MENTAL HEALTH MAGAZINE
Medicinal Marijuana... Can a joint a day keep the psychiatrist away?
Creativity, akin to insanity? Creativity is known to be associated with increased risks of depression, schizophrenia and bipolar disorder
ISSUE #1
Bipolar, and it’s influence on an adolescent’s life “ At a young age of 14 I dealt with alcohol
abuse – I turned to the drug as a way of coping with my feelings”
Everything you need to know about Epilepsy What is epilepsy? What exactly is a seizure? What triggers a seizure? How does it happen? What do I do if a person starts seizuring?
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REFERENCES
Image sources
Article sources
FRONT COVER:
ARTICLE ONE: Creative minds ‘mimic schizophrenia’
- lucidabsinthe.wordpress.com
ARTICLE ONE: Creative minds ‘mimic schizophrenia’ By Health reporter Michelle Roberts, BBC News - wikimedia.org - lucidabsinthe.wordpress.com
NEURON’S LIST OF MOVIES: -
2.bp.blogspot.com - ’The Roommate’ posterwire.com - ‘Duece Bigalow-European Gigolo’ collider.com - ‘Black Swan’ www.impawards.com - ‘The Butterfly Effect’
ARTICLE THREE: Medicinal marijuana for psychiatric disorders
NEURON’S LIST OF MOVIES - http://en.wikipedia.org/
ARTICLE THREE: Medicinal marijuana for psychiatric disorders
A transcript from podcast ‘Optimal Living’ with Dr Jeremy Speigel - http://www.psychologytoday.com
THE INFORMATION TRAIN:
Everything you need to knw about Epilepsy - www.epilepsyaustralia.net
A transcript from podcast ‘Optimal Living’ with Dr Jeremy Speigel - cannabisnews.org - photo: Jeff Deminski - thejointblog.com - 2.bp.blogsplot.com - cannabisculture.com
ARTICLE FOUR: A promising future for youth mental health
THE INFORMATION TRAIN: Everything you need to know about Epilepsy
TEN TIPS TO STAY MENTALLY HEALTHY:
- www.epilepsyaustralia.net
ARTICLE FOUR: A promising future for youth mental health by Prof. Patrick McGorry -http://www.amsj.org/archives/262
TEN TIPS TO STAY MENTALLY HEALTHY: -http://www.betterhealth.vic.gov.au/
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By Health reporter Michelle Roberts, BBC News -http://www.bbc.co.uk/news/10154775
by Prof. Patrick McGorry -http://www.amsj.org/archives/262
-http://www.betterhealth.vic.gov.au/
CONTENTS 4................................. CREATIVITY & THE MIND 6......................................... PERSONAL STORY 7.................................... NEURON’S MOVIE LIST 8-10........................................... HEALTHCARE 11.................................................. ‘FREEDOM’ 12-13........................... THE INFORMATION TRAIN 14................................ YOUTH MENTAL HEALTH 15......................... BE MORE MENTALLY HEALTHY
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CREATIVITY & THE MIND
Creative minds ‘mimic schizophrenia’ By Michelle Roberts
Creativity is akin to insanity, say scientists who have been studying how the mind works. Brain scans reveal striking similarities in the thought pathways of highly creative people and those with schizophrenia. Both groups lack important receptors used to filter and direct thought. It could be this uninhibited processing that allows creative people to “think outside the box”, say experts from Sweden’s Karolinska Institute. In some people, it leads to mental illness. But rather than a clear division, experts suspect a continuum, with some people having psychotic traits but few negative symptoms.
“Creative people, like those with psychotic llnesses, tend to see the world differently to most. It’s like looking at a shattered mirror, they see the world in a fractured way” Mark Millard - UK Psychologist
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Art and suffering Some of the world’s leading artists, writers and theorists have also had mental illnesses - the Dutch painter Vincent van Gogh and American mathematician John Nash (portrayed by Russell Crowe in the film ‘A Beautiful Mind’) to name just two. Creativity is known to be associated with an increased risk of depression, schizophrenia and bipolar disorder. Similarly, people who have mental illness in their family have a higher chance of being creative. Associate Professor Fredrik Ullen believes his findings could help explain why. He looked at the brain’s dopamine (D2) receptor genes which experts believe govern divergent thought. He found highly creative people who did well on tests of divergent thought had a lower than expected density of D2 receptors in the thalamus - as do people with schizophrenia. The thalamus serves as a relay centre, filtering information before it reaches areas of the cortex, which is responsible, amongst other things, for cognition and reasoning. “Fewer D2 receptors in the thalamus probably means a lower degree of signal filtering, and thus a higher flow of information from the thalamus,” said Professor Ullen.
‘Starry Night’ - 1889 - Vincent van Gogh
Dr Mark Millard believes it is this barrage of uncensored information that ignites the creative spark.This would explain how highly-creative people manage to see unusual connections in problem-solving situations that other people miss. Schizophrenics share this same ability to make novel associations. But in schizophrenia, it results in bizarre and disturbing thoughts. UK psychologist and member of the British Psychological Society Mark Millard said the overlap with mental illness might explain the motivation and determination creative people share. “Creativity is uncomfortable. It is their dissatisfaction with the present that drives them on to make changes”. “Creative people, like those with psychotic illnesses, tend to see the world
differently to most. It’s like looking at a shattered mirror. They see the world in a fractured way”. “There is no sense of conventional limitations and you can see this in their work. Take Salvador Dali, for example. He certainly saw the world differently and behaved in a way that some people perceived as very odd”. He said businesses have already recognised and capitalised on this knowledge. Some companies have “skunk works” - secure, secret laboratories for their highly creative staff where they can freely experiment without disrupting the daily business. Chartered psychologist Gary Fitzgibbon says an ability to suspend disbelief” is one way of looking at creativity. “When you suspend disbelief you are
prepared to believe anything and this opens up the scope for seeing more possibilities”. “Creativity is certainly about not being constrained by rules or accepting the restrictions that society places on us. Of course the more people break the rules, the more likely they are to be perceived as ‘mentally ill’.” He works as an executive coach helping people to be more creative in their problem solving behaviour and thinking styles. “The result is typically a significant rise in their well being, so as opposed to creativity being associated with mental illness it becomes associated with good mental health”.
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PERSONAL STORY
The affects of bipolar disorder on an adolescent An interview with Dannii-Lee Howe - By Jack Packshaw JP- So first off, when were you diagnosed with Bipolar disorder?
JP- What about education? Has it had much of an impact on that?
DLH- Well, Towards the end of last year (2012) when I was close to graduating from High School. I had previously been diagnosed with depression, however, started experiencing “high” symptoms as opposed to just feeling depressed, so I consulted my GP who then organized a consultation with a psychiatrist who diagnosed me and put me on medication.
DLH- The only way I can describe my Bipolar is like a rollercoaster – up and down and “flat” or neutral. It can be really unpredictable and draining.
DLH- If anything, my Bipolar was a facilitating factor towards my high achievements in High School. My psychiatrist told me many people with Bipolar are smart and creative, and that there was probably a link between my diagnosis and my grades at school. On a high I am able to use my energy efficiently by studying or doing assignments, and become very determined. On the flipside, though, the disorder has put me through some dark times with my education. I don’t remember my whole last week of high school – the fun activities we took part in and our graduation are a blur to me and it saddens me that such a great memory is only very partially in my mind. I fell into a coma of depression which lasted for approximately a week – my last week at school.
JP- What are the symptoms from the disorder?
JP- Has support been fundamental along your journey?
DLH- The main characteristics of Bipolar disorder are “highs” and “lows”. When on a high, I am full of energy and feel happy and euphoric, sometimes to the point of having little control over what I say or do. I sometimes also feel intensely determined and at times, delusional. The highs can sometimes be used to your advantage, for example, by exercising. The lows, on the other hand, are just plain horrible. When I’m low, I feel extremely depressed and lifeless. I have little energy and don’t feel like communicating with anyone or doing anything meaningful. I also often sleep for long periods of time.
DLH- Definitely. If there’s one person I couldn’t have made it to where I am today without, it’s my mum. She was by my side the entire time, from the day I told her I thought I was suffering from Bipolar or something similar. Mum has been incredibly understanding about my mental health issues and has fortunately seen some “light at the end of the tunnel” as I have progressed with medication. Sometimes the type of support I need is simply to have people around me who can enjoy my differences rather than doubt me because of them or to judge me. I love it when my family seem entertained by or laugh with me about some of my highs – I can get pretty weird! My friends have also supported me by being there when I need someone to talk to and by accepting me for who I am.
JP- How would you describe your Bipolar?
JP- Do you have any triggers? If so, what are they? DLH- Yeah, excessive alcohol consumption is probably the worst trigger. On many occasions I have experienced what I call a “Bipolar attack” from drinking too much in one night. It basically blows everything out of proportion so when I’m having a high or low it intensifies it. When I’ve been drinking too much and have an attack, I usually swing very rapidly between highs and lows, feeling both at the same time in some instances. It’s confusing for me and those around me. If I miss my medication, even for one day, it can put things “out-of-whack” too. JP- Has it affected your life socially? DLH- It’s affected my social life because it changes how I interact with people and behave around them. I remember some people at school judging me and thinking I was an absolute lunatic. A lot of people don’t understand about my disorder, either because they don’t know I have it, or don’t know what it actually is. The depression side of the disorder, I think, has impacted a bit more than the high side. At a young age of 14 I dealt with alcohol abuse – I turned to the drug as a way of coping with my feelings and lost many friends as a result of my addiction.
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JP- How do you control it? DLH- When I was diagnosed with the disorder, my psychiatrist put me on a medication called Seroquel, which is a mood stabilizer and an anti-psychotic. This helps to bring me down to neutral from highs, or to allow me to stay more in control. I have been on Setraline, an anti-depressant, since I was 12 years old, which brings me up to neutral from lows. JP- And, do you believe that someday you will no longer be affected by Bipolar disorder? DLH- I think that I will always be affected by the disorder, even if the symptoms do eventually stop altogether. I will probably remain on my medication for a long time and already know what happens if I don’t take them. I believe I am able to live a perfectly normal life provided I remain on my medication and do what I can to be healthy.
“A lot of people don’t understand about my disorder, either because they don’t know I have it, or don’t know what it actually is”
Bipolar disorder
NEURON’S LIST OF MOVIES THAT INCLUDE MENTAL DISORDERS IN THEIR STORYLINE
Aarohanam (2012) Love and Other Drugs (2010) 3 (2012) A Woman Under the Influence (1974) Homeland (TV) (2012) Manic (2001) Michael Clayton (2007) Misery (1990) Mr. Jones (1993) Observe and Report (2009) Splendor in the Grass (1961) The Devil and Daniel Jonhson (2005) The Hours (2002) The Informant! (2009) The Big C (TV series) (2010) The Roommate (2011) Silver Linings Playbook (2012) Biutiful (2010) OC87 (2010} Dad’s in Heaven with Nixon (2010) Union Square (2011) O Brother, Where Art Thou? (2000)
Obsessive-compulsive disorder Secrets of a Soul (1926) Cat People (1942) As Good as It Gets (1997) K-PAX (2001) Matchstick Men (2003) Dirty Filthy Love (2004) The Aviator (2004) Deuce Bigalow: European Gigolo (2005) Phoebe in Wonderland (2008) The Stepfather (2009 film) (2009) Black Swan (2010) Silver Linings Playbook (2012) What About Bob? (1991) “Glee” (2008)
Social anxiety disorder
Clinical depression The Fire Within (1963) Interiors (1978) Little Miss Sunshine (2006) Ordinary People (1980) An Angel at My Table (1990) Leaving Las Vegas (1995) Raja Hindustani (1996) Sue (1997) The Butcher Boy (1997) American Beauty (1999) The Virgin Suicides (1999) On the Edge (2001) Prozac Nation (2001) The Hours (2002) House of Sand and Fog (2003) The Butterfly Effect (2004) The Assassination of Richard Nixon (2004) Wristcutters: A Love Story (2006) Goodbye Solo (2008) A Single Man (2009) Helen (2009) My Suicide (2009) Shrink (2009) Veronika Decides to Die (2009) It’s Kind of a Funny Story (2010) Detachment (2011) Melancholia (2011) The Beaver (2011) Side Effects (2013)
Delusional disorder and other psychotic disorders Sunset Boulevard (1950) Repulsion (1965) The King of Comedy (1983) Misery (1990) In the Mouth of Madness (1994) Invisible Child (1999) Swimfan (2002) Lars and the Real Girl (2007) Black Swan (2010)
Elling (2001) Adaptation (2002) Bubble (2006) Ali’s Eight Days (2009) The King’s Speech (2010) Nerve (2012)
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HEALTHCARE
Medical marijuana for psychiatric disorders... A transcript from the podcast Optimal Living with U.S Dr. Jeremy Spiegel Welcome to Optimal Living. In today’s podcast I’m going to make the case for medical marijuana in the treatment of psychiatric disorders. First I want to give you a general defense of medical marijuana. Then, I’ll tell you what I’ve seen in my own practice. Finally, I will explain in brief three studies, two for anxiety and one for depression where medical marijuana has been of great benefit. It’s generally true that little stories, one specific case after another, add up to an enormous amount of what we call anecdotal evidence. And in medicine anecdotal evidence is often sufficient to guide treatment, or at the very least, to initiate further investigation. In the case of medical marijuana, and contrary to the belief of many physicians, much of that investigation has been already done. So does your own doctor know about the research? Marijuana as a treatment has not been studied by them due to political factors. Which, ridiculous as it sounds, is like a scientist shunning a particular chemical system in the body for reasons that have nothing to do with science. Imagine a family practitioner who in his total person evaluation of a patient skips over the organs which exist ‘below the belt’ because when activated they have some tendency to cause people to feel different from how they are when they’re, say, quietly waiting on line at Chipotle. The sex organs might make these same people joyful even. The might giggle. They could feel tightly connected to another person. Just imagine that whole bodies of information should vanish, the specialties of Urology and OBGYN, much maligned due to the stigma of these other effects of these potentially consciousness expanding sexual organs.
“For some, medical marijuana is helpful, not curative. But others have been able to completely eliminate their dependence on other medications altogether” Consider this. The anti-medical marijuana lobby contends that because pot has been used recreationally it has no place within medicine’s treatment armamentarium. Clearly this kind of argument bears little merit since marijuana has not only wide clinical application, but because certain strains and formulations may be targeted towards the specific conditions warranting therapeutic effects, say, Crohn’s Disease, or glaucoma. Not to mention, such a naive and reactive view ignores a natural and critical regulating system which every human body has built in to our physiology—the body’s natural cannabinoids and cannabinoid receptors—the endocannabinoid system. This system—even in the total absence of marijuana plant material—regulates mood, memory, appetite, and pain sensation. The plant-based or what’s called phytocannabinoids merely serve to enhance these already present processes in the body. Let me give you two brief examples of cases that I’ve encountered in my practice over the past year.
There was a young person in my Boston area office who suffered needlessly owing to the fates that gave him a cancerous tumor in a place that is very difficult to get to surgically. Yet his world-class physicians at a premier medical center pooh-poohed the idea of his use of marijuana as medicine. Why should this be? If his prejudiced doctors were blind to this medicine’s much maligned past and route of administration—in this case vaporizing—they would be ecstatic that there were something their patient could take to improve his diminished appetite, chronic nausea, demoralizing pain, as well as—to be honest—the will to live. I’m really not sure why the doctors were so nervous about the use of medicinal marijuana. In another case I had a patient who had been on multiple agents fordepression, the usual medications we employ when talk therapy just doesn’t seem to operate fast enough to reverse the lack of appetite, flagging energy, bankrupt motivation, and dark moods which take hold of a person and don’t let go until they’re curled up in bed all day with thoughts of death, unable to function at their job or in their relationships.
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After years of feeling like a human guinea pig having been switched from one medicine to another, combining a few and suffering the slings and arrows of medication side effects and even antidepressant withdrawal symptoms, she decided to use medical marijuana to treat her depression and anxiety. And while yes, of course, she is the same person she always has been— struggling with the same issues around love and neglect and abandonment—her moods, motivation and outlook are significantly improved by daily use of marijuana. As soon as my eyes became open to the possibility of marijuana’s capacity to improve depression in some people, I began to see more and more of it. I permitted my own years-long prejudices to move aside so that I can see more clearly what is right before my eyes. In fact, cutting edge medicinal marijuana research suggests a joint a day might keep your psychiatrist away. In a study published by researchers at University College London in a January volume of Psychopharmacology researchers showed forty-eight human subjects a colored box. Shortly after seeing the box, they were given an electric shock. It’s no surprise that after a few rounds of this small torture, just the sight of the box itself could easily elicit a physicalfear response in the participants. The fear would come with the box, even if the shocks no longer followed. In this study the researchers employed this technique called classical conditioning. Let’s review for a moment. Remember those dogs, Pavlov’s dogs, you learned about in Psych 101? Pavlov classically conditioned dogs to salivate upon hearing the ringing of a bell. Under usual conditions dogs salivate when they’re about to eat food. But because by ringing the bell at feeding time, ringing began to be tightly associated with the presentation of food, you could at some point remove the food from the equation and you’d still get the dogs to salivate. Now, once you’ve conditioned the dogs to do this, removing this response is called extinction. And there are different ways to achieve extinction. In this marijuana study the researchers wondered if by administering to the human subjects a major constituent of marijuana, cannabidiol, or CBD, if extinction could be more robust and sustained. In other words, can CBD from cannabis undo the fear, the anxiety, the physical response to the conditioned stimulus? The answer from this research was an unambiguous ‘yes’. CBD from marijuana was able to successfully maintain extinction in this study which had a double blind placebo controlled design. As psychiatrists we are very careful to say something works as a therapy especially if it passes the standardized test of double blind placebo controlled trials. If a medicine passes this test we can safely prescribe the medication and feel secure about it.
For some medical marijuana is helpful, not curative. But others have been able to completely eliminate their dependence on other medications altogether. Think about it, though. If you closely examine the use of conventional treatments, you will notice the same distribution, the same bell curve. There are those for which a single medication, what we like to call monotherapy, is effective; others need augmentation with additional medications; and some squeak by with a lessening of symptoms but far from what might be called a vast improvement. It’s no different with medical marijuana than it is with the standard canon of psychopharmacological agents.
When we see nicely designed scientific clinical studies it’s impressive because someone took time and put thought into its design to yield information we hadn’t had prior to the study’s implementation. From this the authors generally suggest the next step to take for further research based on the outcome of this original one. Let me just mention another study involving anxiety. This one is from 2008 involving subjects whose brains were scanned by a special type of MRI, the administration of a primary constituent of cannabis, specifically THC, significantly reduced the anxiety and extinguished fear in subjects who were exposed to pictures of threatening faces. The activity of a part of the brain, the amygdala, which is involved in recognizing threat and processing fear, was significantly reduced with the presence of THC.
CONTINUE
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Let me put this into some context. Researchers use functional imaging so they can study activity in parts of the brain under certain conditions. When a threatening face is shown to a subject, the activity in the amygdala increases, the image on the screen brightens so you can see physically a direct correlation between an emotional state and what’s going on in the brain. So if the activity increases naturally under the specific circumstance of seeing a picture of a threatening face, then logic would have it that something with an anxiolytic or soothing, calming effect, should reduce that activity. And that’s precisely what the THC from marijuana does. Anxiety is one thing, and even skeptics of medical marijuana within the medical community might allow that cannabis has a significant anxiolytic effect. But depression? That would seem to be another matter entirely. Yet it isn’t much different at all. One impressive piece of evidence for marijuana’s benefit for depression comes to us from a 2006 study published in the journal titled Addictive Behaviors. Here researchers compiled data from over four thousand questionnaires of depressed patients and marijuana users, and determined that those who smoked daily or even less often, also reported less depressed mood and more positive affect than non users.
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Here is where the beginning of a new understanding emerges. What I mean is, that if you expect that depression only improves by certain methods, you might begin to make excuses for why what we’re seeing in the study couldn’t actually be. Yet if you judged data with an open mind you might then be able to recognize a pattern emerging of people whose moods improve with regular use of medical marijuana. A mind closed to even this possibility will guarantee you’ll remain forever blind to it irrespective of the data. It’s true, anecdotal evidence for marijuana’s benefit in psychiatric disorders is by itself useful to guide us to try using it for intractable disorders, that is, when conventional treatments have already been tried but were inadequate in their effectiveness. But as more and more scientific evidence of marijuana’s benefits emerges, the reasonable and judicious clinician can feel increasingly comfortable utilizing this medication for very specific psychiatric disorders, either adjunctively—as an add on therapy— or as sole treatment. Science, not politics or prejudice, must be our guide. We must look with our own eyes without fear or prejudice. Only then can anyone expect to receive the best treatment possible. This has been Optimal Living with Dr. Jeremy Spiegel.
‘FREEDOM’ A VISUAL SHORT STORY BY JACK PACKSHAW Where does a persons mind go when they experience a seizure? Do they unknowingly re-live memories and past experiences? Experience things they could never experience in reality. Do they manifest new worlds and explore those realms? It is impossible to know what truly happens to an individual when they have a seizure, other than blacking out and having no recollection of the fit occurring. “As a person who suffers from epilepsy and someone who has experienced a seizure, this subject is both interesting and personal to me and I wanted to explore it more.“ Jack says. An image from ‘Freedom’
“I wanted to explore the possibilities of where the mind goes when a fit occurs. I was keen to create a story that could provide an option for this experience.“
“Where are we?” I asked him in a confused manner. “We are in the realms of Freedom of course!” he replied. “It’s really quite simple. Actually it’s quite complicated. No, that’s not right. You see, the realms of Freedom are unique to all of us. They represent our ultimate perception of the word Freedom. Whenever we experience something that disturbs or unnerves us, our mind will at some stage return us to here. You should know, you’ve been here before.”
‘Freedom’ front cover
“Instead of putting myself in the spotlight, I created a fictional child named Natalie and wrote it from her point of view. There is an introduction page where Natalie begins telling the reader a bit about herself. After speaking for a bit she slips into a fit, where she unknowingly experiences this journey into the land of Freedom.” Throughout the story, there are similarities to such well-known stories as Alice in Wonderland and The Wizard of Oz. The similarities relate to the characters and the storyline. “I decided to do an illustrated short story because I love to draw and I’ve always wanted to produce one. I also thought it would challenge my art practice and myself as an artist.” By Vivian Waters
Purchase ‘FREEDOM’ from our website: www.neuronmag.com
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THE INFORMATION TRAIN FIRST STOP
EPILEPSY Epilepsy explained
What causes epilepsy?
To say a person has epilepsy simply means that a person has shown a tendency to have recurring seizures. Therefore, when a person has a single seizure this does not necessarily mean that they have epilepsy. It is estimated that approximately 50% of people who have one seizure go on to have more seizures. For people at risk of recurring seizures, approximately 70% can expect seizure seizure control with medication.
Epilepsy is a common condition in our community and can develop at any age, regardless of gender or ethnic group. Research suggests that 3-4% of the Australian population will develop epilepsy at some stage in their lives. Epilepsy was once considered a disorder of the young as it was believed that most people experienced their first seizure before the age of 20. However, the over 55 years age group is now being recognized as being the most vulnerable group. This rapidly growing demographic group is subject to the kinds of cerebrovascular, respiratory and cardiac events that can lead to epileptic seizures.
There are many causes of epilepsy, which vary with the age at which seizures begin and the nature of the seizures. However 50% of cases, the cause is unknown. We know that structural abnormalities in the developing brain, infections such as meningitis or encephalitis, or lack of oxygen to the brain during birth or after a stroke, can cause epilepsy. A brain injury, which results in scar tissue, predisposes individuals to developing epilepsy, although there can be a long period, often years, between the damage occurring and the seizures commencing. Why this occurs, we still do not know. Epilepsy can result from a tumour (an uncommon cause in children) and, in the over 65s from degenerative conditions such as Alzheimer’s disease. Current research has identified that in many cases of epilepsy in very young children, genetics play an important role. But genetics can be a factor in developing epilepsy at any age. It appears that certain people are simply more prone to having seizures than others. This is, at times, described as having a ‘low-seizure threshold’. A history of seizures in the family makes it more likely for them to develop epilepsy.
Epilepsy lifestyle issues
What is a seizure?
Who gets epilepsy?
Depending on your type of epilepsy, frequency and predictabilityof seizures, you may have to make adjustments to your present lifestyle. It is important not to become obsessed by them. Many people miss out on wonderful life experiences by restricting their lifestyle unnecessarily. With some forward planning you can do whatever you want to and enjoy it. Epilepsy will have an impact on your life, but you can minimize that impact by recognizing those issues that affect you and managing them in a positive way.
Our every thought, feeling or action is controlled by brain cells that communicate with each other through regular electrical impulses. These impulses travel along the network of nerve cells, called neurons, in the brain and throughout the body via chemical messengers called neurotransmitters. A seizure occurs when the brains nerve cells misfire and generate sudden, uncontrolled burst of electrical activity in the brain. The orderly communication between nerve cells becomes scrambled and our thoughts, feelings or movements become momentarily confused or uncontrolled. Seizures can be subtle causing momentary lapses of consciousness, or conspicuous causing sudden loss of body control. Seizures are episodic and unpredictable, and may occur as frequently as every day, or just occasionally in a lifetime. While seizures can be frightening, in most instances they stop without intervention. Once the seizure is over the person gradually regains control and re-orients themselves to their surroundings, generally without any ill effects. Approximately 70% of people diagnosed with epilepsy will have their seizures controlled with medication.
What triggers a seizure? Some people, although not all, find that certain factors induce seizures. You may not become aware of your trigger factors unless you keep a seizure diary for a period of time. There are a number of known seizure triggers including alcohol, stress, tiredness, infections and illness, missed medication, drugs, flashing lights and even an unhealthy diet.
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How is epilepsy diagnosed? Epilepsy is not one condition. There are numerous epilepsy syndromes and each has its own symptoms, seizure types, causes, methods of diagnosis, outcomes and management. Accurate identification of the epilepsy syndrome will ensure the most appropriate treatment. In diagnosing epilepsy, the presence of seizures is often the determining factor. An eyewitness report of the event and the person’s own description of what happened prior to the event and how they felt afterwards can be your doctor’s best diagnostic tools. All the tests the doctor might order are to gather specific data on the kind of seizures experienced and to confirm what is basically diagnosed through observation. A neurological examination will be conducted that generally includes a test to measure the electrical activity of the brain [EEG]. This will help determine where in the brain the electrochemical activity that is generating the seizure activity is occurring. Specialized imaging tests such as computerized tomography [CT] scans and magnetic resonance imaging [MRI] scans may be required, along with blood tests. For some tests
may require hospitalization while the seizures are observed and recordings taken during the event. This kind of testing is not always called for and nor is it always conclusive. Diagnosing epilepsy in a child can be a harrowing experience. Many a parent has observed seizures at home that are not subsequently picked up in hospitals by the most sophisticated scanning. They are sometimes told to stop imagining that their child has epilepsy. This is a frustrating situation for a parent to be in and fortunately most doctors will now listen sympathetically to parents and treat them as a primary information source in helping to manage and correctly diagnose their children’s health. With the advance in mobile phone technology, many handsets now have excellent video capabilities. By capturing the event or behaviour when it occurs on video, parents/carers can provide their doctor with recorded evidence to support their personal observations. Such recordings can be extremely helpful to the doctor when determining a diagnosis.
What to do when a person is seizuring - Remember to stay calm and remain with the person. - Time the seizure. - Protect from injury, remove any hard objects from the area. - Protect the head and place something soft under their head and loosen any tight clothing. - Gently roll the person on their side as soon as it is possible to do so and firmly push the angle of the jaw forward to assist with breathing. A person cannot ‘swallow their tongue’ but the tongue can move back to cause a serious block to breathing. - Stay with the person until the seizure ends naturally and calmly talk to the person until the regain consciousness, usually within a few minutes. - Reassure the person that they are safe and that you will stay with them while they recover.
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NEWS
A promising future for youth mental health By Prof. Patrick McGorry Prof. Patrick McGorry Australian of the Year, 2010 Chair in Youth Mental Health, University of Melbourne
For the last 27 years, Prof. McGorry has been at the forefront of the promotion of youth mental health and early intervention, not only in Australia, but worldwide. A psychiatrist by training, he has become the ninth in a series of distinguished individuals in the field of medicine to be named Australian of the Year since the award’s inception in 1960. In Australia, mental health issues account for 55% of the total burden of disease in those aged between 15-24 years, with depression, anxiety and substance misuse being the most prevalent problems in this age group. Furthermore, epidemiological evidence tells us that over 75% of people who suffer from a mental illness experienced their first episode by the age of 25 years. Given the exquisite developmental sensitivity of this period of life, when psychological, social and vocational pathways are being established as part of the transition to independent adulthood, it is not surprising that mental disorders, even relatively brief and mild ones, can disrupt and disable, seriously limiting or even blocking a young person’s potential. Ample evidence shows that mental ill-health in young people is associated with high rates of enduring disability, including school failure, unstable employment, poor social and family functioning, which all too often lead to a spiral of disability and disadvantage that becomes difficult to reverse. As a society, we cannot afford to ignore the human, social and economic consequences of this situation. A recent report by Access Economics has estimated that in 2009, the financial cost of mental illness in Australians aged between 12 and 25 years was $10.6 billion, with 70.5% of this due to the costs of lost productivity due to lower employment, absenteeism and premature death. Furthermore, the value of the loss in well-being (disability and premature death) was estimated at a further $25 billion. We need to invest in our future, and clearly, investing in youth mental health makes good sense: a strong focus on young people’s mental health has the capacity to generate greater personal, social and economic benefits than intervention at any other time in a person’s lifespan. Put simply, mental health equates with national wealth, in the broadest possible sense. Fortunately, there is a growing movement that aims not only to raise awareness of this crying area of unmet need, but also to redress it. In the early 1990s we began to promote the idea that intervention in the very early stages of the development of a mental illness was the most effective strategy to reduce the burden of disease created by these disorders. Intervening early to stop the progression of a mental illness should also prevent the accumulation of collateral damage to educational, social and vocational functioning associated with the evolution of the illness.
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Prof. Patrick McGorry Evidence supporting this proposition has been building steadily over the last decade, and with this progress, it is now accepted at both the State and Federal Government levels, as well as within the wider community, that major reform and significant investment is required in mental health care in Australia, and indeed world-wide. As Australian doctors, present and future, we live in exciting times. We have reached the tipping point; reform is inevitable, and indeed, the first steps have been taken. A career in psychiatry has always offered benefits such as real contact with patients, rewarding work, intellectual stimulation, interesting research questions and the possibility of maintaining a good work/life balance, but now Australia’s psychiatrists have the potential to be part of a social climate change not only here in Australia, but also world-wide. The need is only too real, and the potential to address it has never been better. As Australia’s doctors of the future, an exciting career option beckons you: consider psychiatry, and make a real difference to our future.
“Ample evidence shows that mental ill-health in young people is associated with high rates of enduring disability, including school failure, unstable employment, poor social and family functioning”
Ten tips to stay mentally healthy Enjoying mental health means having a sense of wellbeing, being able to function during everyday life and feeling confident to rise to a challenge when the opportunity arises. Just like your physical health, there are actions you can take to increase your mental health. Boost your wellbeing and stay mentally healthy by following a few simple steps.
1. Connect with others. Develop and maintain strong relationships with people around you who will support and enrich your life. The quality of our personal relationships has a great effect on our wellbeing. Putting time and effort into building strong relationships can bring great rewards.
7. Deal with stress. Be aware of what triggers your stress and how you react. You may be able to avoid some of the triggers and learn to prepare for or manage others. Stress is a part of life and affects people in different ways. It only becomes a problem when it makes you feel uncomfortable or distressed. A balanced lifestyle can help you manage stress better. If you have trouble 2. Take time to enjoy. Set aside time for activities, hobbies winding down, you may find that relaxation breathing, yoga or and projects you enjoy. Let yourself be spontaneous and creative when the urge takes you. Do a crossword; take a walk in your local meditation can help. park; read a book; sew a quilt; draw pictures with your kids; play 8. Rest and refresh. Get plenty of sleep. Go to bed at a with your pets – whatever takes your fancy. regular time each day and practice good habits to get better sleep. Sleep restores both your mind and body. However, feelings 3. Participate and share interests. Join a club or group of of fatigue can still set in if you feel constantly rushed and overpeople who share your interests. Being part of a group of people with a common interest provides a sense of belonging and is good whelmed when you are awake. Allow yourself some unfocussed for your mental health. Join a sports club; a band; an evening walk- time each day to refresh; for example, let your mind wander, daydream orsimply watch the clouds go by for a while. It’s OK to ing group; a dance class; a theatre or choir group; a book or car add ‘do nothing’ to your to-do list! club. 4. Contribute to your community. Volunteer your time for a cause or issue that you care about. Help out a neighbour, work in a community garden or do something nice for a friend. There are many great ways to contribute that can help you feel good about yourself and your place in the world. An effort to improve the lives of others is sure to improve your life too. 5. Take care of yourself. Be active and eat well – these help maintain a healthy body. Physical and mental health are closely linked; it’s easier to feel good about life if your body feels good. You don’t have to go to the gym to exercise – gardening, vacuuming, dancing and bushwalking all count. Combine physical activity with a balanced diet to nourish your body and mind and keep you feeling good, inside and out.
9. Notice the here and now. Take a moment to notice each of your senses each day. Simply ‘be’ in the moment – feel the sun and wind on your face and notice the air you are breathing. It’s easy to be caught up thinking about the past or planning for the future instead of experiencing the present. Practising mindfulness, by focusing your attention on being in the moment, is a good way to do this. Making a conscious effort to be aware of your inner and outer world is important for your mental health. 10. Ask for help. This can be as simple as asking a friend to babysit while you have some time out or speaking to your doctor (GP) about where to find a counsellor or community mental health service. The perfect, worry-free life does not exist. Everyone’s life journey has bumpy bits and the people around you can help. If you don’t get the help you need first off, keep asking until you do.
6. Challenge yourself. Learn a new skill or take on a challenge to meet a goal. You could take on something different at work; commit to a fitness goal or learn to cook a new recipe. Learning improves your mental fitness, while striving to meet your own goals builds skills and confidence and gives you a sense of progress and achievement.
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MENTAL HEALTH MAGAZINE
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