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Drug treatments, often referred to as ‘medication’, are an important part of the treatment of major mental illness. Medication is prescribed by a doctor (your GP or psychiatrist), and careful monitoring by a doctor is an essential part of treatment. Anti-psychotic drugs are used particularly in the treatment of schizophrenia and sometimes for brief periods in treatment of manic depression. They act to prevent or reduce some of the psychotic symptoms people experience, e.g. hallucinations and delusions, and also have a calming effect. Anti-psychotic drugs are known to be effective in treating acute episodes of mental illness, and also a long-term treatment to maintain good health for people who would otherwise suffer a relapse. Some older drugs may have a variety of side-effects, including tremor and drowsiness, which are temporary. Doctors will monitor this carefully and adjust the dosage of medication, or prescribe additional medication to help side effects. Sometimes, usually in people who have taken high doses of anti-psychotic drugs over a number of years, a condition develops known as ‘tardive dyskinesia’, in which there are involuntary movements of the face, tongue, or body. This may continue after medication has stopped. If you are concerned about this you should talk to your doctor and be aware of any possible warning signs. Recently newer drugs, such as Olanzapine, have been introduced which are more expensive and have fewer undesirable side effects. Lithium is a drug which can be very effective in the treatment of affective disorders or manic depression. It acts to stabilise mood, and can also be used to control both manic and depressive symptoms. It is essential to have the correct level of Lithium in the blood, and the doctor will arrange for regular blood tests to check this. People taking Lithium should be given a card by their chemist with advice about precautions. Carbamazepine, although quite different from Lithium chemically, is another drug which is used like Lithium to stabilise mood in people who have a recurring tendency to manic depression. With both Lithium and Carbamazepine it is necessary to continue treatment for months or years, and to continue taking them when in apparent good health. Anti-depressant drugs are used in the treatment of severe or persistent depression. They usually take two or three weeks to have an initial effect. They relieve the symptoms of depression and help to lift mood. Anti-depressants are not addictive. They can have side effects, such as causing drowsiness. With some types of anti-depressants there may be a reaction with alcohol or with certain foods. The doctor should explain about this, and cards with information are available. Anti-anxiety drugs are sometimes prescribed to reduce anxiety or agitation, and to help with sleeping problems. They can be effective as a short-term way of relieving symptoms, but with long-term use they become less effective and can be addictive. Information leaflets may be obtained from Hillingdon Mind Electro-convulsive therapy (ECT) ECT is a controversial treatment used mainly for severe depression. An electric current is passed through the brain for about half a second. This is done under anaesthetic and with a muscle relaxant. ECT can be an effective treatment for depression in some people. It is common to experience some confusion in the first half-hour after treatment, and some memory disturbance is sometimes reported Psychotherapy is a talking treatment which can help people with a range of problems. These may be experienced as emotional unhappiness or anxiety, and can sometimes be expressed as worrying and mysterious physical symptoms. There are no simple answers to these sorts of problems which can often be very frustrating for people. In the process of psychotherapy there is an exploration between the patient and therapist of what may be behind the problems. It involves looking at thoughts, feelings and behaviour. Slowly it may be possible to piece together bits of the puzzle, by looking carefully at the symptoms and by looking at how the patient and therapist relate to one another, and at earlier childhood relationships, as well as current relationships. Sometimes people need help that concentrates more on direct problem solving. Others need help to cope with a crisis that seems to have stirred up feelings from past events the person has forgotten about. Psychotherapy is a painful process and can be hard work, but can give benefits not just in alleviating symptoms but in improved relationships in general. It can be offered to individuals, couples, families, or in groups. Psychotherapy is available through the clinical psychology department at Hillingdon Hospital. You can ask your GP to refer you. There is also a Primary Care counselling service available through your GP or the psychology service. There is a national centre for psychotherapy at the Tavistock Clinic, 120 Belsize Lane, London NW3 5BA. Phone 020 7435 7111 or visit www.tavi-port.org You may also ask your GP to refer you although there is likely to be a waiting list. Private psychotherapy can be obtained at a cost of between £10 - £50 per session of usually one hour. It is important to have an assessment first so that an initial understanding of the problems can be reached and an informed decision as to what kind of help is needed can be made. Any good organisation or therapist will do such an assessment first. Occupational therapists (OTs) use purposeful activities to treat people with physical or mental health problems. The object is to enable people to obtain maximum independence at home, at work and in their social life. OTs help people identify and solve their problems. These can range from a lack of confidence, anxiety, depression, irrational thoughts and relationship difficulties to the more practical, like coping with the stresses of a family or a job. People are helped and encouraged to take part in activities which reflect aspects of daily life. Therapy may include cooking, shopping, work skills, sport and exercise, relaxation and leisure pursuits as well as specific groups such as anxiety management, self help, communication and art to develop their coping skills and self esteem Mental health OTs are based at the Riverside Mental Health Unit, the Woodland Centre, and Community Mental Health Resource Centres. Most people are referred directly to the relevant Community Mental Health Team but others requiring the service can contact their GP. Complementary therapies are often helpful for people experiencing problems with pain control, sleep patterns, anxiety or depression. However, they should not be seen as a substitute for more orthodox treatments for acute psychotic symptoms but as a complement to them. Examples of complementary therapies include acupuncture, aromatherapy, herbalism, homeopathy, hypnotherapy, massage or reflexology. Many complementary therapies take a holistic approach where the aim is to induce a sense of overall well being rather than just treating a number of symptoms. Anyone can set themselves up as a complementary therapist, even if they are untrained or inexperienced so it is important to check their credentials. This can be done through the: Institute for Complementary Medicine, PO Box 194, London SE16 1QZ. Phone
020 7237 5165 or visit their website at www.icmedicine.co.uk Effective medical diagnosis and treatment is a priority for people with a mental illness, although for many that is not the only help that is needed. Mental illness can often contribute to a loss of confidence and problems with social relationships. Very often people are faced with having to cope not only with mental health problems, but with isolation, housing problems and money worries as well. Help and support with both practical and emotional problems can therefore be very important to people experiencing or recovering from mental illness. This may include:
While mental health problems can cause great stress and distress, it is also the case that some people with a mental illness cope poorly with stress. It can therefore be important for them and their families to be able to get help and advice about managing stress. Families and carers may also need help and support for themselves. Help and advice should be available from the Community Mental Health Teams or other advice agencies. |
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