals or psychiatric wards in general hospitals are used to treat patients in acute phases of their illnesses and when the severity of their symptoms requires constant supervision. Most individuals who suffer from severe mental illness, however, do not require such close attention, and they can usually receive treatment in community settings.
 Often, patients who have just completed a period of hospitalization go to group homes or halfway houses before returning to independent living. These facilities offer patients the opportunity to take part in group activities and to receive training in social and job skills. In supportive housing, mentally ill individuals can live independently in an environment that offers an array of mental health and social services. Some people with chronic and severe mental illnesses require care in long-term facilities, such as nursing homes, where they can receive close supervision.