MENTAL ILLNESS — Part II

There are so many stereotypes and myths in society today relating to mental illness and the people that suffer from it, so we have decide to do a three part feature on mental illness in our blog.  Part I (below this blog) provided a brief introduction to Mental Illness and review Anxiety and Mood disorders.  Part II will review Personality Disorders, Psychosis, Schizophrenia, and Schizoaffective Disorder.  

Personality Disorders:

People with personality disorders have chronic, pervasive problems managing life’s ups and downs. People with personality disorders suffer life-altering, negative, consequences in social, career and family arenas. There are a range of personality disorders which include: Borderline Personality Disorder, Antisocial Personality Disorder, Narcissistic Personality Disorder, Dependent Personality Disorder, Schizoid Personality Disorder, Obsessive-compulsive Personality Disorder, Paranoid Personality Disorder, Histrionic Personality Disorder, Avoidant Personality Disorder and finally, Schizoidal Personality Disorder. We will not go into a description of each type of disorder but will give a general description of the common manifestations of personality disorders.

Some of the characteristics in common with all personality disorders are trouble maintaining relationships, disturbances in self image, difficulty with impulse control, and with managing strong emotions in a healthy way. People with personality disorders can seem over-the-top emotionally; often their emotions and behaviour seem way out of proportion to the situation and can lead to conflict with others. People with personality disorders can seem rigid in their thinking and often denigrate themselves; often people with personality disorders do not accept themselves, their reactions and their situations.

Some of the symptoms of personality disorders are: stormy relationships; frequent mood swings; social isolation; angry outbursts; difficulty making friends; suspicion and mistrust of others; problems with impulse control; and substance abuse problems.

Psychosis:

Psychosis is a word used to describe medical conditions that affect the brain, so that what a person thinks is real is different from what other people think is real. Although we don’t completely understand what causes psychosis, many medical researchers think that people are born with a vulnerability or tendency towards psychosis. This doesn’t mean they’ll automatically become ill, but that if the person is exposed to enough stress it can trigger psychosis. Psychosis is a medical condition and it can be treated. Many people recover fully after they are ill with psychosis for the first time and never have it again. Others may have more during the course of their life. Almost all people with psychosis improve with treatment.

The brain is a part of your body, and it can get sick too. Psychosis is a serious brain illness. When a person has psychosis, what they think is real is not the same as what other people think is real.

Some doctors think certain people are born with the possibility of getting psychosis. Some people are born with the same genetic risk but never get psychosis. The ones that do get psychosis may also experience a “trigger”. Triggers may be stresses like a sad life event, injury, illness or street drug use. A person with a family history of mental illness is more likely to get psychosis if they also have a “trigger”.

Schizoaffective disorder:

Schizoaffective disorder is an illness that combines the symptoms of schizophrenia and a mood disorder. Schizoaffective disorder is one of the most challenging disorders to diagnose because of the combination of schizophrenia and bipolar mood symptoms; symptoms which can present as schizophrenia, major depressive disorder or bipolar disorder. According to the Encyclopedia of Mental Disorders, because of the difficulty diagnosing this illness there are no statistics on incidence rates. Moreover, “The proportion of schizoaffective disorder identified in persons undergoing treatment for psychiatric disorders has ranged from 2% to almost 30%, depending on the study cited. ” 

There are two main types of schizoaffective disorder; bipolar and depressive. People with schizoaffective disorder may present psychotic-type symptoms such as paranoid delusions, hallucinations, distorted thinking and speaking, and mania. Schizoaffective disorder with depression includes bouts of major depression presenting in combination with psychotic symptoms. Women seem more prone to the disorder, which is generally diagnosed in early adulthood. Sometimes adolescents are diagnosed with this illness after an initial diagnosis of bipolar disorder has been incorrectly made; again, the symptoms of mania can imitate psychosis.

Misdiagnosis of this illness is common in both adolescents and adults because the illness is so complex. When symptoms of bipolar disorder, psychosis and depression are all present, it may be difficult for clinicians to sort them out. In terms of prognosis, despite the severity of symptoms, the effects of this illness are generally episodic in nature and, compared to the diagnosis of schizophrenia, the outcome is more favorable.

Schizophrenia:

Schizophrenia is characterized by a broad range of unusual behaviors that cause profound disruption in the lives of people suffering from the condition, as well as in the lives of the people around them. Schizophrenia strikes without regard to gender, race, social class or culture.

Schizophrenia is a complex illness. Mental health experts are not sure what causes it. However, genes may play a role. Certain events may trigger schizophrenia in people who are at risk for it because of their genes. You are more likely to develop schizophrenia if you have a family member with the disease.

Schizophrenia affects both men and women equally. It usually begins in the teen years or young adulthood, but it may begin later in life. It tends to begin later in women, and is more mild. Childhood-onset schizophrenia begins after age 5. Childhood schizophrenia is rare and can be hard to tell apart from other developmental problems in childhood, such as autism.

Do You Have Schizophrenia Quiz? http://psychcentral.com/quizzes/schizophrenia.htm

Part III will review Self Injury, Suicide and Violence, and end with a synopsis of Mental Health issues in Canada today (to be posted in two weeks).

The stigma attached to mental illnesses presents a serious barrier not only to diagnosis and treatment but also to acceptance in the community.  We hope that by sharing a little information we can do our small part to educate some people not familiar with, or have lingering questions about, mental illness.

MENTAL ILLNESS — Part I

There are so many stereotypes and myths in society today relating to mental illness and the people that suffer from it, so we have decided to do a three part feature on mental illness in our blog.  Part I will provide a brief introduction to Mental Illness and review Anxiety and Mood disorders.  Part II will review Personality Disorders, Psychosis, Schizophrenia, and Schizoaffective Disorder.  Part III will review Self Injury, Suicide and Violence, and end with a synopsis of Mental Health issues in Canada today.

The stigma attached to mental illnesses presents a serious barrier not only to diagnosis and treatment but also to acceptance in the community.  We hope that by sharing a little information we can do our small part to educate some people not familiar with, or who have lingering questions about, mental illness.

What Is Mental Illness:

Mental illnesses takes many forms, just as physical illnesses do. Unfortunately, many people still misunderstand and fear mental illness; hopefully the fear and shame will diminish as society learns the truth about mental health issues and discusses them openly. If you, or someone you know, has a mental illness, there is good news: all mental illnesses can be treated.

We are not just physical bodies. Our mental health is just as important as our physical health, the two are very much dependent on each other.  Our mental health directly affects our physical health, and vice versa. People with physical health problems may experience anxiety or depression that can affect their recovery. Similarly, mental health challenges increase the risk of developing physical problems such as:

• diabetes
• heart disease
• weight gain or loss
• gastrointestinal problems
• reductions in immune system efficiency
• blood biochemical imbalances

Mental illnesses are characterized by alterations in thinking, mood or behaviour (or some combination thereof) associated with significant distress and impaired functioning. The symptoms of mental illness vary from mild to severe, depending on the degree of illness, the individual, their family and socio-economic environment.

Types of Mental Illness:

Anxiety Disorders: 

Generalized Anxiety Disorder is a condition where you experience chronic and debilitating anxiety and/or worry.  The level of your anxiety is out of proportion compared to the likelihood the potential event will actually occur. The anxiety affects your ability to complete your normal activities of daily living at work, home, school, and can even interfere with personal relationships. Anxiety can also cause physical symptoms such as stomach pains, dizziness, forgetfulness, numbness, agitation, shortness of breath, and chest pain.

Obsessive-Compulsive Disorder is a condition where you experience thoughts, images or impulses that are very disturbing to you and make you feel anxious (obsessions). You may need to repetitively perform specific acts (rituals) to make yourself feel better or relieve the feelings of anxiety (compulsions).

Panic attacks are intense episodes of fear that often occur for no apparent reason and can peak in ten minutes or less. They happen when your built-in alarm system gets activated and your body prepares to fight or run for your life through a survival mechanism called the ‘Fight or Flight’ response. When this alarm system gets triggered you are likely to experience a series of physical and cognitive symptoms which can be overwhelming such as trembling, heart palpitations, hot or cold flashes, a choking sensation or a fear of going crazy.

Post- Traumatic Stress Disorder (PTSD) can develop after you have been exposed to traumatic events that cause you to experience distressing psychological symptoms which can then become disabling to you. Events that can cause PTSD include being involved in an accident, sexual or physical assault, extreme weather events (Hurricane Katrina), witnessing a serious injury or death, having a near death experience or the feeling you almost died, being exposed to repetitive trauma like serving in active duty, etc.

Social Anxiety Disorder (or Social Phobia) is the most common anxiety disorder. It’s a condition which involves being afraid of being judged negatively by others and results in feelings of embarrassment and humiliation.  Your fears of about what others will think are out of proportion to reality, and even if you are aware, it will still worry you and cause enough anxiety that you’ll want to try and avoid social situations.

Phobias: Many of us are afraid of snakes and spiders (myself certainly included in that demographic), but most of us can manage our fears. On the other hand, phobias can cause a level of fear that is unmanageable can be quite disabling and you may experience considerable distress. For example, a fear of flying could result in your not being able to travel for your job and therefore you might have to pass up a much wanted promotion. A fear of snakes could result in not going on family outings to the park and/or not using the basement of your own home.

Attention Deficit Disorders:

Attention deficit hyperactivity disorder (ADHD) is a disorder characterized by a an inability to concentrate, sometimes combined with hyperactivity-impulsivity that is persistent, developmentally inappropriate, and occurs in at least two different settings.

ADHD, also known as attention deficit disorder (ADD) or hyperkinetic disorder, has been around a lot longer than most people realize.  In fact, a condition that appears to be similar to ADHD was described by Hippocrates, who lived from 460 to 370 BC.

Mood Disorders:

Mood disorders affect about 10% of the population. Everyone experiences normal “highs” and “lows” in life, but people with mood disorders experience them with greater intensity and for longer periods of time than most people.

Depression is the most common mood disorder that presents with depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep, constant tiredness, an inability to have fun, poor concentration, and thoughts of death or suicide. These problems can become chronic or recurrent and lead to substantial impairments in an individual's ability to take care of his or her everyday responsibilities and feelings of hopelessness. At its worst, depression can lead to suicide, a tragic fatality associated with the loss of about 850,000 lives every year (as per the WHO).

Dysthymia is characterized by depressive symptoms present most of the day for two years or more in adults and for one year or more in children and adolescents. In children diagnosed with this illness, irritability as opposed to depression may be present. Dysthymia is different from major depressive disorder because of the chronic, long term nature of the illness and because there are fewer depressive symptoms (two or three) than in major depressive disorder (four or more symptoms). Often people suffering from dysthymia have experienced depressive symptoms like hopelessness, poor concentration, sleep disturbances and low motivation for years, but have never been diagnosed with depression; for some the symptoms begin to feel like a chronic state of being. People with dysthymia may appear outwardly to be coping well enough, but seem very unhappy most, if not all, of the time.

Bipolar disorder (historically known as manic depression) causes serious shifts in mood, energy, thinking, and behavior–from the highs of mania on one extreme, to the lows of depression on the other. More than just a fleeting good or bad mood, the cycles of bipolar disorder last for days, weeks, or months. And unlike ordinary mood swings, the mood changes of bipolar disorder are so intense that they interfere with your ability to function. It is a serious condition; the mania often causes sleeplessness, sometimes for several days,  hallucinations, delusions, paranoid rage and possibly even psychosis.

People are frequently confused what the differences is between a clinical depression and manic depression and it’s not surprising as they both have the word depression in their names. That’s one of the reason’s manic depression’s clinical name changed to “bipolar disorder” many years ago, to clearly distinguish it from regular depression.

Postpartum depression.  Having a baby is a challenging time, both physically and emotionally for all women and some degree of emotional vulnerability is natural and expected after childbirth.  It’s natural for new mothers to have mood swings after delivery, feeling joyful one minute and overwhelmed the next. These feelings are sometimes known as the "baby blues" and usually go away within a few days after the birth. However, some women may experience a deep and ongoing depression which lasts much longer; this is postpartum depression and can begin any time during the first two months after you give birth.

If you feel depressed after the birth of your child, tell someone you trust about how you feel.  Call a sympathetic friend, join a mothers' group for support, or chat with moms about postpartum depression in the BabyCenter Community.  You may be surprised at how many women are experiencing similar feelings. If you have a supportive partner, make sure they know what's going on and how they can help.

Seasonal Affective Disorder (SAD). Weather often affects people’s moods. Sunlight breaking through clouds can lift our spirits, while a dull, rainy day may make most of us feel quite gloomy. These mood shifts generally do not affect our ability to cope with daily life but some people are vulnerable to a type of depression that follows a seasonal pattern.  For them, the shortening days of late autumn are the beginning of a type of clinical depression that can last until spring; this condition is called “Seasonal Affective Disorder," or SAD.  

We will post Part II and Part II of our Mental Health series in the coming weeks so stay tuned and please feel free to post your comments below or email them in confidence  HERE

AVOID THE PAIN OF SHINGLES!

As someone who has suffered the relentless pain Shingles can inflict, I can honestly tell you that this is something you do want to protect yourself against – WHY SUFFER IF YOU DON’T HAVE TO?!

FACTS

Shingles is a viral infection that causes a painful rash. Although Shingles can occur anywhere on your body, it most often appears as a single stripe of blisters that distinctively wraps around one side of your torso. The early signs of Shingles usually develop in three stages: severe pain and/or tingling, possibly an itchy rash, and blisters that look similar to Chickenpox. Personally, I could always feel the Shingles acting up before any sign of the rash appeared; the affected area would feel like it was sore and bruised, then it would tingle and felt like a mild itch that was too deep under the skin to scratch. 

Shingles is caused by the Varicella Zoster (aka Herpes Zoster) virus — the same virus that causes Chickenpox. After you've had Chickenpox, the virus lies inactive in nerve tissue near your spinal cord and brain. Years later, the virus may reactivate as shingles. Once you are infected with the Herpes Zoster virus, it remains in your body for life and remains inactive until a period when your immunity is down. I could always tell when I was overtired and rundown because my Shingles would flare up again.

When the virus becomes reactivates, you may get symptoms such as rash, upset stomach, malaise, headache, fever and chills. Additional symptoms can include: abdominal pain; difficulty moving some of the muscles in the face; drooping eyelid; general ill-feeling; genital lesions; hearing loss; joint pain; loss of eye motion; swollen glands (lymph nodes); taste problems and/or vision problems.

When the virus enters its "quiet" phase after Chickenpox, it remains dormant in certain nerves.  Shingles will break out in the areas of the body connected to those nerve cells; as a result, only one section or one side of the body is often affected.  Common sites for the rash include the chest, back, buttocks, neck, and sometimes the face and scalp.

The rash itself is reddish, with many tiny, fluid-filled blisters. For a few days, the rash spreads, although its extent varies from one person to another. The rash commonly occurs on one side of the trunk of your body as a band of blisters that go from the middle of your back around one side of your chest to your breastbone. The blisters break, forming small ulcers that begin to dry and form crusts; the crusts generally fall off in 2 to 3 weeks and scarring is rare.

From before the time the rash erupts until after it's healed, you'll be itchy - in some cases, the rash can be extremely painful. The rash usually lasts about 7 to 10 days and completely disappears after one month. The pain can last for up to 3 months or longer in a small percentage of people. While you will likely have only one bout of Herpes Zoster, some people may get it several times.

RISKS

Anyone who has ever had Chickenpox can develop Shingles. Most adults in the North America had Chickenpox when they were children, before the advent of the routine childhood vaccination that now protects against Chickenpox. 

If you have not had Chickenpox and you come into contact with someone who has Shingles, ask your healthcare provider whether you should get a Chickenpox vaccination.  You should try to avoid contact with anyone who has Shingles; the fluid from their open blisters is infectious. You will not get Shingles, but you could get Chickenpox if exposed.

Unlike Chickenpox, with Shingles, the virus is NOT transmitted by someone breathing or coughing on you. You have to come in contact with the blister fluid itself. Once the blisters scab over, the contagious period is ended.

If you have had Chickenpox, nothing will happen to you if you are exposed to someone who has Shingles.  

Factors that may increase your risk of developing Shingles include:

• Age: Shingles is most common in people over 50; the risk increases with age. Some experts estimate that half the people who live to the age of 85 will experience Shingles at some point in their lives.
• Diseases: Diseases that weaken your immune system, such as HIV/AIDS and Cancer, can increase your risk of Shingles.
• Cancer treatments: Undergoing Chemotherapy and/or Radiation can lower your resistance to diseases and may trigger Shingles.
• Medications: Drugs designed to prevent rejection of transplanted organs (e.g. Corticosteroids) can increase your risk of Shingles — as can prolonged use of steroids, such as Prednisone.

 

COMPLICATIONS

Complications from Shingles can include:

·  Postherpetic Neuralgia - For some people, Shingles pain continues long after the blisters have cleared. This condition is known as Postherpetic Neuralgia, and it occurs when damaged nerve fibers send confused and exaggerated messages of pain from your skin to your brain.

·  Vision loss - Shingles in or around an eye [Ophthalmic Shingles] can cause painful eye infections that may result in vision loss or blindness. 

·  Hearing loss - Shingles in or around an ear may result in hearing loss or deafness.

·  Neurological problems - Depending on which nerves are affected, Shingles can cause an inflammation of the brain (Encephalitis), facial paralysis, or hearing or balance problems. If the virus spreads to two particular nerves in your face, then a condition called Ramsay Hunt syndrome may develop; this can lead to temporary ear pain, facial paralysis, and loss of hearing and taste.

·  Infections - If Shingles blisters aren't properly treated, bacterial skin infections may develop; in severe cases you can even develop Sepsis.

TREATMENT OPTIONS

Antiviral medications (e.g., Acyclovir, Valacyclovir, and Famciclovir) work best if started within 3 days of developing the Shingles rash. This will minimize the extent and spread of the rash and minimize the pain associated with it. Blisters will also crust over and heal faster. Antiviral medications may also help to reduce the risk of developing chronic pain from Shingles.

There's some evidence that starting treatment quickly can lower your risk of developing PHN (severe pain along affected nerves), or at least shorten the duration of symptoms if you do get it.

To relieve the itching and pain of shingles, you can try:

• applying Calamine lotion to the blisters
• using cool, moist compresses
• soaking in a tub with Cornstarch or Oatmeal

Natural Treatments:

Capsaicin, a natural compound derived from cayenne or chili pepper, can be used topically for pain relief. It is available in ointment form as Zostrix, and can be applied four to five times daily for pain relief. It works by blocking pain signals from nerves just under the skin, and is very effective in reducing the pain of Herpes Zoster.

Echinacea and Goldenseal are both antivirals, immune- stimulating, and detoxifying, and are helpful in the treatment of Herpes.

PREVENTION

To prevent Shingles, the first step is to avoid getting Chickenpox. If you haven't had it, make sure you don't touch the blisters of people with either Chickenpox or Shingles. 

A vaccine against Chickenpox is available for both children and adults. As more children become immunized, the incidence of Chickenpox will go down and fewer people will be susceptible to developing Shingles. 

There's also a Herpes Zoster vaccine available for people 60 years of age or older. The Herpes Zoster vaccine is different than the Chickenpox vaccine. Older adults who receive the Herpes Zoster vaccine are less likely to have complications from Shingles. People over 60 should receive the Herpes Zoster vaccine as part of routine medical care.

If you've already had Chickenpox, you can help prevent the virus from becoming active again and causing Shingles by keeping your immune system healthy - a balanced diet, regular exercise, and adequate rest can go a long way to help.

Quote: “The secret of health for both mind and body is not to mourn for the past, nor to worry about the future, but to live the present moment wisely and earnestly.” Buddha

Excerpts from:

www.bodyandhealth.canada.com

www.nihseniorhealth.gov/shingles

www.mayoclinic.com/health/shingles