Understanding Severe and Enduring Mental Illness:
Bipolar Disorder and Schizophrenia
Bipolar Disorder and Schizophrenia are two mental illnesses which have a lot in common. They are relatively rare disorders effecting approximately1% of the population, they are very debilitating for the sufferer, cause a lot of distress for families and they are often the least understood therefore the most feared types of mental illness.
What do the terms Bipolar Disorder and Schizophrenia actually mean ?
Bipolar Disorder describes repeated episodes during which a person’s mood and levels of activity are significantly disturbed. This includes an elevation of mood, or ‘high’ with increased energy and activity, clinically known as mania or hypomania. At other times the person experiences a lowering of mood and decreased energy and activity, called depression.
At times having a ‘high’ mood can be very pleasant as the person can feel extremely happy with boundless energy and motivation. Unfortunately the down side to elevated mood is the longer it persists the person may begin to feel restless and exhausted with insomnia, an inability to concentrate and extreme irritability. Psychosis (see next paragraph) can also occur. Depression is characterized by low mood, sometimes with suicidal thoughts, strong negative feelings or feeling empty of all emotions, with no motivation or energy. Depression is rarely pleasant, although it can sometimes be a relief after a traumatic elevated mood. People with Bipolar Disorder, sometimes referred to as Manic Depression, will often experience periods of stability between mood swings.
Schizophrenia is the name given to a range of symptoms where a person’s thinking, perception, mood and emotions are radically distorted. When acutely ill, people will often say inappropriate things or display unusual behaviour. A common myth is that schizophrenia refers to a split personality. There is no truth in this myth. People with schizophrenia often suffer from psychosis and describe feeling not in control of their thoughts or experiencing strong unusual beliefs called delusions. For example, paranoid delusions when a person may feel persecuted by a member of their family, neighbours or others. Paranoid delusions are very disturbing and frightening for the individual and may cause great distress for their family members and others involved. Schizophrenia sufferers may also experience hallucinations which are sounds, sights, scents or sensations which no one else can see, hear, smell or feel. Hallucinations are usually unpleasant, very distressing and interfere in the sufferer’s life significantly. People who suffer from schizophrenia are more likely to experience episodes of depression too.
What treatments are available for severe and enduring mental illnesses ?
There are no cures for either Bipolar Disorder or Schizpophrenia. Both types of illness are chronic in nature although there are a broad range of treatments available. A combination of treatments tailored to suit the needs of the individual are recommended to ensure optimum health.
Medication A full range of medication is available including antipsychotic medication, antidepressants, mood stabilizers, anxiolytics, or anti anxiety drugs and sleeping tablets. Similar to taking any other type of medication there are risks that individuals may develop unpleasant side effects, therefore drug treatment has to be closely monitored by a Doctor or Nurse.
Talking treatments Accepting a diagnosis of Bipolar Disorder or Schizophrenia and learning to understand the illness are complex issues. Research has shown that learning strategies to help manage or reduce the symptoms greatly reduces the levels of personal distress and can prevent relapse. Cognitive Behaviour Therapy is recommended for both Bipolar Disorder and Schizophrenia.
Self Help Maintaining a full and active lifestyle, eating and resting regularly while avoiding stressful situations or relationships are important ways to prevent a deterioration in mental health. Many self help organizations exist to support people in managing their illness. (See useful addresses)
Relapse Prevention Recognizing the early warning signs that may indicate a deterioration in mental health are important and seeking help earlier rather than waiting until the person is severely distressed by their illness. Family often have a role to play in relapse prevention as they can often notice the early warning signs before the person is aware of a change in their mental state. It is important that joint working and collaboration exist to ensure that a correct assessment is made, as there is a wide degree of variation in what is considered normal behaviour within society.
Support Services People who suffer from severe and enduring mental illness may be unable to work or maintain independent living and they may need extra support in the form of supported employment, supported accommodation, welfare benefits or day care. Accessing the right level of support is important in maintaining the health and wellbeing of individuals.
Are people who suffer from severe and enduring mental illness a danger to society ?
Sometimes the media report people being attacked or killed by someone with a psychotic mental illness. This is the exception rather than the rule. The vast majority of people who have Bipolar Disorder or Schizophrenia are vulnerable due to their illness therefore they are themselves at risk of attack or abuse by others. They are more likely to be a danger to themselves than others, either through self neglect or engaging in risk taking behaviours.
Further Information
Are range of leaflets are available at KEMH. Or, if you would like more information on Bipolar Disorder or Schizophrenia please contact your GP or Karen Chenery, CPN on 28082.
Useful Addresses
National Schizophrenia Fellowship www.rethink.org or www.nsfscot.org.uk
Manic Depression Fellowship www.mdf.org.uk
MIND (National Association for Mental Health) www.mind.org.uk
Specifically for children and young people contact www.youngminds.org.uk
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