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.

Zonisamide – Zonegran

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.

Warnings

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 or call the Poison Help line at 1-800-222-1222.

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 rashhivesfever, 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.

Zonisamide may cause serious side effects. 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 of zonisamide may include:

  • drowsinessdizziness;
  • 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

Detailed Zonisamide dosage information

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.

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.

Vagus nerve stimulation (VNS)

Overview

Vagus nerve stimulation involves the use of a device to stimulate the vagus nerve with electrical impulses. An implantable vagus nerve stimulator is currently FDA-approved to treat epilepsy and depression. There’s one vagus nerve on each side of your body, running from your brainstem through your neck to your chest and abdomen.

In conventional vagus nerve stimulation, a device is surgically implanted under the skin on your chest, and a wire is threaded under your skin connecting the device to the left vagus nerve. When activated, the device sends electrical signals along the left vagus nerve to your brainstem, which then sends signals to certain areas in your brain. The right vagus nerve isn’t used because it’s more likely to carry fibers that supply nerves to the heart.

Why it’s done

Device placement in vagus nerve stimulationVagus nerve stimulationOpen pop-up dialog box

About one-third of people with epilepsy don’t fully respond to anti-seizure drugs. Vagus nerve stimulation may be an option to reduce the frequency of seizures in people who haven’t achieved control with medications.

Vagus nerve stimulation may also be helpful for people who haven’t responded to intensive depression treatments, such as antidepressant medications, psychological counselling (psychotherapy) and electroconvulsive therapy (ECT).

The Food and Drug Administration (FDA) has approved vagus nerve stimulation for people who:

  • Are 4 years old and older
  • Have focal (partial) epilepsy
  • Have seizures that aren’t well-controlled with medications

The FDA has also approved vagus nerve stimulation for the treatment of depression in adults who:

  • Have chronic, hard-to-treat depression (treatment-resistant depression)
  • Haven’t improved after trying four or more medications or electroconvulsive therapy (ECT), or both
  • Continue standard depression treatments along with vagus nerve stimulation

Additionally, researchers are studying vagus nerve stimulation as a potential treatment for a variety of conditions, including headaches, rheumatoid arthritis, inflammatory bowel disease, bipolar disorder, obesity and Alzheimer’s disease.

Risks

For most people, vagus nerve stimulation is safe. But it does have some risks, both from the surgery to implant the device and from the brain stimulation.

Surgery risks

Surgical complications with implanted vagus nerve stimulation are rare and are similar to the dangers of having other types of surgery. They include:

  • Pain where the cut (incision) is made to implant the device
  • Infection
  • Difficulty swallowing
  • Vocal cord paralysis, which is usually temporary, but can be permanent

Side effects after surgery

Some of the side effects and health problems associated with implanted vagus nerve stimulation can include:

  • Voice changes
  • Hoarseness
  • Throat pain
  • Cough
  • Headaches
  • Shortness of breath
  • Difficulty swallowing
  • Tingling or prickling of the skin
  • Insomnia
  • Worsening of sleep apnea

For most people, side effects are tolerable. They may lessen over time, but some side effects may remain bothersome for as long as you use implanted vagus nerve stimulation.

Adjusting the electrical impulses can help minimize these effects. If side effects are intolerable, the device can be shut off temporarily or permanently.

How you prepare

It’s important to carefully consider the pros and cons of implanted vagus nerve stimulation before deciding to have the procedure. Make sure you know what all of your other treatment choices are and that you and your doctor both feel that implanted vagus nerve stimulation is the best option for you. Ask your doctor exactly what you should expect during surgery and after the pulse generator is in place.

Food and medications

You may need to stop taking certain medications ahead of time, and your doctor may ask you not to eat the night before the procedure.

What you can expect

Before the procedure

Before surgery, your doctor will do a physical examination. You may need blood tests or other tests to make sure you don’t have any health concerns that might be a problem. Your doctor may have you start taking antibiotics before surgery to prevent infection.

During the procedure

Surgery to implant the vagus nerve stimulation device can be done on an outpatient basis, though some surgeons recommend staying overnight.

The surgery usually takes an hour to an hour and a half. You may remain awake but have medication to numb the surgery area (local anesthesia), or you may be unconscious during the surgery (general anesthesia).

The surgery itself doesn’t involve your brain. Two incisions are made, one on your chest or in the armpit (axillary) region, and the other on the left side of the neck.

The pulse generator is implanted in the upper left side of your chest. The device is meant to be a permanent implant, but it can be removed if necessary.

The pulse generator is about the size of a stopwatch and runs on battery power. A lead wire is connected to the pulse generator. The lead wire is guided under your skin from your chest up to your neck, where it’s attached to the left vagus nerve through the second incision.

After the procedure

The pulse generator is turned on during a visit to your doctor’s office a few weeks after surgery. Then it can be programmed to deliver electrical impulses to the vagus nerve at various durations, frequencies and currents. Vagus nerve stimulation usually starts at a low level and is gradually increased, depending on your symptoms and side effects.

Stimulation is programmed to turn on and off in specific cycles — such as 30 seconds on, five minutes off. You may have some tingling sensations or slight pain in your neck and temporary hoarseness when the nerve stimulation is on.

The stimulator doesn’t detect seizure activity or depression symptoms. When it’s turned on, the stimulator turns on and off at the intervals selected by your doctor. You can use a hand-held magnet to initiate stimulation at a different time, for example, if you sense an impending seizure.

The magnet can also be used to temporarily turn off the vagus nerve stimulation, which may be necessary when you do certain activities such as public speaking, singing or exercising, or when you’re eating if you have swallowing problems.

You’ll need to visit your doctor periodically to make sure that the pulse generator is working correctly and that it hasn’t shifted out of position. Check with your doctor before having any medical tests, such as magnetic resonance imaging (MRI), which might interfere with your device.

Results

Implanted vagus nerve stimulation isn’t a cure for epilepsy. Most people with epilepsy won’t stop having seizures or taking epilepsy medication altogether after the procedure. But many will have fewer seizures, up to 20 to 50 percent fewer. Seizure intensity may lessen as well.

It can take months or even a year or longer of stimulation before you notice any significant reduction in seizures. Vagus nerve stimulation may also shorten the recovery time after a seizure. People who’ve had vagus nerve stimulation to treat epilepsy may also experience improvements in mood and quality of life.

Research is still mixed on the benefits of implanted vagus nerve stimulation for the treatment of depression. Some studies suggest the benefits of vagus nerve stimulation for depression accrue over time, and it may take at least several months of treatment before you notice any improvements in your depression symptoms. Implanted vagus nerve stimulation doesn’t work for everybody, and it isn’t intended to replace traditional treatments.

Additionally, some health insurance carriers may not pay for this procedure.

Studies of implanted vagus nerve stimulation as a treatment for conditions such as Alzheimer’s disease, headaches and rheumatoid arthritis have been too small to draw any definitive conclusions about how well it may work for those problems. More research is needed.

Living with hidden disabilities

In the UK alone, 1 in 5 people has a disability, with 80% of those having an invisible disability.

What is an invisible disability?

A person is considered to have a disability if he or she has difficulty performing certain functions (seeing, hearing, talking, walking, climbing stairs and lifting and carrying), or has difficulty performing activities of daily living, or has difficulty with certain social roles (doing school work for children, working at a job and around the house for adults).

Invisible disabilities, also known as Hidden Disabilities or Non-visible Disabilities, are disabilities that are not immediately apparent. Typically, they are chronic illnesses and conditions that significantly impair normal activities of daily living.

Living with these conditions can make daily life more demanding for many people. They affect each person in different ways and can be painful, exhausting, and isolating. Without visible evidence of the hidden disability, it is frequently difficult for others to acknowledge the challenges faced and as a consequence, sympathy and understanding can often be in short supply.

Examples of Hidden Disabilities
While this list is by no means exhaustive, some examples of hidden disabilities include:

  • Autism
  • Brain injuries
  • Crohn’s Disease
  • Chronic pain
  • Cystic Fibrosis
  • Depression, ADHD, Bipolar Disorder, Schizophrenia, and other mental health conditions
  • Diabetes
  • Epilepsy
  • Learning difficulties, including dyslexia, dyspraxia, dysgraphia, and language processing disorder
  • Lupus
  • Rheumatoid Arthritis
  • Visual and auditory disabilities. These could be considered visible if the person with the disability didn’t wear support aids such as glasses or hearing aids

During the COVID-19 pandemic, invisible disabilities have become a talking point, which is why it is important to raise awareness of them.

Epilepsy

Epilepsy is a common condition where sudden bursts of electrical activity in the brain cause seizures or fits. There are lots of possible symptoms of epileptic seizures, including uncontrollable shaking or losing awareness of things around you. The main treatment for epilepsy is medicine to help prevent seizures. It’s often not clear what causes epilepsy. Sometimes it runs in families or is caused by damage to the brain from trauma such as a severe head injury.

Useful Resources

Epilepsy bed sensor

Footprint GPS Alarm

Seizures and me: Charlotte’s story

Epilepsy Action – Free online course What to do when someone has a seizure

Epilepsy first aid poster

How we can help

Assistive technology can promote a sense of independence for those living with epilepsy, whilst providing peace of mind and reassurance for loved ones and carers.

Epilepsy sensors are used to monitor people with epilepsy while they are asleep in bed. Patented sensor technology detects a person’s movement in bed and is able to differentiate normal movements from epileptic seizures enabling tonic clonic seizures to be detected the moment they occur. They help carers respond quickly when needed, and avoid disturbing a person’s sleep when they are not. The sensitivity of the sensor can be adjusted to best suit the person’s requirements.

This sensor is suitable for use with children as well as adults.

Outside the home                                   

Our GPS falls detector recognises when a person falls and connects straight through to our alarm response centre – ensuring help is on its way when you need it most. The alarm can be set up to alert an emergency contact or we can request an ambulance right away – the plan can be tailored to your individual needs.

This is a great solution for teenagers or adults with epilepsy. In many cases a parent or carer for someone with epilepsy will undertake regular checks or need to be on hand 24/7. This means constant worry for the care giver and a loss of independence for the individual. Our Footprint device will automatically raise an alert if it detects a fall, (no need to press a button) as well as being able to locate where you are. This enables appropriate care to be provided quickly, without the need for manual checks. 

A Helping Hand

Our products and plans are tailor made to help you or your loved ones stay safe. Explore the range below and see how Progress Lifeline can assist those with Epilepsy.

Epilepsy bed sensor

These are used to detect seizures whilst in bed. They are able to detect movements that are associated with a tonic clonic type seizure.

Footprint GPS Alarm & Falls Detector

The Footprint is a GPS location device, pendant alarm & falls detector all-in-one.

Falls Detector

The Falls Detector can be worn as a pendant or as a watch. When a fall is detected, the device automatically connects the wearer to our alarm response centre – no need to even press the button.

Key Safe

A KeySafe can be installed externally to allow safe and secure emergency access to your home. (A code is used by contacts that you approve to help in an emergency).

Emergency Home Response

Add our Emergency Home Response service to any alarm package for just £11 per month. Our responders provide 24/7 assistance to you at home if your family and named contacts can’t get there.

  

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.

Mental Health in Young People

A few nights ago, I watched a programme about the effects of ‘Mental health in young people’.

It mentioned a few mental health issues such as Autism, ADHD, PTSD, Aspergers Syndrome and that wasn’t them all. The was one I had never heard of before. Hopefully that will come to me so that I can use it at a later date.

One Young person not only had Autism but was bordering on ADHD as well.

An interesting factor with all of the young people in the programme was that during the two periods of lockdown we had in the UK their mental health state climbed to a high

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.

Tips on Dealing with Depression in Relationships: Guest Post — Mental Health @ Home

This guest post on dealing with depression in relationships, either as the depressed or the non-depressed person, comes from Marimeia of Through Anxiety and Beyond. We’ve done a guest post tradesies, and you can read my post about how fabulous all of you are on her blog here. I have recently been to visit a […]

Tips on Dealing with Depression in Relationships: Guest Post — Mental Health @ Home