What's Normal Anyway? Celebrities' Own Stories of Mental Illness (29 page)

What is the treatment for anxiety disorders?

Most anxiety disorders are best treated by a combination of techniques:

S
ELF-HELP MEASURES
:
Relaxation techniques, breathing exercises, and meditation can be beneficial in treating anxiety. Sufferers may also find reading self-help materials and books, and joining self-help groups (one-to-one or online), helpful.

A
LTERNATIVE AND COMPLIMENTARY THERAPIES
:
Hypnotherapy, acupuncture, and homeopathy may be effective in some cases of anxiety. The homeopathic remedy Aconite may be particularly helpful in treating anxiety and panic attacks. Some people also take herbs such as
Valeriana officinalis
(valerian),
Matricaria recutitat
(German chamomile), and
Melissa officinalis
(lemon balm) to relieve symptoms, although these may interact with prescription medications.

T
ALKING THERAPY
:
Although counselling, psychotherapy, behavioural therapy (BT), and cognitive behavioural therapy (CBT) can all be used to treat anxiety disorders, CBT and/ or BT are currently the most commonly used approaches in the UK. In BT – usually used for specific phobias – systematic desensitisation (gradual exposure) or flooding (total immersion) to whatever it is that the person fears has been found to be effective. In CBT, often used for GAD, current thinking patterns – which are usually negative, illogical, or false – are identified and replaced with more positive, logical, and realistic ones.

M
EDICATION
:
Drugs for anxiety disorders include benzodiazepines (‘tranquillisers'), antidepressants (such as selective serotonin reuptake inhibitors [SSRIs], tricyclics, and monoamine oxidase inhibitors [MAOIs]), beta-blockers, pregabalin, and buspirone. SSRIs are considered the first line of treatment; benzodiazepines are usually used for short courses only, although they may be appropriate for long-term use in particularly severe cases.

What are the risks associated with having an anxiety disorder?

Anxiety disorders can seriously affect the quality of people's lives and what they are able to do. Over a prolonged period, anxiety may also cause physical problems such as digestive issues, lower immunity, high blood pressure, and an increased risk of heart attacks and strokes. Excessive or ongoing anxiety may also lead to depression and self-medication with drugs or alcohol.

Who can I contact if I think I have an anxiety disorder?

Your first point of contact should be your GP who may perform an examination to rule out any physical causes for the anxiety and then, if a diagnosis of anxiety is made, refer you for a course of therapy and/or prescribe medication. You may also be referred to a community mental health team (CMHT). In addition, the below organisations may be able to offer help, support, and advice:

Anxiety UK
Tel: 08444 775 774
Web:
www.anxietyuk.org.uk

Anxiety Alliance
Tel: 0845 296 7877
Web:
www.anxiety-alliance.org.uk

No Panic
Tel: 0800 138 8889
Web:
www.nopanic.org.uk

TOP (Triumph Over Phobia)
Tel: 0845 600 9601
Web:
www.topuk.org

Please see the ‘Useful contacts and links' pages for more resources and organisations that may be able to help, including national mental health charities such as Mind, Sane, and Rethink.

Obsessive compulsive disorder (OCD)

What is OCD?

OCD is a type of anxiety disorder that has two key features to it: obsessions and compulsions. Obsessions are recurring, intrusive, and unwelcome thoughts, beliefs, urges, ideas, and impulses that come into the mind and cause distress and anxiety. Compulsions are repetitive behaviours and activities that the sufferer feels they have to perform to relieve the obsessive thoughts and ease the anxiety.

What are the symptoms of OCD?

O
BSESSIONS
:
The most common obsessions in OCD are fear of contamination (such as contact with germs); excessive doubt (such as whether the door is locked); thoughts of aggression (such as doing somebody harm); fear that the person themself or someone they love may come to harm (from disease or some ‘higher power'); and ‘forbidden' sexual or religious thoughts.

C
OMPULSIONS
:
The most common compulsions in OCD are washing or cleaning (such as hand-washing or house-cleaning); checking (making sure the gas is off or reading through letters/ emails for mistakes); repetition of actions (such as switching a light on and off a certain number of times); ordering (such as spending a long time arranging clothes in a wardrobe); mental compulsions (such as praying, mentally repeating a phrase, or counting); and hoarding (such as keeping broken items).

Are there different types of OCD?

OCD:
For a formal diagnosis of OCD, a person must be suffering from obsessions and/or compulsions that take up more than an hour of their time every day and cause distress and problems functioning in everyday life. They must also recognise that their thoughts and behaviours are irrational and take no pleasure from them.

‘P
URE
-O':
In this type of OCD obvious compulsions are absent. In these cases, sufferers may perform more hidden mental rituals or try to avoid situations that trigger obsessional thoughts (such as keeping away from places they think are dirty).

O
BSESSIVE-COMPULSIVE PERSONALITY DISORDER
:
In OCPD the characteristics of the disorder are compatible with the person's personality (such as being a perfectionist) and the sufferer will deny that there is anything wrong, seeing their actions as rational.

How common is OCD?

It is thought that 1–3 per cent of the general population suffer from OCD.

Are certain people more likely to develop OCD?

Although it can affect people of all ages, and men and women equally, OCD usually starts before the age of 25, beginning in early adulthood for women and teenage years for men. People with OCD have also been found to have certain personality traits, including an overly developed sense of responsibility, attention to detail and planning, above average-intelligence, and avoidance of taking risks.

Why do people get OCD?

There may be several factors involved in the development of OCD:

G
ENES
:
OCD is often found to run in families. People with OCD are around four times more likely to have a family member suffering from it, in comparison with other people.

E
NVIRONMENT AND LIFE EXPERIENCES
:
Children may learn obsessive compulsive behaviours from observing their parents. Traumatic or distressing experiences, often in childhood, may also trigger OCD, the obsessions and compulsions being used as a way of coping with anxiety.

B
ODY CHEMISTRY
:
People with OCD may have abnormalities with the neurotransmitters serotonin and dopamine.

What is the treatment for OCD?

T
ALKING THERAPY
:
Cognitive behavioural therapy (CBT) or behavioural therapy (BT) are usually recommended for OCD. Exposure and response prevention (ERP), where the sufferer is exposed to what they most fear and then attempts not to compensate with compulsive behaviours, has also been found to be particularly effective.

M
EDICATION
:
Antidepressants, in the form of selective serotonin reuptake inhibitors (SSRIs), are usually the first choice of medication, sometimes along with atypical antipsychotics.

What is the prognosis for people with OCD?

It is estimated that, without treatment, people with OCD may still suffer from symptoms after thirty years. However, properly treated, the prognosis for OCD is good. Over half of people on medication improve, although symptoms may return after stopping taking the medication. The best results come from a combination of medication and ERP (or ERP alone), with around three-quarters of people who complete between ten and twenty sessions improving significantly.

What are the risks associated with OCD?

Aside from a poorer quality of life and daily distress, people with OCD are more likely to suffer from other mental health disorders, particularly panic attacks and depression. Substance abuse, sleep disturbances, tics, body dysmorphic disorder, and extreme grooming habits (such as skin picking, nail biting, and hair pulling) are also more common in people with OCD. It is estimated that more than half of people suffering from OCD have suicidal tendencies.

Who can I contact for help if I think I have OCD?

Your first point of contact should be your GP, who may prescribe you medication and/or refer you for therapy, depending on how severe your disorder is. In addition, the below organisations may be able to offer help, support, and advice:

OCD Action
Tel: 0845 390 6232
Web:
www.ocdaction.org.uk

OCD-UK
Tel: 0845 120 3778
Web:
www.ocduk.org

Anxiety UK

Tel: 08444 775 774

Web:
www.anxietyuk.org.uk

TOP (Triumph Over Phobia)
Tel: 0845 600 9601
Web:
www.topuk.org

Please see the ‘Useful contacts and links' pages for more resources and organisations which may be able to help, including national mental health charities such as Mind, Sane, and Rethink.

Eating disorders: bulimia and anorexia

Eating disorders

We all have different eating habits and make personal choices about what we eat, whether that's choosing to become a vegetarian, eliminating certain foods – such as wheat or dairy – from our diet, or simply trying to eat in a healthier way. However, people whose eating choices are determined by the fear of putting on weight may have an eating disorder. In these people, avoiding calorie intake or trying to get rid of already consumed calories may become an obsession. Anorexia nervosa and bulimia nervosa are the most common eating disorders and, although they are separate conditions, often overlap.

What is bulimia?

Bulimia is an eating disorder characterised by eating large amounts of food all in one go (binge-eating) and then attempting to ‘make up for it' by getting rid of the food by vomiting or using laxatives (known as ‘purging'), fasting, or exercising.

What are the symptoms of bulimia?

People with bulimia usually have a distorted perception of their body shape or weight and often dislike how they look. They may crave certain foods, think about eating all the time, and have uncontrollable urges to eat large amounts. These feelings manifest in binge-eating, often over a short space of time and in secret, with sufferers often feeling out of control and disconnected from reality when binging. These episodes are then followed by vomiting, the use of laxatives, diuretics and enemas (purging), and/or fasting, diet pills, and excessive exercise. Those with bulimia may also suffer from mood swings, anxiety, depression, and have feelings of shame, guilt, and low self-esteem. People with bulimia are often of a normal weight, so it can be hard to diagnose.

Are there different types of bulimia?

P
URGING BULIMIA
:
Those with purging bulimia binge-eat and then vomit or use laxatives, diuretics, or enemas to rid their body of the food eaten.

N
ON-PURGING BULIMIA
:
Those with non-purging bulimia – which accounts for less than 10 per cent of cases – fast or excessively exercise to get rid of the calories consumed.

How common is bulimia?

Recent research has found that up to 6.4 per cent of adults in England have symptoms of an eating disorder, with 40 per cent of those being bulimic, 10 per cent anorexic, and the rest suffering from an Eating Disorder Not Otherwise Specified (EDNOS).

Are certain types of people more likely to develop bulimia?

It is thought that women are around ten times more likely than men to suffer from bulimia, with white middle-class females being at the highest risk of developing the disorder, which usually begins between the ages of seventeen and twenty-five. Bulimia has also been found to be more common in Western nations and in those who live in urban, rather than rural, areas. Sufferers often share certain personality traits, including: perfectionism, competitiveness, low self-esteem, feelings of inferiority, difficulty in managing emotions, compulsive or obsessional behaviour, and a lack of confidence.

Why do people get bulimia?

Multiple factors are thought to contribute to the development of bulimia:

G
ENES
:
A genetic predisposition has been implicated in bulimia, as those with close family members who have suffered from the condition are more likely to suffer from it themselves.

E
NVIRONMENT AND LIFE EXPERIENCES
:
Experiences such as childhood sexual abuse and/or neglect, and a history of family substance misuse, alcoholism, depression, and anxiety have been found to be more common in those with bulimia. Negative or obsessional parental attitudes towards food, eating, weight, and body shape may also play a role.

B
ODY CHEMISTRY
:
Abnormal levels of neurotransmitters such as serotonin and/or of hormones such as cortisol may also contribute to the development of bulimia.

S
OCIETAL/CULTURAL TRENDS
:
The current Western trend for slenderness, propagated by the media and the fashion industry, has also recently been implicated in the development of bulimia, where thin female ‘role models' such as actresses, singers, and models are seen as images to aspire to.