Specific Mental Disorders

People experiencing Bipolar Disorder (sometimes referred to as manic-depression) experience recurrent episodes of extreme mood variation from depression to very elevated mood (mania).

 

Symptoms of a manic episode tend to include:

These symptoms and the behaviours produced can be damaging to people's lives and relationships. People experiencing Bipolar Disorder often have to contend with large debt, broken relationships and damaged reputations as a result of out-of-character behaviour during a manic episode.

Research indicates that the onset of Bipolar Disorder is most common in peoples' twenties, though it may sometimes start in adolescence. Bipolar Disorder occurs in about 1% of the population and tends to occur equally among men and women.

 

 

The exact cause of Bipolar Disorder is unknown. What is known is that that Bipolar Disorder is essentially a biological disorder, meaning that it occurs in a specific area of the brain that regulates mood. Research suggests that Bipolar Disorder is likely to be caused by a combination of factors, including brain chemistry and genetic inheritance.
 

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The symptoms of Bipolar Disorder are generally managed through a combination of:

As Bipolar is a recurring illness that can be triggered through stress, life changes or even seasonal change, care needs to be taken in assertively monitoring manic or depressive symptoms. A number of factors can influence the course of treatment and the length of each treatment stage. This includes, the severity of the manic episode, the frequency of manic episodes, and whether the person has a history of both manic and/or depressive episodes.

 

Treatment of a manic episode usually occurs in three stages:

 

Acute treatment: This is essentially a pharmacotherapy (medication based) treatment stage in which the aim is to stabilise acute symptoms of mania (usually through a hospital admission) until remission. This treatment phase usually last for 2 to 10 weeks depending on the severity of the manic phase.

 

Continuation treatment: Following the stabilisation of acute mania, continuation treatment involves psychological interventions such as psychoeducation and psychotherapy. This period usually lasts for 6 to 12 weeks whereby medical treatment is continued in order to prevent a return of symptoms from the same episode.

 

Maintenance treatment: Dependent on whether the person’s mood has remained stable during the continuation treatment phase and/or whether they have had a history of manic or depressive episodes, maintenance treatment involves ongoing psychotherapy with the view to either continue long term medication use or gradual cessation of medical treatment.

 

Between episodes of low or high mood, people experiencing Bipolar Disorder experience normal mood variation and are able to live full and productive lives. For some people, extreme mood swings occur regularly; for others, the highs or lows may be occasional with years of stable moods between.

Generally, most people respond to a medication and or combination of medications. Research indicates that 10 to 20 percent of people experiencing Bipolar will have chronic (unresolved) mood symptoms despite treatment. Approximately 10 percent of people experiencing Bipolar will continue to experience recurrent episodes requiring regular hospital admissions. Clinical studies report that on average, the average interval between first and second manic episodes is usually five years. As time goes on, the interval between episodes may shorten, especially in cases in which treatment is discontinued too soon. It is estimated that a person with Bipolar Disorder will have an average of eight to nine mood episodes during his or her lifetime.

SANE Australia
www.sane.org
(03) 9682 5933

 

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Everyone feels sad, moody or low occasionally. Sometimes people experience these feelings for lengthy periods of time at intense levels. Clinical Depression is different from the everyday description of “being depressed”, and it is more than just temporary unhappiness or feeling down. It is often a constant feeling that life is a struggle; that life has little point.

A person experiencing depression may feel “tired all of the time”, irritable or angry for no reason, unmotivated or sad. As a result, people experiencing depression can feel stuck in a pattern of negative thinking that effects the way they see themselves, their future and the world. This has people withdrawing from social relationships, or experiencing difficulty in being able to get out of bed or get motivated to do even the things that once were enjoyable. Sometimes, as a way of dealing with negative thoughts or feelings, people engage in self-soothing behaviours such as comfort eating or drinking more than usual. More serious forms of this may include excessive drinking or self-harming in the form of cutting with sharp objects, punching walls or hitting oneself.

Often people experiencing depression may find themselves thinking about death, sometimes unconsciously in that sudden thoughts about killing oneself may enter the head involuntarily, or sometimes people find themselves thinking about ways and plans of attempting suicide.
 

Some of the symptoms that often occur with major depression include:

There are a number of classifications and types of depression, for more information click here.

Depression is one of the most common mental health problems, with major depression being experienced by one in five adults at some point in their lives. Up to two fifths of Australia's young people suffer from depressed moods in any six monthly period. In fact Major Depression accounts for more days lost to illness than almost any other health problem, physical or mental. About 20% of people will be affected by depression and 6% will experience a major depressive illness.

 

Depression can be caused due to a major event, such as a loss of a loved one, loss of employment, a relationship breakup, separation, or even returning back to work after a long holiday. Depression may also occur due to repeated feelings of stress caused by a number of different factors such as family or relationship problems, financial concerns, and unhappiness. One thing that often doesn’t get talked about is the fact that depression can occur when a person is living in a domestically violent relationship.

Research indicates that there is a genetic component to depression, meaning that if someone in your immediate family experiences depression or bipolar disorder, you are two to three times more likely to do so.

Medical conditions may contribute to higher than average rates of depression. These may include people for example, with an under-active thyroid, had a heart attack, stroke, cancer, or diabetes. Some prescription medications can also increase the risk.

Hormonal changes that occur naturally throughout life are a common trigger of depression. The hormonal changes at puberty, during pregnancy, childbirth and menopause may cause symptoms of depression.
 

This can occur soon after the birth of a baby and affects about 10% of all new mothers. Postnatal depression is not just 'the normal ups and downs' that come with having a baby. Symptoms may include mood changes, sleep and appetite disturbance, anxiety, loss of concentration and memory, feelings of guilt and inadequacy, and social withdrawal.

 

Treatment

Treatment is essential to supporting a person’s recovery from depression. An episode of major depression may last six to twelve months, or even for many years if left untreated. Also, of those who suffer an untreated episode of depression, half re-experience depression within two years of the first episode.

 

Effective treatment can greatly assist people to recover much faster and can lessen the pain and the cost that may be associated with the illness. It can also help people to develop strategies to better protect themselves against future bouts of depression.

Research indicates that anti-depressant medication is an effective treatment option when used in conjunction with psychological therapy. Anti-depressants help to lift mood and provide relief from negative thinking, irritability and lack of motivation, whilst psychotherapy (for example therapeutic approaches such as Cognitive Behaviour Therapy, Dialectical Behaviour Therapy, Interpersonal Therapy or Narrative) assists in the development of cognitive, emotional and behavioural resources to deal with depression.

Recovery is dependent on a number of factors, including:

 

The severity of depression – in some cases severe depression may require a brief hospitalisation. Examples of severe depression may include strong intense desire or plan to attempt suicide or harm another person; chronic and debilitating depression in which persons become bed bound.
 

Motivation – it is one thing to acknowledge there is a problem, another thing to talk about it, but doing something about it like changing your behaviours and willing to engage in different ways of thinking is a whole different story. It is achievable–the easiest thing in the world is to do nothing about depression, it is much harder to actually address it. But once you start, it gets easier!
 

Support – a supportive environment of friends or family is important to feeling positive about oneself. If these things are absent, be creative! Online chat rooms or support groups are a great way to connect with people who are going through the same experience.
 

And most importantly – Patience – change doesn’t occur overnight. Often we only notice change when big things occur, but in the small steps, that is where hope resides.

beyondblue
The National Depression Initiative
www.beyondblue.org.au

(03) 9810 6100

 

BluePages
www.bluepages.anu.edu.au

Dark Side of the Mood
www.abc.net.au/health/depression

 

Dona Maria Pre and Postnatal Support Network
Support line: 1300 555 578

 

PaNDa
www.vicnet.net.au/~panda

 

SANE Australia
www.sane.org
(03) 9682 5933
 

 

Stress and worry are normal everyday experiences of feeling under ‘pressure’ in some way or another. They may be experienced when important decisions need to be made, doing something for the first time, or having to give a presentation. When people talk about the experience of ‘anxiety’, they often mean ‘stress’. Whilst stress and anxiety have much in common, there is a significant difference.
 

Anxiety is not just feeling tense or worried. Anxiety is a persistent sense of stress, worry or fear that continues to affect a person even when the cause of the stress is absent. Anxiety affects the way people think, feel and behave in their everyday life. For example, some people experiencing anxiety commonly experience a strong sense of fear together with physical sensations of shortness of breath, tight chest, racing heart or even dizziness.

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Anxiety can occur in almost all age groups. According to the Australian Bureau of Statistics, one in five people will develop an anxiety problem at some point in their lives. Furthermore, there is an increased risk of developing depression for people suffering anxiety problems, in the order of two to four times those without anxiety problems. Depression and anxiety are commonly found together when depression is diagnosed.

Anxiety problems are not the result of a single cause, but are a product of a number of interrelated factors including environment, relationships, ability to cope with stress, and genetics. Anxiety does not occur in a vacuum, it occurs in a context. The context in which anxiety problems occur may include major life stressors such as financial difficulties, marital problems, or bereavement.
 

 

 

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Anxiety symptoms can be effectively treated usually through psychological therapies such as Cognitive Behavioural Therapy (CBT). CBT is a form of psychotherapy that focuses on changing the way people think in order to change the way they feel and respond to anxiety provoking situations, thoughts or feelings. Through this approach people learn specific skills for example:
 

 

 

Further CBT techniques include:

 

Medication such as anti-depressants can also be useful for people suffering severe anxiety, and is used in conjunction with psychological therapy. It may also be used where there are recurrent episodes of panic or obsessional thinking.

 

Examples of anxiety problems include:

This problem is characterised by the experience of an excessive and persistent anxiety and worry for at least daily for six months or more. The person experiences great difficulty in controlling worrying thoughts. The worry is so that great that they experience symptoms such as:

GAD causes people excessive worry about daily, routine circumstances such as family health and finances, or even household chores. GAD affects up to 12% of the population, with two-thirds of those being female.

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A specific phobia is an intense fear of a particular thing or a situation. Exposure of the phobic object or situation to the person usually provokes an anxiety response, such as a panic attack. This leads to an avoidance of the thing or situation that is feared. Approximately 10-20% of the population develop a phobia during their lives. Phobias often start in childhood but can occur at any age. Phobias are roughly twice as common among women than men.
 

Social phobia is the marked and persistent fear of social or performance situations, where the people find themselves feeling negatively evaluated or judged by others. Physical symptoms of anxiety usually occur in anticipation or participation in the feared situation. This leads to avoidance of the phobia. A diagnosis of social phobia is usually made if it interferes significantly with work or daily routine. Social phobia may start in early childhood, or more typically in the mid-teens, after a childhood history of shyness, or social inhibition. It happens more frequently between first-degree biological relatives.
 

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Post-traumatic stress problem develops after someone is exposed to an extremely traumatic event and they reacted to the event with intense fear, horror or helplessness. It can occur at any age, including childhood.
 

Such traumatic events include but are not limited to:

The traumatic event can be re-experienced through distressing dreams, or thrpugh recurrent and intrusive recollections (flashbacks) of the event. The person may also act or feel that the traumatic event is actually occurring. This may last from a few seconds to even days.
 

The person may experience intense psychological distress and physical symptoms (such as muscle tension, rapid heartbeat and sweating) when exposed to a trigger that is similar to, or symbolizes, a feature of the traumatic event. Other on-going symptoms include:

People who experience panic disorder experience recurrent unexpected panic attacks. The attacks are spontaneous, that is, they are not triggered by any other stimulus. Two panic attacks are needed for a diagnosis, but most people have many more.

Panic Attacks have an abrupt onset and peak within 10 minutes. People with Panic Problem also often have situational Panic Attacks with exposure to a trigger (e.g. Agoraphobia).
 

Symptoms can include:

Research suggests that approximately 1.5 to 3.5 % of the population experience panic disorder. The onset of panic disorder is highly variable, but most typically starts between late adolescence and mid-30’s. First-degree relative have an increased risk of developing panic disorder.
 

Agoraphobia is anxiety about being in a place or situation from which escape could be difficult. The anxiety leads to avoidance of the situation.
 

OCD is characterised by recurrent obsessions or compulsions that are time consuming (more than 1 hour per day) or cause significant distress or impairment. The obsessions and compulsions significantly interfere with a person’s normal daily routine, at work, and in social situations. Many OCD sufferers avoid objects or situations that trigger their OCD behaviour. OCD sufferers usually try to ignore or suppress their worrying thoughts and impulses or to neutralize them with a compulsion.

Obsessions are thoughts, impulses, images, or persistent ideas that cause marked anxiety or distress. The sufferer has difficulty switching to another thought.
 

Compulsions are repetitive behaviours (e.g., washing hands, checking, ordering) or mental acts (e.g., repeating words, praying) that are performed to prevent or reduce the anxiety and distress of obsessions.
 

Some studies have estimated OCD to be experienced by about 2.5% of the population. It usually begins in adolescence, although it can start in childhood. There is a higher risk of OCD in first-degree relatives with the condition.
 

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The Anxiety Problems Clinic, St Vincent's Hospital
www.crufad.com
(02) 9332 1013

Anxiety Network Australia
www.anxietynetwork.com.au
(07) 3369 6090

 

1300224636

 

1800674200

 

There are a number of signs and symptoms that are characteristic of schizophrenia, however, the expression of these symptoms varies greatly from one individual to another. No one symptom is common to all people. As such, diagnosis and treatment must always be tailored to the individual's unique experience of schizophrenia.
 

Mental health clinicians use the umbrella term psychosis to describe the mental state of a person experiencing acute symptoms of schizophrenia. A psychotic episode is a term that describes a period of time whereby the following positive or psychotic symptoms are highly active. The term positive symptoms refer to an excess or distortion of everyday thought processes or perception (the process of acquiring, interpreting, selecting, and organising information gathered from our five senses).
 

Positive symptoms include:
 

Stages of Psychosis

• changes in thinking: difficulty in concentrating, poor memory, preoccupation with odd ideas, increased suspiciousness.
• changes in mood: lack of emotional response, rapid mood changes, and/or inappropriate moods.
• changes in behaviour: odd or unusual behaviour.
• physical changes: sleep disturbances or excessive sleep and loss of energy.
• social changes: withdrawal and isolation from family and friends.

• loss of drive, initiative or motivation;
• reduced ability to express emotions or respond appropriately to people;
• withdrawal from contact with other people;
• lack of insight into own behaviour and thinking, and denial of the illness;
• side effects of medication. While medication is improving, many side effects may be unpleasant and disruptive.

Occurrence
 

• Family history (genetics) – A family history of psychosis is associated with an increased risk of vulnerability to schizophrenia.
• Physical abnormality of the brain –there is some evidence that suggests that people with schizophrenia have some alterations in brain shape (enlarged ventricles, smaller hippocampus).
• Chemical imbalance – there is some evidence to suggest that the chemical systems involving the neurotransmitters dopamine and glutamate are involved.
   

Treatment
 

• antipsychotic medication (neuroleptics);
• psychoeducation – learning to manage symptoms of schizophrenia and to prevent further episodes;
• counselling;
• case management;
• psychological therapy;
• crisis intervention;
• psychosocial support - social and psychological supports are critical in managing stress to support individuals experiencing psychosis to live meaningful lives. This should include educational and vocational support, participation in social activities, financial guidance and accommodation support.
• family education and support – to assist families in understanding and coping with schizophrenia in order to minimise family disruption and support healthy relationships.

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Contacts & Other Resources

Mental Health First Aid - Guidelines for Psychosis
Developed by the Mental Health Council of Australia
www.mhfa.com.au

Mental Health First Aid - Guidelines for Aboriginal & Torres Strait Islander Peoples: Psychosis
Developed by the Mental Health Council of Australia
www.mhfa.com.au

Schizophrenia Fellowships

ACT
(02) 6287 4214

NSW
(02) 9879 2600
www.sfnsw.org.au

NT
(08) 8999 4945

QLD
(07) 3358 4424
(South Queensland)

(07) 4725 3664
(North Queensland)

Eating Disorders

• Anorexia Nervosa
• Bulimia Nervosa
• Causes
• Prevalence
• Treatment/Prognosis
• Contacts

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When food ceases to be a source of enjoyment or nourishment, but a source of constant preoccupation, unhappiness, worry or even fear, the act of eating takes on a completely new meaning in a persons life.

For a person experiencing an eating disorder, eating becomes a means of controlling certain thoughts or feelings about oneself. This may involve eating to control feelings of sadness or stress, or stopping eating in order to control feelings of self-hatred.

An eating disorder is not a dieting method or a lifestyle choice. Once active in a person’s life it proceeds to take over many aspects of life beyond eating and weight loss. For example, eating disorders affect people’s:

Mood – Often people experience depressed mood as a result of poor nutrition practices. The pursuit of attaining an unnatural body size can itself be a tremendous source of struggle, frustration and mood swings, for example, some people experiencing eating disorders have commented that their weight reading on the bathroom scales can determine whether they are in a happy or depressed mood for the day

Eating patterns – In Australia, eating is an essential ingredient to social gatherings. Whether it is going out for coffee, dating, anniversaries, or any other celebrations, you can be assured that people will be eating. For people experiencing an eating disorder, social gatherings become a complex affair. Often people find themselves having to make excuses for not eating, or finding themselves avoiding social situations involving food. Difficulties arise in having to lie to friends, loved ones or colleagues about eating and weight, and dealing with fears of having problematic eating patterns discovered, especially if this involves going directly to the bathroom after consuming meals.

Daily activities – A person experiencing an eating disorder may find that their time table revolves around weight control whether that be exercising excessively, spending a lot of time talking about their appearance, or looking in the mirror and even the time taken for concealing and disposing food, or acquiring food or purging.

Appearance – regardless of whether a person is controlling their food intake to lose weight or engaging in comfort eating, the telltale signs of an eating disorder can usually be seen through a person’s appearance.

 

• Self-induced weight loss (through starvation, exercise and purging)
• Intense fear of weight gain
• Cessation of menstrual periods in women

• Repeated bouts of uncontrolled over-eating (bingeing)
• Intense fear of gaining weight
• Attempts to limit weight gain through intensive exercise, self-induced vomiting and use of laxatives and fluid tablets

• genetic factors;
• personal and psychological factors related to adolescence or family issues;
• unhappiness;
• stress level ;
• societal preoccupation with dieting and weight control;
• media representation of body image;
• low self esteem increases the chance of developing disordered eating;
• more than half of anorexia sufferers have experienced some major trauma.

• psychological therapy around beliefs and distorted body image;
• nutritional treatment to recover physical health;
• psychotherapy;
• medication.

Contacts & Other Resources

Mental Health First Aid - Guidelines for Eating Disorders
Developed by the Mental Health Council of Australia
www.mhfa.com.au 

Eating Disorders Association (QLD)
www.uq.net.au/eda

Eating Disorders Foundation of New South Wales
www.edsn.asn.au
(02) 9412 4499

Eating Disorders Foundation of Victoria
www.eatingdisorders.org.au
(03) 9885 0318

Personality Disorders 

• Types of Personality Disorders
• Causes
• Occurence
• Treatment
• Contacts

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What is Personality?

Everyone is unique in his or her own way. When we think about the characteristics that make people unique or different from one other, we often use the word personality. Personality is an umbrella term that describes the ways in which a person thinks, feels, responds, behaves, relates, communicates or engages with other people. Each of us has our own unique ways of relating with other people, but when our ways of relating causes intense distress to ourselves or to others, that’s when personality becomes a problem.

What are Personality Disorders?

Personality Disorders are diagnostic categories used to describe specific types of personality problems. Mental Health Clinicians use this term to describe patterns of thinking and behaviour that are extreme, inflexible and maladaptive. Personality disorders may cause major disruption to a person’s life and are usually associated with significant distress to the self or others.

A NOTE ON PERSONALITY DISORDERS: Some of the symptoms of Personality Disorders appear incredibly general on face value. It is important to keep in mind that personality disorders aren’t merely eccentricities; they are crippling problems that make relationships and everday functioning extremely difficult.

For people experiencing a personality disorder:

• Negative emotions can feel incredibly overwhelming. For example, extreme feelings of sadness, anger, hurt, or frustration. Sometimes it feels like there are no emotional resources available to deal with every day difficulties. Stressful life events can therefore have a devastating impact on everyday living.
• Sometimes the responses or actions of other people may be interpreted in ways that were not intended. Sometimes a way of dealing with fears of rejection from another person and intense feelings of anger is to distance oneself off from another person/ or people.
• Sometimes a way of coping with intense emotional pain or an experience of feeling “out of control” is through engaging in harmful or suicidal behaviours. Often these behaviours are not about an intention to die, but a need to control unbearable emotional pain or intense feelings of self-hatred.
• Sometimes a way of dealing with intense self-hatred is through the use of substances or an overwhelming need to have sex, even with strangers, in order to feel loved or worthy.
• Often the world feels like a very cold and lonely place, because no one understands or can see the emotional pain. Quite often, people experiencing a personality disorder are labelled as “manipulative” or “attention-seeking” when the people in their life do not understand what they are experiencing.

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