PIIMIC Glossary

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Behaviour therapy - Various counseling techniques based on psychology to change abnormal behaviour such as phobias and obsessions or to treat anxiety. Includes several treatment techniques, such as: graduated exposure to a feared experience under safe conditions, to make it less threatening; and encouraging desirable behaviour with a system of awards.

Benzodiazepine drugs - A large group of anti-anxiety drugs and tranquilizers. They modulate brain activity, promote mental and physical relaxation, and are useful for short-term treatment of anxiety, stress, insomnia, alcohol withdrawal and epilepsy. If used for more than two or three weeks, however, they create psychological and physical dependency, and may need to be discontinued very gradually to avoid severe withdrawal symptoms.

Bereavement (See Post traumatic stress disorder) - Following the death of a loved one, survivors experience emotional changes, grief and trauma, more strongly when the death occurs unexpectedly or prematurely. There are usually distinct stages of reaction: numbness, sometimes with hallucinations and denial, usually lasting a few days, or even several weeks. When numbness wears off, there are sometimes overwhelming reactions of anxiety, anger and despair that can lead to depression, with insomnia, malaise, agitation, and tearfulness. If untreated, strong symptoms may pose increased risks of attempted suicide, abuse of alcohol, tranquilizers or other drugs. Usually within two years bereavement gives way to a more positive and enthusiastic outlook with renewed plans for the future.

Bipolar Affective Disorder (BAD) (BAD) – A cyclic mood disturbance, previously known as Manic Depressive Disorder. Persons suffering from BAD typically experience swings between mania (elation – with high energy, sometimes bizarre behaviour, rapid excited speech), and depression (with low energy, minimal speech). A high or low episode can last from days to months, or mixed episodes can alternate rapidly. Between episodes there can be complete or partial remission of symptoms, allowing normal functioning. Bipolar is often linked with artistic temperament. Famous examples: Lord Byron, Edgar Allan Poe, Robert Schumann, Vincent Van Gogh, Virginia Woolf, Ernest Hemingway, and Curt Cobain. Prevalence: bipolar disorder affects 1 to 2 per cent of the population world-wide. The average age of onset - in the early twenties - has been falling, at least partly due to better diagnosis. Onset is being found more often in adolescents and even in children. Police need to know that a bipolar subject in crisis can be unpredictable, troubling, disabled (e.g. by impaired judgement), endangering, manipulative, and suicidal. Alcohol and drug-abuse is sometimes a complication. The suicide rate may approach 20 per cent. On the plus side, BAD usually responds well to medication, which helps to restore the normal range of functioning. Discontinuing medication can result in a rapid or gradual return of symptoms.

Borderline Personality Disorder (BPD) - This is one of several personality disorders that have enduring difficult behaviour patterns, and are usually treated by long-term psychotherapy backed by very firm management plans.  However BPD is the most likely of the personality disorders to have complications such as depression, anxiety, psychosis and suicidal tendencies that may benefit from psychiatric treatment, and may meet the intervention criteria of the BC Mental Health Act.

The subject suffering from BPD is emotionally unstable, intolerant of frustration, and impulsive, taking risky actions without considering consequences. They may cling to relationships but the relationships are often unstable. Police need to be prepared to remain calm, firm and caring despite provocative, aggressive or manipulative behaviours.

Typical symptoms of BPD include:

 *Highly reactive and sudden mood swings;

*Intense episodes of irritability or anxiety lasting from a few hours to a few days;

*Taking impulsive actions  - often harmful to the subject - without considering consequences: spending sprees, sexual indiscretions, substance abuse, reckless driving, shop-lifting, binge eating.

*Impaired coping ability in planning ahead and solving problems;

*Poor tolerance for frustration: outbursts of intense anger or constant angry feelings, tantrums, aggression (shouting, verbal abuse);

*Unclear or disturbed self-image, chronic emptiness, terror of being left alone;

*Relationships that are intense, clinging, but unstable;

*Recurring suicidal or self-mutilating gestures. Self-harm can occur during substance abuse and in a relationship crisis.

Brain Disease, geriatric - Brain diseases of old age are often irreversible but mental exercise (staying socially connected, playing cards, hobbies) can help to fight these diseases just like eating better reduces risks of heart disease. Geriatric brain diseases are likely to increase because of the demographic aging of the general population. They are predicted to become Canada’s leading cause of death and disability by 2020. Research into cause and treatment is being stepped up world-wide, and in BC is headed by Dr. Max Cynader at the Vancouver Hospital/UBC Brain Research Center (which is not a crisis service). See Dementia in the Glossary.

Alzheimer’s disease - is the most common cause of dementia among people 65 years of age and over. One person in ten over 65, and one in four over 85, is afflicted with the disease. It is a progressive and irreversible degeneration of the brain causing dementia (a general decline in all areas of mental function). Cause and cure not known. Treated with nursing and social care for the patient and relatives.

Huntington’s Disease -this rare inherited disorder is characterized by involuntary movements, gait disturbance, personality changes, memory loss, and less commonly, psychiatric disorders. Symptom onset is usually in mid-life, with progression to death over a period of years. Huntington’s disease affects approximately one in 10,000 persons worldwide, and many more are at risk for developing the disease.

Parkinson’s Disease -is characterized by tremor, muscular rigidity, difficulty in initiating motor activity, and loss of postural reflexes. Onset most commonly occurs between 50 and 65 years of age. Medical treatments can control Parkinson’s signs and symptoms, and temporarily improve the quality of life.

Brain disorders - In addition to mental illness, the brain can have a wide range of physical defects and disorders just like other body organs, but they can be linked with mental symptoms such as depression. The brain is well-protected physically by the skull, but also confined by it, so that localized brain tumors or blood clots create pressures which can impair total brain function. Brain cells destroyed through congenital or developmental defects, injuries or disease cannot be replaced, making it difficult and sometimes impossible for brain circuits to recover lost function. See OBS in the Glossary.

Bulimia Nervosa - Compulsive binge-eating followed by purging or self-induced vomiting. Behaviour is strongly affected by concerns about weight and body shape. Serious medical problems can occur, along with mental problems like depression, moodiness and low self-esteem. See Eating disorders in the Glossary.  

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