Psychiatry

The exact cause of anxiety disorders is not known; but anxiety disorders are not the result of personal weakness or a character flaw. As research into mental health problems continues, it is becoming clear that many of these disorders are caused by a combination of factors, including changes in the brain and environmental stress.

Like certain illnesses, such as diabetes, anxiety disorders may be caused by chemical differences in the body. Studies have shown that severe or long-lasting stress can change the balance of chemicals in the brain that control mood. Other studies have shown that people with certain anxiety disorders have changes in certain brain structures that control memory or mood. In addition, studies have shown that anxiety disorders run in families, which means that they can be inherited from one or both parents, certain environmental factors such as a trauma or a major event can prompt an anxiety disorder in people who have an inherited susceptibility to developing the disorder.

Generally, people who experience anxiety for unknown reasons over a period of weeks are at risk of developing a chronic condition. These chronic conditions can trigger dangerous physical problems, especially for people with heart problems and hypertension. The stress, frustrations, and negative mood associated with generalized anxiety disorder may interfere with your quality of life. 

If you find that your quality of life is suffering from your anxiety or you feel depressed, suicidal, and homicidal or start to experience mood changes, you should consult a doctor as soon as possible.

Post-traumatic stress ailment is a reaction people sometimes have to very frightening, upsetting or dangerous events, such as a car accident, witnessing a crime, or being abused or injured. They might find it hard to sleep, and have nightmares. They may keep thinking about the event or remembering it over and over again. Concentration can be affected. They often find it hard to relax and become very anxious, clingy and restless.

It’s the extreme fear of being scrutinized and judged by others in social or performance situations. Symptoms may be so extreme that they disrupt daily life. People with this disorder, also called social phobia, may have few or no social or romantic relationships, making them feel powerless, alone, or even ashamed. The anxiety can interfere significantly with daily routines, occupational performance, or social life, making it difficult to complete school, interview and get a job, and have friendships and romantic relationships.

The symptoms of depression can be difficult and vary widely between people. Some of the symptoms are: 

• Low mood or sadness all the time 

• Feeling hopeless and helpless 

• Having low self-confidence  

• Feeling tearful 

• Feeling guilt-ridden 

• Feeling ill-tempered and intolerant of others  

• Having no incentive or interest in things 

• Finding it difficult to make decisions 

• Not getting any pleasure out of life 

• Feeling apprehensive or nervous   

Generally if you are depressed, you feel sad, hopeless and lose interest in things you usually enjoy. The symptoms continue for weeks or months and are bad enough to interfere with your daily life socially and mentally.

Eating disorders are serious, actually life-threatening conditions that affect a person’s emotional and physical health. People struggling with an eating disorder need to seek professional help. The earlier a person with an eating disorder seeks treatment, the greater the likelihood of physical and emotional recovery.

Eating disorders are real, complex, and overwhelming conditions that can have serious concerns for health, productivity, and relationships. Eating disorders are not a cult, phase or lifestyle choice.

Phobias and Fears: An unwarranted and irrational fear reaction is known as phobia. If you have a phobia you will experience a deep sense of fear, and sometimes panic, upon encountering the source of your fear. The fear can be of a certain place, situation, or object. Unlike general anxiety disorders, a phobia is usually connected to something specific.

Phobias cause people to experience extreme fear. Many common phobias include fear of spiders, heights, airplanes, agoraphobia, and claustrophobia. People with these phobias will commonly experience panic attacks of extreme anxiety.

The influence of a phobia can range from annoying to severely incapacitating. People with phobias often realize their fear is unreasonable, but are unable to do anything about it. If such fears impede with your work, school, and personal relationships and stops you from leading a normal life, you should see a doctor’s help.

It is known that psychotic disorders can occur from the use of a substance or a medical condition, but specific causes for most psychotic disorders are not known. However, the association of genetic (familial), biological, environmental, and psychological factors is thought to be involved.

Environmental risk factors, like a history of problematic drinking, using tobacco, marijuana, or other drugs, have been associated with the development of a psychotic disorder

Thus, people with psychosis can experience positive, negative or mental symptoms like: 

• Positive symptoms: hearing voices or otherwise hallucinating, suspiciousness, feeling under frequent or constant surveillance, delusions, or making up words without a meaning.

• Negative symptoms: social withdrawal, difficulty in expressing emotions, difficulty in taking care of themselves, inability to feel pleasure 

• Mental symptoms: difficulties attending to and processing information, in understanding the environment, and in remembering simple tasks

Bipolar disorder is linked to genetics, chemical factors and stressful trigger factors such as:  

• Physical illness 

• Sleep disturbances 

• Overwhelming problems related to financial, work or relationships

Bipolar disorder is widely believed to be the result of chemical imbalances in the brain. The chemicals responsible for controlling the brain's functions are called neurotransmitters and include noradrenaline, serotonin and dopamine. If there is an imbalance in the levels of one or more neurotransmitters, a person may develop bipolar disorder.

With bipolar disorder, you will experience periods of:

• Depression  – where you feel very low and lethargic 

• Mania – where you feel very high and overactive 

There are several options for treating bipolar disorder that can make a difference. They aim is to control the effects of an episode and help someone with bipolar disorder live life as normally as possible.

The following treatment options are available:

• Mood stabilizers and are taken every day on a long-term basis can prevent episodes of mania and depression 

• Medication to treat the main symptoms of depression and mania when they occur 

• Learning to recognize the triggers and signs of an episode of depression or mania 

• Psychological treatment – such as talking therapy, which can help you deal with depression, and provides advice about how to improve your relationships 

• Lifestyle advice – such as doing regular exercise, planning activities you enjoy that give you a sense of achievement, as well as advice on improving your diet and getting more sleep 

• It's thought using a combination of different treatment methods is the best way to control bipolar disorder. 

Schizophrenia is a long-term mental health condition that causes a range of different psychological symptoms, including: 

• Hallucinations: hearing or seeing things that do not exist 

• Delusions:  unusual beliefs not based on reality that often contradict the evidence 

• Muddled thoughts based on hallucinations or delusions 

• Behavioral changes

Doctors often describe schizophrenia as a psychotic illness. This means sometimes a person may not be able to distinguish their own thoughts and ideas from reality.

The exact cause of schizophrenia is unknown. However, it is believed that the condition is caused by a combination of genetic and environmental factors.

It is thought certain things make you more vulnerable to developing schizophrenia, and certain situations can trigger the condition.

Schizophrenia is one of the most common serious mental health conditions with many people continuing to lead normal lives. 

There is no single test for schizophrenia. It is most often diagnosed after an assessment by a mental health care professional, such as a psychiatrist.

It is important that schizophrenia is diagnosed as early as possible, as the chances of recovery improve the earlier it is treated.

Personality disorders affect how a person thinks and behaves, making it hard for them to live a normal life. People diagnosed with personality disorder may be very inflexible, they may have a narrow range of attitudes, behaviours and coping mechanisms which they can’t change easily, if at all. They may not understand why they need to change, as they do not feel they have a problem. 

The causes of personality disorders are not fully known. Possible causes include trauma in early childhood such as abuse, violence, inadequate parenting and neglect. Neurological and genetic factors may also play a part.

Personality disorder is not strictly a mental health problem. Medication is often used, but mainly to control other, associated symptoms. Short-term treatments which are given for short periods or at times of severe stress, usually help in controlling risk and stress rather than having any long term impact on the personality disorder itself. 

Cognitive therapies and self-management approaches are also proven successful in helping people live with personality disorder. 

Personality disorder is a controversial diagnosis. They are very deep-rooted, so hard to treat, but people can be helped to manage their difficulties. People who think they may be suffering from a personality disorder should consult a physiatrist.

Self-harm is when somebody intentionally damages or injures their body. It is a way of coping with or expressing overpowering emotional distress.

Sometimes when people self-harm they intend to die but often the intention is more to punish themselves, express their distress or relieve insufferable tension. Self-harm can also be a cry for help.

Treatment for people who self-harm will usually involve seeing a therapist to discuss your feelings and thoughts and how these affect your behaviour and wellbeing. If you are badly depressed it could also involve taking antidepressant medication

Substance misuse covers misuse of a range of mind altering substances. It can have a severe impact on your functioning as well as your physical health. 

Substance misuse is formally defined as the continued misuse of any mind-altering substance that severely affects person’s physical and mental health, social situation and responsibilities. 

Alcohol dependence is the most common form of substance misuse, but any drug, including heroin, cocaine, crack and cannabis, comes into this category, as does the misuse of glue and aerosols. 

Most forms of substance abuse may give you a temporary feeling of well-being or of being in control, but all of them can ultimately damage your health. 

The most severe forms of substance misuse are normally treated by specialist drug and alcohol rehabilitation services. There is also a lot you can do to help yourself. 

This is a condition commonly linked to an unhealthy preoccupation with small details, neatness, and order. People with obsessive compulsive disorder have irrational fears and will frequently show unusual behaviour in order to achieve perfection or maintain a highly controlled environment. People with obsessive compulsive disorder will repeat the same behaviours and abide extremely over situations, creating or intensifying problems.

OCD is sometimes accompanied by depression, eating disorders, substance abuse disorder, a personality disorder, attention deficit disorder, or another of the anxiety disorders. Co-existing disorders can make OCD more difficult both to diagnose and to treat. Treatment for OCD is by cognitive behavioural therapy and/or medication. 

At a time when you may find making decisions difficult, it can also seem like an added burden to try and choose between a ranges of treatment options, hence it helps to seek professional help who will be able to help and advise you.

The recommended guidelines for the treatment of depression is:

• Active monitoring: this helps with mild depression and this means keeping an eye on you while waiting to see if your depression goes away without treatment, which mild depression often does.

• Cognitive behavioural therapy (CBT): this helps to identify and change negative thoughts and feelings affecting your behaviour and, although often a short-term treatment, may last up to 12 months. For mild depression you may be offered computerised CBT, which uses a programme you can follow either by yourself or in addition to sessions with a therapist.

• Mindfulness-based cognitive therapy: is an approach to wellbeing that involves accepting life, and living and paying attention to the present moment. It includes taking time to see what is happening around you in a non-judgmental way, rather than going over your problems again and again. Mindfulness-based cognitive therapy is usually done in groups.

• Behavioural activation: makes you look at the simple everyday tasks you may be avoiding and start doing them. Activity helps you to feel better, and once you have conquered some everyday tasks, you may feel ready to tackle some bigger ones. For example, you may have felt too depressed to do the washing up and let it pile up in the kitchen. The bigger the pile, the less you feel like doing it. Behavioural activation would encourage you to tackle it, even if you start by only doing some of it. As you do it, the dishes get clean, your kitchen gets tidier, and you feel a bit better about everything. Behavioural activation usually forms part of a CBT programme, but may be offered on its own.

• Guided self-help delivers a 6-8 week therapy programme through self-help books, under the guidance of a healthcare professional.

• Interpersonal psychotherapy focuses on relationships. Therapy can continue for 6 to 12 months

• Counselling, which can be short- or long-term. This involves talking with someone who is trained to listen with empathy and acceptance. It allows you to express your feelings and helps you to find your own solutions to your problems

• Psychodynamic counselling and psychotherapy focus on how past experiences may be contributing to experiences and feelings in the present. Therapy can be short- or long-term. It may be more frequent and intensive than counselling, and may go deeply into childhood experience and significant relationships

• Medication for severe depression, but not for mild to moderate depression unless other treatments have not helped. This should be combined with CBT or psychotherapy.

• Group therapy allows a group of people to work together on their problems, with a therapist. You may find it easier to talk with others who have similar experiences, and that the insights of others help you to understand yourself better; you may also learn about relationships with others.

• Exercise: Regular exercise probably helps ease depression in a number of ways, which may include:

  • Releasing feel-good brain chemicals that may ease depression (neurotransmitters, endorphins and endocannabinoids)

  • Reducing immune system chemicals that can worsen depression

  • Increasing body temperature, which may have calming effects

  • Regular exercise has many psychological and emotional benefits, too. 

   

It can help you:

Gain confidence. Meeting exercise goals or challenges, even small ones, can boost your self-confidence. Getting in shape can also make you feel better about your appearance.

Take your mind off worries. Exercise is a distraction that can get you away from the cycle of negative thoughts that feed anxiety and depression.

Get more social interaction. Exercise and physical activity may give you the chance to meet or socialize with others. Just exchanging a friendly smile or greeting as you walk around your neighborhood can help your mood.

Cope in a healthy way. Doing something positive to manage anxiety or depression is a healthy coping strategy. Trying to feel better by drinking alcohol, dwelling on how badly you feel, or hoping anxiety or depression will go away on its own can lead to worsening symptoms.