Dr Donna has compiled a collection of resources to give you a broad overview of some of the most common psychological conditions.
Serious Mental Illness
Serious mental illnesses such as psychotic disorders, schizophrenia and bi-polar illness can have severe impact on an individual and their family. Donna can assist you to manage your illness and teach you strategies to prolong your periods of wellness and to deal with your relapse when it happens. Psycho-education cognitive behaviour therapy will help you learn about ways to manage your illness and skills training, problems solving skills, and stress management are all methods of addressing the debilitating results of a relapse.
Schizophrenia is a condition characterised by disturbances in a person’s thoughts, perceptions, emotions and behaviour. It affects about 1% of people. More often than not the first onset occurs in adolescence or early adulthood. It is a complex disorder and no single symptom is unique to the disorder. However there are a number of symptoms that people often have in common:
- Disorganised speech
- Disorganised behaviour
- Negative symptoms – poor motivation, non-reactive responses
While schizophrenia can be a devastating illness for the people who experience it as well as for their families, it is important to recognise that there is hope. Treatments, both medical and psychosocial, are becoming more effective. A diagnosis of schizophrenia does not necessarily mean that a life long illness is inevitable. People do improve and recover. Research reports a range of outcomes varying from full recovery to severe and continuous incapacity.
Causes of schizophrenia
No single cause of schizophrenia has been identified; there are most likely to be several contributing factors.
Possible Contributing Factors:
The risk of developing schizophrenia is 1%. However a child of one parent who has schizophrenia has about a 10% chance of developing schizophrenia; if both parents have schizophrenia, the risk is increased to 40%.
Possible environmental factors include complications during pregnancy such as exposure to influenza in utero or poor nutrition during pregnancy. It has also been suggested that stress and trauma can lead to the emergence of schizophrenia.
The research in this area investigates the possibility that individuals who develop schizophrenia in early adult life have suffered some form of disorder in the development of their brain while in the womb.
Some research suggests that substance misuse is related to the development of schizophrenia. It is likely that substance misuse may worsen the symptoms and interfere in the treatment of a person with schizophrenia.
Certain biochemical imbalances in the brain are believed to be involved in the cause of schizophrenia. Neurotransmitters (the substances that allow communication between nerve cells) have long been thought to be involved in the development of schizophrenia.
Myths and facts around Schizophrenia
Myth: Schizophrenia is a split personality.
Fact: People with schizophrenia have only ONE personality. The word ‘schizophrenia’ comes from the Greek word meaning ‘split’ and this is perhaps where the confusion started. However, schizophrenia is a split from reality rather than a split in personality.
Myth: People who have schizophrenia are violent.
Fact: People who have schizophrenia are no more likely to be violent than any other group in the community. This myth is often exacerbated by the media. People with schizophrenia are much more likely to harm themselves than other people. Often violence is self-directed either through fear, delusional thinking or the decision to ‘no longer cope’ with the illness. It is fair to say that a person with schizophrenia has more to fear from the general community than the reverse, as they are often on the receiving end of severe stigmatisation, misunderstanding and outright discrimination.
Myth: People with schizophrenia have a lower than average intelligence.
Fact: People with schizophrenia do NOT have a lower than average intelligence level. As with any population, there is a variation, but this is not a characteristic of the illness.
People suffering from bipolar disorder suffer recurrent episodes of mood swings characterised by elevated mood and depression. The illness can range from mild to severe. In between the symptoms, people often experience normal moods when they can lead normal lives.
- Elevated mood. People feel ‘high’ and see the world as a fantastic place.
- Increased energy
- Reduced need for sleep
- Irritability. Usually when others disagree with their ‘way-out’ ideas.
- Rapid thinking and speech. Thoughts will be more rapid than usual or erratically jumping from topic to topic. People sometimes speak quickly.
- Overspending. Sufferers will sometimes spend excessive amounts of money often on items they do not need or without thought for the financial consequences.
- Reckless behaviour. Gambling, dangerous driving, promiscuity.
- Grandiose beliefs. Sufferers often feel they are special with considerable talent. They sometimes make grand plans to change the world.
- Lack of insight. People with Bipolar often fail to understand the inappropriateness of their behaviour.
- Depression. People with Bipolar often lose all interest and pleasure in life. They are unable to cope with their daily responsibilities, experience poor concentration and sleep, feelings of guilt and suffer an overwhelming sadness.
There is clear evidence that the disorder is caused by a combination of factors:
Genetics. Clear evidence indicates that the disorder is genetically transmitted.
Biochemical. The disorder is associated with a chemical imbalance in the brain.
Stress. Stress will often trigger the onset and will impact on any relapses.
Seasons. Highs are common in spring and lows in winter.
Depression & Anxiety
Many famous and successful Australians have suffered from depression and anxiety. These are very common illnesses, which affect 10% of Australian men and 20% of Australian women. You are not alone as a sufferer or as a carer of someone with depression or anxiety concerns. It is not a sign of weakness. A psychologist can assist you with counselling and choosing the best therapy for you.
Behaviour interventions including behaviour modification, exposure techniques, activity scheduling, and relaxation strategies have been shown to be most effective in managing depressive and anxiety symptoms. Another effective therapy for depression – interpersonal therapy – focuses on relationships, particularly in certain situations (such as when someone is going through a change in their social role, or a period of extreme grief).
Types of Depression
There are two categories of depression. They are major depression and dysthymia.
Major depression is characterised by a range of symptoms that last more than two weeks. Dysthymia is similar to major depression except the symptoms may not be as severe but they do last for a least a year.
Some people develop depression following a distressing situation such as relationship breakup or death of a loved one. At other times the cause of depression may be unclear.
Signs of Depression
These can differ in intensity but often include:
- Depressed or irritable mood
- Loss of pleasure or interest in most activities
- Disturbed sleep
- Changes in appetite
- Loss of energy
- Poor concentration
- Self-destructive thoughts.
There are many interrelated factors associated with depression:
Genetic. The tendency to develop depression runs in families.
Biochemical imbalance. Some types of depression are due to a chemical imbalance in the brain.
Stress. Stress at different stages of life, such as menopause or childbirth in women and retirement in men.
Personality. Certain personalities are more prone to depression. Perfectionists and those who are very dependent on others are susceptible to depression.
Learnt response.In some situations a person exposed to repeated losses and stress learns to feel helpless and depressed.
Types of Anxiety:
- Panic Disorder
- Obsessive Compulsive Disorder
- Generalised Anxiety Disorder
- Social Phobia
- Post Traumatic Stress Disorder
People with panic disorder have recurrent, unexpected panic attacks. These panic attacks are a period of intense fear or discomfort and consists of 4 or more of the symptoms listed below. Panic attacks have an abrupt onset and the symptoms peak within 10 minutes.
Panic symptoms include:
- trembling or shaking
- shortness of breath
- choking sensations
- chest pain or discomfort
- feeling detached from oneself
- fear of losing control or dying
- numbness or tingling
- chills or hot flushes
Some people with panic disorder will have recurrent, unexpected panic attacks. Other people may find that their panic attacks almost always occur when they are confronting or anticipating particular things or situations.
Obsessive Compulsive Disorder
Obsessive Compulsive Disorder (OCD) is an anxiety disorder made up of two parts –obsessions which are unwanted thoughts and compulsions which are repetitive actions to ease the obsessions.
If you suffer this condition you may be compelled to repeat certain actions (such as handwashing) or may be obsessed with thoughts and images that seem illogical but which you may find difficult to ignore. This disorder occurs in about 2% of the population and many people who suffer OCD manage to keep it a secret for many years. However, OCD often causes a great deal of stress and often impacts on the sufferer’s ability to function.
The most common obsessions are usually around contamination, violence, guilt and doubt. The thoughts occur constantly despite attempts to ignore or suppress them.
The most common compulsions include cleaning and checking behaviours which may be performed many times a day and may be very debilitating. Often a person suffering OCD also experiences anxiety or depression. In most cases this arises from the inability to cope with unwanted thoughts or actions.
What is the cause?
There are many theories to the cause of OCD but the actual cause is not yet clearly understood. There is some evidence that the disorder may run in families.
Generalised Anxiety Disorder
Generalised anxiety disorder (GAD) affects up to 12% of the population and is more common in women than men, with two thirds of sufferers being women.
People who have generalised anxiety disorder experience persistent and excessive worry. GAD sufferers worry excessively about real life situations such as: finances, the health of family members, housework, being late for appointments and losing one’s job. Children tend to worry about their academic performance and/or sporting prowess or natural or manmade disasters (e.g. September 11).
Their worry is so that great that they experience symptoms such as:
- restlessness or edginess
- impaired concentration
- muscle tension
- disturbed sleep
People who have social anxiety are worried that they will be negatively evaluated or judged by others. Therefore, sufferers are concerned that they will do something to embarrass or humiliate themselves when in social or performance situations. When sufferers anticipate a feared social or performance situation they may experience physical symptoms of anxiety.
- heart palpitations
- blurred vision
- trembling and nausea.
Sufferers of social anxiety either endure feared social situations under considerable psychological and physical distress or avoid them. Feared social situations include:
- speaking to authority figures
- initiating or maintaining conversations
- attending parties
- eating or drinking in public
- using public toilets
- public speaking
- job interviews
- performing ( e.g. singing, acting, playing an instrument or sport)
The Causes of Anxiety Disorders
There are several factors that can contribute to an anxiety disorder:
Stress Overload/Lifestyle Factors
We all know what anger is, and we’ve all felt it: whether as a fleeting annoyance or as full-fledged rage. Anger is a normal, healthy, human emotion. But when it gets out of control and turns destructive, it can lead to problems; problems at work, in personal relationships, and in the overall quality of your life. If you feel as though you’re at the mercy of unpredictable and powerful emotions, if your anger is really out of control and impacting on important parts of your life, you might want to consider anger management counselling. The goal of anger management is to reduce both your emotional feelings and the physiological arousal caused by anger in order to help you learn to control your reactions. A psychologist will work with you in developing a range of techniques for changing your thinking and behaviour. You will develop a variety of life skills, including social skills, assertiveness, problem solving skills, relaxation, and managing crises.
Anger management may be for you:
- Do you lose your temper often or you dwell on things?
- Do you feel guilt or shame about your behaviour to others?
- Have you hurt loved ones because of your behaviour?
- Are you dealing with a violent or angry partner?
- Do you destroy your own or other people’s property?
- Do you bully or threaten others?
- Do you get into physical fights?
If you say YES to any of these questions you will benefit from anger management.
Understanding and Recovering from Post Traumatic Stress Disorder
Post Traumatic Stress Disorder (PTSD) can be a debilitating disorder that may affect not only an individual’s life but also the lives of family and friends. The disorder may emerge following exposure, either directly or indirectly, to a distressing situation such as witnessing a death, natural disaster, suffering or witnessing abuse, accidents, etc.
PTSD symptoms can begin to be experienced 3 months after a distressing event; however, the symptoms sometimes does not emerge until later in a person’s life. This is called delayed onset and can be overwhelming as the symptoms may occur seemingly at random.
The symptoms of PTSD include:
- Intrusive experiences, consisting of a sense of reliving the event in visual images (or thoughts and nightmares) with physiological responses, sounds and smells, all of which occur with the same intense feeling of panic and fear as experienced in the original event. Any reminder of the event triggers these intrusive experiences at any time resulting in a sense of lack of control. These experiences often feel disorganised, fragmented and confusing. An inability to place the event in a sequential time line, or to remember elements of the event at all, often occurs and causes both distress and frustration.
- Avoidance of thoughts and feelings, or people, places and things related to the event or directly associated with the traumatic event. Avoidance may not only result in an increase in symptoms, it often results in a diminished interest in participating in activities leading to withdrawal and feelings of detachment and estrangement from others.
- Altered thoughts and moods, including low self-esteem, blaming oneself, frequent feelings of fear, guilt and shame, feeling of fear and danger, loss of interest in things, and a restricted range of emotions (or feeling numb). Inability to remember all or parts of the event is common.
- Increased arousal, such as irritability, self-destructive acts (reckless behaviour), lack of concentration, being constantly vigilant for danger, a high startle response (feeling very “jumpy”), lack of concentration and difficulties sleeping. Distress and physiological arousal (eg. pounding heart, increased breathing rate) when exposed to reminders of the event.
Therapy for PTSD
Eye Movement Desensitisation and Reprocessing Therapy, or EMDR, has been proven to be one of the most effective treatments for PTSD. Trauma Focussed CBT and Exposure Therapy are also proven effective therapeutic models. EMDR has been verified as an effective treatment for PTSD and meets criteria for evidence-based practice in the UK by the National Institute for Clinical Excellence (2005), in Australia by the Australian Centre for Posttraumatic Mental Health (2013).
EMDR involves pulling together emotions, physical sensations, thoughts and beliefs associated with the individual’s trauma. Desensitisation begins with the individual’s attention being directed to the chosen target memory, negative beliefs, and body sensations, while following with their eyes the therapist fingers moving from side to side. Following a set of eye movements the therapist asks the client to report what they notice now; they are then asked to either focus on what had emerged, on a body sensation or their level of distress. When distress has reduced to 0 or 1 (on a scale of 10) a preferred positive belief statement is installed with more sets of eye movements, until the positive statement is rated as highly believable. Any residual sensations are then desensitised with eye movements until there are no longer present.
Psychology.org Tip Sheets – Psychology.org has a wide range of tip sheets available to download.
Depression, Anxiety and Bipolar Disorder
Mental Health Emergency?
Call Lifeline on 13 11 14 (24 hour service)
Call the Crisis Assessment and Treatment Team (CATT) Mental Health Service on 1800 629 354 (24 hour service)
Phone the Ambulance Service – 000
Visit your local hospital emergency department
Call your local GP
Lifeline – 13 11 14
Kids Helpline – 13 11 14
Beyond Blue – 1300 22 4636