Am I Just Freaking Out- Or Is It an Anxiety Disorder?
Am I Just Freaking Out- Or Is It an Anxiety Disorder? Know the Signs
For some tips on dealing with anxiety check out this blog post!
1. Am I Just Freaking Out- Or Is It an Anxiety Disorder from Adprime Media on Vimeo.
Delirium: A Patient Story at Leicester’s Hospitals
This is David and his wife Gloria’s story. Two years ago David was treated at Leicester’s Hospitals for community acquired pneumonia. During his admission David experienced an episode of delirium. Patients with delirium frequently experience hallucinations, false ideas or paranoia. These symptoms can be very distressing and frightening for patients and their families.
David explains what the experience was like: “Slowly but surely I descended into this land of…well it was different. Unfortunately my brain was telling me this isn’t real but no matter what I did I couldn’t wake up, I couldn’t get rid of it. This is the first experience, it was quite frightening.”
Patients may act in a way that is not normal for them, leading them to be labelled a nuisance or troublesome. David was isolated due to his ‘rude’ behaviour, which was very out of character. David adds: “All types of weird things were going on in my head. The whole thing was quite terrifying but I remember speaking to Gloria on the phone to tell her there was a bomb going to go off. I was firmly convinced this was going to happen. This thought was there but I knew it was wrong.”
It is important to recognise this is not the patient’s fault, in this case David, and to help re-orientate them to their surroundings and the care that they are being provided with.
Delirium can also have a significant impact on family and carers. Gloria didn’t know how to respond: “I didn’t know whether to say you’ll be ok it’s not really happening or to say thank you for the last 64 years, it’s been nice knowing you… you just don’t know how to reply to a person. I found it very difficult. Delirium can change the character of a person; this can be very distressing and difficult to understand for loved ones. A better understanding can help lessen the distress and family members can work alongside healthcare professionals to resolve the delirium quicker.”
Slowly but surely reality returned for David, who says: “Two years later it is still clear in my head what I was thinking. It is quote frightening. It felt so real. You can taste it. The only regret I have is that I would like to go back to say sorry to those people, if they all existed and I didn’t make them up, that I was rude to.”
Dr Chris Miller, Geriatric Medicine Specialist Doctor at Leicester’s Hospitals, looks after patients like David: “Delirium affects up to half our adult inpatients. Those with chronic conditions such as dementia, or Parkinson’s disease, and those with sensory deficits such as visual or hearing impairments are more at risk. Unfortunately, delirium is not very well recognised and frequently leads to poorer outcomes. Patients are often distressed by these episodes. A lack of understanding of this medical condition can exacerbate problems.”
David spent three weeks in hospital recovering from his pneumonia and delirium. He was subsequently discharged home to his wife, Gloria. He remains distressed by his experiences of delirium that he still remembers vividly.
As Chris highlights: “We encourage our staff to ask if their patients are more confused or more withdrawn than normal and if so, to ‘THINK DELIRIUM’ and work to find, investigate and treat any cause. Similarly, if family members or carers notice their loved one is more confused or more withdrawn than their normal self to alert our staff to this. Prompt actions can reduce the severity of any episode and improve outcomes for our patients.”
We would like to thank David and Gloria for sharing their story.
Famous People with Mental Illness
Depression counselor Douglas Bloch talks about how there may be a link between struggles with mental illness and the enormous creativity that inspired many of our culture’s most beloved artists.
Body dysmorphic disorder
Body dysmorphic disorder (BDD) is an anxiety disorder that causes a person to have a distorted view of how they look and to spend a lot of time worrying about their appearance.
For example, they may be convinced that a barely visible scar is a major flaw that everyone is staring at, or that their nose looks abnormal.
Having BDD does not mean the person is vain or self-obsessed.
Almost everyone feels unhappy about the way they look at some point in their life, but these thoughts usually come and go, and can be forgotten.
However, for someone with BDD, the thoughts are very distressing, do not go away and have a significant impact on daily life.
The person believes they are ugly or defective and that other people perceive them in this way, despite reassurances from others about their appearance.
It’s estimated that up to one in every 100 people in the UK may have BDD, although this may be an underestimate as people with the condition often hide it from others. BDD has been found to affect similar numbers of males and females.
The condition can affect all age groups, but usually starts when a person is a teenager or a young adult, when people are generally most sensitive about their appearance.
It’s more common in people with a history of depression or social phobia. It often occurs alongside obsessive compulsive disorder (OCD) or generalised anxiety disorder, and may also exist alongside an eating disorder, such as anorexia or bulimia.
BDD can seriously affect daily life, often affecting work, social life and relationships.
A person with BDD may:
constantly compare their looks to other people’s
spend a long time in front of a mirror, but at other times avoid mirrors altogether
spend a long time concealing what they believe is a defect
become distressed by a particular area of their body (most commonly their face)
feel anxious when around other people and avoid social situations
be very secretive and reluctant to seek help, because they believe others will see them as vain or self-obsessed
seek medical treatment for the perceived defect – for example, they may have cosmetic surgery, which is unlikely to relieve their distress
excessively diet and exercise
Although BDD is not the same as OCD, there are some similarities. For instance, the person may have to repeat certain acts, such as combing their hair, applying make-up, or picking their skin to make it “smooth”.
BDD can also lead to depression, self-harm and even thoughts of suicide.
The cause of BDD is not clear. It may be genetic or caused by a chemical imbalance in the brain.
Past life experiences may play a role too – for example, BDD may be more common in people who were teased, bullied or abused when they were children.
People with BDD are often reluctant to seek help because they feel ashamed or embarrassed.
However, if you have BDD, there is nothing to feel ashamed or embarrassed about. It is a long-term health condition, just like many physical conditions, and it’s not your fault.
Seeking help is important because it’s unlikely that your symptoms will improve if left untreated, and they may get worse.
You should visit your GP if you think you may have BDD. Initially, they will probably ask a number of questions about your symptoms and how they affect you, such as:
Do you worry a lot about the way you look and wish you could think about it less?
What specific concerns do you have about your appearance?
On a typical day, how many hours is your appearance on your mind?
What effect does it have on your life?
Does it make it hard to do your work or be with friends?
If your GP suspects BDD, they can refer you to a mental health specialist for further assessment and any appropriate treatment.
With treatment, many people with BDD will experience an improvement in their symptoms.
The specific treatments recommended for you will depend on how severely BDD affects your daily life.
If you have relatively mild BDD, you will usually be referred for a talking treatment called cognitive behavioural therapy (CBT). More severe cases may be treated with a type of medication called a selective serotonin reuptake inhibitor (SSRI) and/or more intensive CBT.
CBT is a type of therapy that can help you manage your problems by changing the way you think and behave. You’ll work with the therapist to agree on some goals – for example, one aim may be to stop obsessively checking your appearance.
An important element of CBT for treating BDD is known as graded exposure and response prevention (ERP). This involves facing situations where you would normally think obsessively about your appearance, so you are able to gradually cope better with these situations over time.
As part of your therapy, you may also be given some self-help materials to use at home and you may be invited to participate in some group work.
SSRIs are a type of antidepressant that increase the levels of a chemical called serotonin in your brain. Serotonin is a chemical that the brain uses to transmit information from one brain cell to another.
A number of different SSRIs are available, but most people with BDD will be prescribed a course of fluoxetine.
Your medication should be taken daily and it may take 12 weeks before it has an effect. If it’s effective, this treatment should continue for at least 12 months, to allow for further improvements and prevent a relapse.
When the treatment is complete and your symptoms are under control, the SSRI dose should be reduced gradually to minimise the possibility of withdrawal symptoms.
Common side effects of SSRIs include headaches, feeling agitated or shaky, and feeling sick. However, these will often pass within a few weeks.
Adults younger than 30 will need to be carefully monitored when taking SSRIs, because of the potential increased risk of suicidal thoughts and self-harm associated with the early stages of treatment.
If SSRIs aren’t effective in improving your symptoms, you may be prescribed a different type of antidepressant called clomipramine.
In some cases of BDD that are particularly difficult to treat, you may be referred to The National OCD/BDD service in London.
This service offers assessment and treatment to people with BDD who have not responded to treatments that are available from their local and regional specialist services.
