What's Normal Anyway? Celebrities' Own Stories of Mental Illness (31 page)

Anticonvulsants
are medications used primarily to treat epilepsy, which work by suppressing the excessive firing of neurons in the brain that trigger seizures. However, some anticonvulsants may also be used to treat mental health conditions. For example, sodium valporate may be used as a mood stabiliser for people with bipolar disorder, and pregabalin may be prescribed for generalised anxiety disorder.

Antidepressants
are psychoactive drugs used for the treatment of depression and other mental health conditions. They include different classes of medication, such as selective serotonin reuptake inhibitors (SSRIs), serotonin–norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, and monoamine oxidase inhibitors (MAOIs). They work by increasing the levels of certain neurotransmitters in the brain, such as serotonin and norepinephrine, which improve mood.

Antipsychotics or neuroleptics
are psychoactive drugs used mainly to treat psychotic conditions such as schizophrenia. However, antipsychotics may also be used in the treatment of other mental health disorders, such as bipolar disorder, severe anxiety, and depression. There are two classes of antipsychotic drug: typical (e.g. chlorpromazine) and atypical (e.g. quetiapine). While both work by blocking the effects of dopamine, atypical antipsychotics also affect serotonin.

Assertive outreach teams
work with people who are experiencing the most severe kinds of mental illness who are unable to engage with, or who have lost touch with, mainstream services.

Behavioural therapy (BT)
is based on the premise that behaviour is learnt and, therefore, can be unlearnt. As a type of therapy, it may include systematic desensitisation, aversion therapy, and flooding. Flooding, for example, is a technique that may be used to overcome phobias, involving exposing the patient to their feared object or situation until their fear subsides. The therapist may help the patient during this process by using relaxation techniques.

Benzodiazepines (BZDs, ‘benzos', or ‘tranquillisers')
are psychoactive drugs that work by enhancing the chemical GABA in the brain, producing calming effects. They reduce anxiety, promote sleep, relax muscles, have anticonvulsant properties, and are sedating. Although they are very effective for anxiety states, they are usually only used as a short-term treatment due to their addictive qualities. Diazepam (Valium) is an example of a benzodiazepine.

Beta-blockers
are medications that block the release of adrenaline and noradrenaline in various parts of the body. Although they are usually used to treat heart problems and high blood pressure, they may also sometimes be used to treat the physical symptoms of anxiety, such as palpitations and shaking. However, they do not help the mental symptoms of anxiety, such as feelings of worry or dread.

Cognitive behavioural therapy (CBT)
is a type of talking therapy that focuses on the here and now rather than the past. It attempts to change the way a person thinks (their cognitions) and how they respond to these thoughts (their behaviour). It may, for example, involve identifying and challenging negative and unhelpful thought patterns and replacing them with positive ones, leading to beneficial behavioural change. It is frequently used to treat depression, anxiety, and eating disorders.

Community mental health teams (CMHT)
are made up of different types of professionals – such as psychiatrists, social workers, community psychiatric nurses, and support workers – who work together to give care to people with mental illness.

Cortisol
is a steroid hormone released by the adrenal gland. It is sometimes known as a ‘stress' hormone as it is released into the bloodstream in response to stress.

Crisis services
are services available at short notice to support people through an acute mental health episode. Available on the NHS or through charities, such services can be in the form of telephone helplines, acute inpatient wards in hospitals, and/ or crisis resolution and home treatment (CRHT) teams.

Delusions
are irrational and illogical beliefs that may occur in certain mental illnesses, such as schizophrenia. Somebody experiencing delusions may think, for example, that their phone is a mind-control device or that they are being followed or monitored by a law enforcement agency.

Dopamine
is a neurotransmitter produced in the brain which is often known as a ‘feel good' chemical as it controls the brain's reward and pleasure centres.

Early intervention services (EIS)
are local teams – made up of experts such as psychiatrists, psychologists, social workers, support workers, and occupational therapists – who give help and support to people who have recently experienced their first psychotic episode.

Electroconvulsive therapy (ECT)
involves having an electrical current passed through the brain while under general anaesthetic. It is usually only used in cases of severe clinical depression that have not responded to other treatment. It is unclear exactly how ECT works but it can be very effective in the short term, although it doesn't seem to stop depression coming back in the future.

Exposure and response prevention (ERP)
is a type of therapy, used particularly in anxiety disorders such as phobias and OCD. Used in the treatment of OCD, it involves a patient, guided by their therapist, being exposed to what they most fear, without then compensating with compulsive behaviours. For example, a person with a fear of germs might be encouraged to gradually build up to touching a toilet seat without washing their hands afterwards. If the patient is able to complete the course of therapy it has been found to be very effective.

Gamma-aminobutyric acid (GABA)
is a neurotransmitter that helps to regulate over-excitement of the nervous system. Drugs that enhance GABA – such as benzodiazapines – have a calming effect.

Hallucinations
can affect all of the senses and may involve hearing, seeing, smelling, tasting, or feeling things that aren't actually there. For example, people experiencing hallucinations may hear voices in their head or feel as if there are insects crawling on their skin. Hallucinations may be symptoms of a mental illness such as schizophrenia or may be induced by drugs, alcohol, or a physical illness (such as infection).

Interpersonal therapy (IPT)
is a type of therapeutic approach that views psychological symptoms as being a response to current problems and conflicts in the relationships in a person's life. As a therapy, it is structured and time-limited, usually performed over a course of between eight and sixteen sessions.

Monoamine oxidase inhibitors (MAOIs)
are an older form of antidepressant drug that are usually only used today when other medications haven't worked. They have to be used with care as they can interact dangerously with foods that contain high levels of tyramine, such as aged cheeses, fermented foods, liver, alcohol, yeast, and some meats. Eating such foods while taking MAOIs may result in seriously high blood pressure and, in severe cases, can be fatal.

Neurotransmitters
are chemical substances that transmit signals between nerve cells in the brain.

Norepinephrine/noradrenaline
is a neurotransmitter and hormone. It is commonly known as a ‘stress hormone' or ‘fight or flight chemical' as it underpins the body's ‘fight or flight' response, speeding up the heart rate, raising blood pressure, narrowing blood vessels in non-essential organs, and dilating pupils.

Psychiatrists
are medical doctors who go on to specialise in the diagnosis and treatment of mental health disorders. Unlike psychologists, they are able to prescribe medication.

Psychoanalysis
is a type of psychotherapy, initially developed by Sigmund Freud. Its underlying premise is that early childhood experiences provide unconscious patterns which affect a person's psychological well-being and functioning into adulthood. In psychoanalysis such patterns are brought back into conscious awareness so that a patient can understand what is creating their mental distress.

Psychologists
are specialists in human behaviour. Clinical or counselling psychologists are trained to work with people with mental health conditions. They may work in various settings, such as hospitals, health centres, or privately.

Psychosis
is a general term that describes mental states where people are out of touch with reality. Psychotic symptoms may include hallucinations, delusions, and muddled, disordered, and jumbled thinking. Psychosis is not a mental health disorder in itself but may be a symptom of other disorders, such as schizophrenia or bipolar I disorder. Psychotic symptoms may also be brought on by traumatic events or by some physical illnesses (such as infections).

Psychosomatic symptoms or somatisation
is the tendency to experience and express psychological distress in the form of physical symptoms such as chest pain, palpitations, headaches, nausea, insomnia, dizziness, and fatigue.

Psychosurgery/neurosurgery
involves using brain surgery to treat mental illness, by destroying or removing a small piece of the brain. Today, psychosurgery is very rarely used in the UK and can only be carried out with the patient's permission.

Psychotherapy
is an umbrella term that generally refers to the process of talking therapy conducted by a trained therapist with a patient experiencing psychological distress. The treatment aims to increase the patient's sense of well-being and improve their mental health. Psychotherapy may also encompass non-talking therapies such as art, drama, or music therapy.

Schizophrenia
is a mental illness that affects the way that a person thinks, feels, and behaves. The symptoms of schizophrenia are often classed as ‘positive' and ‘negative'. Positive symptoms include hallucinations, delusions, and jumbled thinking (‘not thinking straight'). Negative symptoms may include memory problems, an inability to concentrate, becoming isolated, problems communicating with other people, and loss of interest in usual activities.

Sectioning, or being sectioned
, is when a person is detained at a hospital under the Mental Health Act, whether or not they agree to it. In order to be sectioned someone must be suffering from a mental health condition that needs treatment or assessment in hospital, in order to protect their own safety or other people's safety.

Selective serotonin reuptake inhibitors (SSRIs)
are antidepressant medications, used to treat a variety of mental illnesses, that are thought to work by increasing the levels of serotonin in the brain. They are usually now used instead of the older-style antidepressants as they have fewer side effects. SSRIs can take up to four weeks to work and patients usually start on a small dose, which is then gradually increased, in order to minimise side effects. Similarly, when discontinuing treatment, the medication should be gradually reduced. Some people may have to try several different SSRIs before they find one that works for them. Fluoxetine (Prozac) is an example of an SSRI.

Serotonin
is a neurotransmitter that regulates mood. It is thought that those with low levels of serotonin may be prone to depression.

Tricyclics
are an older style of antidepressant medication that affect three neurotransmitters: serotonin, norepinephrine, and acetylcholine. They are now generally less popular than SSRIs, as their ‘anticholinergic' effects can have adverse effects on the heart and circulation, and taking more than the prescribed dose can be dangerous. Examples of tricyclics include amitriptyline and imipramine.

Mind

Infoline: 0300 123 3393
Web:
www.mind.org.uk
A charity that provides advice and support to those living with mental illness.

Rethink

Helpline: 0300 5000 927
Web:
www.rethink.org
A charity that provides information, services, and a voice for those affected by mental illness.

SANE

Helpline: 0845 767 8000
Email:
[email protected]
Web:
www.sane.org.uk

A charity that provides emotional support, information, and practical help to people suffering from mental illness.

The Samaritans

24-hour helpline: 08457 90 90 90
Email:
[email protected]
Web:
www.samaritans.org
A 24-hour service that provides confidential emotional support for
people who are in distress or having suicidal thoughts.

Mental Health Foundation

Web:
www.mentalhealth.org.uk
A charity that aims to help people live with and recover from mental illness, through research, campaigning, and pioneering practical solutions. It provides statistics and information on mental health conditions for the public.

The Mental Elf

Web:
www.thementalelf.net
Up-to-date information on mental health research, policy, and guidance.

NHS Choices

Web:
www.nhs.uk
National Health Service information on mental health conditions, treatments, local services, and healthy living.

British Association for Counselling and Psychotherapy (BACP)

Tel: 01455 883300
Web:
www.bacp.co.uk
The largest professional body representing counselling and psychotherapy, including an accredited register where members of the public can find therapists in their area.

British Association for Behavioural and Cognitive Psychotherapies (BABCP)