MHAP July

2018

MENTAL HEALTH

Awareness

The magazine raising awareness of mental health issues

INFORM

INVOLVE

INFLUENCE

Focus on Addiction, Dementia & Depression

Focus on the local work of the Harbour Club

How to get help for mental health issues

www.mhap co.uk

Welcome A very warm welcome to Mental Health Awareness 2018, an independent magazine which brings the issue of Mental Health directly to the general public.

Our objective is to provide educational and informative content which will raise the profile of Mental Health issues across the local community.

There are many different types of Mental Health disorders that can affect anybody at any stage in their lives. If you or a family member or friend have been diagnosed with a mental health problem you might be looking for information on your diagnosis, treatment options and where to go for support. We provide an important list of useful first point contact information which can be used to get help for varying mental health issues (pages 14 and 15).

Our publication also provides helpful and informative articles on the following specific Mental Health issues: General Addiction (page 2) Alcohol (page 4) Drugs (page 6) Gambling (page 8) Smoking (page 9) Dementia (pages 10 & 11) Anxiety / Panic Attacks (page 16) Eating Disorders (page 18) Depression (pages 20 & 21) Post Natal Depression (page 22) Phobias (page 24) In addition, our magazines give a vital platform to various local mental health organisations and volunteer groups to highlight the wide range of support services that are available to those who may need them.

In this edition we highlight ‘The Harbour Club’ based in Battlesbridge (page 12). The Harbour Club is a Social Enterprise, a ‘Not For Profit’ organisation with a Mission Statement - ‘To help to maintain cognitive function and enhance the well-being of older adults living with Dementia’.

It is a day centre offering specialised activities and support for older adults living with dementia. Led by an HPC registered Occupational Therapist they offer members an opportunity to make friends and participate in a variety of activities designed to stimulate members’ cognitive, physical and social skills.

Mental Health Publications Publisher Email: sales@mhap.co.uk www.mhap.co.uk

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Mental Health Publications Limited do not make any recommendations as to the fitness of the advertisers appearing in this publication to carry our their services and no recommendations should be deemed to have been made.

All rights reserved. No part of Mental Health Publications Limited publications may be reproduced or used in any form or by any means either wholly or in part without prior permission of the publisher.

This magazine is published by Mental Health Publications Limited. © Mental Health Publications Limited 2018

www.mhap.co.uk

1

General Addiction: What is it?

If you have an addiction, you’re not alone. According to the charity Action on Addiction, one in three of us are addicted to something.

Addiction is defined as not having control over doing, taking or using something to the point where it could be harmful to you. Addiction is most commonly associated with gambling, drugs, alcohol & nicotine, but it’s possible to be addicted to just about anything, including: work – workaholics are obsessed with their work to the extent that they suffer physical exhaustion. If your relationship, family & social life are suffering & you never take holidays, you may be a work addict. internet – as computer & mobile phone use has increased, so too have computer & internet addictions. People may spend hours each day & night surfing the internet or gaming while neglecting other aspects of their lives. solvents – volatile substance abuse is when you inhale substances such as glue, aerosols, petrol or lighter fuel to give you a feeling of intoxication.

Solvent abuse can be fatal. shopping – shopping becomes an addiction when you buy things you don’t need or want to achieve a buzz. This is quickly followed by feelings of guilt, shame or despair.

What causes addictions?

There are lots of reasons why addictions begin. In the case of drugs, alcohol & nicotine, these substances affect the way you feel, both physically & mentally.

These feelings can be enjoyable & create a powerful urge to use the substances again.

The strain of managing an addiction can seriously damage your work life & relationships. In the case of substance abuse (for example, drugs & alcohol), an addiction can have serious psychological & physical effects.

Some studies suggest addiction is genetic, but environmental factors, such as being around other people with addictions, are also thought to increase the risk.

An addiction can be a way of blocking out difficult issues. Unemployment & poverty can trigger addiction, along with stress & emotional or professional pressure.

Getting help for addictions: Addiction is a treatable condition. Whatever the addiction, there are lots of ways you can seek help.

You could see your GP for advice or contact an organisation that specialises in helping people with addictions.

Alcohol addiction services Alcoholics Anonymous 0845 769 7555 www.alcoholics-anonymous.org.uk

Gambling may result in a similar mental “high” after a win, followed by a strong urge to try again & recreate that feeling. This can develop into a habit that becomes very hard to stop.

Drug addiction services - Narcotics Anonymous 0300 999 1212 www.ukna.org.uk

Being addicted to something means that not having it causes withdrawal symptoms, or a “come down”. Because this can be unpleasant, it’s easier to carry on having or doing what you crave, & so the cycle continues.

Stop smoking services SmokeFree 0300 1231044

Often, an addiction gets out of control because you need more & more to satisfy a craving & achieve the “high”.

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How addictions can affect you:

Gambling addiction services - Gamblers Anonymous UK www.gamblersanonymous.org.uk

To speak to someone anonymously about any kind of addiction, you can also call the Samaritans on 116 123 – 24 hour helpline. Other helpful contacts can be found on our Mental Health Glossary on pages 14 and 15.

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3

Alcohol Addiction Alcohol misuse means drinking excessively. If someone loses control over their drinking and has an excessive desire to drink, it’s known as dependent drinking (alcoholism).

Alcohol misuse increases your long term risk of serious health problems such as heart disease, stroke, liver disease, pancreatitis and various forms of cancer. It can also lead to social problems, such as unemployment, divorce, domestic abuse and homelessness.

To keep your risk of alcohol-related harm low, the NHS recommends not regularly drinking more than 14 units of alcohol a week. A unit of alcohol is 10ml of pure alcohol, which is about half a pint of normalstrength lager. you often feel the need to have a drink you get into trouble because of your drinking other people warn you about how much you’re drinking you think your drinking is causing you problems you feel guilty or bad about your drinking

Treating alcohol misuse A good place to start is with your GP. Try to be accurate and honest about how much you drink and any problems it may be causing you. Your level of alcohol intake may be assessed using various tests and this will determine your type of treatment.

Treatment options include counselling, medication and detoxification. Detoxification involves a nurse or doctor supporting you to safely stop drinking; this can be done by helping you slowly cut down over time or by giving you medicines to prevent withdrawal symptoms.

A dependent drinker usually experiences physical and psychological withdrawal symptoms if they suddenly cut down or stop drinking, including anxiety after waking, sweating, nausea and vomiting, hallucinations, seizures or fits, hand tremors, depression and insomnia. This often leads to “relief drinking” to avoid withdrawal symptoms. To stop drinking instantly could be harmful and you should take advice from your GP to do this safely.

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Cutting down or stopping drinking is usually just the beginning, & most people will need some degree of help or some long term plan to stay in control or to stay completely alcohol-free. Getting the right support can be crucial to maintaining control in the future. Only relying on family, friends or carers for this is often not enough.

Some people with medium or high levels of alcohol dependence may need intensive rehabilitation & recovery support for a period after they stop drinking completely; either through a programme of intensive support in their local community or by a residential rehabilitation service. This may be in an NHS inpatient unit, or in a medically-supported residential service, depending on your situation and the assessed medical need.

Getting Help for Alcohol Abuse As well as the NHS, there are a number of charities and support groups across the UK that provide support and advice for people with an alcohol misuse problem. Helpful contacts for Alcohol Addiction can be found on our Mental Health Glossary on pages 14 and 15.

to advertise in the next issue of Mental Health Awareness call: 01375 402 546

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5

Drug Addiction If you need treatment for drug addiction, you’re entitled to NHS care in the same way as anyone else who has a health problem. With the right help and support, it’s possible for you to get drug free and stay that way.

Where to get help for drugs: Your GP is a good place to start. They can discuss your problems with you and get you into treatment.

They may offer you treatment at the practice or refer you to your local drug service.

If you’re not comfortable talking to your GP, you can approach your local drug treatment service yourself.

Visit the Frank website to find local drug treatment services or call the Frank drugs helpline on 0300 123 6600. They can talk you through all your options.

Charity and private drugs treatment - as well as the NHS, there are charities and private drug and alcohol treatment organisations that can help you. Visit the Adfam website to see a list of useful organisations.

Private drug treatment can be very expensive but sometimes people get referrals through their local NHS.

Your first appointment: At your first appointment for drug treatment, staff will ask you about your drug use. They will also ask about your work, family and housing situation. You may be asked to provide a sample of urine or saliva.

Staff will talk you through all of your treatment options and agree a treatment plan with you. They can tell you about local support groups for drug users and their families or carers. You’ll also be given a keyworker who will support you throughout your treatment.

What drug treatment involves: This depends on your personal circumstances and also what you’re addicted to. Your keyworker will work with you to plan the right treatment for you.

Your treatment may include: Talking therapies – talking therapies, such as cognitive behavioural therapy (CBT), help you

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to see how your thoughts and feelings affect your behaviour.

Treatment with medicines – if you are dependent on heroin or another opioid drug, you may be offered a substitute drug, such as methadone. This means you can get on with your treatment without having to worry about withdrawing or buying street drugs. .

Detoxification (detox) – this is for people who want to stop taking opioid drugs like heroin completely. It helps you to cope with the withdrawal symptoms.

Self-help – some people find support groups like Narcotics Anonymous helpful. Your keyworker can tell you where your nearest group is.

Reducing harm – your drugs workers will help you reduce the risks associated with your drug-taking.

You may be offered testing and treatment for hepatitis or HIV, for example.

Where will you have your treatment?

You may have your treatment while living at home or as a hospital inpatient. If your drug-related problems are severe or complicated you may be referred to a residential rehab. For more information about residential rehab, or to find a rehab near you, visit rehabonline.

Other contacts for help with Drug Addiction can be found on our Mental Health Glossary on pages 14 and 15.

to advertise in the next issue of Mental Health Awareness call: 01375 402 546

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7

Gambling Addiction Being a compulsive gambler can harm your health and relationships, and leave you in serious debt. If you have a problem with gambling and you’d like to stop, support and treatment is available.

Are you a problem gambler?

Try this questionnaire: Do you bet more than you can afford to lose?

Do you need to gamble with larger amounts of money to get the same feeling?

Have you tried to win back money you have lost (chasing losses)?

Have you borrowed money or sold anything to get money to gamble?

Have you wondered whether you have a problem with gambling?

Has your gambling caused you any health problems, including feelings of stress or anxiety?

Have other people criticised your betting or told you that you had a gambling?

Has your gambling caused any financial problems for you or your household?

Have you ever felt guilty about the way you gamble or what happens when you gamble?

For each time you answer

Score 0 “never”

Score 1 “sometimes”

Score 2 “most of the time”

Score 3 “almost always”

If your total score is 8 or higher, you may be a problem gambler.

Help for problem gamblers and for friends and family affected by someone else’s gambling problem There’s evidence that gambling can be successfully treated in the same way as other addictions. Cognitive behavioural therapy usually has the best results.

Treatment and support groups are available for people who want to stop gambling: Gamcare - offers free information, support and counselling for problem gamblers in the UK and

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also for partners, friends and family of people who gamble compulsively. It runs the National Gambling Helpline (0808 8020 133) and also offers face-to-face counselling. If you’re having problems because of another person’s gambling, it’s best to be honest with them about it. They need to know how their behaviour is affecting you.

National Problem Gambling Clinic - If you live in England or Wales, are aged 16 or over and have complex problems related to gambling, you can refer yourself to this specialist NHS clinic for problem gamblers.

Gamblers Anonymous UK - Gamblers Anonymous UK runs local support groups that use the same 12-step approach to recovery from addiction as Alcoholics Anonymous. There are also GamAnon support groups for friends and family affected by someone else’s gambling problem.

Self-help tips for problem gamblers Do: pay important bills, such as your mortgage, on payday before you gamble spend more time with family and friends who don’t gamble deal with your debts rather than ignoring them – visit the National Debtline for tips Don’t: view gambling as a way to make money – try to see it as entertainment instead bottle up your worries about your gambling – talk to someone take credit cards with you when you go gambling Other contacts for help with Gambling Addiction can be found on our Mental Health Glossary on pages 14 and 15.

to advertise in the next issue of Mental Health Awareness call: 01375 402 546

Smoking Self-help tips to stop smoking.

Get some stop smoking support - if friends or family members want to give up too, suggest to them that you give up together.

There is also support available from your local stop smoking service. Did you know that you’re up to four times more likely to quit successfully with their expert help and advice? www.nhs.uk/Service-Search/Stopsmoking-services/LocationSearch/1846

You can also call the NHS Smokefree Helpline on 0300 123 1044 open Monday to Friday 9am to 8pm, and Saturday to Sunday 11am to 4pm.

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9

About Dementia As you get older, you may find that memory loss becomes a problem. It’s normal for your memory to be affected by stress, tiredness, or certain illnesses and medications. This can be annoying if it happens occasionally, but if you’re becoming increasingly forgetful, particularly if you’re over the age of 65 and it’s affecting your daily life or is worrying you or someone you know, it may be a good idea to talk to your GP about the early signs of dementia.

What is dementia?

Dementia isn’t a single disease, but is a syndrome (a group of related symptoms) associated with an ongoing decline of brain functioning. Several different diseases can cause dementia.

Alzheimer’s disease is the most common type of dementia and, together with vascular dementia, makes up the vast majority of cases. Because both vascular dementia and Alzheimer’s disease are common – especially in older people – they may be present together. This is often called mixed dementia because a mix of these two conditions is thought to be the cause of the dementia.

Many of these diseases are associated with an abnormal build-up of proteins in the brain. This build-up causes nerve cells to function less well and ultimately die. As the nerve cells die, different areas of the brain shrink.

Vascular dementia is caused by reduced blood flow to the brain. Nerve cells in the brain need oxygen and nutrients from blood to survive. When the blood supply to the brain is reduced, the nerve cells function less well and eventually die.

There are many rarer diseases and conditions that can lead to dementia, or dementia-like symptoms.

These conditions account for only 5% of dementia cases in the UK. Mild Cognitive Impairment (MCI) isn’t a cause of dementia. It refers to a condition in which someone has minor problems with cognition, or their memory and thinking, such as memory loss, difficulty concentrating and problems with planning and reasoning. These symptoms aren’t severe enough to cause problems in everyday life, so aren’t defined as dementia.

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How common is dementia?

According to the Alzheimer’s Society there are around 850,000 people in the UK with dementia. One in 14 people over 65 will develop dementia, and the condition affects 1 in 6 people over 80.

The number of people with dementia is increasing because people are living longer. It is estimated that by 2025, the number of people with dementia in the UK will have increased to around 1 million.

Symptoms of Dementia Dementia is not a natural part of the ageing process and you need to be aware of the symptoms of dementia, which tend to worsen with time and can affect the way you speak, think, feel and behave.

People with dementia can become apathetic or uninterested in their usual activities, or may have problems controlling their emotions. They may also find social situations challenging and lose interest in socialising. Aspects of their personality may change. A person with dementia may lose empathy (understanding and compassion), they may see or hear things that other people do not (hallucinations).

Because people with dementia may lose the ability to remember events or fully understand their environment or situations, it can seem as if they’re not telling the truth, or are wilfully ignoring problems.

As dementia affects a person’s mental abilities, they may find planning and organising difficult.

Maintaining their independence may also become

to advertise in the next issue of Mental Health Awareness call: 01375 402 546

tests and assessments to see if there is an alternative explanation for the problems. The doctor will also want to discuss how the problems being experienced have developed over time.

How to talk to someone you think has signs of dementia Raising the issue of memory loss and the possibility of dementia can be a difficult thing to do. Someone who is experiencing these symptoms may be confused, unaware they have any problems, worried or in denial.

Before starting a conversation with someone you’re concerned about, the Alzheimer’s Society suggests that you ask yourself the following questions: have they noticed the symptoms? do they think their problems are just a natural part of ageing? a problem. A person with dementia will therefore usually need help from friends or relatives, including help with decision making.

Although dementia isn’t just about memory loss, it’s one of the key symptoms. Others include: increasing difficulty with daily tasks and activities that require concentration and planning changes in personality and mood understanding - periods of mental confusion language - difficulty finding the right words or not being able to understand conversations as easily memory loss, thinking speed and mental sharpness judgement movement

Why is it important to get a diagnosis?

Although there is no cure for dementia at present, if it’s diagnosed in the early stages, there are ways you can slow it down and maintain mental function.

A diagnosis can help people with dementia get the right treatment and support, and help those close to them to prepare and plan for the future.

With treatment and support, many people are able to lead active, fulfilled lives.

Dementia is diagnosed by doctors ruling out other conditions that could cause the symptoms, as well as completing a thorough assessment. A GP, or a doctor specialising in memory problems, will run a series of

are they scared about what the changes could mean? are you the best person to talk to them about memory problems? do they think there won’t be any point in seeking help?

When you do talk to them, choose a place that is familiar and non-threatening. And allow plenty of time so the conversation isn’t rushed.

You may like to suggest that you accompany your friend or relative to the GP so you can support them. This also means that after the appointment, you can help your friend or relative recall what has been discussed.

If the diagnosis is dementia A dementia diagnosis can come as a shock, but over time some people come to view it in a positive way.

This is because a diagnosis is the first step towards getting the information, help and support needed to manage the symptoms.

A diagnosis of dementia can help people with these symptoms, and their families and friends, take control, make plans and prepare for the future.

Further Help and Information Other contacts for help with Dementia can be found on our Mental Health Glossary on pages 14 and 15. www.mhap.co.uk

11

Local Community Focus

The Harbour Club Battlesbridge The Harbour Club is a Social Enterprise, ‘Not For Profit’ local day centre based in Battlesbridge which offers specialised activities and support to enhance the well-being and help maintain cognitive function for older adults living with dementia.

The Director of Service is a registered Occupational Therapist specialising in care for older people with direct family experience of dementia and working for the NHS and Social Services. She has witnessed, first-hand the benefits derived from attending a day centre for adults with dementia.

In particular, it increases self esteem, changing persona from one of dependence, to one of an adult engaging with society on their own level, thus improving their quality of life.

All clients attending the day centre are referred to as members, in an effort to avoid institutionalisation and give a sense of belonging. Individuals are treated with dignity and respect in a safe, caring environment. We always put our members at the centre of the service we provide, ensuring their voices are heard. Members are individuals over the age of 65 years who are living with dementia or cognitive impairment with unusually poor mental function, associated with confusion, forgetfulness and difficulty concentrating; this can be diagnosed or undiagnosed.

At The Harbour Club Members have the opportunity to make friends and participate in a variety of user led activities designed to stimulate members’ cognitive, physical and social skills dependent on their needs and preferences which include: Group Discussions / Newspaper Readings Multi-Sensory & Cognitive Stimulation Therapy Darts / Pool / Bowling / Board Games

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Entertainers / Pet Therapy Music and Movement / Singing Armchair Exercises / Manicures / Hand Massage Arts and Crafts /Baking Pot Gardening The Harbour Club provide a service from Mondays to Thursdays, 09.30 to 15.30. Members can be collected in the morning and returned home in the afternoon, with a two course lunch plus tea and coffee - staff and members eat together promoting social interaction.

Whilst members are enjoying their day, their carers benefit enabling them to enjoy some well earned respite, safe in the knowledge that their loved one is in good hands in a safe, caring therapeutic environment.

The Harbour Club operate a high staff to member ratio and they deliver a high level of care. All Therapy Staff have completed dementia awareness training and been instructed on the principles of client centred dementia care and the philosophy of Occupational Therapy.

Funding your attendance at the Harbour Club can be paid privately or by Social Services or a combination of the two. Tel: Essex Social Services: 0845 603 7630 / Southend Social Services: 01702 352641 The Harbour Club - Making every day count Free Church Hall, Hawk Hill, Battlesbridge T: 07788 619 452 E: info@theharbourclub.org.uk

to advertise in the next issue of Mental Health Awareness call: 01375 402 546

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A Summary of Contact Numbers and Information for Selected Mental Health Disorders Specialised Area Contact Details SANE - emotional support, information & guidance for people affected by mental illness, their families & carers. SANEline: 0300 304 7000 www.sane.org.uk/support Mind - 0300 123 3393 (Mon-Fri, 9am-6pm) www.mind.org.uk Rethink Mental Illness - support and advice for people living with mental illness.

Phone: 0300 5000 927 (Mon-Fri, 9.30am-4pm) www.rethink.org

Mental Health

Mental Health Foundation - provides information & support for anyone with mental health problems or learning disabilities. www.mentalhealth.org.uk Young Minds - information on child & adolescent mental health. Parents helpline 0808 802 5544 www.youngminds.org.uk (Mon-Fri, 9.30am-4pm) The Samaritans - confidential support for people experiencing feelings of distress or despair.

Phone: 116 123 (free 24-hour helpline). www.samaritans.org.uk NHS Choices – www.nhs.uk/conditions/online-mental-health-services Information on online mental health services.

British Association for Counselling & Psychotherapy – 01455 883 300 www.itsgoodtotalk.org.uk

General Addictions

Adfam - a national charity working with families affected by drugs & alcohol.

Has a database of local support groups. www.adfam.org.uk Addaction - a UK-wide treatment agency that helps individuals, families & communities manage the effects of drug and alcohol misuse. www.addaction.org.uk Drinkline - the national alcohol helpline. Free & confidential 0300 123 1110 Alcoholics Anonymous - 0845 769 7555 (24 hr) www.alcoholics-anonymous.org.uk

Alcohol Misuse

Al-Anon Family Groups - offers support to the families & friends of problem drinkers.

Helpline 0207 403 0888. www.al-anonuk.org.uk The National Association for Children of Alcoholics - for children of alcohol-dependent parents and others concerned about their welfare. Free confidential helpline 0800 358 3456. www.nacoa.org.uk

Drugs / Substance Abuse

Gambling

FRANK drugs helpline 0300 123 6600 Narcotics Anonymous - 0300 999 1212 (daily until midnight) www.ukna.org GamCare – the National Gambling Helpline 0808 8020 133 - offers free information, support and counselling for problem gamblers in the UK. Gamblers Anonymous - runs local support groups www.gamblersanonymous.org.uk GamAnon - support groups for friends and family. www.gamanon.org.uk NHS Smokefree - helpline on 0300 123 1044

Smoking Dependency

There is also support available from your local stop smoking service. www.nhs.uk/Service-Search/Stop-smoking-services/LocationSearch/1846 National Dementia - helpline 0300 222 1122 Alzheimer's Society - helpline 0300 222 1122 www.alzheimers.org.uk

Dementia

Alzheimer's Research UK - 0300 111 5 111 www.alzheimersresearchuk.org Dementia UK - to talk to an Admiral Nurse, who are registered nurses & experts in dementia care, call 0800 888 6678 www.dementiauk.org The Carers Trust - if you are looking after someone with dementia, get help & support & even a break from caring. www.carers.org

Anxiety Disorders & Social Anxiety Disorder

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Anxiety UK - Phone: 03444 775 774 (Mon-Fri, 9.30am-5.30pm) www.anxietyuk.org.uk Anxiety Care UK – www.anxietycare.org.uk

to advertise in the next issue of Mental Health Awareness call: 01375 402 546

Panic Disorder

No More Panic – www.nomorepanic.co.uk No Panic – www.nopanic.org.uk / helpline: 08449 674848 (10.00am – 10.00pm)

Phobias

Triumph Over Phobia – www.topuk.org

Depression

Depression Alliance - for sufferers of depression. www.depressionalliance.org

Bipolar Disorder

Bipolar UK - www.bipolaruk.org.uk The Association for Post Natal Illness - 0207 386 0868 www.apni.org

Postnatal Depression

Pre and Postnatal Depression Advice and Support - 0843 2898401 www.pandasfoundation.org.uk

Psychotic Depression / Episodes / Confusion (Sudden Delirium)

If you think the person's symptoms are placing them or others at possible risk of harm you can take them to your nearest A&E department, call their GP or local out-of-hours GP or call 999 to ask for an ambulance.

Seasonal Affective Disorder

SAD Association - www.sada.org.uk

Eating Disorders Body Dysmorphic Disorder

Beat - Phone: 0808 801 0677 (adults) or 0808 801 0711 (for under-18s) Website: www.b-eat.co.uk (Anorexia Nervosa, Binge Eating Disorder & Bulimia).

Body Dysmorphic Disorder Foundation – www.bddfoundation.org Respect – 0808 802 4040 www.respect.uk.net

Anger

National Domestic Abuse - helpline – 0808 2000 247 Refuge – www.refuge.org.uk

Autism Spectrum Disorder

The National Autistic Society - Autism Helpline 0808 800 4104 www.autism.org.uk

Dissociative Disorders

MIND - www.mind.org.uk has a list if useful contacts

Grief / Bereavement

Cruse Bereavement Care - Phone: 0844 477 9400 (Mon-Fri, 9am-5pm) www.crusebereavementcare.org.uk

Hoarding Disorder

www.ocduk.org – 0845 120 3778

Obsessive Compulsive Disorder

OCD Action - support for people with OCD related disorders.

Phone: 0845 390 6232 Website: www.ocdaction.org.uk (Mon-Fri, 9.30am-5pm)

Paranoia

National Paranoia Network – 0114 271 8210 www.nationalparanoianetwork.org

Post-Traumatic Stress Disorder Premenstrual Dysphoric Disorder

ASSIST trauma care – helpline 0178 856 0800 www.assisttraumacare.org.uk Combat Stress – helpline 0800 1381 619 www.combatstress.org.uk PTSD Resolution – 0300 302 0551 www.ptsdresolution.org National Association for Premenstrual Syndrome – www.pms.org.uk The National Association for People Abused in Childhood (NAPAC)

Sexual Abuse

0808 801 0331 (freephone, Monday–Thursday 10am–9pm and Friday 10am–6pm) www.napac.org.uk HAVOCA (Help for Adult Victims of Child Abuse) www.havoca.org Lifecentre - helpline: 0808 802 0808 www.lifecentre.uk.com

Self-Harm

Harmless – email info@harmless.org.uk

Stress

Men's Health Forum - 24/7 stress support for men by text, chat and email.

Website: www.menshealthforum.org.uk PAPYRUS - Young suicide prevention society. HOPElineUK 0800 068 4141 (Mon-Fri,10am-5pm & 7-10pm. Weekends 2-5pm) www.papyrus-uk.org

Suicide / Suicidal Feelings

Childline – for children and young people under 19 Call 0800 1111 – the number won’t show up on your phone bill CALM - the Campaign Against Living Miserably, for men aged 15-35. www.thecalmzone.net The Silver Line – for older people Call 0800 4 70 80 90

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15

Anxiety / Panic Attacks Anxiety is a normal emotion that we all experience, such as in the run up to exams or a job interview.

But when anxiety becomes much more severe this feeling can take over and begin to interfere with everyday life. Conditions under the anxiety disorder umbrella include: social anxiety, generalised anxiety disorder (GAD), panic disorder, obsessivecompulsive disorder (OCD), phobias, and posttraumatic stress disorder (PTSD).

For people with an anxiety disorder, feelings like stress, panic and worry are longer lasting, more extreme and far harder to control. Anxiety can stop people living the life they want – whether that means not being able to work, see friends or, in the most severe cases, even leave the house.

As with many mental health conditions, the exact cause of panic disorder isn’t fully understood. But it’s thought the condition is probably linked to a combination of things, including a traumatic or very stressful life experience, such as bereavement, having a close family member with the disorder or an imbalance of neurotransmitters (chemical messengers) in the brain.

Symptoms Everyone experiences feelings of anxiety and panic at certain times. It’s a natural response to stressful or dangerous situations. But for someone with panic disorder, feelings of anxiety, stress, panic or fear occur regularly and at any time, often for no apparent reason. You may start to avoid certain situations because you fear that they will trigger another attack. This can create a cycle of living “in fear of fear”. It can add to your sense of panic and may cause you to have more attacks.

A panic attack is when your body experiences a rush of intense mental and physical symptoms. It can come on very quickly and for no apparent reason and can be very frightening and distressing. Symptoms may include a racing heartbeat, feeling faint, sweating, nausea, chest pain, shortness of breath, trembling, hot flushes, chills, shaky limbs and, a choking sensation.

Most panic attacks last for between 5 and 20 minutes, but may last up to an hour. The number of attacks you have will depend on how severe your condition is, sometimes once or twice a month, while others have them several times a week. Although panic attacks

16

are frightening, they’re not dangerous. An attack won’t cause you any physical harm, and it’s unlikely that you’ll be admitted to hospital if you have one.

Treatments for panic disorder Panic disorder is treatable and you can make a full recovery. If you’ve been experiencing symptoms of panic disorder visit your GP. They’ll ask you to describe your symptoms, how often they occur and how long you’ve had them. They may also carry out a physical examination to rule out other conditions that could be causing your symptoms. If you don’t get medical help, panic disorder can escalate and become very difficult to cope with. You’re more at risk of developing other mental health conditions, such as agoraphobia or other phobias, or an alcohol or drug problem.

Treatment aims to reduce the number of panic attacks you have and ease your symptoms, using one or a combination of Psychological therapy (based on cognitive behavioural therapy) and medication. If your symptoms don’t improve after CBT, medication and connecting with a support group, your GP may refer you to a mental health specialist such as a psychiatrist or clinical psychologist.

Further Help and Information Other contacts for help with Anxiety and Panic can be found on our Mental Health Glossary on pages 14 and 15.

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Eating Disorders An eating disorder is when a person’s relationship with food becomes abnormal, forcing them to change their eating habits and behaviours. It can involve eating too much or too little, or becoming obsessed with your weight and body shape. It can take over your life and make you ill. Men and women of any age can get an eating disorder, but they most commonly affect young women aged 13 to 17 years old.

Eating problems can disrupt how a person eats food and absorbs nutrients, which affects physical health, but can also be detrimental both emotionally and socially. Eating disorders often occur alongside other mental health conditions, such as anxiety, depression, panic disorder, obsessive-compulsive disorder and substance misuse disorders.

Types of eating disorders Anorexia Nervosa – keeping your weight as low as possible by restricted food intake and/or excessive exercise Bulimia Nervosa – binge eating followed by deliberate purging (deliberately sick, use laxatives) to restrict what you eat, or do too much exercise to try to stop yourself gaining weight Binge Eating Disorder (BED) – episodes of overeating in a short space of time until you feel uncomfortably full, and are then often upset or guilty Other Specified Feeding or Eating Disorder (OSFED) - when your symptoms don’t exactly match those of anorexia, bulimia or binge eating disorder.

Symptoms of eating disorders include: dramatic weight loss /spending a lot of time worrying about your weight and body shape avoiding socialising when you think food will be involved eating very little food / eating a lot of food very fast / cutting food into small pieces or eating very slowly deliberately making yourself sick or taking laxatives after you eat wearing loose or baggy clothes to hide weight loss exercising excessively or obsessively exercising lying about how much and when they’ve eaten, or how much they weigh having very strict habits or routines around food changes in your mood

18

You may also notice physical signs including feeling cold, tired or dizzy, problems with your digestion, your weight being very high or very low for someone of your age and height and not getting your period for women and girls.

What causes eating disorders?

There is no single reason why someone may develop an eating disorder - it can be the result of a combination of genetic, psychological, environmental, social and biological factors.

Getting help for an eating disorder If you think you may have an eating disorder, even if you aren’t sure, see your GP as soon as you can.

They’ll ask you questions about your eating habits and how you’re feeling, and will check your overall health and weight. If they think you may have an eating disorder, they should refer you to an eating disorder specialist or team of specialists.

You can also talk in confidence to an adviser from eating disorders charity Beat by calling their adult helpline on 0808 801 0677 or youth helpline on 0808 801 0711.

Treatment for eating disorders While they can be very serious mental health conditions they are also treatable and, although it may take a long time, full recovery is possible. Treatment normally consists of monitoring a person’s physical health while addressing the underlying psychological problems with psychological therapy such as cognitive behavioural therapy (CBT) or family therapy. Medication such as a type of antidepressant may also be used.

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Depression Overview Depression is more than simply feeling unhappy or fed up for a few days. Most people go through periods of feeling down, but when you’re depressed you feel persistently sad for weeks or months, rather than just a few days. Some people think depression is trivial and not a genuine health condition. They’re wrong – it is a real illness with real symptoms. Depression isn’t a sign of weakness or something you can “snap out of” by “pulling yourself together”. The good news is that with the right treatment and support, most people with depression can make a full recovery.

Symptoms Depression affects people in different ways and can cause a wide variety of symptoms. But as a general rule, if you’re depressed, you feel sad, hopeless, anxious, tearful and lose interest in things you used to enjoy. There can be physical symptoms too, such as feeling constantly tired, sleeping badly, having no appetite or sex drive, and various aches and pains.

The symptoms of depression may persist for weeks or months and are bad enough to interfere with your work, social life and family life. There are many other symptoms of depression and you’re unlikely to have all of those listed below.

Psychological symptoms:

not doing well at work avoiding contact with friends and taking part in fewer social activities neglecting your hobbies and interests having difficulties in your home and family life

Severities of depression Doctors categorize the symptoms of depression from mild to severe: mild depression – has some impact on your daily life and you may simply feel persistently low in spirit

continuous low mood or sadness / feeling hopeless and helpless / having low self-esteem

moderate depression – has a significant impact on your daily life

feeling tearful / / feeling anxious or worried

severe depression – makes it almost impossible to get through daily life; a few people with severe depression may have psychotic symptoms and it can make you feel suicidal and that life is no longer worth living.

feeling irritable and intolerant of others / feeling guilt-ridden having no motivation or interest in things / not getting any enjoyment out of life finding it difficult to make decisions having suicidal thoughts or thoughts of harming yourself Physical symptoms: moving or speaking more slowly than usual changes in appetite or weight (usually decreased, but sometimes increased) / constipation unexplained aches and pains lack of energy / low sex drive (loss of libido) / changes to your menstrual cycle disturbed sleep / finding it difficult to fall asleep at night / waking up very early in the morning

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Social symptoms:

How to tell if you have depression and when to see a doctor Most people experience feelings of stress, unhappiness or anxiety during difficult times. A low mood may improve after a short period of time, rather than being a sign of depression. However, it’s important to seek help from your GP if you think you may be depressed. Don’t wait before seeking help for depression, the sooner you see a doctor, the sooner you can be on the way to recovery.

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Bipolar Disorder (also known as manic depression) - there are spells of both depression and excessively high mood (mania); the depression symptoms are similar to clinical depression, but the bouts of mania can include harmful behaviour, such as gambling, going on spending sprees and having unsafe sex.

Seasonal Affective Disorder (SAD) – also known as “winter depression”, SAD is a type of depression with a seasonal pattern usually related to winter.

Treating depression

Depression can often come on gradually, so it can be difficult to notice something is wrong. Many people try to cope with their symptoms without realising they’re unwell. It can sometimes take a friend or family member to suggest something is wrong.

What causes depression?

Depression is fairly common, affecting about 1 in 10 people at some point during their life. It affects men and women, young and old. Studies have shown that about 4% of children aged five to 16 in the UK are anxious or depressed.

Sometimes there’s a trigger for depression. Lifechanging events, such as bereavement, losing your job or even having a baby, can bring it on. People with a family history of depression are more likely to experience it themselves. But you can also become depressed for no obvious reason.

Grief - it can be difficult to distinguish between grief and depression. They share many of the same characteristics, but there are important differences between them. Grief is an entirely natural response to a loss, while depression is an illness. People who are grieving find their feelings of sadness and loss come and go, but they’re still able to enjoy things and look forward to the future.

In contrast, people who are depressed constantly feel sad. They don’t enjoy anything and find it difficult to be positive about the future.

Postnatal Depression – some women develop depression after they have a baby and it’s treated in a similar way to other types of depression, with talking therapies and antidepressant medicines.

Treatment for depression can involve a combination of lifestyle changes, talking therapies and medication. Your recommended treatment will be based on whether you have mild, moderate or severe depression.

If you have mild depression, your doctor may suggest waiting to see whether it improves on its own, while monitoring your progress. This is known as “watchful waiting”. They may also suggest lifestyle measures such as exercise and self-help groups. Talking therapies, such as cognitive behavioural therapy (CBT), are often used for mild depression that isn’t improving or moderate depression. Antidepressants are also sometimes prescribed.

For moderate to severe depression, a combination of talking therapy and antidepressants is often recommended. If you have severe depression, you may be referred to a specialist mental health team for intensive specialist talking treatments and prescribed medication.

Living with depression Many people with depression benefit by making lifestyle changes, such as getting more exercise, cutting down on alcohol, giving up smoking and eating healthily. Reading a self-help book or joining a support group are also worthwhile.

They can help you gain a better understanding about what causes you to feel depressed. Sharing your experiences with others in a similar situation can also be very supportive.

Further Help and Information Other contacts for help with Depression can be found on our Mental Health Glossary on pages 14 and 15. www.mhap.co.uk

21

Post Natal Depression Postnatal depression is a type of depression that many parents experience after having a baby. It’s a common problem, affecting more than 1 in every 10 women and up to 1 in 25 new fathers within a year of giving birth.

Many women feel a bit down, tearful or anxious in the first week after giving birth. Having a baby is a life-changing event and it often takes time to adapt to becoming a new parent. Looking after a small baby can be stressful and exhausting. This is often called the “baby blues” and is so common that it’s considered normal.

Unlike the “baby blues”, which generally do not last more than 2 weeks after giving birth, postnatal depression can start any time in the first year after giving birth. It’s important to seek help as soon as possible if you think you might be depressed, as your symptoms could last months or get worse and have a significant impact on you, your baby and your family. With the right support most women make a full recovery.

Symptoms There is no evidence that there’s anything specific you can do to prevent the condition developing, apart from maintaining a healthy lifestyle. However, if you or your family have a history of depression or mental health problems earlier in life or during and after pregnancy, tell your GP if you’re pregnant or thinking of having a baby. If you have had a mental health problem while pregnant, your doctor should arrange for you to be seen regularly in the first few weeks after birth. Signs that you or someone you know might be depressed include: a persistent feeling of sadness and low mood / lack of enjoyment and loss of interest in the wider world lack of energy and feeling tired all the time / trouble sleeping at night and feeling sleepy during the day difficulty bonding with your baby withdrawing from contact with other people problems concentrating and making decisions frightening thoughts – for example, about hurting your baby

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Getting help for postnatal depression Speak to your GP or health visitor if you think you may be depressed. Many health visitors have been trained to recognise postnatal depression and have techniques that can help. If they can’t help, they’ll know someone in your area who can. Don’t struggle alone hoping that the problem will go away. Remember that: a range of help and support is available, including therapy depression is an illness like any other / it’s not your fault you’re depressed – it can happen to anyone being depressed doesn’t mean you’re a bad parent / it doesn’t mean you’re going mad your baby won’t be taken away from you – babies are only taken into care in very exceptional circumstances

Treatments Postnatal depression can be lonely, distressing and frightening, but support and effective treatments are available. These include self-help such as talking to your family and friends about your feelings and what they can do to help; making time for yourself to do things you enjoy; resting whenever you get the chance and getting as much sleep as you can at night; exercising regularly; eating a healthy diet.

Psychological therapy and antidepressants may also be prescribed..

Local and national organisations, such as the Association for Post Natal Illness (APNI) and Pre and Postnatal Depression Advice and Support (PANDAS), can also be useful sources of help and advice – see pages 14 &15..

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Phobias A phobia is an overwhelming and debilitating fear of an object, place, situation, feeling or animal. They are the most common type of anxiety disorder and are more pronounced than fears. They develop when a person has an exaggerated or unrealistic sense of danger about a situation or object.

Symptoms You may not experience any symptoms until you come into contact with the source of your phobia and even thinking about the source of a phobia can make a person feel anxious or panicky (anticipatory anxiety). Symptoms may include unsteadiness, dizziness and light-headedness, nausea, sweating, increased heart rate or palpitations, shortness of breath, trembling or shaking and an upset stomach.

Types of phobia Specific or simple phobias - centre around a particular object, animal, situation or activity, for example: animal phobias – such as. dogs, spiders, snakes or rodents environmental phobias –such as heights, deep water and germs

situational phobias – such as visiting the dentist or flying bodily phobias – such as blood, vomit or having injections Complex phobias tend to be more disabling than simple phobias, for example: Agoraphobia –anxious about being in a place or situation where escaping may be difficult.

Social phobia - feeling anxious in social situations such as speaking in front of people.

Causes Phobias don’t have a single cause, but there are a number of associated factors e.g. with a particular incident or trauma, it may be a response that a person develops early in life from another family member or genetics may play a role (there’s evidence to suggest that some people are born with a tendency to be more anxious than others).

Treating phobias Almost all phobias can be successfully treated and cured.

Seek help from your GP. Simple phobias can be treated through gradual exposure to the object, animal, place or situation that causes fear and anxiety. Treating complex phobias often takes longer and involves counselling, psychotherapy and cognitive behavioural therapy.

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