Each year approximately 20% of people are affected by a mental illness.
The most common problems suffered are depression, anxiety disorders, obsessive-compulsive
disorders and psychoses (such as schizophrenia and bipolar disorder). These conditions are all
largely out of the control of the patient and are a disease state, as is, for example, diabetes. Mental
illnesses are due to an alteration in brain neurotransmitters (for example, serotonin and dopamine)
and these facts form the basis of treatment with medications.
There is also a strong hereditary component involved and environmental triggers, such as significant
life stresses, are frequently a precipitant of episodes of mental illness.
Importantly, the results from using medication will always be maximised if the patient also has
professional counselling and a supportive environment.
It is also important to remember that stress and insomnia, although not considered a ‘disease state’,
like depression, for example, will also have an effect on mental wellbeing if they are being
experienced over a long period of time.
Insomnia
Insomnia is a sleep disorder and refers to problems going to sleep or waking in the middle of the night
or early morning and being unable to fall back asleep. A related problem is waking up feeling that sleep
has been disturbed and has been of poor quality. It is wise to think about what could be causing
insomnia – relationship or work stresses, change in routine, illness, depression and environmental
triggers (such as noise or light) are common causes. Often there is no obvious cause, or the original
cause has gone away but the pattern of insomnia persists.
The management of insomnia involves addressing any contributing factors and trying to maintain a
regular routine. It is important to relax for a couple of hours before going to bed; specific relaxation techniques may be useful. Exercise earlier in the day often helps. Avoid coffee, tea, alcohol and
cigarettes in the late afternoon or evening.
The hormone Melatonin may also be useful, but you will require a prescription from your doctor for it
in Australia. If sleeping tablets appear to be the next choice, medical review is definitely a good idea.
Depression
Almost everyone will experience feelings of depression at some point in their lives. This may often be
the result of a traumatic life event such as the loss of a loved one or the accumulation of a number of stressful factors. These ‘depressed’ moments are quite a natural response and usually pass.
However, depression can also be a serious illness and may need clinical intervention.
The main features of depression include an ongoing sense of sadness and pessimism, lack of
motivation to do everyday tasks, slowness of actions, fatigue, sleep disturbance, appetite disturbance
and personality change, many of which are frequently noted by others.
There is frequently an inability to control negative thoughts which may be obsessive and include guilt, sadness, paranoia, anxiety and in the worst instances death and a temptation to harm oneself.
Post-natal depression is common, and will affect approximately one in seven pregnant women. Many
things may contribute to the condition, for example, lack of support and education regarding caring for
a new baby, hormonal and physical changes, changes in lifestyle, fatigue and sometimes physical
illness (such as recovery from caesarian section or anaemia).
Post-natal depression is more common if the mother has had depression before, if the pregnancy has
been particularly stressful, if the mother or the baby has medical problems or if the home environment
or key relationships are not supportive. The management is very similar to other types of depression,
but it is easy for the condition to go unrecognized or passed off as fatigue by both the mother and those around her for many months. It is important to seek advice as soon as possible for the benefit of the
baby, the mother and for the rest of the family.
It is important to seek the professional opinion from a doctor or trained psychologist if you think you may
be depressed as it may be difficult for others to see the depth of the illness. Antidepressant medication
may be prescribed and should always be taken in conjunction with professional counselling to ensure
a wholistic treatment.
The herb St John’s Wort has been suggested to help with the symptoms of depression. As this herb
has the potential to interact with some medications, it is essential that you let your GP know if you are planning on taking it.
Stress
Stress is an unpleasant feeling of anxiety that is being caused by a specific situation. Usually the stress resolves when the cause resolves, and meanwhile the sufferer may not have significant problems with other aspects of life. It is often useful for a person to talk about the things that are stressful with family and friends or to a Psychologist. There are some supplements and products available to help manage stress, and it is also a good idea to learn to deal with the underlying problems. Hypnosis and relaxation techniques (such as slowing down breathing) may be useful for certain situations. If relationships or other areas of life are significantly affected by stress it is wise to speak to a doctor about it.
Anxiety
Anxiety disorders (generalised anxiety, phobias, obsessional compulsive disorder and panic attacks) can have a debilitating effect on a person’s life and may lead to the additional diagnosis of depression. Frequent, inappropriate anxiety, or ‘generalised anxiety disorder’, should not be underestimated. It usually presents with the patient feeling apprehensive, panicky, agitated, unable to relax or concentrate effectively and feeling fatigued. The patient may think there is an underlying medical condition present, as the heart rate is often fast, the patient may be flushed or sweaty and deep breathing may feel restricted.
Phobias are a severe anxiety reaction, often appearing irrational, due to the thought of, or experience of, a particular thing or situation (for example, spiders, leaving the house, public speaking or visiting hospitals). There are specific ways of managing the different types of phobia, depending on whether there is also depression or another type of anxiety problem present, specific counselling and behaviour modification techniques are often used and medications may be prescribed. |
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Panic attacks may be part of phobias or other anxiety conditions and occur in at least 10% of the
population. People having frequent panic attacks may end up at hospital because of breathing difficulty
and ‘collapse’, although loss of consciousness is most uncommon. It is important to have a correct diagnosis so that reassurance and relaxation techniques during future attacks may be suggested
without any hesitation. Specific counselling techniques are the main form of treatment if panic attacks
are the only problem to be addressed.
Obsessive-compulsive disorder is a frustrating condition affecting about one in thirty people where the sufferer has recurrent obsessions (persistent ideas, thoughts, images or impulses) or compulsions
(the acting out of such a thought) that are time consuming or cause significant distress or impairment
to their daily lives. The sufferer has difficulty switching their train of thought to another topic. The
condition is usually treated by cognitive psychotherapy and often with medication; hypnosis may also
be helpful as part of the management.
Psychosis
‘Psychosis’ means that the sufferer is out of touch with reality and doesn’t interpret what is happening around them the way everyone else does. There are different types of psychosis, but the most
common forms are schizophrenia and bipolar disorder (which used to be called manic depression).
There is a genetic component to such illnesses, but they are also commonly triggered by traumatic life events or illicit drug use. The management of psychoses is complex and involves medication,
counselling, family involvement and psychiatric advice.
© Australian Pharmaceutical Industries Limited 2006
Produced by API, 11 Grand Avenue, Camellia NSW 2142 ABN 57 000 004 320
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