When he is well, he refuses to talk about the illness. I know that this illness can be managed, but feel that unless he accepts this illness and talks about it more, that the same thing will happen year after year. Is there some kind of counselling available that might help him to accept his condition and make plans for the future?
Sophie Corlett says:
You are right in that it can take a while for people to accept that they have a problem such as bi-polar disorder - more commonly known as manic-depression. Many people - with the help of talking treatments, self help, support of family and friends and medication - can live creative and fulfilling lives, and indeed many famous figures have been thought to have been bi-polar, including Winston Churchill and Florence Nightingale.
Does your partner possibly suffer unwanted side-effects from his medication? If so - perhaps you could suggest that he discusses these with his GP - as there are alternative mood stabilisers that may be easier to tolerate.
One type of counselling that could be helpful is Cognitive Behavioural Therapy, which might help him both acknowledge the consequences of his problem, and how he can look how to recognise 'early warning signs' which many people experience prior to a 'high.' _________________________________________
2. Why am I finding it so hard to get counselling for depression?
I would like to know why it is so difficult to get help. I have suffered from depression for years, but every time I go to my doctor I am given tablets.
I have asked about counselling or psychiatric help, but was told that counselling had a really long waiting list and that generally only suicidal people are referred to psychiatrists. I feel that I would benefit from counselling and would recover quicker, so why is it so hard to get?
Sophie Corlett says:
Talking treatments such as counselling should be far more readily available than they are - and it is important that you are given other choices and options other than medication. Mind's 'My Choice' campaign this year has been calling for more choice for people with mental health problems at GP level.
You might find that your local Mind group or other mental health groups in the local community have a counselling service, so your GP is not the only route to getting counselling. MindinfoLine can search for a service in your area. The number is 08457 660 163.
However, don't let your GP fob you off - insist that you want counselling, and if you don't have any success, you might want to think about changing to a GP who is more sympathetic to mental health problems.
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3. Can I change the counsellor assigned to me on the NHS?
Could you tell me if it is possible to change counsellors if you don't like the one who has been assigned to you on the NHS?
I had a counsellor, but I found her to be quite false and I didn't go back after a couple of sessions because of this problem. I feel that I need to talk about a lot of things. What can I do?
Sophie Corlett says:
Unless you see a therapist privately, you have no choice regarding who you see. GPs are usually the 'gatekeepers' to NHS services, and the decision about whether or not to make a referral to specialist services, e.g. to a counsellor, is theirs alone.
It comes down to the individual doctor's clinical judgement. The same is true with regard to referral for a second opinion or to a different counsellor. The GP has the power to refer you to someone else, but not the duty; this means it comes down to whether your GP thinks a re-referral is necessary.
You could consider changing your GP if he or she refuses to refer you, but this might not be the best option, particularly if you are otherwise happy with the service. In addition, it may be the case that another GP refuses to refer you at all!
You could consider a counselling service run by a voluntary organisation; these are usually low cost or free of change. MindinfoLine can search for a service in your area. The number is 08457 660 163.
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4. Alternative treatments haven't cured my depression - where next?
I have been suffering depression for the last five years now. I have tried a lot of different alternative treatments such as St Johns wort, aromatherapy and homeopathy. I now feel beaten.
I have been to the doctor and have in the past been offered Prozac which I am worried about taking. I worry at the moment as I seem to have lost all confidence and suffer low self esteem. My relationships with others are now suffering. Where should I go from here?
Sophie Corlett says:
Antidepressants are an increasingly popular option, and many people find them very useful and effective. However, they can have side-effects, and you need to talk through your options with your doctor.
Call the Mind Campaigns Line on 020 8215 2424 for a copy of our Prescribing Protocol, which outlines how you and your GP can best reach an agreement on the best type of medication for you, and the My Choice booklet, which will give you an idea of other therapies which can help.
Counselling may also be a possible option to help you with issues of self-esteem - ask your doctor to refer you to a counsellor, or make inquiries about mental health services in your local community.
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5. Is mental illness genetic?
My late mother spent most of her adult life on mental wards. I would like to know what the chances are of any of her children inheriting this illness in later adult life.
Can mental illnesses be inherited? If so, which ones?
Sophie Corlett says:
No-one knows what causes mental health problems, even though there has been a huge amount of research into this. Just because your mother was unwell for long periods, this does not necessarily mean that you will experience any kind of mental health problem.
It is thought that mental health problems are caused by a mixture of childhood experiences, environmental causes such as housing, as well as being triggered by life events such as bereavement, though inheritance may be a factor too.
It is thought that there is more of a genetic link for bi-polar disorder (manic depression) than there is for unipolar depression (depression without 'highs').
You might find genetic counselling helpful, or you may want to talk through with someone how you can learn to challenge the idea that you may become ill just because your mother was. MindinfoLine can search for a service in your area. The number is 08457 660 163.
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6. Which foods can help beat depression?
Which foods help you beat depression and what foods should be avoided as quick-fixes so that you feel better for a while?
Sophie Corlett says:
A diet that contains plenty of fresh fruit and vegetables will contain many nutrients that are essential for good mental health. It is recommended that we eat five portions of fruit and vegetables every day.
Unrefined and organically-grown products can be helpful, as they reduce the possibility of symptoms associated with a build-up of toxins from the environment, or reaction to artificial additives and preservatives.
These type of wholefoods will also contain essential vitamins, minerals and, in particular, essential fatty acids - which people experiencing depression are often lacking. You can find these fatty acids in oil-rich fish such as mackerel, or pumpkin seeds and walnuts.
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7. My daughter had a psychotic episode - what does this mean?
Could you please explain what it means when somebody is described as suffering from a brief psychotic episode? Or is it a name they give when they cannot put a diagnosis on a person's condition? Can a brief psychotic episode be caused by severe stress?
Can a person also suffer from a drug induced psychosis lasting about one week? The reason I ask is because my daughter was mugged and traumatised whilst travelling in the Far East. She was fine when she returned but a couple of weeks later she became unstable and was very high and talked a lot about the past and what happened to her.
I phoned the GP and he thought it could be drugs and she was referred the Mental Health Team. Unfortunately the drugs they gave her did not suit her and she suffered a severe reaction and had to be taken to the Emergency Department. She was then put on an antipsychotic drug after being referred to a psychiatrist, she wanted counselling as she thought she needed to talk but they wanted to prescribe her drugs which she eventually took.
She took the drug Olanzapine for a week and then told the psychiatrist that she was not going to take them any more as they made her feel weird. Since stopping the drugs she has made a good recovery, having recovered enough to restart her travelling.
It's now a year since this incident and she does not want to talk about what happened during her travels, she says she wants to forget. Her psychotic episode lasted about a week. I still don't know what caused her to be psychotic and I am worried about another re-occurence.
Sophie Corlett says:
The term 'psychosis' refers to a set of symptoms. It is not a specific diagnosis and it is difficult to say what causes it. It can occur as a result of severe mental health problems such as schizophrenia or can be a reaction to alcohol/substance misuse. It can also occur in people who are severely depressed or who have been traumatised.
The main criteria of psychosis are a lack of insight into one's own mental state; holding a perception of reality that is unshared by others of the same culture; unshared sensory perceptions (e.g. hearing voices or seeing things); delusions (a strong belief held on insufficient grounds) and paranoia. People who are in a 'psychotic state' can differ in their symptoms and the way they react.
It is very difficult to say whether a person who has had a brief episode of psychosis will ever experience the same thing again, or whether he or she will need to be on medication for any length of time. Some people do have one episode of psychosis and never experience the same thing again at any point in their lives; others will go on to have a number of episodes, perhaps resulting in some form of diagnosis.
This may just be an isolated incident. Antipsychotic drugs, whilst essential for some people, do have a number of distressing side-effects. It is therefore best to only take them where they are definitely needed.
It is impossible to say whether the psychosis will happen again, but the important thing is for your daughter to look after herself and to try and avoid stressful situations. |
