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Mental Illness and
Treatment
Disclaimer
The listed internet links to medical and health information are meant for
general education only and are not intended as a substitute for consultation
with your physician or other healthcare professional. Remember also that any
information found on the Internet cannot be guaranteed accurate. If you or a
family member are worried about a medical problem or symptom, please consult a
qualified physician.
Symptoms
of Mental Illness
Types of Mental Illness
Other
Mental Health Links
Medications
Alternate Treatment Approches
People with mental illness have disorders of thought, feeling or behaviour that
result in an inability to cope with the demands of everyday life. Symptoms vary
in type and degree from illness to illness and from person to person. They are
often cyclical in nature and vary in severity over time. An acute episode may
last from weeks to months for some and many years or a lifetime for others.
The following list of symptoms could be warning signs
of a mental illness developing.
· Social
withdrawal
· Depression
· Thought disorders
· Strong, absent or inappropriate expressions of feeling
· Destructive behaviours
· Impaired thinking
· Disturbances in relationships with others
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They should be taken seriously and, when more than one symptom appears in
adolescents, should not be considered just a passing phase.
It is always best to start with a physical examination to rule out the
possibility of an underlying medical disease (hypothyroidism, multiple
sclerosis, brain tumour, disordered metabolism) when mental illness is
suspected.
It is important to know that research is progressing at a steady rate and there
are many medications that can help affected individuals lead productive lives.
It is often suggested that combining the appropriate type of psychotherapy with
medications and rehabilitation intervention can increase a person’s chances of
remaining stable and functional.
For
more information on mental illness:
The
Canadian Mental Health Association offers downloadable
pamphlets
Canadian Heath
Network
National Alliance for
the Mentally Ill
American
Academy of Child & Adolescent Psychiatry
Schizophrenia
Schizophrenia is a
disorder of the brain that affects mental processes such as thinking and
judgment, sensory perception and the ability to appropriately interpret and
respond to situations. Contrary to popular belief, it is not a split
personality.
A biological brain disorder, schizophrenia is no one’s fault. About one percent
of the adult population has schizophrenia. The first symptoms usually appear
between ages 17 and 24 and can be confused with other common adolescent
behaviours.
Many clinicians find it useful to describe typical schizophrenia symptoms as
either "positive" or "negative."
Positive symptoms include:
·
Hallucinations: hearing, feeling or seeing things that exist only in the
individual's mind
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Delusions: persistent false beliefs, suspicions
·
Communication difficulties or incoherence
·
Bizarre and disorganized behaviour
Negative symptoms include:
·
Deficiency in flow of thought, speech
·
Inability to experience pleasure
·
Lack of emotion or flatness of emotion
·
Little desire for social contact
·
Lack of interest or persistence
·
Apathy
Both types of symptoms are part of the illness, but each person affected may
have more of the positive or negative types. While schizophrenia cannot be
cured, its symptoms can be treated successfully through medication.
For
more information on schizophrenia:
Schizophrenia Society of Canada – support group
chapters across Canada
The Schizophrenia Home Page
Schizoaffective Disorder
Some
people have symptoms that place them at a point between schizophrenia and
bipolar disorder. These disorders have not been very clearly defined or
studied. Their symptoms include those of both schizophrenia and mood disorders,
though not at the same time. Physicians often treat these disorders with a
combination of antipsychotics or anti-depressants and mood stabilizers. More
information is available at Depression Central
Affective Disorders (Bipolar Disorder
and Depression)
Affective disorders
or mood disorders include depression and bipolar affective disorder
(manic-depressive illness). These are common psychiatric problems and affect 5
percent of adults at any given time. The essential characteristic is a
disturbance in mood.
Bipolar illness is characterized by cycles of depression and/or mania.
Manic symptoms may include:
·
Boundless energy, enthusiasm and need for activity
·
Rapid, loud, disorganized speech
·
Short temper and argumentativeness
·
Involvement in activities that have painful consequences such as shopping
sprees, reckless driving and unwise business investments
·
Delusional thinking
When depressed, a person may:
·Have
difficulty sleeping (too much or too little)
·
Lose interest in daily activities, lose his appetite
·
Suffer feelings of worthlessness, guilt or hopelessness
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Exhibit feelings of sadness
·
Be unable to concentrate
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Experience extreme irritability
Major depression (described above) should not be confused with reactive
depression or "the blues." Reactive depression, sometimes called situational
affective disorder, is a temporary condition triggered by life problems. Should
this condition persist, the affected individual should consult a doctor to find
out if it is becoming a major depression.
For more information on depression and bipolar disorder:
Depression and
Bipolar Support Alliance
Dr. Ivan’s Depression Central
Seasonal Affective
Disorder
Depression
Screening
| Concerned that you or someone you know has symptoms of depression or bipolar
disorder?
Click on one of these sites for a confidential screening for bipolar disorder or depression
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Postpartum
Depression
Postpartum depression, which many people consider "baby blues," is also a form
of major depression, not just a mild, short-term feeling of sadness after a
baby is born. Along with the symptoms of depression, mothers may also
experience:
·
Lack of interest in the baby, family or friends
·
Fear of being a bad mother
·
Fear that harm will come to the baby
·
Thoughts of harming the baby or herself
Postpartum depression is a treatable medical illness and should not be
considered a natural reaction to being a mother of a newborn baby.
For more information on postpartum depression:
Depression in Women
Postpartum
Depression
Revivre Association
québécoise de soutien aux personnes souffrant de troubles anxieux, dépressifs
ou bipolaires
Déprimés Anonymes
Obsessive-Compulsive Disorder
This is a spectrum
of disorders causing people to be constantly troubled by persistent ideas and
feelings (obsessions) that force them to carry out repetitive actions and
rituals (compulsions). Patients consider these thoughts senseless and sometimes
disagreeable, but are unable to ignore or resist them. One-sixth of the
population shows mild obsessive symptoms. Obsessive compulsive disorder
generally starts in adolescence and develops intermittently. More information
and better treatment is becoming available for those with the disorder.
Common obsessions include:
·
Violent thoughts
·
Fear of being infected by germs or dust
·
Perpetual doubts (is the front door locked?)
·
Obsessive ruminations that oblige a return to the same word, sentence or
insolvable problem
Common compulsions include:
·
Checking repeatedly
·
Washing continually
·
Cleaning to avoid contamination
·
Arranging things JUST RIGHT by size, colour, number
For
more information on OCD:
Obsessive Compulsive Foundation
OCD Online
OCD Center of Los Angeles
Anxiety
Disorders
Anxiety disorders affect approximately 7 to 15 percent of the population.
One particular form, panic disorder, is characterized by recurrent panic
attacks. The person experiences dizziness, chest discomfort, choking and
sweating. The attacks generally last from a few minutes to a few hours. Panic
attacks are accompanied by a sense of looming danger and a strong desire to
escape. Anticipation of an attack and the subsequent fear of helplessness often
complicate the problem and increase anxiety. Other forms of anxiety include
fear of specific objects (phobias) or fear of going out (agoraphobia).
Anxiety Disorders and Youth
Recognizing the prevalence and effects of anxiety in youth, in 2001 the
Régie Régionale embarked on a public awareness campaign to promote screening,
referrals and treatment of anxiety among young people ages 14-25.
For
more information on anxiety and related disorders:
Anxiety Disorders
Association of America
Panic Disorder
Understanding Agoraphobia & Panic Disorder
Personality Disorders
This
is a very broad category of disorders related to rigid and deeply rooted
impaired patterns in relating to, perceiving, and thinking about the
environment and oneself. It is evident in individuals who fail to adjust to
socially acceptable norms of behavior in vocational and social settings and who
are incapable of establishing adequate, stable relationships.
Some
of these disorders are:
Antisocial
personality disorder
Borderline personality disorder
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Marked changes in mood for brief periods of time
-
Having unstable, intense interpersonal relationships
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Prone to unpredictable action which could be self-damaging (ie cutting)
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Unstable self-image
| Concerned that you or someone you know has a personality disorder?
Click here for a confidential screening.
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Paranoid personality disorder
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Characteristically behaving towards others with unwarranted suspicion, envy,
jealousy and stubbornness
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Feelings of having been taken advantage of, even in the face of evidence to the
contrary
Obsessive
compulsive personality disorder
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Characterized by a pervasive pattern of perfectionism and inflexibility
beginning in early adulthood and present in a variety of contexts that
interfere with task completion (indecisiveness, over-conscientiousness)
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Preoccupation with details while losing sight of over-all goals
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Unreasonable insistence on a particular way of doing things
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Excessive devotion to work
-
This disorder can also cause restricted expression of affection, lack of
generosity, inability to discard worthless objects.
For more information on personality
disorders:
Borderline
Personality Disorder Central
Eating
Disorders
Anorexia Nervosa & Bulimia Quebec
Suicide
Suicide Information
& Education Center
Depression and
Bipolar Support Alliance
Children & Adolescents
Child &
Adolescent Bipolar Foundation
Prevention of Teenage Suicide
Teenage
Depression
American
Academy of Child & Adolescent Psychiatry
Medication
can help people with mental illnesses in several ways. It can relieve the
distress and anguish caused by illness by controlling symptoms, such as
depression, mania, panic attacks, obsessions and hallucinations. In addition,
it can prevent relapse of both schizophrenia and mood disorders. Certain
medications can also reduce the negative symptoms of schizophrenia. Medication
is so important that it is often considered essential in the treatment of
mental illness, particularly if the illness is severe and persistent. However,
medication does not "cure" the illness and, of course, has side effects. In
each case, therefore, the risks must be weighed against the benefits of taking
a medication or not.
It
is important to know the names of prescribed medications (both the
manufacturer's trade name and the chemical generic name), as well as the
dosage, therapeutic benefits, and possible side effects. Keeping a written
record of all this can be very useful at a later date. Any other doctor or
dentist should be aware of all medications taken to ensure that any medical
operation or treatment is undertaken without risk of interaction with the
psychiatric medication.
Medications
vary as to the amount of time needed before taking effect (from a few hours in
the case of anxiolytics to several weeks in the case of antidepressants). Side
effects, however, can appear very rapidly, leading many people to stop their
medication before they take full effect. Many side effects, though, are only
temporary and may disappear after a few weeks. In any case, ongoing treatment
with medications should be supervised carefully.
Antipsychotics
Antipsychotics
(also known as neuroleptics) are prescribed to counteract psychotic thinking
such as occurs with schizophrenia, mania and extreme depression. They help stop
hallucinations, delusions and agitation, and significantly reduce the rate of
relapse. The most common antipsychotics are Zyprexa, Risperdal, Haldol and
Seroquel.
Some
antipsychotics are injectable in intervals ranging from one week to several
months. Often, the total dosage of the medication may be reduced by giving an
injection, because it is better absorbed in this form. Injections are
preferable for persons who are either non-compliant or forget to take their
pills.
Use of antipsychotic drugs can produce side effects. It is important to discuss
with the physician or pharmacist the side effects of each medication, since the
profile can vary considerably with the dose and medication taken. Following are
typical side effects of antipsychotics:
-
Dizziness, dry mouth, blurred vision, urinary retention, and constipation.
These symptoms are due to the antichlorine effect and may decrease or disappear
with time. Notify your physician if the constipation is persistent
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Stiffness, shakiness, restlessness, muscle spasms (especially neck, eyes or
tongue) and akathysia (fidget/need to walk)
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Lack of concentration or memory loss, reduced libido, increased saliva,
sensitivity to the sun. In certain cases, these effects may improve with time.
They are not permanent because they disappear once the medication stops.
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Flu-like symptoms with fever, sore throat, rash, stomach pain, diarrhoea,
vomiting or asthma. These symptoms represent an allergic reaction, which is
rare and usually occurs during the first month of treatment. Notify a physician
of all these symptoms.
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Involuntary movements, especially of the mouth and fingers. When antipsychotics
are used for extended periods of time, these symptoms of tardive dyskinesia may
develop. Certain precautions may be taken to prevent tardive dyskinesia, such
as keeping the dosage of the medication to the minimum and, perhaps, the use of
vitamins E and C. Although tardive dyskinesia may improve, it is sometimes
irreversible.
These
symptoms are due to the neuroleptic effects on the extrapyramidal system, a
part of the brain that controls muscle movements. They are worse in young males
and often require a medication to counter the side effects. Medications for
these reactions include: Kemadrin and Cogentin.
Antidepressants
These
drugs are used to treat depression by reducing the symptoms of sadness,
agitation, irritability and inability to enjoy life. Some are useful for panic
attacks, obsessive-complusive disorder and chronic pain. Antidepressants are
different from most medications since they are slow to act: with the adequate
dosage, it takes two to six weeks to see if the patient reacts favorably to the
medication. Overall, antidepressants can help 70 to 80 % of people with major
depression. As with antipsychotics, antidepressants treat the symptoms but do
not cure the illness, hence they must be taken for the natural duration of the
depressive episode. Like many other drugs, they are toxic when taken in
overdose, so the prescribed dosage should be carefully followed.
There are many antidepressants on the market, which may lead to confusion. The
choice of medication may be based on its side effects, the presence of
agitation or anxiety, lack of energy or the experience that the person already
has with a previous antidepressant. Antidepressants are grouped according to
their mode of action and structure.
The
side effects of antidepressants vary considerably according to the category and
it is always good to check with the physician or the pharmacist to know the
effects of the prescribed medication. The most common side effects are dry
mouth, blurred vision, urinary retention and constipation. These symptoms are
due to the antichlorine effect and may decrease or disappear with time. In some
cases they may cause stomach upset, weight gain, nightmares, inability to
sleep, sexual difficulties or increased seizure activity in people who already
suffer from epilepsy.
Notify
your physician if the symptoms persist over a long period of time.
For
severe and persistent depressions that do not respond to traditional
antidepressants, the physician can suggest a potentialization strategy : adding
another medication such as Lithium to increase the efficacy of the
antidepressant.
Mood
Stabilizers
Drugs
in this category are used to treat hypomania (state of perpetual excitement
with an overabundance of energy, lack of sleep, irritability, etc.), mania and
psychosis in bipolar disorder (alternation of mania and depression). The most
common medications in this group are Lithium, Epival and Topamax.
Lithium
is the most common mood stabilizer. Lithium is not a tranquillizer but works in
a more fundamental way to settle the person’s mood so that he can sleep, eat,
think, feel and relate more normally. In acute mania, lithium is often combined
with other medications including the more powerful antipsychotics. People with
manic-depressive illness take lithium continuously even when they feel better
in order to prevent episodes of mania or depression from returning.
Lithium
has side effects which may include tremor, nausea, diarrhea, frequent
urination, weight gain, marked thirst and water retention. If the lithium level
gets too high in the blood, side effects will include lethargy, changes in
mental function, vomiting and diarrhoea. For this reason the dose of lithium is
carefully controlled by regular blood tests during visits to the doctor. Long
term side effects of lithium can include decreased functioning of the thyroid
gland, kidney damage, and heart problems, so these too are checked regularly.
Anxiolytics
These
drugs are used to relieve the symptoms of severe anxiety, panic attacks,
short-lasting sleep disorders, and to increase the effects of antipsychotics
among highly agitated patients. They also help relax muscle spasms, reduce the
agitation caused by antipsychotics (akathysia) and cause sedation. They should
normally be used for short periods of time because they are addictive and may
produce severe reactions when used with alcohol. Commonly used anxiolytic
medications are Ativan, Rivotril, Buspar and Serax.
Side effects can
include
dizziness, drowsiness, loss of muscle coordination, blurred vision,
agitation, decreased memory, increased appetite, and diarrhoea.
Nevertheless, there is a place for anxiolytics when a person is
receiving regular mental health care.
For
more information on psychiatric medications:
Schizophrenia and its treatment
Bipolar Medication Profile
Mood Disorder Medications
Anxiety Medication
Listed and Explained
Orthomolecular Medicine
"Orthomolecular Medicine, as conceptualized by double-Nobel Laureate Linus
Pauling, aims to restore the optimum environment of the body by correcting
imbalances or deficiencies based on individual biochemistry using substances
natural to the body such as vitamins, minerals, amino acids, trace elements and
essential fatty acids." (source: www.orthomed.org)
Recent titles about the Orthomolecular treatment of mental illness in our AMI
library and available to our members are:
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Adventures in Psychiatry: The scientific memoires of Dr. Abram Hoffer
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Orthomolecular treatment of schizophrenia : Abraham Hoffer, Md, Phd
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Mask of Madness: Science of healing : International Schizophrenia Foundation
(video)
For a personal story read
page 6 of our Fall 2005 newsletter and for more information go to
www.orthomed.org.
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