Disability

  • What is a disability?
  • What if I’m getting medication or treatment for my mental health problem?
  • What if I had a disability in the past?
  • Checklist: Is my mental health problem a disability?

What is a disability?

You have to show that your mental health problem is a disability to get the protection of the Equality Act.

‘Disability’ has a special legal meaning under the Equality Act, which is broader than the usual way you might understand the word. Even if you don’t think you have a disability, the Equality Act may protect you from discrimination if your mental health problem fits its definition of disability.

The Equality Act says you have a disability if you have a physical or mental impairment that has a substantial, adverse, and long-term effect on your ability to carry out normal day-to-day activities.

The focus is on the effect of your mental health problem, rather than the diagnosis. So you need to show that your mental health problem:

  • has more than a small effect on your everyday life
  • makes things more difficult for you, and
  • has lasted at least 12 months, is likely to last 12 months, or (if your mental health problem has improved) that it is likely to recur.

Examples of ‘substantial adverse effect’

Simon has obsessive-compulsive disorder (OCD). He has to check and recheck whether lights are switched off and doors are locked. This can make him late for work or other appointments. His obsessive thoughts often distract him from activities that he is doing and disrupt his daily routines. His mental health problem therefore has a substantial adverse effect on the way he does things.

Examples of ‘long term’

  • Jenny has had depression for 10 months and the doctor says it will be likely to last at least another 4 to 5 months.
  • Selina has bipolar affective disorder. She had her first and second episode in January 2013, then a third episode in January 2014. Even though there was a gap between her second and third episode, her mental health problem is considered to have continued over the whole period (in this case, a period of 13 months).

What if I’m getting medication or treatment for my mental health problem?

If you are getting some treatment or taking medication for your condition, you ignore the effect of your treatment when deciding whether your condition is having a substantial, adverse effect on your daily activities. This means the law is looking at how your condition affects you without your treatment or medication.

Example

Mohammed has long-term anxiety and is being treated by counselling. Anxiety would normally make him find simple tasks difficult. Because he has counselling, he is able to get up and go to work.

The Equality Act says you have to ignore his treatment in deciding whether his mental health problem has a substantial adverse effect on his day-to-day activities and so he has a disability.

What if I had a disability in the past?

You are still protected from discrimination if you had a disability in the past. That means that if your past mental health problem had a substantial, long-term and adverse effect, you will get the protection of the Equality Act.

Examples

Four years ago, Mary had depression that lasted 2 years and had a substantial effect on her ability to carry out normal day-to-day activities. She has not experienced depression since then.

If Mary is treated worse by her employer because of her past mental health problem, she will be protected by the Equality Act.

Checklist: Is my mental health problem a disability?

You can ask yourself these questions:

  1. Do I have a mental or physical health impairment?
  2. Is it long-term (meaning lasting more than 12 months or likely to do so)?
  3. Does it have a more than minor adverse effect on my day-to-day living, if I discount my treatment or medication?

If you answered “yes” to all three questions, then your mental health problem could get the protection of the Equality Act.

If you want to get the protection of the Equality Act, you may find it helpful to get some evidence from your GP, or another medical professional. You can ask them to write a letter saying whether they think you have a disability under the Equality Act. It would be particularly useful if they can give their opinion on the answer to each of these three questions.

Example

Esra doesn’t consider herself disabled because she doesn’t receive disability benefits and she is physically healthy.

Esra has been living with an anxiety disorder for the past 3 years. Because of this, it takes her a longer time to do things like get up in the morning, dress herself for the day and do the shopping. She takes medication to control the symptoms.

Esra would be protected by the Equality Act because she has:

  • a mental impairment – an anxiety disorder
  • it is long term – she has had it for the past 3 years
  • it has a substantial effect on her daily life – her mental health has a major effect on her daily life when you ignore the effect of her medication  
  • it has an adverse effect – her mental health problem makes things more difficult for her.

Coping with Disability

Probably everyone reading this will have or know someone with a disabilty of some kind. The list of disabilities is endless.

I myself was born with slight Cerebral Palsy which later in life contributed to me developing Epilepsy. Although my seizures are controlled by medication I sltill suffer the odd Focal or Partial seizure (though i haven’t had any for weeks).

My Cerebral Palsy is giving me more cause for concern at the moment as I keep loosing my balance.

Fortunately because of my positive mind I think I try not to let my disabilities get me down .

For more information check the link below

How to Emotionally Cope With Having Disabilities: 14 Steps (wikihow.com)

Epilepsy – Carbamazepine/Tegratol

What is carbamazepine?

Carbamazepine is an anticonvulsant. It works by decreasing nerve impulses that cause seizures and nerve pain, such as trigeminal neuralgia and diabetic neuropathy.

Carbamazepine is also used to treat bipolar disorder.

Carbamazepine may also be used for purposes not listed in this medication guide.

Important Information

You should not take carbamazepine if you have a history of bone marrow suppression, if you are allergic to it, or take an antidepressant such as amitriptyline, desipramine, doxepin, imipramine, or nortriptyline.

TELL YOUR DOCTOR ABOUT ALL OTHER MEDICINES YOU USE. Some drugs can raise or lower your blood levels of carbamazepine, which may cause side effects or make this medicine less effective. Carbamazepine can also affect blood levels of certain other drugs, making them less effective or increasing side effects.

Carbamazepine may cause serious blood problems or a life-threatening skin rash or allergic reaction. Call your doctor if you have a fever, unusual weakness, bleeding, bruising, or a skin rash that causes blistering and peeling.

Some people have thoughts about suicide while taking seizure medicine. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

Do not stop taking this medicine without asking your doctor first, even if you feel fine.

If you are pregnant, do not start or stop taking carbamazepine without your doctor’s advice.

Before taking this medicine

You should not take carbamazepine if you have a history of bone marrow suppression, or if you are allergic to carbamazepine or to an antidepressant such as amitriptylinedesipraminedoxepinimipramine, or nortriptyline.

Do not use carbamazepine if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include furazolidoneisocarboxazidlinezolidphenelzinerasagilineselegiline, and tranylcypromine.

Carbamazepine may cause severe or life-threatening skin rash, and especially in people of Asian ancestry. Your doctor may recommend a blood test before you start the medication to determine your risk.

Tell your doctor if you have ever had:

You may have thoughts about suicide while taking carbamazepine. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Do not start or stop taking seizure medication during pregnancy without your doctor’s advice. Carbamazepine may harm an unborn baby, but having a seizure during pregnancy could harm both mother and baby. The benefit of preventing seizures may outweigh any risks to the baby.

Tell your doctor right away if you become pregnant.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of this medicine on the baby.

Carbamazepine can make birth control pills or implants less effective. Use a barrier form of birth control (such as a condom or diaphragm with spermicideto prevent pregnancy.

You should not breastfeed while you are using carbamazepine.

How should I take carbamazepine?

Take carbamazepine exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Take with food.

Swallow the extended-release tablet or capsule whole and do not crush, chew, or break it. Tell your doctor if you cannot swallow a pill whole.

The chewable tablet must be chewed before you swallow it.

Shake the oral suspension (liquid) before you measure a dose. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and call your doctor promptly if this medicine seems to stop working as well in preventing your seizures.

You will need frequent medical tests.

Store at room temperature away from moisture, heat, and light.

Do not stop using carbamazepine suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor’s instructions about tapering your dose.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include severe drowsiness, weak or shallow breathing, and loss of consciousness.

What to avoid

Drinking alcohol with this medicine can cause side effects, and can also increase your risk of seizures.

Grapefruit may interact with carbamazepine and lead to unwanted side effects. Avoid the use of grapefruit products.

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.

Carbamazepine could make you sunburn more easily. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Carbamazepine side effects

Get emergency medical help if you have signs of an allergic reaction to carbamazepine (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (feversore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).

Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes.

Report any new or worsening symptoms to your doctor, such as: sudden mood or behavior changes, depression, anxietyinsomnia, or if you feel agitated, hostile, restless, irritable, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • a skin rash, no matter how mild;
  • loss of appetite, right-sided upper stomach pain, dark urine;
  • slow, fast, or pounding heartbeats;
  • anemia or other blood problems – fever, chills, sore throat, mouth sores, bleeding gums, nosebleeds, pale skin, easy bruising, unusual tiredness, feeling light-headed or short of breath; or
  • low levels of sodium in the body – headache, confusion, severe weakness, feeling unsteady, increased seizures.

Common carbamazepine side effects may include:

  • dizziness, loss of coordination, problems with walking;
  • nausea, vomiting; or
  • drowsiness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.Carbamazepine side effects (more detail)

What other drugs will affect carbamazepine?

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Using carbamazepine with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety, depression, or seizures.

Many drugs can interact with carbamazepine, and some drugs should not be used together. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all your current medicines and any medicine you start or stop using.

Zonisamide

What is zonisamide?

Zonisamide is used together with other medicines to treat partial seizures in adults and teenagers at least 16 years old.

Zonisamide may also be used for purposes not listed in this medication guide.

Important Information

Taking zonisamide can cause permanent vision loss. Tell your doctor right away if you have any eye pain or redness or any changes in your vision.

Some people have thoughts about suicide while taking zonisamide. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

Before taking this medicine

You should not use zonisamide if you are allergic to it.

You may not be able to take zonisamide if you have ever had a severe allergic to a sulfa drug.

Tell your doctor if you have ever had:

  • liver disease;
  • kidney disease;
  • high levels of ammonia;
  • stomach flu or illness causing diarrhea;
  • a growth disorder;
  • a bone disorder that causes soft or weak bones or low bone mineral density;
  • depression, or suicidal thoughts or actions;
  • if you have ever had metabolic acidosis (too much acid in your blood); or
  • if you have been on a ketogenic diet (high-fat, high-protein, low-carb).

Some people have thoughts about suicide while taking zonisamide. Your doctor will need to check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Zonisamide may harm an unborn baby. Use effective birth control to prevent pregnancy, and tell your doctor if you become pregnant.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of zonisamide on the baby.

You should not breastfeed while using zonisamide.

Zonisamide is not approved for use by anyone younger than 16 years old.

How should I take zonisamide?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Zonisamide can be taken with or without food.

Swallow the capsule whole and do not crush, chew, break, or open it.

While using zonisamide, you may need frequent blood tests.

Do not stop using zonisamide suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor’s instructions about tapering your dose.

Do not share zonisamide with another person, even if they have the same symptoms you have.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention

Overdose symptoms may include slow heart rate, feeling light-headed, fainting, and slow or shallow breathing.

What should I avoid while taking zonisamide?

Avoid driving or hazardous activity until you know how zonisamide will affect you. Your reactions could be impaired.

Drinking alcohol with this medicine can cause side effects.

Zonisamide side effects

Get emergency medical help if you have signs of an allergic reaction: any form of skin rashhives; fever, swollen glands, feeling weak or tired, severe muscle pain, unusual bruising or bleeding; yellowing of your skin or eyes; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: sudden mood or behavior changes, anxietypanic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • eye pain or redness or any changes in your vision;
  • decreased sweating, feeling very hot;
  • signs of metabolic acidosis–confusion, vomiting, lack of energy, irregular heartbeats;
  • symptoms of a blood cell disorder–fever, chills, body aches, flu symptoms, sores in your mouth and throat;
  • symptoms of a kidney stone–severe pain in your stomach or lower back, blood in your urine;
  • increased or worsening seizures;
  • the first sign of any skin rash, no matter how mild; or
  • severe skin reaction–fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

  • drowsiness, dizziness;
  • problems with memory or concentration;
  • feeling agitated or irritable;
  • loss of coordination, trouble walking; or
  • loss of appetite.

Zonisamide dosing information

Usual Adult Dose for Seizures:

16 years of age and older:
-Initial dose: 100 mg orally once a day
-Titration: After 2 weeks at 100 mg/day, the dose may be increased to 200 mg/day as either a single or divided dose (100 mg orally 2 times a day) for at least 2 weeks; it can then be increased to 300 mg/day, then 400 mg/day either as a single daily dose or divided into 2 daily doses, with the dose stable for at least 2 weeks to achieve steady state at each level
-Maintenance dose: 400 mg/day
-Maximum dose: 600 mg/day

Comments:
-This drug may be taken with or without food.
-Capsules should be swallowed whole.
-Because of the long half-life of this drug, up to 2 weeks may be required to achieve steady state levels upon reaching a stable dose or following dosage adjustment.
-The prescriber may wish to prolong the duration of treatment at the lower doses in order to fully assess the effects of this drug at steady state (noting that many of the side effects are more frequent at doses of 300 mg per day and above). Although there is some evidence of greater response at doses above 100 to 200 mg/day, the increase appears small and formal dose response studies have not been conducted.

Use: As adjunctive therapy in the treatment of partial seizures

Usual Pediatric Dose for Seizures:

Less than 16 years of age: Not recommended
16 years of age and older: See adult dosing

What other drugs will affect zonisamide?

Taking zonisamide with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking zonisamide with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety or depression.

Other drugs may interact with zonisamide, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Psychosis

What is psychosis?

Psychosis is characterized by an impaired relationship with reality. It’s a symptom of serious mental disorders. People who are experiencing psychosis may have either hallucinations or delusions.

Hallucinations are sensory experiences that occur within the absence of an actual stimulus. For example, a person having an auditory hallucination may hear their mother yelling at them when their mother isn’t around. Or someone having a visual hallucination may see something, like a person in front of them, who isn’t actually there.

The person experiencing psychosis may also have thoughts that are contrary to actual evidence. These thoughts are known as delusions. Some people with psychosis may also experience loss of motivation and social withdrawal.

These experiences can be frightening. They may also cause people who are experiencing psychosis to hurt themselves or others. It’s important to see a doctor right away if you or someone you know is experiencing symptoms of psychosis.

Recognizing the symptoms of psychosis

Symptoms of psychosis include:

Suicide prevention

  1. If you think someone is at immediate risk of self-harm or hurting another person:
  2. • Call 999 or your local emergency number.
  3. • Stay with the person until help arrives.
  4. • Remove any guns, knives, medications, or other things that may cause harm.
  5. • Listen, but don’t judge, argue, threaten, or yell.
  6. If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline.

What are delusions and hallucinations?

Delusions and hallucinations are two very different symptoms that are both often experienced by people with psychosis. Delusions and hallucinations seem real to the person who is experiencing them.

Delusions

A delusion is a false belief or impression that is firmly held even though it’s contradicted by reality and what is commonly considered true. There are delusions of paranoiagrandiose delusions, and somatic delusions.

People who are experiencing a delusion of paranoia might think that they are being followed when they aren’t or that secret messages are being sent to them. Someone with a grandiose delusion will have an exaggerated sense of importance. Somatic delusion is when a person believes they have a terminal illness, but in reality they’re healthy.

Hallucinations

A hallucination is a sensory perception in the absence of outside stimuli. That means seeing, hearing, feeling, or smelling something that isn’t present. A person who is hallucinating might see things that don’t exist or hear people talking when they’re alone.

Causes of psychosis

Each case of psychosis is different, and the exact cause isn’t always clear. There are certain illnesses that cause psychosis, however. There are also triggers like drug use, lack of sleep, and other environmental factors. In addition, certain situations can lead to specific types of psychosis developing.

Illnesses

Illnesses that can cause psychosis include:

Some types of dementia may result in psychosis, such as that caused by:

Risk factors for developing psychosis

It’s not currently possible to precisely identify who is likely to develop psychosis. However, research has shown that genetics may play a role.

People are more likely to develop a psychotic disorder if they have a close family member, such as a parent or sibling, who has a psychotic disorder.

Children born with the genetic mutation known as 22q11.2 deletion syndrome are at risk for developing a psychotic disorder, especially schizophrenia.

Types of psychosis

Some kinds of psychosis are brought on by specific conditions or circumstances that include the following:

Brief psychotic disorder

Brief psychotic disorder, sometimes called brief reactive psychosis, can occur during periods of extreme personal stress like the death of a family member. Someone experiencing brief reactive psychosis will generally recover in a few days to a few weeks, depending on the source of the stress.

Drug- or alcohol-related psychosis

Psychosis can be triggered by the use of alcohol or drugs, including stimulants such as methamphetamine and cocaine. Hallucinogenic drugs like LSD often cause users to see things that aren’t really there, but this effect is temporary. Some prescription drugs like steroids and stimulants can also cause symptoms of psychosis.

People who have an addition to alcohol or certain drugs can experience psychotic symptoms if they suddenly stop drinking or taking those drugs.

Organic psychosis

head injury or an illness or infection that affects the brain can cause symptoms of psychosis.

Psychotic disorders

Psychotic disorders can be triggered by stress, drug or alcohol use, injury, or illness. They can also appear on their own. The following types of disorders may have psychotic symptoms:

Bipolar disorder

When someone has bipolar disorder, their moods swing from very high to very low. When their mood is high and positive, they may have symptoms of psychosis. They may feel extremely good and believe they have special powers.

When their mood is depressed, the individual may have psychotic symptoms that make them feel angry, sad, or frightened. These symptoms include thinking someone is trying to harm them.

Delusional disorder

A person experiencing delusional disorder strongly believes in things that aren’t real.

Psychotic depression

This is major depression with psychotic symptoms.

Schizophrenia

Schizophrenia is a lifelong disease that is generally accompanied by psychotic symptoms.

How is psychosis diagnosed?

Psychosis is diagnosed through a psychiatric evaluation. That means a doctor will watch the person’s behavior and ask questions about what they’re experiencing. Medical tests and X-rays may be used to determine whether there is an underlying illness causing the symptoms.

Diagnosing psychosis in children and teenagers

Many of the symptoms of psychosis in adults aren’t symptoms of psychosis in young people. For example, small children often have imaginary friends with whom they talk. This just represents imaginative play, which is completely normal for children.

But if you’re worried about psychosis in a child or adolescent, describe their behavior to a doctor.

Treatment of psychosis

Treating psychosis may involve a combination of medications and therapy. Most people will experience an improvement in their symptoms with treatment.

Rapid tranquilization

Sometimes people experiencing psychosis can become agitated and be at risk of hurting themselves or others. In these cases, it may be necessary to calm them down quickly. This method is called rapid tranquilization. A doctor or emergency response personnel will administer a fast-acting injection or liquid medicine to quickly relax the patient.

Medication

Symptoms of psychosis can be controlled with medications called antipsychotics. They reduce hallucinations and delusions and help people think more clearly. The type of antipsychotic that is prescribed will depend on the symptoms.

In many cases, people only need to take antipsychotics for a short time to get their symptoms under control. People with schizophrenia may have to stay on medications for life.

Cognitive behavioral therapy

Cognitive behavioral therapy means meeting regularly to talk with a mental health counselor with the goal of changing thinking and behaviors. This approach has been shown to be effective in helping people make permanent changes and better manage their illness. It’s often most helpful for psychotic symptoms that don’t completely resolve with medications.

Complications and outlook of psychosis

Psychosis doesn’t have many medical complications. However, if left untreated, it can be challenging for people experiencing psychosis to take good care of themselves. That could cause other illnesses to go untreated.

Most people who experience psychosis will recover with proper treatment. Even in severe cases, medication and therapy can help.

Stress

Stress can be defined as the degree to which you feel overwhelmed or unable to cope as a result of pressures that are unmanageable. 

What is stress?

At the most basic level, stress is our body’s response to pressures from a situation or life event. What contributes to stress can vary hugely from person to person and differs according to our social and economic circumstances, the environment we live in and our genetic makeup. Some common features of things that can make us feel stress include experiencing something new or unexpected, something that threatens your feeling of self, or feeling you have little control over a situation.1  

When we encounter stress, our body is stimulated to produce stress hormones that trigger a ‘flight or fight’ response and activate our immune system 2. This response helps us to respond quickly to dangerous situations.

Sometimes, this stress response can be an appropriate, or even beneficial reaction. The resulting feeling of ‘pressure’ can help us to push through situations that can be nerve-wracking or intense, like running a marathon, or giving a speech to a large crowd. We can quickly return to a resting state without any negative effects on our health if what is stressing us is short-lived 3, and many people are able to deal with a certain level of stress without any lasting effects. 

However, there can be times when stress becomes excessive and too much to deal with. If our stress response is activated repeatedly, or it persists over time, the effects can result in wear and tear on the body and can cause us to feel permanently in a state of ‘fight or flight’ . Rather than helping us push through, this pressure can make us feel overwhelmed or unable to cope. 

Feeling this overwhelming stress for a long period of time is often called chronic, or long-term stress, and it can impact on both physical and mental health.

Stress is a response to a threat in a situation, whereas anxiety is a reaction to the stress.

What makes us stressed?

There are many things that can lead to stress. The death of a loved one, divorce/separation, losing a job and unexpected money problems are among the top ten causes of stress according to one recent survey 5.  But not all life events are negative and even positive life changes, such as moving to a bigger house, gaining a job promotion or going on holiday can be sources of stress. 

What are the signs of stress?

Emotional changes

When you are stressed you may experience many different feelings, including anxiety, fear, anger, sadness, or frustration. These feelings can sometimes feed on each other and produce physical symptoms, making you feel even worse. For some people, stressful life events can contribute to symptoms of depression.6 7   

Work-related stress can also have negative impacts on mental health 8.  Work-related stress accounts for an average of 23.9 days of work lost for every person affected 9

Behavioural changes

When you are stressed you may behave differently. For example, you may become withdrawn, indecisive or inflexible. You may not be able to sleep properly 10. You may be irritable or tearful. There may be a change in your sexual habits 11.Some people may resort to smoking, consuming more alcohol, or taking drugs 12.  Stress can make you feel angrier or more aggressive than normal 13. Stress may also affect the way we interact with our close family and friends.

Bodily changes

When stressed, some people start to experience headaches, nausea and indigestion. You may breathe more quickly, perspire more, have palpitations or suffer from various aches and pains. You will quickly return to normal without any negative effects if what is stressing you is short-lived, and many people are able to deal with a certain level of stress without any lasting adverse effects.

If you experience stress repeatedly over a prolonged period, you may notice your sleep and memory are affected, your eating habits may change, or you may feel less inclined to exercise. 

Some research has also linked long-term stress to gastrointestinal conditions like Irritable Bowel Syndrome (IBS), or stomach ulcers14 as well as conditions like cardiovascular disease15

Who is affected by stress?

All of us can probably recognise at least some of the feelings described above and may have felt stressed and overwhelmed at some time or another. Some people seem to be more affected by stress than others. For some people, getting out of the door on time each morning can be a very stressful experience. Whereas others may be able to cope with a great deal of pressure.

Some groups of people may be more likely to experience stressful life events and situations than others. For example, people living with high levels of debt, or financial insecurity are more likely to experience stress related to money16, 17, people from minority ethnic groups or whose who are LGBT (lesbian, gay, bisexual and transgender) may be more likely to experience stress due to prejudice, or discrimination18,19,20, and people with pre-existing or ongoing health problems may be more likely to experience stress related to their health, or stress due to stigma associated with their condition.

How can you help yourself?

There are some actions that you can take as an individual to manage the immediate, sometimes unpleasant, signs of stress and identify, reduce, and remove stressful factors that may cause you to feel overwhelmed and unable to cope. If you feel comfortable, talking to a friend or close colleague at work about your feelings can help you manage your stress.

However, sometimes individual actions on their own are not enough to reduce long-term stress for everyone. We can often be affected by factors that are beyond our direct control. Communities, workplaces, societies, and governments all have a role to play in tackling these wider causes of stress.

1. Realise when it is causing a problem and identify the causes

An important step in tackling stress is to realise when it is a problem for you and make a connection between the physical and emotional signs you are experiencing and the pressures you are faced with. It is important not to ignore physical warning signs such as tense muscles, feeling over-tired, and experiencing headaches or migraines. 

Once you have recognised you are experiencing stress, try to identify the underlying causes. Sort the possible reasons for your stress into those with a practical solution, those that will get better anyway given time, and those you can’t do anything about. Take control by taking small steps towards the things you can improve. 

Think about a plan to address the things that you can. This might involve setting yourself realistic expectations and prioritising essential commitments. If you feel overwhelmed, ask people to help with the tasks you have to do and say no to things that you cannot take on. 

2. Review your lifestyle

Are you taking on too much? Are there things you are doing which could be handed over to someone else? Can you do things in a more leisurely way? You may need to prioritise things you are trying to achieve and reorganise your life so that you are not trying to do everything at once.

3. Build supportive relationships

Finding close friends or family who can offer help and practical advice can support you in managing stress. Joining a club, enrolling on a course, or volunteering can all be good ways of expanding your social networks and encourage you to do something different. Equally, activities like volunteering can change your perspective and helping others can have a beneficial impact on your mood.  

4. Eat Healthily

A healthy diet will reduce the risk of diet-related diseases. There is also a growing amount of evidence showing how food can affect our mood. Feelings of wellbeing can be protected by ensuring our diet provides adequate amounts of nutrients including essential vitamins and minerals, as well as water.

5. Be aware of your smoking and drinking

 If possible, try to cut right down on smoking and drinking. They may seem to reduce tension, but in fact they can make problems worse. Alcohol and caffeine can increase feelings of anxiety.

6. Exercise

Physical exercise can be an excellent initial approach to managing the effects of stress. Walking, and other physical activities can provide a natural ‘mood boost’ through the production of endorphins. Even a little bit of physical activity can make a difference, for example, walking for 15-20 minutes three times a week is a great start.21

7. Take Time Out

One of the ways you can reduce stress is by taking time to relax and practicing self-care, where you do positive things for yourself.  Striking a balance between responsibility to others and responsibility to yourself is vital in reducing stress levels. 

8. Be Mindful

Mindfulness meditation can be practiced anywhere at any time. Research has suggested it can be helpful for managing and reducing the effect of stress, anxiety, and other related problems in some people22. Our ‘Be Mindful’ website features a specifically-developed online course in mindfulness, and details of local courses in your area.

9. Get some restful sleep

Sleep problems are common when you’re experiencing stress. If you are having difficulty sleeping, you can try to reduce the amount of caffeine you consume23 and avoid too much screen time before bed24. Writing down your to do list for the next day can be useful in helping you prioritise but also put the plans aside before bed25. For more tips on getting a good night’s sleep read our guide ‘How to  sleep better’.

10. Don’t be too hard on yourself

Try to keep things in perspective and don’t be too hard on yourself. Look for things in your life that are positive and write down things that make you feel grateful. 

If you continue to feel overwhelmed by stress, seeking professional help can support you in managing effectively. Do not be afraid to seek professional help if you feel that you are no longer able to manage things on your own. Many people feel reluctant to seek help as they feel that it is an admission of failure. This is not the case and it is important to get help as soon as possible so you can begin to feel better.

The first person to approach is your family doctor. He or she should be able to advise about treatment and may refer you to another local professional. Cognitive Behavioural Therapy (CBT) has been shown to be helpful in reducing stress by changing the ways we think about stressful situations26, this might include focusing on more positive aspects of a situation and reassessing what their likely impact might be. Other psychosocial interventions that can be helpful include brief interpersonal counselling, which can give people the opportunity to discuss what causes them to feel stress and develop coping strategies; and mindfulness-based approaches27.

Post-traumatic stress disorder (PTSD)

What is PTSD?

Post-traumatic stress disorder (PTSD) is a type of anxiety disorder which you may develop after being involved in, or witnessing, traumatic events. The condition was first recognised in war veterans and has been known by a variety of names, such as ‘shell shock’. But it’s not only diagnosed in soldiers – a wide range of traumatic experiences can cause PTSD.

“When something traumatic happens in your life it rocks you to the core. The world is no longer a safe place. It becomes somewhere that bad things can and do happen.”

What is it like to have PTSD

When is it diagnosed?

When you go through something you find traumatic it’s understandable to experience some symptoms associated with PTSD afterwards, such as feeling numb or having trouble sleeping. This is sometimes described as an ‘acute stress reaction’.

Many people find that these symptoms disappear within a few weeks, but if your symptoms last for longer than a month, you might be given a diagnosis of PTSD. Your GP might refer you to a specialist before this if your symptoms are particularly severe.

“I started experiencing symptoms of PTSD after my boyfriend died. I suffered extremely vivid flashbacks that could happen at any time, anywhere, and were deeply distressing… I threw myself into another relationship very quickly to try and avoid how I was feeling, but then also would not express much affection to my new partner.”

Are there different types of PTSD?

If you are given a diagnosis of PTSD, you might be told that you have mild, moderate or severe PTSD. This explains what sort of impact your symptoms are having on you currently – it’s not a description of how frightening or upsetting your experiences might have been.

PTSD may be described differently in some situations:

  • Delayed-onset PTSD – if your symptoms emerge more than six months after experiencing trauma, this might be described as ‘delayed PTSD’ or ‘delayed-onset PTSD’.
  • Complex PTSD – if you experienced trauma at an early age or it lasted for a long time, you might be given a diagnosis of ‘complex PTSD’. (See our page on complex PTSD for more information.)
  • Birth trauma – PTSD that develops after a traumatic experience of childbirth is also known as ‘birth trauma’. (See our page on PTSD and birth trauma for more information.)

If you experience some PTSD symptoms while supporting someone close to you who’s experienced trauma, this is sometimes known as ‘secondary trauma’.

“I couldn’t understand why I felt like my brain wasn’t functioning – I couldn’t remember things, I couldn’t process things. It was like my brain had just slowed down and ground to a halt.”

Experiences of facing stigma

There are lots of misconceptions about PTSD. For example, people may wrongly assume it means you are ‘dwelling’ on past events. They might even suggest that you should ‘get over it’ or ‘move on’. But having PTSD isn’t a choice or a sign of weakness, and it’s important to remember that you are not alone.

Mental Health – Anorexia

People with anorexia nervosa don’t eat enough, usually because they feel that their problems are caused by what they look like.

Anorexia Nervosa is an eating disorder characterised by restrictive eating and an intense fear of gaining weight. While anorexia is often recognised physically through excessive weight loss, it is a serious mental health problem.1,2

Someone with anorexia often has an intense fear of gaining weight and for many people they judge themselves and their worth based on their weight.3

Anyone can be affected by anorexia. While statistics show that anorexia is more commonly reported by young females, anorexia is increasingly being reported by men and boys, women over the age of 40, and in children as young as seven.4

What causes anorexia nervosa?

There is no single cause of anorexia and everyone’s reasons or triggers can be very different. It is usually understood as being due to a combination of factors.5

Psychological factors

Low self-esteem has been commonly associated as a trigger for the onset of anorexia.6 Many people with anorexia report feeling worthless and not good enough. Losing weight can start to feel like a sense of achievement and can become a way for some people to feel a sense of worth.

Certain personality traits such as perfectionism have also been found to make a person more likely to be affected by anorexia.7 Other psychological factors which are associated with anorexia include:8

  • other mental health conditions, particularly depressionself-harm and anxiety
  • finding it hard to handle stress and cope with life
  • having feelings of obsession and compulsion.
Social factors

We live in a society where body image is highly important. This means we are constantly being told that how we look reflects our worth which can leave us feeling increasingly ashamed of our bodies if they do not fit the model of what is a ‘good body’.

This can have an impact on our body-esteem and how we feel about ourselves. While these cultural and social pressures do not cause eating disorders, they can make those particularly vulnerable to developing an eating disorder feel more pressure to look a certain way and they can trigger an eating disorder.9

Biological factors

New research is looking into the genetic links that may underpin anorexia.10 There is also increasing work focusing on exploring the neurochemical and neurological make-up that may help us understand why some people develop anorexia and why some do not.11

Signs and symptoms of anorexia

It can be difficult to tell if you, someone you know or a friend has anorexia nervosa. Someone who has lost a lot of weight may have another type of health condition. However, particular signs that indicate that someone may have anorexia include are:12

Behavioural signs

  • Fear of fatness or pursuit of thinness.
  • Pre-occupation with body weight.
  • Distorted perception of body shape or weight, for example the person thinks they are overweight when actually they are underweight.
  • May underestimate the seriousness of the problem even after diagnosis.
  • May tell lies about eating or what they have eaten, give excuses about why they are not eating, pretend they have eaten earlier.
  • Not being truthful about how much weight they have lost.
  • Finding it difficult to think about anything other than food.
  • Strict dieting.
  • Counting the calories in food excessively.
  • Avoiding food they think is fattening.
  • Eating only low-calorie food.
  • Missing meals (restricting).
  • Avoiding eating with other people.
  • Hiding food.
  • Cutting food into tiny pieces – to make it less obvious they have eaten little and to make food easier to swallow.
  • Obsessive behaviour and rituals around eating.
  • Excessive exercising.
  • Social withdrawal and isolation, shutting yourself off from the world.

Physical signs

  • Severe weight loss.
  • Lack of sexual interest or potency.
  • Difficulty sleeping and tiredness.
  • Feeling dizzy.
  • Stomach pains.
  • Constipation and bloating. 
  • Feeling cold or having a low body temperature. 
  • Growth of downy (soft and fine) hair all over your body (called Lanugo).
  • Getting irritable and moody.
  • Difficulty concentrating.
  • Low blood pressure.

What treatments are available?

Talking therapies

Talking therapies can last up to 12 months or more depending on how severe and persistent someone’s anorexia is. The aim of talking therapies is to help identify the feelings and fears that cause one to stop eating and to help develop a healthier attitude towards food and one’s body.13

  • Cognitive analytical therapy (CAT) – this is based on the theory that the unhealthy patterns which trigger anorexia, are usually developed during childhood. It involves three stages: reformulation (looking at past events that may provide a reason for unhealthy patterns), recognition (helping people see how these patterns contribute to anorexia) and revision (identification of changes which can break these unhealthy patterns).14
  • Cognitive behavioural therapy (CBT) – focuses on identifying and altering dysfunctional thought patterns, attitudes and beliefs which may trigger and perpetuate the person’s restrictive eating. The therapist helps the individual understand, identify and change eating disordered thoughts such as “everyone thinks I am fat”. A therapist can work with the individual with anorexia through specific behavioural interventions, such as promoting healthy eating behaviours through goal setting etc.15

Family therapy

One type of family therapy which is most often used with young people with anorexia is called ‘The Maudsley Approach.’ It is an intensive outpatient treatment programme where parents play an active and positive role in order to restore their child’s weight to normal healthy levels, give control of eating choices back to their child and encourages normal adolescent development.16

Inpatient treatment

Most people with anorexia do not need to have inpatient treatment, but for some it may be needed to manage poor physical health. The decision to start inpatient treatment will usually be made alongside someone’s therapist and GP and the type of treatment will be decided to suit the person’s needs.

Young Carers for people with Disabilities

What are young carers?

The BBC estimates that there are about 700,000 young carers in the UK. Being a young carer often means looking after a family member who is ill or helping them by looking after the other members of the family while they can’t.

Young carers often do more chores than other children would. On top of providing emotional support to the person they are caring for they may also have to learn how to nurse them or look after their personal needs like bathing and dressing.

It can be hard work being a young carer. Sometimes other children don’t understand your responsibilities and you have less free time than others.

Many young cope well with caring, especially if you have support from other family members and it’s important to look after yourself. You have the right to be looked after too and there are lots of places and people you can go to to get help.

Getting help

Sometimes, being a young carer can get too much to deal with on your own. If you’re having any of these feelings, talk to your teacher, school nurse, college counsellor or GP who can help you.

  • Stressed by too much responsibility
  • Physically tired
  • Worried about your relative’s health
  • Coping with other people’s mood
  • No time for yourself or your homework
  • Missing school
  • Feeling embarrassed about your situation
  • Being bullied
  • Low self-esteem, anxiety, anger or guilt

You’re not alone if any of these happen to you. Young carers miss an average of 48 days of school because of their role and 68% have been bullied at some point directly because of having to care for someone. Organisations set up to help young carers recognise all of these problems and have people and strategies to support you.

Even if you don’t feel like you need help for a problem, it is always good to have the support of others who understand your situation. Young carers groups run all around the UK to help with advice as well as giving you somewhere to let off steam and enjoy yourself.

Autism

What is autism?

Autism is a lifelong developmental disability that affects how people perceive the world and interact with others.

Autistic people see, hear and feel the world differently to other people. If you are autistic, you are autistic for life; autism is not an illness or disease and cannot be ‘cured‘. Often people feel being autistic is a fundamental aspect of their identity.

Autism is a spectrum condition. All autistic people share certain difficulties, but being autistic will affect them in different ways. Some autistic people also have learning disabilitiesmental health issues or other conditions, meaning people need different levels of support. All people on the autism spectrum learn and develop. With the right sort of support, all can be helped to live a more fulfilling life of their own choosing.

How common is autism?

Autism is much more common than most people think. There are around 700,000 autistic people in the UK – that’s more than 1 in 100. People from all nationalities and cultural, religious and social backgrounds can be autistic, although it appears to affect more men than women.

How do autistic people see the world?

Some autistic people say the world feels overwhelming and this can cause them considerable anxiety.

In particular, understanding and relating to other people, and taking part in everyday family, school, work and social life, can be harder. Other people appear to know, intuitively, how to communicate and interact with each other, yet can also struggle to build rapport with autistic people. Autistic people may wonder why they are ‘different’ and feel their social differences mean people don’t understand them.

Autistic people often do not ‘look’ disabled. Some parents of autistic children say that other people simply think their child is naughty, while adults find that they are misunderstood. We are educating the public about autism through our Too Much Information campaign.

Diagnosis

diagnosis is the formal identification of autism, usually by a multi-disciplinary diagnostic team, often including a speech and language therapist, paediatrician, psychiatrist and/or psychologist.

The benefits of a diagnosis

Getting a timely and thorough assessment and diagnosis may be helpful because:

  • it helps autistic people (and their families, partners, employers, colleagues, teachers and friends) to understand why they may experience certain difficulties and what they can do about them
  • it allows people to access services and support.

How autism is diagnosed

The characteristics of autism vary from one person to another, but in order for a diagnosis to be made, a person will usually be assessed as having had persistent difficulties with social communication and social interaction and restricted and repetitive patterns of behaviours, activities or interests since early childhood, to the extent that these “limit and impair everyday functioning“.

Read more about diagnostic criteria and the triad of impairments theory.

Persistent difficulties with social communication and social interaction

SOCIAL COMMUNICATION

Autistic people have difficulties with interpreting both verbal and non-verbal language like gestures or tone of voice. Many have a very literal understanding of language, and think people always mean exactly what they say. They may find it difficult to use or understand:

  • facial expressions
  • tone of voice
  • jokes and sarcasm.

Some may not speak, or have fairly limited speech. They will often understand more of what other people say to them than they are able to express, yet may struggle with vagueness or abstract concepts. Some autistic people benefit from using, or prefer to use, alternative means of communication, such as sign language or visual symbols. Some are able to communicate very effectively without speech.

Others have good language skills, but they may still find it hard to understand the expectations of others within conversations, perhaps repeating what the other person has just said (this is called echolalia) or talking at length about their own interests.

It often helps to speak in a clear, consistent way and to give autistic people time to process what has been said to them.

Social interaction

Autistic people often have difficulty ‘reading’ other people – recognising or understanding others’ feelings and intentions – and expressing their own emotions. This can make it very hard for them to navigate the social world. They may:

  • appear to be insensitive
  • seek out time alone when overloaded by other people
  • not seek comfort from other people
  • appear to behave ‘strangely’ or in a way thought to be socially inappropriate.

Autistic people may find it hard to form friendships. Some may want to interact with other people and make friends, but may be unsure how to go about it.

Read more about communication and social interactionsocial isolation and social skills.

Restricted and repetitive patterns of behaviours, activities or interests

REPETITIVE BEHAVIOUR AND ROUTINES

The world can seem a very unpredictable and confusing place to autistic people, who often prefer to have a daily routine so that they know what is going to happen every day. They may want to always travel the same way to and from school or work, or eat exactly the same food for breakfast.

The use of rules can also be important. It may be difficult for an autistic person to take a different approach to something once they have been taught the ‘right’ way to do it. People on the autism spectrum may not be comfortable with the idea of change, but may be able to cope better if they can prepare for changes in advance.

HIGHLY-FOCUSED INTERESTS

Many autistic people have intense and highly-focused interests, often from a fairly young age. These can change over time or be lifelong, and can be anything from art or music, to trains or computers. An interest may sometimes be unusual. One autistic person loved collecting rubbish, for example. With encouragement, the person developed an interest in recycling and the environment.

Many channel their interest into studying, paid work, volunteering, or other meaningful occupation. Autistic people often report that the pursuit of such interests is fundamental to their wellbeing and happiness.

SENSORY SENSITIVITY

Autistic people may also experience over- or under-sensitivity to sounds, touch, tastes, smells, light, colours, temperatures or pain. For example, they may find certain background sounds, which other people ignore or block out, unbearably loud or distracting. This can cause anxiety or even physical pain. Or they may be fascinated by lights or spinning objects.

Read more about repetitive behaviour and routines and sensory processing.

Different names for autism

Over the years, different diagnostic labels have been used, such as autism, autism spectrum disorder (ASD), autism spectrum condition (ASC), classic autism, Kanner autism, pervasive developmental disorder (PDD), high-functioning autism (HFA), Asperger syndrome and Pathological Demand Avoidance (PDA). This reflects the different diagnostic manuals and tools used, and the different autism profiles presented by individuals. Because of recent and upcoming changes to the main diagnostic manuals, ‘autism spectrum disorder’ (ASD) is now likely to become the most commonly given diagnostic term.

Read more about different diagnostic profiles, terms and criteria.

Causes and cures

What causes autism?

The exact cause of autism is still being investigated. Research into causes suggests that a combination of factors – genetic and environmental – may account for differences in development. Autism is not caused by a person’s upbringing, their social circumstances and is not the fault of the individual with the condition.