Tragedy In Psychiatry DVD – A Harrowing Story

 Trigger Warning: Mention of suicide

Why does it happen?

Although there can be great improvement with psychiatric care for a lot of mental health problems, sadly many cases do still end in tragedy. This is why we have a tragedy in psychiatry DVD. As uncomfortable as it is to speak about suicide, it’s a topic that we should not be silent about. There needs to be a greater understanding of what people who take their own lives go through, in order for us to make a difference. Some may argue that it is inevitable, but I like to think that anybody could be helped.

 About Our Programme

In our programme, we use interviews with a woman who was also a mental health patient. Sadly, she eventually took her own life.  The programme helps to show her state of mind before she passed away, and highlights that sometimes the things she said didn’t line up with her actions. For example, she said she had no plans to end her life. I think this highlights the importance of always checking in on somebody, regardless of what they say their intentions are. Her mother also took part in an interview, so she could share the first symptoms her daughter experienced. 

Symptoms and Analysis

The woman began to not want to see her own reflection. Her mum came home to find crosses everywhere and all of the mirrors covered. Her daughter kept saying that the angels didn’t like her. Her belief that the angels were watching and judging her was completely unshakeable. In the programme, a group of doctors discuss the symptoms and what diagnosis they may point towards. They discuss psychosis, delusions, schizophrenia and other possibilities. They also discuss ways that they might approach treatment for somebody like her. Later, it is revealed that the woman was also abused by her father as a child – something her mother didn’t know about until a lot later on.

 Bereavement

The programme also explores the effect the woman’s death had on her mother. Bereavement through suicide is an incredibly difficult thing to recover from, and it was very brave of her mother to speak about the way that she felt and how her daughter’s illness affected her. This highlights the importance of support for those who have lost their loved ones to suicide. It should be spoken about a lot more, so that people know they can reach out for support, and others are more likely to give their support.

Mental Health Education: Why Is It Important?

Awareness

Without mental health awareness, people are less likely to know if they have a problem, and are less likely to be understanding if somebody else is having a problem. Awareness is needed to educate people on medication, mental health problems, treatments and the stigma around all of it. Although society has come quite far in relation to mental health awareness, it still has a way to go.

 

Medication 

Unfortunately, many people still look at medication for mental health problems with skepticism. After all, it’s hard for some to empathise with others who have a problem they’ve never had to deal with. This can actually lead to people sabotaging mental health treatment. It doesn’t take a lot to put somebody off of taking their medication, especially in the beginning when they may be struggling with side effects. Family members may share their disagreement and misconceptions, for example, “You don’t need to take those. They’re so bad for you,”, and, “You just need more fresh air, that’s the best anti-depressant.” The stigma can also lead somebody to be afraid to go and speak to a mental health professional, because they think they will just be put on lots of medication straight away. The truth about medication, at least when it comes to mental health, is that in the beginning a patient does need to be monitored. With lots of things, it’s difficult to get it exactly right on the first try. Some medications agree with patients, while others may take the same and have severe side effects, eventually finding that they suit something different. Sometimes treatment may include ECT (electro-convulsive therapy). Many films and television programmes have put out an unfavourable view of ECT, which can be quite effective. However, it’s important to acknowledge that there are side effects such as memory loss. ECT is a last resort treatment.   

Types of Mental Health Problem

Some mental health problems, like depression and anxiety (which we most frequently hear about compared to other mental health problems), can usually be treated using therapy and sometimes medication. Although everybody experiences anxiety, this kind of anxiety isn’t a ‘normal’ level. A usual reason to experience anxiety may be a driving test, or a job interview. Some people experience extremely high levels of anxiety around things that aren’t actually very stressful for the average person – for example, social gatherings (with friends), going outside, and using public transport. This level of anxiety is extremely disruptive to daily life. SSRIs are also sometimes prescribed to those who are depressed and anxious. There are more complicated mental health problems that aren’t talked about as much as depression and anxiety. Examples would be bipolar disorder (once known as manic depression), dissociative identity disorder, post traumatic stress disorder, emotionally unstable personality disorder (also known as borderline personality disorder) and schizophrenia. These illnesses are debilitating and require long-term management, which may be through medication and regular therapy sessions. The side effects to the medications for these illnesses may be a bit more difficult to live with, and it can be a balancing act with the focus being the overall well-being and safety of the patient.

 

There is still a lot to learn

There is still a lot of work and research to be done for mental health problems and treatments. Mental health education is important for society, and for the future of treatments. 

Stress And Depression In The Workplace During COVID-19

 Stress and depression in the workplace are very common. Now, during the COVID-19 pandemic, many are being furloughed or are being made to work from home. This, for some, makes life easier, and for others may add to the stress.

Furlough

Stress and depression in the workplace can be transferred home. Furlough may reduce concern for staff around COVID-19, but it would also be a big change. For some, staying at home will be a much-needed break. For others, it may be a huge change of routine and may affect their mental health negatively. For example, many parents have had to be furloughed so that they can look after their children while the schools are closed. It is not just childcare that’s expected of parents, though. There is also the need to home-school. Most parents are not prepared for this. The UK school curriculum is always changing, so it’s understandable that some parents may find teaching difficult. Although not much can be done about the need to home-school, employers can still check in on their employees to make sure that they’re okay during their furlough. 

Working from home

Those who are able to are now working from home. For many, this means having to rearrange the layout of their home to accommodate for a desk and proper office chair, with work computers. This may be a squeeze for some people. Some may find that they struggle to concentrate at home, after all, it is the place that they may associate with relaxation or the hobbies they do in their own time. This can go both ways, and make it difficult for them to relax properly – even more so if they live in a studio flat, so there is no separation from their workspace and their relaxation space. Employers should regularly check in on employees, to make sure that they’re still getting some relaxation time. It is also worth reassuring employees and being understanding if they’re struggling to be as productive as they may have been in the office. Stress and depression in the workplace can become stress and depression at home.

Unable to stay at home

Some people are unable to work from home and have essential jobs working with the public. It’s important that these people are provided with adequate PPE, and all necessary health and safety measures are put in place. It’s important for everybody to feel and be as safe as possible when they go to work.

 

Mental Health Education – Demand

 Mental Health

Over the past year, the COVID-19 pandemic has caused a demand for more online learning resources. The pandemic has also created a higher demand for mental health support, understandably. Mental health is a very broad topic, and the way mental health problems affect people vary from person to person. In my opinion, there is always more room for educational content on mental health.

Covering Various Topics

There is a lot of educational content on depression and anxiety. I think a lot more awareness is growing in these two areas. Having said that, there is still progress to be made to reduce the stigma in these areas. However, there is a lot less awareness of other mental health problems. There needs to be more mental health education on illnesses like schizophrenia, borderline personality disorder, bipolar disorder, and dissociative identity disorder. Even commonly suffered problems like premenstrual dysphoric disorder could do with some more educational content on the subject.

Why is it important to cover topics other than depression and anxiety?

Although there is a stigma attached to depression and anxiety, there is a lot more awareness around them than other mental illnesses. Film and television still use mental health problems like schizophrenia and bipolar disorder inaccurately to drive narratives, reinforcing the misconceptions around these illnesses.

Incorrect use of mental illnesses in conversation

You may have noticed that some people may describe themselves as, “A bit OCD”, or they may say, “I’m so bipolar today.” This may seem like a harmless comment, but it takes away from the seriousness of the mental illnesses and also reinforces misconceptions. For example, many people think that bipolar disorder just means having a lot of mood swings. While mood swings can be a part of it, they’re not the only symptom. Bipolar Disorder is characterized by episodes of mania and/or hypomania and long periods of depression. People often misunderstand the seriousness of mania and hypomania, thinking of them as just being more energetic and in high spirits. In reality, mania can lead somebody to think that they’re invincible, which can cause an extreme change in behavior. It could lead them to put themselves or others in danger. An example I recently heard was that somebody with bipolar disorder just decided to fly to another country last minute. This is something that somebody in the right mind would plan in advance, take time off of school or work for and make sure they had the right amount of money to do. Doing something like this without any plan or thinking will have consequences.

Conclusion

This post alone shows that you can’t cover all aspects of mental health in a short blog post, which is why I believe mental health education is always and always should be in demand. 

 

Bereavement in Obstetrics – World Prematurity Day & Miscarriages

World Prematurity Day – What is it?

On the 17^th of November, it was World Prematurity Day. This is a global movement made to help raise awareness of premature birth and the effect that it has on people. Expecting parents dream of the day that they can hold their baby in their arms. When a baby is born prematurely, they have to go into neonatal care. This can mean only being able to see their baby in an incubator, connected to tubes. They don't go on straight away to settle down at home and do all of the things that they as new parents have been taught to do. It can mean weeks of visiting their baby in the hospital until the baby is stable enough to go home. Sadly, not all babies make it home. According to the charity 'Bliss', out of the 15 million babies born prematurely every year, 1 million of them will not survive. This is why I decided to include World Prematurity Day in this blog post about bereavement in obstetrics. 

What is considered a premature birth?

A birth is considered premature when it happens three weeks or more before the due date. Premature births can lead to complications and medical problems. It is possible for babies born as early as 24 weeks to survive, but they do need specialist care. As mentioned above, some of these babies still do not survive.

Miscarriage:

Bereavement in obstetrics (for example, miscarriages) are very common, but there is a taboo around conversations about it. This is probably due to it being a difficult topic for some to understand, and one that makes people very uncomfortable. Although it makes people uncomfortable, it is still important to discuss. Recently, Meghan Markle opened up about a miscarriage she experienced this year. There has been a huge response, with some of the comments being grateful and some being unhelpful. Some people have said, “Not all grief needs to be made public knowledge!” Sadly, all this sort of response does it makes those who have experienced miscarriage or given birth to a stillborn baby feel that they cannot talk about it. Another comment states, “Meghan Markle may not see the awful comments about her, but your friends who have experienced miscarriages will.”

Complications during pregnancy, miscarriages and premature births:

 It's really important that parents dealing with the above get the empathy and support that they need and deserve. This can start by sharing experiences, so that others don't feel alone.  

Post Traumatic Stress Disorder – What Causes It?

What is Post Traumatic Stress Disorder?

Post Traumatic Stress Disorder was referred to as, ‘combat fatigue’, after World War One, and, ‘shell-shock’, after World War Two. However, post-traumatic stress disorder is not something only suffered by soldiers. PTSD can happen to anyone who experiences something traumatic in their life. Most people will experience some of the symptoms of PTSD after a traumatic experience, however, usually, the symptoms will reduce after 4-6 weeks on their own. If the symptoms continue after this point, further treatment is required. PTSD is treatable.

What can be classed as trauma?

There are loads of different types of trauma. The most obvious kind would be disasters, such as hurricanes and earthquakes, railway or plane crashes. However, bullying can also be considered a traumatic event, along with the death of a parent, medical trauma, and sexual abuse. The sudden death of a loved one can cause PTSD. Trauma can change the way that the brain responds to situations in future.

Symptoms of PTSD

Posttraumatic stress disorder can cause the physical symptoms of anxiety (for example, sweating, shakiness, clamminess, palpitations), as well as irritability, mood swings, flash-backs, nightmares, difficulty sleeping, being hyper-vigilant (tense and jumpy, ready to escape). Somebody with PTSD may attempt to avoid their feelings altogether, which can lead to avoiding anything that may trigger even the slightest memory of their trauma. 

What is the treatment?

Someone with PTSD may be referred to counselling or other forms of psychotherapy. Usually, medications aren’t prescribed unless the PTSD is very severe. Eye movement desensitisation and reprocessing is also a form of treatment that seems to have a good effect on those suffering from PTSD. According to the Center for Anxiety Disorders (https://centerforanxietydisorders.com/ptsdsudden-death-loved-one/),“...a study funded by the Kaiser Permanente HMO found that 100% of single-trauma victims and 77% of multiple trauma victims were no longer diagnosed with PTSD after just six 50-minute sessions.”  

What is EMDR?

EMDR is a form of therapy. The therapist will make side to side movements (usually hand tapping, or lights). Then they will ask the patient to recall the traumatic event. Usually, there will be at least 6 sessions of this. It is thought to help the brain process the traumatic event properly. 

Conclusion

PTSD can happen to anybody, after any event that a person finds traumatic, whether it be war, abuse, a bereavement, or bullying. If you have symptoms of PTSD, then it is worth going to your GP to see if you can be referred for some kind of therapy. 

 

Teaching About Alcoholism – It’s A Tough Topic

Why is Teaching About Alcoholism Important? 

Unfortunately, alcoholism is often blamed on the alcoholic themselves. It is looked at as a simple problem with a simple solution. While on the outside, it does definitely appear this way, it is often a lot more complicated than that. There needs to be more understanding of how to support somebody who is addicted to alcohol. 

Alcoholism is dangerous:

In moderation, although still bad for us, alcohol’s effect can be managed easily and we can recover. However, alcoholism can be very dangerous. Although the liver is a very forgiving organ, too much alcohol consumption on a regular basis can push it to the limit. Alcohol also has a bad effect on other organs in the body, and overuse can affect appetite, leading to an overall lack of self-care. Being run-down puts an alcoholic at higher risk of other issues.

Alcohol detox is a lot more difficult than it sounds:

Detoxification from alcohol can be very difficult. Some people might try detoxing at home, or some in an in-patient facility. Either way, it is a huge challenge, and some may face health risks even detoxing. If somebody is too dependant on alcohol, they may need medication to help wean themselves off of the alcohol. Completely cutting out alcohol at this stage can be dangerous, with some of the worst side effects being seizures or even death. Medical supervision is ideal for these cases. 

Relapse is a part of addiction:

Every addict faces a huge amount of judgement when they relapse. Relapses are common because addiction is just not an easy thing to defeat. Unfortunately, this is a difficult thing to change peoples’ perspectives on. Judgement is something that can bring out feelings of shame in somebody suffering from addiction, making them more secretive. They may hide a relapse out of shame and this could lead to further self-harm.

Underlying mental health problems:

A lot of addicts have underlying mental health problems that drive them to substance abuse. It is a way to numb the pain that they may be feeling. This is something not often obvious to those who judge somebody with alcoholism or any other addiction. 

Biological Factors:

Genetics and physiology can play a part in alcoholism. Some people have no trouble limiting their alcohol intake, while others really struggle to know when to stop. According to an article from Alcohol Rehab Guide, there are certain chemicals in the brain that can make someone more susceptible to alcohol abuse, and this could explain why alcoholism seems to run in families. 

Other Factors:

There are plenty of other factors that can play a part in the development of alcoholism. For example, living closer to shops or venues that sell alcohol may make you more likely to drink alcohol regularly. Culture, family and social circles can also have an impact on whether you drink a lot of alcohol or not. Pair this with a stressful new job or any kind of big life change and this can make a person more susceptible to alcoholism.

So there we have it, alcoholism is a lot more complex than just, ‘choosing to drink too much’.