CHAPTER-4

Abnormality and psychological disorders

There is no Universal acceptance of the definition of abnormal behaviour. Most definitions
have certain common features which are often called the four D's of abnormal behaviour

 Deviance: refers to highly unusual behaviours that stray

far from the norm. behaviour which deviants (different,
extreme, unusual even bizarre). The word abnormal
literally means away from the normal, it implies deviation
from some clearly defined norms or standard of society
 Distressing: behaviour and feelings which are unpleasant
and upsetting to the person and to others
 Dysfunctional: interfering with the person's ability to
function in daily life. A person is not able to carry out daily
activities in a constructive way
 Dangerous: refers to behaviours and feelings that can
potentially lead to or cause harm to the individual or those
around the individual. These include suicidal behaviours
and excessive aggression.

Two basic Views or approaches about what is

abnormal behaviour
1. Deviation from social norms:
 Abnormality can be defined as a deviation from social
norms This means that we label people as abnormal
if their behaviour is different from what we accept as
the norms of society.
 Some social norms are explicit, which means they
are legal written laws.
 While other social norms are implicit and are
unwritten, or unspoken rules in society. If people
break these rules, then they are deviating away from
social norms and therefore, could be labelled as
abnormal.
 For example a society whose culture values
competition assertiveness may accept aggressive
behaviour, whereas one that emphasizes cooperation
and family values may consider aggressive behaviour
as unacceptable or even abnormal.

Serious questions have been raised about this definition as it is

based on the assumption that socially acceptable behaviour is
not abnormal and that normality is nothing more than
conformity to social norms but society's values may change
over time causing its views of what is psychologically abnormal
to change as well.

2. Second approach views abnormal behaviour as

maladaptive :
 Maladaptive behaviour is behaviour that prevents you
from making adjustments that are in your own best
interest.
 Wellbeing is not simply maintenance and survival but also
includes growth and fulfilment i.e., actualisation of
potential
 According to this criteria, confirming behaviour can be
seen as abnormal if it is maladaptive I.e. if it Interferes
with optimal functioning and growth
 For example, student in the class prefers to remain silent
even when s/he has questions in her/ his
mind
HISTORICAL BACKGROUND

1. Ancient Western world: Organismic approach

 Belief that humans behave strangely because their

bodies and their brains are not working properly.
This is the biological or organic approach
 Hippocrates, Socrates and Plato developed
organismic approach
 They viewed disturbed behaviour as arising out of
conflict between emotion and reason
 Galen gave the concept of four humours in
personal character and temperament
 According to him there are four body Fluids blood,
black bile, yellow bile and phlegm in our body.
 each of these fluids was believed to be responsible
for a different temperament
 imbalance among humours were believed to cause
various disorders
 This is similar to the Indian notion of the three
doshas of vata, pitta and kapha which were
mentioned in ayurvedic texts
2. Middle ages: demonology and superstition
 Demonology and superstition gained importance
in the explanation of abnormal behaviour in this age
 Abnormal behaviour was explained by operation of
supernatural and magical forces such as Evil
spirits(bhoot-pret) or the devil( shaitan) .
 Demonology is related to a belief that people with
mental problems were evil
 There are numerous instances of ‘witch-hunt’ during
this period
 Exorcism i.e., Removing the evil that resides in the
individual through counter magic and prayer was
used.
 In many societies the Shaman or medicine man
(Ojha) is a person who is believed to have contact
with Supernatural forces and is the medium through
which spirits communicate with human beings.
Through the Shaman an afflicted person can learn
which spirits are responsible for her/ his problem and
what needs to be done to appease them

3. The Renaissance period:

 In this period there was increased humanism and
curiosity about behaviour
 Psychological conflict and disturbed
interpersonal relationships were considered as
the causes of psychological disorders

4. Age of reason and enlightenment:

 In which period scientific method replaced faith and
dogma as ways of understanding abnormal
behaviour
 Growth of scientific attitude toward psychological
disorders contributed to the Reform movements
and to increase compassion for people who suffered
from these disorders
 reforms of asylums were initiated in both Europe and
America
 one of the aspects of the Reform movement was the
new incubation for Deinstitutionalisation which
place and faces in providing community care for
recovered mentally ill individuals

5. In recent years all three factors i.e. biological,

psychological and social factors are considered to play
important roles in psychological disorders. This approach
is called interactional approach or bio-psycho-social
approach.
Classification of psychological disorders:

In order to understand psychological disorders classification is

done. classifications are useful because:
1. Enable psychologist, psychiatrists and social workers to
communicate with each other
2. help in understanding cause of psychological disorder
3. Help In understanding processes involved in their
development and maintenance
4. help in diagnosis and deciding direction of treatment

Two types of classifications

1. DSM 5 (Diagnostic and statistical manual of mental
disorders)
 It is published by American Psychiatric Association
 It describes and classifies various kinds of
psychological disorders
 It has criteria which indicate the presence or absence
of disorder
1. ICD 10 (International Classification of Behavioural and
mental Diseases)
 It is published by World Health Organisation
 For each disorder Main symptoms are described
 Diagnostic guidelines are also provided in this

Factors underlying abnormal behavior

n
Biological Psychological Diathesis
Socio-cultural
factors factors factors stress model
Humanistic-
existential

Biological factors:
 Assumption of this model is that biological factors are
responsible for abnormal behaviour
 faulty genes
 endocrine imbalance
 Malnutrition
 Injuries
 abnormal activities by neurotransmitters Can
lead to specific psychological disorders. Anxiety
disorders have been linked to low activity of the
GABA, schizophrenia to excess activity of
dopamine and depression to low activity of
serotonin.

Psychological model :
 According to this model psychological and interpersonal
factors play important role in abnormal behaviour
1. Psychodynamic model: this model was first formulated
by Sigmund Freud. According to him the reason for
abnormal behaviour is
 The conflict between id, ego and superego
 material (desires and fears) in unconscious
 childhood events
2. Behavioural model: abnormal behaviour results from
faulty or ineffective learning.
 Both normal and abnormal behaviour is learned
 psychological disorders are the result of learning
maladaptive ways of learning
 According to this model what has been learned can
be unlearned
 both Normal and abnormal behaviour is learnt
through
 Classical conditioning
 operant conditioning and
 observational learning

3. cognitive model: People engage in abnormal behaviour

because of particular thoughts that are based on
 Assumptions about themselves that are irrational and
inaccurate
 in logical ways
 negative conclusions on the basis of a single in significant
event
 overgeneralization

4. Humanistic- existential model: According to Carl

Rogers people are rational beings, able to make their own
choices and are born with natural tendency to be friendly
and cooperative.
 Psychological problems occur when people
experience incongruence between their real self and
their ideal self. This generates feeling of low self-
worth
 Existentialists believe that from birth, each person
has total freedom to give meaning to their life
 those who shrink from the responsibility of giving
meaning to life live empty and inauthentic life

Socio- cultural model: This model holds that abnormal

behaviour is caused by the role that society and culture
play in individuals’ life
 Behaviour is shaped by family structure, communication,
social networks and social roles
 Abnormal behaviour is learnt within society, which
includes family, community and culture
 for example, anorexia nervosa and bulimia are
psychological disorders found mostly in western culture
which values the thin female body
Diathesis-stress model: This model has three
components:
 Diathesis: Is defined as a person's predisposition
towards problem or disorder
 person becomes vulnerable to develop
psychological disorder i.e. the person is at risk to
develop disorder
 presence of stressors: if such ‘at risk’ person is
exposed to these stresses they may develop
disorder
Major psychological disorders
1. Anxiety disorders
2. obsessive-compulsive and related disorders
3. trauma and stressor-related disorders
4. somatic symptoms and related disorders
5. dissociative disorders
6. depressive disorders
7. bipolar and related disorders
8. Schizophrenia spectrum and other psychotic disorders
9. neurodevelopmental disorders
10. disruptive impulse control and conduct disorder
11. substance related and addictive disorders

Anxiety disorders

Generalize Separation
Panic phobia anxiety
anxiety
disorder disorder
disorder
anxiety is diffuse, vague and very unpleasant feeling of fear
and apprehension.
symptoms of anxiety: Rapid heart rate, shortness of breath,
fainting, Loss of appetite, dizziness, sweating and
sleeplessness.
Types of anxiety disorders:
 Generalized anxiety disorder (GAD)
 panic disorder
 Phobia
 separation anxiety disorder (SAD)

Generalized anxiety disorder(GAD) : prolonged,

vague, unexplained fears that are not attached to any
particular object

Symptoms of GAD: worry and apprehensive feelings about

the future, motor tension, the person is unable to relax,
restless, shaky, tense and scanning the
environment for dangers.

Panic disorder:
anxiety attacks in which a person experiences intense fear. In
this panic attack there is a sudden increase in anxiety which
rises to a peak when a person thinks of particular stimuli.
Symptoms: shortness of breath, design, choking, nausea,
chest pain, fear of going crazy or dying

Phobia: Phobia is irrational fear related to a specific object,

people or. phobias are grouped into three types

 Specific phobia: this includes irrational fear of a certain

object, animal or situation. For example, fear of lizards,
height, spider
 Specific phobia: this includes irrational fear of a certain
object, animal or situation. For example, fear of lizards,
height, spider

 Specific phobia: this includes

irrational fear of a certain object,
animal or situation. For example, fear
of lizards, height, spider

 Social phobia: intense fear and

embarrassment in dealing with other
people

 Agoraphobia: fear of entering

unfamiliar situations, fear of
crowded places. Many persons
with agoraphobia are afraid of
leaving their home.
Obsessive- compulsive and related
disorders

obsessive behaviour: is the

inability to stop thinking about a
particular Idea or topic. These
Thoughts are unpleasant and
shameful. For example, Thoughts
about religion and sex.
Compulsive behaviour: is
the need to perform certain behaviour over and over again.
Example, compulsion of counting, ordering, checking, touching
and washing

Trauma and stressor related

disorders
Post-traumatic stress disorder:
 people who are caught in a natural disaster or are victims
of bomb blast or been in serious accident sometimes
experience PTSD.
 They have the recurrent dreams, flashbacks, impaired
concentration and emotional numbering
 Adjustment disorder and acute stress disorder are also
included under this category

Somatic symptom and related disorders

Somatoform
disorders

Somatic
llness anxiety Conversion
symptom
disorder disorder
disorder

In these disorders there are physical symptoms for which there

is no biological cause.
Types of somatoform disorders are:
 Somatic symptom disorder
 Illness anxiety disorder
 conversion disorders

Somatic symptom disorder:

 In this person is
having persistent
body related
symptoms which
may or may not be
related to any
serious medical
condition.
 People with this disorder are overly preoccupied with their
symptoms and they continually worry about their health
 they make frequent visits to doctors
 Experience significant distress and disturbances in their
daily life
Illness anxiety disorder:

 People with this disorder have

persistent preoccupation
about developing a serious
illness and constantly worry
about the possibility of
developing a serious illness
 They are always anxious about
their health
 They are always anxious and concerned about
undiagnosed disease
 If the doctor gives them negative diagnostic results then
also, they are worried about developing illness

Conversion disorders :
 People with this disorder report loss of part of body or
some body function.
 paralysis, blindness, deafness and difficulty in walking are
generally the symptoms.
 these symptoms occur after a stressful experience

Dissociative disorders

Dissociative Dissociative Dissociative

Depersonalization
amnesia Fugue identity disorder

dissociative disorder is mental health condition that changes

persons sense of real. it involves breakdown of memory,
awareness, identity of perception
types of dissociative disorders are:
 Dissociative Amnesia
 dissociative fugue
 dissociative identity disorder
 depersonalization

Dissociative amnesia:
 selective memory loss that has no organic cause (head
injury or accident).
 person is unable to recall important, personal information.
 others can no longer requires specific events, people,
place or object.
 this disorder is often after traumatic stressful event
Dissociative fugue( flight) :
 unexpected travel away from home and workplace,
assuming new identity and unable to record previous
identity.
 Fugue ends when the person suddenly wakes up with no
memory of fugue period

Dissociative Identity disorder:

 In this disorder the person

consumes alternative
personalities that may or may
not be aware of each other.
 this disorder is associated
with traumatic experiences in
childhood

Depersonalization:

 It involves dreamlike state in

which the person has a sense
of being separated both from
self and from real
 person have strong feelings
of detachment from their own body

Depressive disorders
Major depressive disorder:
 period of depressed mood and loss of interest and
pleasure in most activities.
 symptoms include: change in body weight, sleep
problems, tiredness, inability to think clearly, slowed
behaviour, thought of death, excessive guilt and feeling of
worthlessness
Factors predisposing for depression( causes for
depression)
 Genetic makeup or heredity: is major risk factor for
depression and bipolar disorders. If parents have bipolar
disorder then their children are vulnerable to this disorder
 Age: women are at risk during young adulthood while
men are at risk in early middle age
 Gender: women in comparison to men are more at risk
for depressive disorder
 negative life events and lack of social support are also
causes of depression

Bipolar and Related

disorders

 Bipolar I disorder involves both Mania and depression

which are alternatively present and sometimes and
interrupted by periods of normal mood.
 manic phase: It is defined as an extremely unstable euphoric or
irritable mood along with an excess activity, creativity or
energy level, excessively rapid thought and speech, reckless
behavior.
 Depressive phase: Feelings of sadness, tearfulness, emptiness or
hopelessness. Angry outbursts, irritability or frustration, even over small
matters.
 Manic episodes rarely appear by themselves, they usually
alternate with depression
 Examples of bipolar and related disorders include bipolar I,
bipolar II and cyclothymic disorder
Suicide :
Suicide can takes place throughout the life span
Risk factors for suicide
 Suicide is result of complex interface of biological,genetic,
psychological, sociological, cultural and environmental
factors
 Mental disorders especially depression and alcohol use
disorder
 going through natural disasters
 experiencing violence and abuse or loss
 Isolation At any stage of life
 previous suicidal attempt is the strongest risk factor
 Difficulty in problem solving, stress management and
emotional expression

The stigma surrounding suicide continues. Due to this many

people who are contemplating or even attempting suicide do
not seek help thus preventing kindly help from reaching them.
Therefore, improving identification, referral and management
of behaviour is important for preventing suicide.
Sides are prevented. there is need for comprehensive multi-
sectoral approach where the government, media and civil
society all play an important role. some measures suggested
by WHO are:

 Limiting access to the means of suicide

 reporting of suicide by media in a risk
 bringing in alcohol-related policies
 early identification, free and
 screening health workers in assessing and managing for
suicide
 care for people who attempted suicide and providing
community support

Schizophrenia spectrum and other

psychotic disorders
 Schizophrenia is a debilitating disorder
 schizophrenia is term for a group of psychotic disorders in
which person’s
 Personal
 Social and
 occupational functioning deteriorates as a result of
 disturb thought process
 strange perception
 Unusual emotional States
 motor abnormalities

Symptoms of schizophrenia
1. Positive symptoms
2. negative symptoms
3. psychomotor symptoms
symptoms of
schizophrenia

Positive Negative Psychomotor

Symptoms Symptoms symptoms
* (1)DELUSION * (1)ALOGIA- * (1)
Poverty of CATATONIA
*persecution
speech
* Reference STUPOR
*Grandeur
*control

(2)HALLUCINATION (2)BLUNTED (2)

* Visual AFFECT- less CATATONIA
*Auditory emotions
RIGIDITY
* Tactile
*Somatic
*gustatory
* Olfactory

(3)FORMAL (3)FLAT (3)

THOUGHT AFFECT- No CATATONIA
DISORDER emotions
POSTURING

(4) AVOLITION-
(4) INAPPROPRIATE lack of
AFFECT enthusiasm

Positive symptoms
 Delusion
 Hallucination
 formal thought disorder
 inappropriate affect

I. Delusion : Is false belief which is not affected by

rational argument and has no basis in reality
 Delusion of persecution:

people with this delusion believe that they are being plotted
against, spied on, attacked or threatened. For example one
who believes that the intelligence agencies are conspiring to
trap him in a Spy scandal

 Delusion of reference :

in this they attach special and

personal meaning to the actions of others
or to objects and events. For example
one who believes that the Tsunami
occurred to prevent him from enjoying his
holidays

 Delusion of grandeur:

 in this people believe themselves to

be specially empowered. For
example one who believes that he is
the incarnation of God and can make
things happen
 Delusion of control :

they believe that their feelings,

thoughts and actions are controlled by
others. For example one who believes
that his actions are controlled by the
satellite through a chip implanted in his
brain by some extra-terrestrial beings

II. Formal thought disorder Thought disorder is a

disorganized way of thinking that leads to abnormal ways
of expressing language when speaking and writing. This
includes rapidly shifting from one topic to another so that
the normal structure of thinking is muddled and becomes
illogical.
 Derailment: loosening of associations
 neologisms: inventing new words or phrases
 perseveration: persistent and inappropriate
repetition of the same thoughts

III. Hallucination: perception that occurs in the absence of

external stimuli
 Auditory hallucination: patients hear sounds are voices
that speak words, Phrases and sentences
 directly to the patient (second person
hallucination) or
 talk to one another referring to the patient
( third person hallucination)
 Visual hallucinations: seeing things that aren't there.
The hallucinations may be of objects, visual patterns,
people, or lights. For example, patient might see a person
who's not in the room or flashing lights that no one else
can see.
 Tactile hallucinations: forms of tingling and burning
 somatic Hallucination: something happening inside the
body such as snake crossing inside one step
 gustatory hallucinations: strange taste of food or drink
 Olfactory hallucinations: smell of poison or smoke

IV. Inappropriate affect: patients show emotions that

are unsuited to the situation

Negative symptoms: negative symptoms describe

a lessening or absence of normal behaviors
 Alogia: (Poverty of speech) decrease in speaking
 Blunted affect: showing less Emotions like anger, sad
sadness, joy and other feelings than most people do
 flat affect: showing no emotions at all
 Avolition: Lack of enthusiasm, and inability to start or
complete an action

Psychomotor symptoms : Patients move less

spontaneously or make odd gestures

 catatonia stupor:
remain motionless and silent for long
stretches of time

 Catatonia rigidity:
 Catatonia posturing: assuming, awkward, bizarre
positions for long period of times

Neurodevelopmental disorders

SPECIFIC
INTELLECTUAL
ADHD AUTISM LEARNING
DISABILITY
DISORDER
maintain a rigid, upright posture for

 These disorders manifest in the early stage of

development
 Symptoms appear During the early stage of schooling
 Disorders hamper personal, social, academic and
occupational functioning
 These disorders either show deficits or excesses in a
particular behaviour or delays in achieving a particular
age-appropriate behaviour

Types of neurodevelopmental disorders;

 Attention deficit hyperactivity disorder (ADHD)
 autism spectrum disorder
 intellectual disability
 specific learning disorder

Attention-deficit hyperactivity disorder

Inattention
 Children who are inattentive find it difficult to sustain
mental effort during work or play
 they have hard time keeping their Minds on any one
thing or in following instructions
 common complaints are that the child does not
listen, cannot concentrate, does not follow
instructions, is disorganised, easily distracted,
forgetful, does not finish assignments and is quick to
lose interest in boring activities

Impulsive
 Children who are impulsive seem unable to control
their immediate reactions or to think before they act
 Defined it difficult to wait or take turns
 have difficulty adjusting immediate temptations or
delaying gratification
 meinl meshup such as knocking things over are
common where is more serious accidents and injuries
can also occur

Hyperactivity
 Children with ADHD are in constant motion,
 sitting still through a lesson is impossible for
them
 the child may fidget, squirm, climb and run
around the room aimlessly
 parents and teachers describe them as ‘driven
by a motor’, always on the go, and talk
incessantly

Autism spectrum disorder

 Widespread impairment in social interaction and

communication skills and stereotyped patterns of
behaviour, interest and activities.
 Children with Autism spectrum disorder have marked
difficulties in social interaction and communication
 they have restricted range of interest
 and a strong desire for routine
 about 70% of children with Autism spectrum disorder
have intellectual disabilities
 They have profound difficulties in relating to other people
 they are unable to initiate social behaviour and seem
unresponsive to other people's feelings
 they are unable to share experiences or emotions with
others
 they also Show serious abnormalities in communication
and language that passes over time
 many of them never develop speech and those who do
have repetitive and deviant speech patterns
 They show narrow patterns of interest
 repetitive behaviour such as lining up objects or
 stereotyped body movements such as Rocking, hand
flapping for self injurious such as banging their head
against the wall
 ,They have difficulty in starting, maintaining and even
understanding relationships

Intellectual disability
 Intellectual disability refers to below average intellectual
functioning ( with an IQ of approximately70 or below)
 They have deficits or impairments in adaptive behaviour(
in the areas of communication, selfcare, home living,
social/ interpersonal skills, functional academic skills, work
etc.
 All these deficits are manifested before the age of 18
years

Specific learning disorder

 Individual experiences difficulty in perceiving or

processing information efficiently and accurately
 these difficulties get manifested during early School
years
 individual encounters problems in basic skills in reading,
writing and/ for mathematics
 the affected child performs below average for her/ his age
 but if additional inputs and efforts are done individual
may be able to reach acceptable performance
 specific learning disorder is likely to impair functioning
and performance in activities/ occupations dependent on
the related skills

Disruptive, impulse control and conduct disorders

OPPOSITIONAL
DEFIANT CONDUCT
DISORDER DISORDER

The disorders included under this category are

1. Oppositional defiant disorder
2. conduct disorder

Oppositional defiant disorder (ODD)

Children with ODD
 Display age inappropriate amounts of stubbornness
 Are irritable
 Defiant
 disobedient and
 behave in a hostile manner
 do not see themselves as angry, oppositional defiant and
often justify their behaviour as reaction to circumstances

Conduct disorder and antisocial behaviour

 Violate family expectations, social norms and the personal
property rights of others
 aggressive actions that cause or threaten harm to people
for animals
 Non aggressive conduct that cause property damage
 major decide fullness or theft
 serious rule violations

Types of aggressive behaviour

 Verbal aggression: name calling, swearing
 physical aggression: hitting, fighting
 hostile aggression: directed at inflicting injury to others,
motivated by feeling of anger with an intention to cause
pain
 proactive adoration: dominating and bullying others
without provocation. this aggression is is gold directed
design to achieve an objective beyond physical violence

Feeding and eating disorders

Eating
disorder

Anorexia Bulimia Binge

nerovas nervosa eating

These are of three types

1. Anorexia nervosa
2. bulimia nervosa
3. binge eating
Anorexia nervosa

 The individual has a distorted

body image that leads her/
him to see her/ himself as
Overweight
 refuse to eat and exercise
compulsively and develop unusual habits such as refusing
to eat in front of others
 they lose large amount of weight and even starve
yourself/ himself to death

 Individual may eat excessive

amounts of food
 then purge her/ his body of
food by using medicines such
as laxative for diuretics or by
vomitting
 the person often feel
disgusted and ashamed when s/he binges and is relieved
of tension and negative emotions after purging

 There are frequent episodes of out

of control eating
 the individual tends to eat at
higher speed than normal and
continuous eating till she feels
uncomfortable full
 in fact large amount of food may be eaten even when the
individual is not feeling hungry
Substance related and addictive
disorders
 These disorders include problems associated with the
use and abuse of alcohol, cocaine, tobacco and
opiods among others which alter the way people
think, feel and behave
 This also includes exccessive intake of high calorie
food resulting in extreme obesity
Frequently Used substances
 Alcohol
 Heroine
 Cocaine

Alcohol :
 People who abuse alcohol drink large amounts regularly
and rely on it to help them face difficult situations
 eventually the drinking interferes with their social
behaviour and ability to think and work
 Tolerance: Their body build up tolerance for alcohol and
they need to drink even greater amounts to get the same
effect
 Withdrawal Symptoms: Physical symptoms that occur
when person stops or cut down use of substance
 Alcoholism destroys millions of families, social
relationships and careers.
 Intoxicated drivers are responsible for many road
accidents
 It also has serious effects on the children of persons with
this disorder. the children have higher rates of
psychological problems particularly anxiety, depression,
phobia Substance related disorders

Effects of alcohol
 All alcohol have Chemical, ethyl alcohol. This chemical is
absorbed into the blood and carried into the central
nervous system (brain and spinal cord) where it depresses
or slows down functioning of the brain
 Those areas of the brain are suppressed that control
judgement and inhibition So people become more
talkative and friendly and they feel more confident and
happy
 Alcohol affects other areas of the brain ttherefore drinkers
are unable to make sound judgements, their speech
becomes less careful and less clear and memory falters,
many people become emotional, loud and aggressive.
 Motor difficulties increase. For example, people become
an study when they walked and clumsy in performing
simple activities, division becomes blood and they have
trouble in hearing, they have difficulty in driving or in
solving simple problems

Heroine
 heroine intake significantly interferes with social and
occupational functioning
 Abuses develop a dependence on heroine revolving their
life around the substance
 they also build up a tolerance for it i.e more of the drug
is needed to get the desired effects

 and also experience a withdrawal reaction when they
stop taking it
 Overdose of heroin slows down the respiratory centres in
the brain, almost paralysing breathing and in many
cases causing death

Cocaine
 A person becomes dependent on cocaine and maybe
intoxicated throughout the day and function poorly in
social relationships and at work
 Person develops dependency
 They also build up a tolerance for it i.e more of the drug
is needed to get the desired effects
 Person also experiences withdrawal symptoms i.e
stopping it results in feelings of depression, fatigue, sleep
problems, irritability and anxiety
 It may also cause problems in short term memory and
attention
 Cocaine has dangerous effects on psychological
functioning and physical well being