Cygnet Health Care - What do we treat?

What do we treat?

Addictions

An addiction involves a person being addicted to a drug, a behaviour or in many cases both. The initial use of a substance or behaviour produces a feeling of security and well being and the person wants to repeat that experience. As the use of the substance or behaviour becomes more frequent a tolerance is developed which could lead to dependency and addiction. The alcoholic or addict becomes preoccupied with either the drug or the behaviour to such an extent that it becomes a central focus in their life, this often has a destructive impact on themselves, their families and their friends. An addiction is a continuous process- not a one off event.

There are two types of addiction: - physical and psychological addiction.

Physical addiction is characterised by an increased tolerance to the chemical you are addicted to. The chemical could be alcohol or a drug and its absence causes withdrawal symptoms. These are a set of uncomfortable feelings, behaviours and changes in physiology such as shakes, sweating and fits and they are potentially dangerous.

Psychological addiction on the other hand does not produce withdrawal symptoms as such, but absence of the substance or behaviour creates a sense of loss and irritability. These feelings could cause some discomfort but would not in themselves produce shakes/tremors or other physical discomfort that physical addiction normally causes in withdrawal.

A person may begin to use addictive substances or behaviours for various social, physical and/or psychological reasons. Alcohol, Drugs, Shopping, Food, Sex, Co-Dependent Relationships and Exercise can all potentially be addictive.

Some addictive substances, for example caffeine or nicotine, do not usually have such an immediate, destructive effect, but those of us who have tried to quit know how hard the process can be.

Treatment is available at:

Amnesia

Amnesia is a profound memory loss due to a head injury, traumatic event or ingestion of a toxic substance which affects the brain. The main types being:

retrograde amnesia where people are unable to remember events before an accident in which they suffer damage to the head;
Korsakoof's psychosis - memory loss caused by prolonged alcohol abuse;
traumatic amnesia - this follows brain damage caused by a severe blow to the head;
hystrical amnesia - caused by psychological trauma

The treatment varies according to the type of amnesia and the suspected cause.

Treatment is available at:

Anger Management

Anger is a normal human emotion which can be very destructive if it is not managed appropriately. As well as the emotional effect of anger, there is a physiological effect caused by the release of hormones such as adrenalin that surge around the system. Often this is known as the “fight or flight” effect. In order to get rid of the anger, the body needs to do something about the physical effect and therefore this can lead to aggression or harm either to others, or to self.

Learning to identify situations or “triggers” which may invoke an anger response is an important step in dealing with anger. The ability to recognise early on when an individual is becoming angry (aroused) and learning to control the physiological response will enable them to control and manage effectively what could otherwise have been a conflict situation.

Treatment is available at:

Anorexia Nervosa

Anorexia Nervosa is characterised by an individual's struggle to maintain their weight at or above a minimally normal level. This struggle is associated with an intense fear of weight gain and a disturbance in the way they perceive their weight and shape, eg. unable to identify the seriousness of low weight and the consequences it may have. Anorexia has many impacts on physical health - one of these is the absence of at least three consecutive cycles in females (amenorrhea).

There are two main types of Anorexia Nervosa - these are restricting and binge-eating/purging type. The restricting type is characterised by a lack of regularly binge-eating or vomiting, misusing laxatives, diuretics or enemas. Instead this type primarily involves fasting/starvation and over exercise. The binge-eating/purging type is characterised by regular binge-eating or vomiting, misuse of laxatives, diuretics or enemas.

Treatment is available at:

Anxiety

Anxiety problems and disorders usually happen as a result of a person misinterpreting perfectly normal bodily responses to stressful situations. When these problems start to interfere with your normal daily life then you may need some help to get things back into perspective. If you are worrying a lot of the time, having difficulty in sleeping or feeling sick with worry then that's the time to start looking for help. Anxiety also commonly exists as a part of depression.

Panic attacks

When you start to misinterpret normal responses to stressful situations as life-threatening this, in turn, causes the normal symptoms of anxiety to intensify and become even more frightening. Choking, dizziness, chest pain or breathlessness may occur together with feeling completely out of control and a need to escape from the situation at all costs. No one ever died from a panic attack, but it doesn't feel that way when you are having one.

Phobic anxiety

When your fear of an object or situation is way out of proportion to the actual danger presented by it, then this may be described as a phobia. Symptoms range from unease and discomfort to absolute terror. No amount of encouragement or rationalising from friends and family seems to make any difference.

Treatment is available at:

Assertiveness

Assertiveness describes a way of communicating with other people that is healthy. People who are unable to be assertive have problems communicating, be it with friends or family, or in a social situation such as at work. They may also find it difficult to receive both criticism and compliments. Difficulties with situations like this leads to a lack of self-confidence and low self-esteem.

Cognitive behavioural therapy is widely recognised as a useful therapy for helping people who have low self-esteem to become more assertive. This is because it teaches the person how to change long-standing feelings and unhelpful feelings and behaviour patterns. Assertiveness training groups use real and imagined scenarios and role play to allow individuals to practise using new communication skills in a safe environment.

Treatment is available at:

Attention Deficit Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder is a cluster of symptoms characterised by a short attention span resulting in poor concentration, impulsivity and hyperactivity.

The three main symptoms are:

Inattention
Impulsivity
Hyperactivity

There are three main types of ADHD:

Combined type ADHD – Signs of both hyperactivity and inattention.
Predominantly hyperactive-impulsive type ADHD – More significant problems with hyperactivity and impulsivity.
Predominantly inattentive type ADHD – Mainly problems with inattention and fewer problems with hyperactivity and impulsivity.

Diagnosis on ADHD should not be made exclusively on ratings, scales, questionnaires or tests. Evaluation should be designed to answer three questions:

DSM-IV criteria present and causing impairment
Have some incidents been present before adulthood?
Are there any alternative explanations for presence of ADHD like symptoms?

How is it treated?

Although there is no cure for ADHD, treatment can help control symptoms.

Education for the patient and family about symptoms and how these impact on their lives and other’s. Academic counselling and / or educational accommodation can be offered.
Medication such as Ritalin and Concerta are both effective in controlling symptoms in children, however; studies show that improvement is more significant when medication is coupled with CBT.
Lifestyle Changes can be implemented. Effective strategies for time management, organisation and structure are beneficial, as well as improved health habits, such as healthy eating, sleep and exercise.
Family Therapy can help the family to understand the ADHD patient, therefore providing more support. This will in turn improve the quality of the family relationship.

Treatment is available at:

Back Pain

Some people find it hard to talk about their feelings or express emotions in any way. These people still face the stresses and strains of everyday life and are as much at risk of an emotional illness as any of us. Since they do not operate on an emotional level their symptoms will often be somatised - that is expressed as physical problems - commonly back pain.

Treatment is available at:

Bereavement

Everyone will experience sadness or grief at some time in their lives. Grief is a process that always occurs after loss, be it loss of a relative or friend through death, or loss of a relationship when it breaks down. There are several stages: an initial period of numbness lasting from hours to a couple of weeks, which gives way to a mixture of sadness, anger, bewilderment, hopelessness and yearning. Over an extended period of time this reaction gradually moves on to acceptance of the loss.

Feeling sad is just as natural as being happy. In times of difficulty, it is more healthy to allow yourself to feel sad than to pretend nothing has happened. Many people are brought up to 'pull themselves together' and get on with their lives; this can make it difficult for them to show their feelings, to cry or to ask for help. If you're coping with a loss, you will need people to help you confront your fears of the unknown. It is important you're able to share your grief with a close friend, a family member or, if necessary, a trained counsellor.

Treatment is available at:

Bi-polar Affective Disorder

Bi-polar Affective Disorder is a mood disorder often known as manic depression. Sufferers undergo marked mood swings which are much more significant than those that most members of the population experience. These extremes range from very low, incorporating periods of deep depression, to very high, when the individual is elated and manic. The number of episodes of these moods and the nature of them range from person to person. Some people will have only one or two short episodes and then never be unwell again, whereas a very small proportion persistently experiences the symptoms of depression or mania or flit quickly from one extreme to the other. The average is nine episodes of mood disturbance over a lifetime.

Depressive episodes are treated in the same way as other episodes of depression. This includes psychological therapy and use of antidepressant medication. Episodes of mania are usually treated with antipsychotic medication. In very acute cases sufferers may need to be admitted to hospital in order to be treated.

Often, during acute episodes of illness, mood-stabilising medications are used. These are also used for longer-term preventive therapy, the aim of which is to prevent relapses. The most widely used example is lithium.

Treatment is available at:

Body Dysmorphic Disorder

Individuals with Body Dysmorphic Disorder (BDD) have a preoccupation with an imagined defect in appearance (eg. a large nose). This preoccupation results in extreme emotional distress and has an impact on everyday life in school, work, home or other important life functions. It is common that individuals with BDD attempt to correct these perceived malformations through eg. cosmetic surgery or dermatological treatments. Individuals with BDD-like symptoms can also suffer with an eating disorder or other psychological problems such as anxiety disorders.

BDD is linked to obsessive compulsive disorders, as sufferers may engage in compulsively checking their appearance, or avoiding mirrors and obsessively thinking about their appearance. In severe cases, the sufferer can become house-bound, or suicidal.

Cognitive Behavioural Therapy with exposure therapy has been found to be effective, coupled with the use of antidepressants to increase the serotonin levels in the brain. However, as the sufferer becomes more chronically unwell over time, early treatment is linked to a greater recovery rate.

Treatment is available at:

Borderline Personality Disorder/Self Harm

Characterised by mood instability and poor self-image.
Constant mood swings and bouts of anger.
Often victims will take their anger out on themselves, causing injury to their own body.
Impulsivity in at least 2 areas that are potentially self-damaging (e.g. spending, sex, drug/alcohol misuse, reckless driving, binge eating).
Think in very black and white terms, and often form intense, conflict-ridden relationships.
Treatment involves therapy in which the patient learns to talk through his/her feelings rather than unleashing them in destructive and self-defeating ways.

Treatment is available at:

Cygnet Hospital Ealing

Bulimia Nervosa

Bulimia Nervosa is characterised by binge eating. Binge eating involves eating in a discreet period of time (eg. 2 hours) that is more food than most people would eat in a similar time and circumstances. In addition, people often feel that they cannot stop eating or control what or how much they are eating during this time. Individuals with Bulimia then try and prevent weight gain following these episodes, using strategies such as vomiting, misusing laxatives, diuretics, enemas, fasting or excessive exercise. This binge eating and using of different strategies to cope will occur at least twice a week for three months. Individuals with Bulimia unduly evaluate themselves according to their body shape and weight. Bulimia can occur in individuals at normal body weight and during episodes of anorexia.

There are two main types of Bulimia Nervosa - these are purging and non-purging type. The purging type is characterised by regularly inducing vomiting or misusing laxatives, diuretics or enemas. The non-purging type is characterised by using strategies such as fasting or excessive exercise. Use of vomiting, misuse of laxatives, diuretics and enemas are not regular.

Treatment is available at:

Burning Mouth Syndrome

Burning Mouth Syndrome is characterised by a burning sensation in the tongue or other oral sites, usually in the absence of clinical and laboratory findings. Affected patients often present with multiple oral complaints are reported more often in women, especially after menopause. Typically, patients awaken without pain but note increasing symptoms through the day and into the evening. Conditions that have been reported in association with Burning Mouth Syndrome include chronic anxiety or depression, various nutritional deficiencies, Type 2 diabetes and changes in salivary function. Given in low dosages, benzodiazepines, tricyclic antidepressants or anticonvulsants may be effective in patients with Burning Mouth Syndrome.Treatment is available at:

Chronic Fatigue Syndrome

Chronic Fatigue Syndrome (CFS) is a condition that causes fatigue severe enough to interfere with a person's normal life. The main features are an overwhelming feeling of fatigue that follows any form of physical exertion along with problems involving memory and concentration. There are clear links with clinical depression, but the main focus of symptoms is physical rather than psychological. Some common symptoms are;

muscle pain / twitching
joint pain often without swelling or tenderness
flu-like symptoms
headaches/migraine
balance problems
unrefreshing sleep pattern
sore throats
glands enlarged
intolerance of extremes in temperature
intolerance of alcohol
low blood pressure
sensitivity to bright lights
sensitivity to loud noises

Treatment is available at:

Dementia

Dementia is a term used to describe various different brain disorders that have in common a loss of brain function that is usually progressive and eventually severe. There are over 100 different types of dementia. The most common are vascular dementia, Alzheimer’s disease and dementia with Lewy bodies.

Symptoms of dementia include loss of memory, confusion and problems with speech and understanding.

The Alzheimer's Society estimates that there are currently over 750,000 people in the UK with dementia.

Vascular disease

This is a common cause of memory loss or dementia in older people. It is due to furring up of the arteries supplying the brain leading to very small stokes that can cause progressive brain damage.

Alzheimer's disease

This one of the most common cause of dementia. During the course of the disease, the chemistry and structure of the brain changes, leading to the death of brain cells.

Dementia with Lewy bodies

This form of dementia gets its name from tiny spherical structures that develop inside nerve cells. Their presence in the brain leads to the degeneration of brain tissue. Memory, concentration and language skills are affected.

Mild cognitive impairment

Mild cognitive impairment (MCI) is a relatively recent term, used to describe people who have some problems with their memory but do not actually have dementia.

Depression

Clinical depression/depressive illness is quite different to feeling a bit low on a Monday morning. It is a serious, often life-threatening illness with clear physical symptoms. Imbalances in your brain chemistry (neurotransmitters) can result from life stresses being too great for your own coping resources. Treatment usually involves a combination of antidepressant medication and therapy to help you change the way you manage your daily life stresses.

Post-natal depression

Following the birth of a child many mums experience ‘baby blues’. Usually this comprises moodiness, sadness and tearfulness which, though unpleasant, do not require treatment. For some mothers the experience is much worse and they may experience a whole range of depressive symptoms, which may put their own life or the life of their child at risk.

Bi-polar disorder/Manic depression

Someone diagnosed with bipolar disorder (manic depression) may experience dramatic mood swings between deep depression and overactivity/overexcited behaviour known as mania. Between these severe highs and lows there may be relatively stable times.

Some people also suffer hallucinations (seeing, tasting, smelling or hearing things that other people cannot) or delusions (believing things about themselves, other people or the World that are outside reality as most people experience it).

Everybody has their ups and downs in daily life, but in manic depression these changes are extreme. During the manic phase, people may feel euphoric, full of a sense of their own importance and brimming with ambitious schemes and ideas. They may spend money extravagantly, and build up debts. They may eat and sleep very little, and talk so quickly that it's difficult to understand them. They may become easily frustrated, irritated and angry.

During a manic phase the sufferer may be quite unaware of the havoc around them. In a depressed phase they may be overwhelmed with guilt, hopelessness and sadness. The risk of suicide and self-harm is often very high.

Treatment is available at:

Eating Disorders Not Otherwise Specified (EDNOS)

EDNOS are disorders of eating that do not meet the criteria of any specific eating disorder. These may include:

all the criteria for Aneroxia Nervosa met but individuals have regular menses;
all the criteria for Anorexia Nervosa met except that despite significant weight loss the current weight is in normal range;
all the critera for Bulimia Nervosa met but binge eating and strategies to compensate for this are less often than twice a week or for less than 3 months;
regular use of compensatory strategies by an individual at normal weight after eating small amounts of food, eg. vomiting after eating two biscuits;
repeatedly chewing and spitting out but not swallowing large amounts of food;
Binge Eating Disorder (BED): episodes of binge eating without using strategies to compensate that characteristic of Bulimia Nervosa.

Treatment is available at:

Epilepsy

Epilepsy is a general term used for a group of disorders that cause disturbances in electrical signalling in the brain. The cause can be illness, brain damage, or abnormal development of the brain. No cause can be determined for about three-quarters of the cases of epilepsy. People with a history of epilepsy appear to be at an increased risk of developing schizophrenia or schizophrenia-like psychosis. The researchers found that people with a history of epilepsy were around 2.5 times more likely to develop schizophrenia and 3.0 times more likely to develop schizophrenia-like psychosis than the general population. Depression is common in patients with epilepsy, and its occurrence could affect seizure control and treatment compliance. Also major depression and attempted suicide independently increase the risk of unprovoked seizure. Gender Identity Disorders

A person with a gender identity disorder is someone who identifies with the opposite sex and may believe that they are a member of the other sex trapped in the wrong body. There is usually persistent discomfort about the assigned sex and a sense of inappropriateness in the gender role of that sex. This can cause problems in many social settings and in many cases adults with these disorders prefer to be seen in public as a member of the other sex.

Psychological therapy is thought to be the best approach to helping with gender identity disorder. The initial focus of the treatment is usually to help the individual function in their biological sex role as well as possible. Individual and family counselling is recommended for children, individual and couples therapy for adults.

Treatment is available at:

Gender Identity Disorders

Treatment is available at:

Headache

Headache is pain in one or more parts of the head or back of the neck. The pain can be mild to severe. Although annoying and painful most headaches do not indicate serious illness. A number of causes have been identified and they fall into two general categories.

Tension Headache - results from contraction of head and neck muscles. It is the most common form of headaches. The pain is in the generalised area of the head and neck, or it might be in the back of the head and neck and feel light a tight band. It is not discriminatory of sex or age but is most common in adults and adolescents. If treated in time it will last for a short duration.

Migraine Headache – occur when blood vessels of the head and neck constrict, resulting in a decrease in blood flow to the vessels. It is a throbbing pain on one side of the head, with a feeling of nausea and a sensitivity to light and sound. It can be accompanied by vomiting, visual disturbances and vertigo like feelings. Usually lasts from a few hours to one or two days in severe cases.

Huntingdon's Disease

Huntingdon's disease is a genetic disorder that causes the degeneration of neurons in the brain. It is a degenerative disorder. At the beginning of the disease sufferers may become irritable, experience mood swings, become depressed, have trouble remembering things and have difficulty performing everyday tasks, such as driving.

A person with Huntingdon's disease may have uncontrollable movements and experience deterioration in their intellectual capabilities. As the disease progresses any intellectual activity becomes difficult and they may be unable to feed themselves and swallow. There are many medications that may help the symptoms of the disease but at this time there is no cure.

Treatment is available at:

Hypochondria

Hypochondria is a disorder in which the sufferer has the unfounded belief that they are suffering from a serious illness. Often this is characterised by irrational fears of dying, obsessions over minor bodily symptoms, doubt over doctors’ diagnoses and preoccupation with the body and self-examination. Hypochondria is associated with depression and obsessive compulsive disorder and can also cause anxiety or panic attacks.

There is some evidence that severe hypochondria can be alleviated using cognitive behavioural therapy and in some cases antidepressant medication.

Treatment is available at:

Hypomania

Hypomania shares symptoms and characteristics with the mania aspects of manic depression (link to bi-polar disorder) but to a less severe degree. Hypomanic episodes do not result in hospitalisation unless they move into being defined as manic episodes, which have a more marked effect on social functioning and relationships with those around the sufferer.

Symptoms of hypomania include for example:

Needing less sleep than normal
Increased activity
Decreased attention span and darting from one task to another
Euphoric mood and excitability which can lead to irritability and intolerance after a few days
Feeling full of ideas and creativity

The treatment for hypomania is similar to that for mania – talking therapies such as cognitive behavioural therapy are very effective, although in some cases medication, usually mood stabilisers, is necessary. Most people who have suffered from a hypomanic episode in the past are able to recognise when one might be approaching and can try to prevent it. In these situations it is helpful to try and promote a feeling of calm, so avoid using stimulants such as caffeine, and get plenty of sleep.

Sometimes hypomania is caused by an overactive thyroid, which means that the metabolic rate is too high. This can be easily treated with medication.

Treatment is available at:

Hypothyroidism

Hypothyroidism is caused by a lack of the hormone Thyroxine. It is a common condition with 1 in 500 women and 1 in 1000 men suffering from it. Thyroxine is made in the thyroid gland in the neck and helps keep the metabolic system (the body's functions) normal. Thyroxine is needed by many cells and tissues in the body. An under active thyroid gland can affect our mood and personality in a number of ways including making us feel lethargic, tired, weepy and depressed. People with an underactive thyroid may feel mentally "slow". Hypothyroidism is easily detected by routine blood tests and easily treated by supplementing Thyroxine in the body by taking Levothyroxine tablets.

Treatment is available at:

Irritable Bowel Syndrome (IBS)

Irritable Bowel Syndrome is a disorder which manifests in the intestines. It causes a great deal of discomfort with symptoms of bloating, abdominal pain, constipation and diarrohea. However symptoms can vary from person to person. Although it does not cause any permanent harm or lead to a more severe condition such as cancer it is very distressing for the individual and can seriously affect their quality of life. It can also be very disabling for some people where they are unable to work, socialise or travel. Symptoms can be controlled with prescribed medication, change in diet and keeping stress levels under control.

Kleptomania

Kleptomania involves a failure to resist impulses to steal items that are not needed or sought for personal use or monetary value. Kleptomania should be distinguished from shoplifting, in which the action is usually well-planned and motivated by need or monetary gain. Some clinicians view kleptomania as part of the obsessive-compulsive spectrum of disorders, reasoning that many individuals experience the impulse to steal as an alien, unwanted intrusion into their mental state. Other evidence suggests that kleptomania may be related to, or a variant of, mood disorders, such as depression. The main diagnostic features are:

The person repeatedly yields to the impulse to steal objects that are needed neither for personal use nor for their monetary worth.
Just before the theft, the person experiences increasing tension.
At the time of theft, the person feels gratification, pleasure or relief.
These thefts are committed neither out of anger or revenge nor in response to delusions or hallucinations.

Treatment is available at:

Korsakov's Syndrome

The Wernicke-Korsakov syndrome is a brain disorder caused by a deficiency of thiamine (vitamin B1). This is often due to prolonged heavy drinking, but can also be a consequence of severe malnutrition, starvation or excessive and prolonged vomiting.

The primary stage, known as Wernicke’s Encephalopathy, is characterised by the following symptoms:

Confusion about time and place
Drowsiness
Poor balance
Double vision
Abnormal eye movements or paralysis of eye muscles

Not all of these symptoms may be present, leaving the condition to go unrecognised, which can have lethal consequences. At this stage the sufferer may be treated by giving vitamin B1.

If untreated, the condition may proceed to the secondary stage, known as Korakov’s Psychosis. This is characterised by the following symptoms:

Loss of memory, particularly short term memory
Loss of spontaneity and initiative
Presenting inaccurate accounts of recent events
These symptoms may be permanent.

Treatment is available at:

Memory Assessments

Memory assessments are valid and reliable tools that determine either the individual’s ability to process information (cognitive), or the extent of impairment to a particular skill, relative to the brain area concerned, which often incorporates the use of neuroimaging techniques (neuropsychological).

Their purpose is to identify individual difficulties and progressive problems of memory functioning, to direct strategies that help the person compensate. There are several levels and dimensions to Human memory (see below), and these might be classified by duration, information type, and temporal direction (retrospective or prospective). Currently, there are many associated memory assessments utilised in clinical settings, the most common in general psychiatric settings are those assessing IQ, which account for more than one memory domain solely.

Episodic memory – The storage of experiences, facts, and concepts
Semantic memory – The storage of linguistic meanings we have for things in our world such as objects, abstracts, and animals etc.
Working memory - Temporarily storing and manipulating information often for problem-solving activities, i.e. a game of chess
Visual short-term memory – A temporary record of visual stimuli that can last for several seconds.
Iconic memory - A temporary record of visual stimuli that can last an average of 1000 Ms.

Treatment is available at:

Munchausen Syndrome

Munchausen syndrome is a form of psychological disorder. As of yet there are no recognised causes for this, but it has been proven to be common among families where at least one of the family members suffers from chronic illnesses such as manic depression.

Munchausen is described as a factitious disorder in which sufferers fake disease, exaggerate, or create symptoms of illnesses in order to gain investigation, treatment, attention, sympathy, and comfort from the medical profession. It is commonly diagnosed when the sufferer fakes so many illnesses it begins to interfere with their everyday life. The role of "patient" is a familiar and comforting one, and it fills a psychological need in people with Munchausen's.

Munchausen was first recognised in 1951 by Sir Richard Asher. Sir Richard Asher came across a patient who continually faked symptoms and remembered back to Baron Munchhausen,1720-1797, who along side Rudolf Raspe wrote a series of fantastically impossible tales, and with this is mind named the illness Muncheasun Syndrome.

There is also a disorder of a similar name known as Munchausen Syndrome by Proxy. This is where an adult (usually a parent or care giver to a child ) fakes illness, symptoms or diseases in a child in their care, again for the same benefit as Munchausen.

Treatment is available at:

Obsessive Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a relatively rare disorder. OCD can be more likely in people suffering from depression although even in these circumstances it remains rare.

The symptoms are a little different from other anxiety disorders and include:

Obsessional thoughts, for example: fear of dirt or germs, doubting that something such as turning the oven off has been done, or unpleasant and graphic images in the mind of harming others or themselves.
Compulsive or obsessional acts are repetitive actions based on the obsessional thoughts. A person with obsessional thoughts about dirt may spend long periods cleaning the house and washing their hands. These actions are not pleasurable, but they help to reduce the anxiety associated with the obsessional thoughts. The compulsive actions often have a 'magical quality', eg a person must turn all the oven dials off exactly five times. If they lose count, they may start all over again. In severe cases, sufferers may spend many hours of the day undertaking these acts so that they have no time for anything else.

Treatment of OCD may require replacement of maladaptive patterns of behaviour with more “normalised” / adaptive routines, whilst managing the anxiety symptoms resulting from this. This may involve the use of medication, learning new coping skills and anxiety management using a cognitive behavioural therapy approach

Treatment is available at:

Personality Disorders

Persistent chronic psychological disorders

Characterised by long-lasting rigid patterns of thoughts and behaviour.
Mild to more severe in terms of how persistent and to what extent a person exhibits the features of a particular personality disorder.
During times of increased stress or external pressures, the symptoms of the personality disorder will gain strength and begin to seriously interfere with their emotional and psychological functioning.
Conflicts with other people and vice-versa.
To be diagnosed as a personality disorder, a behaviour pattern must cause significant distress or impairment in personal, social, and/or occupational situations.

Avoidant Personality Disorder

Characterised by extreme social anxiety.
Often feel inadequate, avoid social situation, and seek out jobs with little contact with others.
Fearful of being rejected and worry about embarrassing themselves in front of the others.
Often they will create fantasy worlds to substitute for the real one.
They are frequently depressed and have low self-confidence.

Borderline Personality Disorder

Characterised by mood instability and poor self-image.
Constant mood swings and bouts of anger.
Often they will take their anger out on themselves, causing injury to their own body.
Impulsivity in at least 2 areas that are potentially self-damaging (e.g. spending, sex, drug/alcohol misuse, reckless driving, binge eating).
Think in very black and white terms, and often form intense, conflict-ridden relationships.
Treatment involves therapy in which the patient learns to talk through his/her feelings rather than unleashing them in destructive and self-defeating ways.

Dependent Personality Disorder

Characterised by a need to be taken care of.
Tend to cling to people and fear losing them.
May become suicidal when a break-up is imminent.
Tend to let others make important decisions for them and often jump from relationship to another.
Often remain in abusive relationship.
Over-sensitivity to disapproval is common.
Often feel helpless and depressed.
Psychotherapy is the best option for treatment.

Histrionic Personality Disorder

Constant attention seekers.
Need to be the centre of attention all the time, often interrupting others in order to dominate the conversation.
May dress provocatively or exaggerate illnesses in order to gain attention.
Manipulative.
Tend to exaggerate friendships and relationships, believing that everyone loves them.
Treatment most often focuses on increasing coping skills and interpersonal relationships skills through psychotherapy.

Narcissistic Personality Disorders

Characterised by self-centeredness.
Seek attention and praise.
Exaggerate their achievements, expecting others to recognise them as being superior.
Tend to be choosy about picking friends, since they believe that not just anyone is worthy of being their friend.
Tend to make good first impressions, yet have difficulty maintaining long-lasting relationships.
Generally uninterested in the feeling of others and may take advantage of them.
Grandiose sense of self-importance.
Lack of empathy.
Obsessed with fantasies of fame, power or beauty

Treatment is available at:

Pain Management

Chronic pain is very distressing to the person concerned and to their carers and affects one's quality of life. There can be many reasons why someone suffers from chronic pain and are usually due to external injury or internal disease and invariably this leads to emotional problems such as anxiety and depression.

Thankfully, there are constantly new approaches being developed and there are some simple things you can do to help such as:

take medicines as prescibed by your GP;
take part in pleasant distracting activities;
learn relaxation skills;
express your emotions in a healthy way;
learn specific exercises where appropriate.

Treatment is available at:

Paranoia

A type of suspicious thinking in which you think that people are making negative comments about you, are following or observing you and, in its extreme belief, there is a conspiracy to cause you harm.

One recent study found that one in three people regularly suffer bouts of paranoia or suspicious fears. As we live in an increasingly competitive and insecure society these results are not surprising.

Most treatment approaches will involve a Cognitive Therapy approach, some social skills training and relaxation skills.

Treatment is available at:

Phobias (Agoraphobia, Social Phobia, Specific Isolated Phobia)

A phobia is a fear that is out of proportion to the situation that causes it and cannot be explained away. The sufferer will often try to avoid the feared situation, as this will help to reduce the anxiety. They are common in the general population but are generally only severe enough to be disabling in a small number of people. Phobias can arise towards many kinds of things or situations. Some are logical from an evolutionary point of view, as they represent a fear of something that would bring danger, such as heights. In other instances, a phobia arise via association, for example having an accident while on holiday in France may lead to a fear of France itself, or of holidays, or of the situation that caused the accident.

Agoraphobia: an intense fear of leaving the home, being in crowded spaces, travelling on public transport and being in any place that is difficult to leave. It commonly occurs with panic attacks. The person may have a panic attack when outside the home and this reinforces the belief that it is safer to stay inside.
Social Phobia: a fear of social interaction with others, talking to people, eating, drinking and speaking in public. Many people have a mixture of both agoraphobia and social phobia. Social phobia is also a common symptom of depression.
Specific Isolated Phobia: these are phobias that are restricted to highly specific circumstances such as proximity to a type of animal, such as a cat, or to exams, or dentists etc. Phobias are as unique as individual people are.

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Post Natal Depression

Postnatal depression (PND) is a depressive illness that occurs after having a baby. It is common for women following childbirth to experience a period of 'low' mood. This can range in severity from a mild and normal period of mood disturbance ('baby blues'), through to PND and the most severe and rarest problem (postnatal psychosis).

Post Traumatic Stress Disorder

Post-Traumatic Stress Disorder is a psychological and physical condition that can be caused by extremely frightening or distressing events.

PTSD can occur after experiencing or witnessing traumatic events such as military combat, natural disasters, serious accidents, terrorist attacks, violent deaths, personal assaults including rape, and other situations in which the person felt extreme fear, horror or helplessness.

PTSD can affect anyone. It is common, and affects around 5% of men and 10% of women some time in their life. It can happen at any age, including in childhood. An individual with PTSD often relives the experience through nightmares and flashbacks, has problems with concentrating and sleeping, with feelings of isolation and detachment from life. These symptoms can be lasting and severe enough to significantly impair the person’s daily life.

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Psychosis

Psychosis is a mental state in which thought and perception are severely impaired. Individuals that experience a psychotic episode may experience hallucinations, hold delusional beliefs, demonstrate personality changes and exhibit disorganised thinking. This can be accompanied by a lack of insight, difficulties with social interaction and impairments in carrying out daily living activities. A psychotic episode can be described as “a loss of contact with reality”.Psychosis is a mental state in which thought and perception are severely impaired. Individuals that experience a psychotic episode may experience hallucinations, hold delusional beliefs, demonstrate personality changes and exhibit disorganised thinking. This can be accompanied by a lack of insight, difficulties with social interaction and impairments in carrying out daily living activities. A psychotic episode can be described as “a loss of contact with reality”.

The treatment of psychosis will depend upon what associated diagnosis may be present. However, the first line of treatment for psychotic symptoms is usually antipsychotic medication, and in some cases hospitalisation. Cognitive behavioural therapy can also be effective in managing the psychotic symptoms.

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Seasonal Affective Disorder (SAD)

Seasonal Affective Disorder is also known as the winter depression. The onset is usually September/October and continuing until March or April. It is caused by a biochemical imbalance in the brain due to shorter daylight hours and a lack of sunlight in the winter months. Some of the symptoms include

Sleep disturbances
Lethargy
Anxiety
Low mood
Weight gain
Lack of concentration
Lack of motivation
Feelings of worthlessness and uselessness

Light Therapy has proved to be very successful in treatment of SAD. Specially designed light boxes with a minimum dose of 2500 lux are usually used to treat SAD.

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Schizophrenia

Forget Dr Jekyll and Mr Hyde, when someone suffers from Schizophrenia it does not mean they have a "split" personality. People with Schizophrenia suffer from changes in their personalities, they may see, hear, feel, smell or taste things that aren't really there (hallucinations). They may become very paranoid, anxious and frightened. They may believe that people are not who they say they are and often view themselves, the World, other people and the Future in a different way from most other people(delusions). They may become very suspicious of family and friends, people who they are very close to, not just strangers.

No-one actually knows categorically what causes Schizophrenia, but there are clear links to stress levels and trauma. It may also be linked to changes in brain chemistry, reactions to environmental factors and genetic or family factors. It is likely that a combination of many different components is involved.

The symptoms of schizophrenia are treated with medicines (usually antipsychotics) and other therapeutic interventions(talking and occupational therapies)

Unfortunately, at this time, there is no cure for Schizophrenia, but most people who suffer from it are able to manage the symptoms effectively and lead a productive and useful life.

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Sleep Disorders

Insomnia is a word which describes not enough sleep, or poor quality sleep. Reasons for Insomnia can be worrying about being able to fall asleep, overuse of alcohol/stimulants/caffeine, napping, erratic sleep habits, stress/anxiety/depression, chronic pain, experiencing life difficulties or life changes.

Hypersomnia is excessive sleepiness. It is a deep, or prolonged sleep period. It may also be difficult to wake up. The onset is gradual over a period of time. The individual may sleep up to twelve hours a night and also have frequent daytime naps. It can also be a symptom of major depression.

Some individuals may also develop symptoms of impulsive behaviour, depression, confusion, irritability or hallucinations.

Sleepwalking Disorder is where an individual will get out of bed and walk around during the night. The individual will usually have a blank stare on their face and will not communicate when spoken to. They seldom remember the details of the sleep walking when they wake up. During sleepwalking some people will go down stairs, eat a snack or even go outdoors. Children who sleepwalk usually grow out of it over a period of time. However, adults who sleepwalk can suffer for many years.

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Stress

Stress occurs as a result of an imbalance between our level of ability to cope and the demands placed upon us. Our level of ability to cope is the resources we have to cope with life demands i.e. Health, Skills, Experience, Beliefs, Emotional Make-up, Attitudes. The demands come from many areas of our everyday life i.e. Work, Family, Social, Financial, Change. It is similar to a set of weighing scales: on one side of scales is level of ability to cope and on the other side is the everyday life demands. If demands on you outweigh your personal coping strategies you will be out of balance and you can become stressed.

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Workplace Stress

Workplace stress is the harmful physical and emotional responses that can happen when there is a conflict between job demands on the employee and the amount of control an employee has over meeting these demands. In general, the combination of high demands in a job and a low amount of control over the situation can lead to stress.
Stress in the workplace can have many origins or come from one single event. It can impact on both employees and employers alike.

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