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.

Anxiety and panic attacks

Explains anxiety and panic attacks, including possible causes and how you can access treatment and support. Includes tips for helping yourself, and guidance for friends and family.

What are anxiety disorders?

Anxiety can be experienced in lots of different ways. If your experiences meet certain criteria your doctor might diagnose you with a specific anxiety disorder.

Some commonly diagnosed anxiety disorders are:

  • Generalised anxiety disorder (GAD) – this means having regular or uncontrollable worries about many different things in your everyday life. Because there are lots of possible symptoms of anxiety this can be quite a broad diagnosis, meaning that the problems you experience with GAD might be quite different from another person’s experiences.
  • Social anxiety disorder – this diagnosis means you experience extreme fear or anxiety triggered by social situations (such as parties, workplaces, or everyday situations where you have to talk to another person). It is also known as social phobia. See our page on types of phobia for more information.
  • Panic disorder – this means having regular or frequent panic attacks without a clear cause or trigger. Experiencing panic disorder can mean that you feel constantly afraid of having another panic attack, to the point that this fear itself can trigger your panic attacks. See our page on panic attacks for more information.
  • Phobias – a phobia is an extreme fear or anxiety triggered by a particular situation (such as going outside) or a particular object (such as spiders). See our pages on phobias for more information.
  • Post-traumatic stress disorder (PTSD) – this is a diagnosis you may be given if you develop anxiety problems after going through something you found traumatic. PTSD can involve experiencing flashbacks or nightmares which can feel like you’re re-living all the fear and anxiety you experienced at the time of the traumatic events. See our pages on PTSD and complex PTSD for more information.
  • Obsessive-compulsive disorder (OCD) – you may be given this diagnosis if your anxiety problems involve having repetitive thoughts, behaviours or urges. See our pages on OCD for more information.
  • Health anxiety – this means you experience obsessions and compulsions relating to illness, including researching symptoms or checking to see if you have them. It is related to OCD. You can find out more about health anxiety on the Anxiety UK website.
  • Body dysmorphic disorder (BDD) – this means you experience obsessions and compulsions relating to your physical appearance. See our pages on BDD for more information.
  • Perinatal anxiety or perinatal OCD – some people develop anxiety problems during pregnancy or in the first year after giving birth. See our pages on perinatal anxiety and perinatal OCD for more information.

You might not have, or want, a diagnosis of a particular anxiety disorder – but it might still be useful to learn more about these different diagnoses to help you think about your own experiences of anxiety, and consider options for support.

Anxiety and other mental health problems

It’s very common to experience anxiety alongside other mental health problems, such as depression or suicidal feelings. If you have symptoms of both anxiety and depression but don’t fit one more clearly than the other, you might be given a diagnosis of ‘mixed anxiety and depressive disorder’.


Living with GAD & panic attacks after losing my Dad

“I really believe that talking is one of the best therapies you can have.”Read Zoe’s story

Bipolar disorder

Photo by Chalo Garcia on Pexels.com

Everyone has changes in their mood, but with bipolar disorder these changes can be extreme, overwhelming and have a big impact on your life.

What are the symptoms of bipolar disorder?

If you have bipolar disorder, you’re likely to have episodes of depression (feeling very low) and mania (feeling very high). You may feel well between these episodes.

Bipolar symptoms can make daily life hard and affect your relationships and work.

During a depressive episode, you may:

  • feel sad, hopeless or irritable
  • lack energy and appetite
  • lose interest in everyday activities
  • have difficulty concentrating or remembering things
  • feel empty, worthless, guilty or despairing
  • have difficulty sleeping.

During a manic episode, you may:

  • feel full of energy
  • feel self-important or have lots of ideas and plans
  • be easily distracted, irritated or agitated
  • have no desire to sleep or eat
  • make decisions or say things that are out of character, risky or harmful.

Some people experience psychosis during a severe episode of depression or mania. This means you may see or hear things that aren’t there or believe things that aren’t true.

Episodes can last for several weeks or months with periods of less extreme mood in between. Depending on how you experience these moods and how severe they are, your doctor may diagnose you with a particular type of bipolar disorder. Mind has more information on these different types.

What causes bipolar disorder?

The exact cause of bipolar disorder is unknown, but researchers believe a combination of factors make someone more likely to develop it. These include:

  • genetics – if you’re related to someone with bipolar disorder, you’re more likely to develop it yourself
  • chemical imbalance in the brain – too much or too little of certain chemicals could make you develop depression or mania
  • childhood trauma – abuse, neglect or bereavement in childhood can cause you to develop bipolar disorder. This could be because of the impact on your ability to regulate your emotions
  • stressful life events – a relationship breakdown or financial difficulties can be the trigger for bipolar symptoms.

You usually develop bipolar disorder before you’re 20. It’s rare to develop it after the age of 40.

Getting support

Treatment for bipolar disorder aims to reduce the severity and number of episodes of depression or mania you experience. The right treatment for you will depend on your type of bipolar, current symptoms, and your preferences and circumstances.

If you think you have bipolar disorder, start by speaking to your GP. It can help to keep a record of your moods to help you both understand your mood swings. You can download a mood scale and mood diary from the Bipolar UK website. Your GP may then refer you to a psychiatrist, who can give you a diagnosis.

There are different types of help you can get with bipolar disorder.

Talking therapy

There are different talking therapies that have been shown to work well for people with bipolar disorder.

  • Cognitive Behavioural Therapy (CBT) can help you recognise how your feelings, thoughts, and behaviour influence each other and build strategies to change these patterns.
  • Interpersonal Therapy (IPT) focuses on your relationships with others and how your thoughts, feelings, and behaviour are affected by your relationships and vice versa.

What you’re offered may depend on what’s available in your area and what you and your GP feel would be best for you.

Medication

There are different medications available to treat bipolar disorder. It’s likely your GP or psychiatrist offer you one of more of the following:

  • medication to prevent episodes of depression and mania. These are known as mood stabilisers
  • medication to treat the symptoms of depression and mania as they happen.

The NHS website has more information about medication for bipolar disorder.

Longer term plans

You may work with healthcare professionals to learn to monitor your mood and recognise what triggers your depression and mania. They may help you to develop a crisis or risk management plan so you know how to manage any early warning signs. This may involve friends and family, so they know how to recognise any early signs of distress and support you.

You can also help yourself by taking care of your physical health as well as your mental health and making sure that you get regular exercise, good quality sleep, and eat a healthy diet.

Disability

What is disability?

A disability is any continuing condition that restricts everyday activities. The Disability Services Act (1993) defines ‘disability’ as meaning a disability:

  • which is attributable to an intellectual, psychiatric, cognitive, neurological, sensory or physical impairment or a combination of those impairments
  • which is permanent or likely to be permanent
  • which may or may not be of a chronic or episodic nature
  • which results in substantially reduced capacity of the person for communication, social interaction, learning or mobility and a need for continuing support services.


With the assistance of appropriate aids and services, the restrictions experienced by many people with a disability may be overcome.

Types of disability

The main categories of disability are physical, sensory, psychiatric, neurological, cognitive and intellectual. Many people with disability have multiple disabilities.

A physical disability is the most common type of disability, followed by intellectual and sensory disability. Physical disability generally relates to disorders of the musculoskeletal, circulatory, respiratory and nervous systems.

Sensory disability involves impairments in hearing and vision.

Neurological and cognitive disability includes acquired disability such as multiple sclerosis or traumatic brain injury. Intellectual disability includes intellectual and developmental disability which relate to difficulties with thought processes, learning, communicating, remembering information and using it appropriately, making judgments and problem solving. Intellectual disability is the result of interaction between developmentally attributable cognitive impairment, attitudinal and environmental barriers.

Psychiatric disorders resulting in disability may include anxiety disorders, phobias or depression.

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.

THE SOCIAL, EMOTIONAL, & PSYCHOLOGICAL EFFECTS OF ADULTS WITH CEREBRAL PALSY


Cerebral palsy (CP) is a cluster of brain disorders that affect an individual’s ability to move, balance, and control posture, muscles, and reflexes. It results from impaired brain development during pregnancy or soon after birth. Those afflicted with cerebral palsy experience its effects and severity differently. Muscles may be weak or stiff. Many cerebral palsy persons experience tremors or unpredictable or uncontrollable reflexes and muscle movements. They may also be visually, hearing, or speech impaired. Severe cases may also have trouble breathing and swallowing, which leads to eating, digestive, and dental problems.

Medical advancements have enabled individuals with cerebral palsy to live well into adulthood. However, there appears to be a limited commitment to help physically disabled adults obtain maximum mental and physical health and well-being. As a result, those with cerebral palsy tend to experience high levels of social and emotional distress as well as physiological challenges.

Social Effects

Cerebral palsy affects one’s mobility and ability to effectively communicate. As a result, cerebral palsy individuals tend to be socially and professionally limited. Employment, marriage, and living independently are viable options only for those with mild cerebral palsy.

Inclusion is important to mitigate feelings of isolationloneliness, and depression. Having a disability does not eliminate the need to be accepted and respected by one’s peers. Cerebral palsy adults may be encouraged to join groups or socialize with individuals their age that have similar disabilities or who do not normally participate in physical activities. Organized crafts, recreational activities, and events aid socialization. Psychologists and behavioral or developmental specialists are often consulted to assist with socialization needs.

Emotional Effects

Aggressiveness, hyperactivity, belligerence, withdrawal, or fearfulness are signs the cerebral palsy individual is having difficulty adjusting to their surroundings or to others. They may act frustrated, mad, or sad. This may be due to painful physical maladies associated with their CP (i.e.: poor sleep, scoliosis, acid-reflux, skin irritations, etc.). This acting-out may also be due to feelings of low self esteem or a negative self-imageAttentiveness to these signs of distressanxiety, and depression provides the impetus for early mental health intervention.

Comprehensive care must include mental health observation and support in addition to customary medical and physical care. Helping the cerebral palsy adult adapt to their disability and/or limitations can help improve mood.

Psychological Effects

Fifty percent of cerebral palsy individuals have a learning disability. The degree of learning disability depends on which area of the brain is damaged. Approximately one-third of individuals with cerebral palsy have moderate-to-severe intellectual impairment (mental retardation). One-third has mild intellectual impairments. One-third shows no signs of cognitive impairment.

More adults with cerebral palsy are furthering their education and entering into the workforce due to advancements in medical treatment, ADA and educational accommodations, and adult cerebral palsy support services. Ensuring physically disabled adults maintain mobility, find inclusion, and have full access to community and adult support services helps ensure they achieve maximum health, well-being, and quality of life.

Caring for someone with Bipolar

Caring for someone with bipolar disorder can be very hard, whether you’re a partner, parent, child, or friend of someone who has this condition. It’s stressful for everyone it touches.

It’s tough to strike a balance. You want to be supportive and empathetic, because you know the person with bipolar disorder isn’t to blame for their illness. But their behavior may affect you, and you have to take care of yourself and your needs, not just theirs.

Although there’s no easy solution, these tips may help.

Learn. Read information from reputable web sites, books, and articles that explain the condition. The more you know, the better.

Listen. Pay attention to what your loved one has to say. Don’t assume that you know what he or she is going through. Don’t dismiss all of their emotions and feelings as signs of their illness. Someone with bipolar disorder may still have valid points.

Encourage them to stick with treatment. Your love one needs to take their bipolar medication and get regular checkups or counseling.

Notice their symptoms. They may not be able to see it as clearly as you do when their bipolar symptoms are active. Or they may deny it. When you see the warning signs of mania or depression, you can try to make sure they get help ASAP.

Do things together. People who are depressed often pull away from others. So encourage your friend or loved one to get out and do things he or she enjoys. Ask him to join you for a walk or a dinner out. If he says no, let it go. Ask again a few days later.

Make a plan. Because bipolar disorder can often be an unpredictable illness, you should plan for bad times. Be clear. Agree with your loved one about what to do if their symptoms get worse. Have a plan for emergencies. If you both know what to do and what to expect of each other, you’ll feel more confident about the future.

Stick to a schedule. If you live with someone who has bipolar disorder, encourage them to stick to a schedule for sleep and other daily activities. Some research shows that it’s helpful to have a regular routine. The person will still need medicine and counseling, but look for everyday things, like exercise and a healthy diet, that supports their overall health.

Express your own concerns. Since your loved one’s behavior can have a huge effect on you, it’s OK to discuss. Don’t blame the other person or list all of his mistakes. Instead, focus on how his actions make you feel and how they affect you. Since this can be really hard to do, you might find it easiest to talk about it together with a therapist.

Take care of yourself. As intense as your loved one’s needs may be, you count, too. It’s important for you to stay healthy emotionally and physically.

Do things that you enjoy. Stay involved with other people you’re close to — social support and those relationships mean a lot. Think about seeing a therapist on your own or joining a support group for other people who are close to someone who has bipolar disorder.

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.