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Who Are The Community Mental Health Team?

If you have been diagnosed with a mental illness then there is the possibility that your doctor will refer you to a Community Mental Health Team (CMHT). The Community Mental Health Team is a group of professional individuals who are specialists in their line of work.

Together they are able to offer you the kind of treatment, advice and support you need to help you cope with difficulties you may be having and to give you the best chance of recovery.

So what kind of professionals might make up a CMHT and what can they do for you?

Psychiatrists

Psychiatrists have a degree in medicine and are fully qualified doctors with further training in mental illness. They are able to prescribe you any medication you might need and make decisions regarding what sort of treatment is appropriate in your case.

Psychologists

Psychologists have a degree in psychology and extensive training before they become qualified psychologists. They are not doctors so cannot prescribe medication but they have an excellent understanding of mind and behaviour and can therefore recommend and offer psychotherapy which can include cognitive and behavioural psychotherapy, psychoanalysis, or any other therapies.

Community Psychiatric Nurses (CPNs)

A CPN will make home visits to you at regular intervals in order to make sure you are coping with life in general and can help you with any practical problems or difficulties you may have including any issues about your medication. Different CPNs may have specialised training in specific areas of mental health so are able to offer you advice and liaise with other members of the CMHT about your treatment and progress.

Social Workers

Social Workers are qualified professionals who are able to help you with practical issues such as finances and benefits, housing, family and relationship problems etc.

Occupational Therapists (OTs)

Occupational therapists are also able to help you with practical things such as what you physically can and cannot do and how you can be more independent. They can help you regain confidence and advise you on what sort of help is available in your area.

Other information about the CMHT

There are many other members of the CMHT which will differ from area to area but can include various counsellors and therapists as well as receptionists and secretaries.

The CMHT will often operate out of a doctor’s surgery or a local hospital or health clinic but again, this varies from region to region.

All the professional members of the Community Mental Health Team work closely with each other and will have regular meetings to discuss specific cases and the best ways of dealing with them.

You are likely to be assigned a key worker who will be your main point of contact. This key worker could be a nurse or a social worker or anyone else in the team. They will be familiar with your case, will get to know you and gain an understanding of any particular difficulties you might have and will be able to talk to you about your treatment and what you can expect regarding your care.

Schizophrenia symptoms and how to recognise them

Unfortunately there isn’t a reliable single test that can diagnose schizophrenia as yet so a diagnosis is usually made by a psychiatrist if the individual concerned displays symptoms of schizophrenia and other possible conditions have been ruled out.

No two people with schizophrenia will display the same symptoms to the same degree; instead there will usually be a combination of positive and negative symptoms which can include hallucinations and delusions, poor social functioning, racing thoughts and disorganised thinking.

Positive symptoms

Positive symptoms can be described as those symptoms which are in addition to normal ways of functioning and behaviour and which people who do not suffer from schizophrenia are unlikely to experience such as hallucinations, illusions and delusions. Hallucinations can take place in any of the senses, for example in the form of sound, sight, touch, taste and smell. A common type of hallucination in schizophrenia is hearing voices that other people cannot hear and these voices are a very real experience. They can be talking to the person with schizophrenia or even tell them to carry out certain orders.

Illusions on the other hand are when certain things are real and do exist but are misinterpreted by the individual and perceived as something different.

Delusions can be described as beliefs which are simply not true and which are not based on any fact or real evidence. For example a common type of delusion in people with schizophrenia is a feeling of being persecuted, in other words paranoid schizophrenia. The individual may falsely believe that another person or persons sometimes close family members are conspiring against them. Another type of delusion often seen in schizophrenia is where the person believes they are extremely important or famous and this is known as delusions of grandeur. They may believe that voices on the radio or people on the television are speaking directly to them giving them personal messages.

Negative symptoms

Negative symptoms can be more difficult to evaluate and treat because they are less obvious than positive symptoms. They can be described as those symptoms that appear to show a loss of normal functioning and behaviour. For example, negative symptoms can include a withdrawal from social contact, showing no emotion, being slower to think and talk, and altered sleeping patterns.

Schizophrenia is more a collection of symptoms and signs so an evaluation of all the symptoms by a psychiatrist is essential for an accurate diagnosis.

Paranoid Schizophrenia, what does that mean?

Paranoid Schizophrenia is a type of Schizophrenia. Schizophrenia is a serious and debilitating mental illness where the individual interprets reality in an abnormal way and as such can experience hallucinations and delusions.

Hallucinations are hearing or seeing things that aren’t really there and can affect any one of the senses. Delusions are where the individual believes in certain things which are not true and persists in believing them despite being presented with evidence to the contrary.

Someone suffering from delusions might believe they are of divine birth and on a special mission in life or that they are famous and extremely important or that the television and radio as well as other forms of media are sending out special messages directed specifically at them.

The behaviour of someone with schizophrenia can appear bizarre, irrational and indeed shocking to others at times and can cause much worry and anxiety for the sufferer, the family and close friends and co workers. In paranoid schizophrenia the individual may feel persecuted and may even mistakenly believe that a close friend or member of the family or anyone else for that matter is trying to poison them or is conspiring against them. This feeling that someone is out to get them or that they are being watched and plotted against can lead to violence and confrontation as they try to ‘defend’ themselves against their perceived threat.

Other symptoms of Paranoid Schizophrenia

•    Extreme jealousy
•    Hearing voices
•    Hallucinations involving any of the senses
•    Beliefs with no basis in reality
•    Anxiety
•    Aggression and confrontation
•    Withdrawing from social situations and contact
•    Anger
•    Thoughts of suicide

The symptoms of schizophrenia are generally categorised into positive and negative symptoms. Positive symptoms can be described as those which involve hallucinations and delusions. Negative symptoms on the other hand can include symptoms such as withdrawing from social situations, showing little or no emotion and being slow to think and talk.

If you feel that you or someone close to you may have symptoms of paranoid schizophrenia it’s vital that you seek help early. The difficulty with this is that many people with schizophrenia will not recognise that they have a problem or that they need help. However, with the right treatment and support from family and friends there is every chance that the individual with schizophrenia can go on to lead a full, productive and happy life.

Different Types Of Depression Treatments

There are many possible causes of depression and, as a result, there are many depression treatments.  Sometimes they are used in conjunction with each other, and sometimes they are used as the solitary method of treatment.  A few of the most common methods of treating depression are medication, psychotherapy, and electroconvulsive therapy.

Medications

Medications used to treat depression are known as antidepressants.  They affect various neurotransmitters in the brain that are thought to play a role in the disorder.

Depression is believed to have a clear chemical component and, in some cases, a chemical imbalance may be the root cause.  Even in cases where the main cause is not chemical, antidepressants can help the patient by providing relief as the other causes are explored and dealt with.

Psychotherapy

This is the one that you picture with a patient on a couch and a therapist with a notepad listening intently as the patient speaks.  There are many different schools of thought as to how to most effectively treat depression in a psychotherapy setting, but many agree that psychotherapy is the method that often produces the most lasting results.

If the causes of the depression are mental in nature then it is not hard to see why this form of therapy would work.  The therapeutic relationship attempts to explore a person’s thoughts and behaviour to discover what is causing the depression and why it is being maintained.  This understanding is used to promote growth and change.

Electroconvulsive Therapy

This form of therapy involves the administration of electricity to the scalp to induce a seizure in the patient.  The necessary course of treatment often involves the administration of these bursts of electricity during sessions that take place over the course of several weeks.

It may seem like the most extreme or even farfetched method of the treatments mentioned here, but it can be effective in cases where the patient has been resistant to treatment.  This resistance could be the ineffectiveness of medications in the patient’s case or a case wherein medications could do harm to the patient.  It may also be applied when the situation is severe and results are needed immediately.

The many treatments for depression all have their benefits.  When used singularly or when used in pairs, they may provide welcome relief to depression patients.  The multiplicity found in the causes of depression has necessitated a similar diversity in its treatments.  This diversity helps professionals approach the problem with the most appropriate of the treatments.

Anxiety

What is depression Anxiety Disorder?

I have written this page in an effort to give you an overview of anxiety and anxiety disorders. You will find information on what anxiety is, what causes anxiety disorders, symptoms of anxiety and anxiety treatment methods that can help. In addition, you can find definitions for the most common types of anxiety disorder. Hopefully, this will help you to identify what is making you feel the way you do, and you can begin to find relief for your dilemma.

Over 18 million people suffer from anxiety disorder. You CAN find help! About 9 in 10 individuals who seek anxiety treatment report feeling better.

Although there are many different forms of anxiety disorders (and anxiety treatment), the general definition for anxiety is:

“a vague, unpleasant and sometimes debilitating emotion that is experienced in anticipation of some misfortune. ”

The misfortune is usually ill-defined, meaning that it is hard to pinpoint the actual reason for what is causing the anxiety. Although many people suffer from anxiety in certain situations, the reasons for why they feel the way they do are generally difficult to identify. Most people understand that they have anxiety. What is difficult to understand is WHY the anxiety has such a strong hold on their life. If you are experiencing anxiety, keep reading and you will find a list of common anxiety disorders in this section. Identifying what type of anxiety you have and why it is happening is the first step in finding effective anxiety treatment.

Depression anxiety

The Causes of Anxiety

The cause of anxiety disorder has been studied for decades. There are various reasons for feeling the way that you do. First, it is important to understand which form of anxiety disorder you may have. Researchers have been studying the effects of anxiety on the brain and have found much insight into how it effects us. Modern studies indicate that as a result of past, present or perceived circumstances that occurred to an individual, a chemical imbalance may have occurred in the brain. The emotions we feel are based on the release and reuptake of neurotransmitters in the brain. This is how cells within the brain communicate. Feelings off anxiety are triggered by an imbalance of specific ‘neurochemicals’ in the brain. The specific neurotransmitters that may be affected include serotonin, norepinephrine, GABA and dopamine.

When we feel stressed, anxious or depressed, our brains may be releasing or absorbing (re-uptake) chemicals either too rapidly or too slowly. If left untreated, a chemical imbalance disorder may increase in severity as time passes.

Most modern methods for treating chemical imbalances come in the form of prescription medications. Drugs like Paxil, Prozac and Effexor are believed to have a direct effect on key neurotransmitters. Though these drugs work in about 60% of individuals who take them, patients often report experiencing a wide variety of side effects, and the drug manufacturers themselves aren’t even sure how the drugs actually work to ‘rebalance’ chemicals in the brain. Users of these drugs often report relapse, as the drugs fail to address the underlying causes of anxiety.

The question that needs to be answered before doctors move too hastily in prescribing medications to their patients is : What is the cause of the chemical imbalance?

Depression anxiety

The Cause of Chemical Imbalance

Some theories suggest that chemical imbalances are a normal part of life. Everyone feels stressed or anxious at times, even depressed. This is a normal response by our body to events occurring around us. It is important to note that the physical or mental feelings we experience and exhibit are being caused by the release of chemicals and hormones in our brains.

Example 1a:

As you prepare your schedule for the week, your manager comes into your office and tells you that you need to have a new certification program written and developed for incoming new-hires by the end of the week. “This is a critical part of our new-hire training, and I need it done by Friday, or my boss will have my head… and I’ll have yours!”, he says to you. [maybe not so dramatic]

You reluctantly agree and ensure your manager that you will have the work completed.. As soon as your manager leaves your office, you begin to experience feelings of stress and nervoussness. “I can never finish this…..what is he thinking?……It’s too much work…. I haven’t even started….. I am going to get fired,” and similar thoughts echo through your mind repeatedly for the next 10 minutes. You can feel a headache coming on, you start thinking of worst case scenarios, your face begins to flush, your heart begins to beat more rapidly….. you become angry. “How can he spring this on me with such short notice!”

In the above example, your body begins to physically respond to your overwhelming thoughts of what might and could go wrong. A common occurrence, this often happens in stressful situations because our brain begins to overload our body with unbalanced releases of neurotransmitters and other brain chemicals. If we are unable to get rid of the feelings, they progressively worsen over the course of the day, or week, or month.

Example 1b:

You begin thinking about some cognitive behavior therapy exercises you learned to help you cope with your stress and anxiety. You realize that your thoughts are causing you to continue to create irrational thinking patterns, which in turn, is causing you to feel physical symptoms of stress and anxiety

“I have been writing training material for years. I bet if I check all of the resources I already have, I can find some things that can help me get this project completed. I am a professional, and I have successfully handled these deadlines before.”

You provide yourself with evidence that you are not helpless in this situation, and that chances are, if you organize yourself, you can get this done. Over the course of 5 – 15 minutes, you reinforce yourself with overwhelming reasons for why you can do it. You begin to take notes and jot down plans for the project.

As you begin to cope with the stresses that presented themselves, your body starts returning to normal chemical states. Physical, and emotional symptoms begin to diminish. You are able to cope with the stress.

In most cases, we are able to develop coping techniques that can help us to immediately deal with the stress and the imbalance of chemicals that happen as a result. However, if we do not cope with the stresses that present themselves today, our negative feelings, emotions and thoughts take hold and might never let go.

Though the examples provided above are very basic, they demonstrate an approach to resolving anxiety based on addressing the underlying causes. Chemical imbalances may very well be caused by the fact that we have not yet found ways to cope with our underlying problems. Over time, the imbalance may become our brain’s normal setting, thus causing stress, anxiety or depression consistently, and for long periods of time.

Depression anxiety

Common Symptoms of Anxiety

Anxiety is an unpleasant and sometimes debilitating emotion that is experienced in anticipation of some form of disaster. It is sometimes difficult to diagnose properly because the symptoms of anxiety are also symptoms shared by other conditions, or symptoms that can occur without any condition at all.

Anxiety, once diagnosed, spawns many different symptoms, including

  • sleeping troubles
  • specific obsessions over stressful topics
  • difficulty thinking about anything besides a stressful topic
  • feeling tense, restless, jittery, or dizzy.
  • having trouble concentrating
  • fluctuations in appetite
  • being overly cautious
  • being startled easily
  • having an omnipresent feeling of impending danger or disaster.

At times, individuals with anxiety may have feelings that cross-over into related conditions such as social anxiety, panic attacks and generalized anxiety disorder.

The symptoms of anxiety can present a person who suffers from them with major obstacles in his or her day-to-day life. Anxiety symptoms can seem to bring a person down and keep them down. This creates a feeling of immense pressure on the individual. However, the symptoms of anxiety can be relieved with the proper treatment so that a person who experiences them can live a normal and productive life. Learning more about yourself, your feelings and what may be causing the stresses in your life is an important step to finding a long-term solution.

St. John’s Wort And Depression

St. John’s Wort Depression (Hypericum) At least one out of every 20 Americans gets depressed each year, and many rely on anti-depressants to help them cope. A new study shows the herb St. John’s Wort might be just as effective, and with fewer side effects. The August 3, 1996 issue of the British Medical Journal contains an analysis of approximately 25 studies that suggest that St. John’s Wort (Hypericum perforatum) is just as helpful as commonly used drugs, without side effects such as headaches or vomiting. Dr. Cynthia Mulrow, one of the study’s authors, says the findings are not surprising. “Some of the commonly used medicines have a basis on herbs or have a basis in plants, and some of the ones were developed using plants.” Although not well known in the United States until recently, researchers in Europe have been studying it for decades. Doctors in Germany have been prescribing it for depression and insurance companies have been paying for it. It has available in herb shops in Europe and the United States, but recently has been increasingly selling out as word has been getting around about it effectiveness. It comes in liquid, capsule and dried form. Clinical Studies Not long ago, experiments were done where mice infected with viruses similar to HIV were given St. John’s Wort extract. The virus’ progress was halted. This led to testing on human HIV and AIDS patients. The results are inconclusive, though anecdotal information reports a significant improvement in some patients. St. John’s Wort contains hypericin that inhibits monoamine oxidase, a bodily chemical associated with depression. It appears that hypericin does not act alone. Like many herbal medicines, St. John’s Wort relies on the complex interplay of many constituents for its antidepressant actions. Patients suffering from depression received relief, increased appetite, more interest in life, greater self-esteem and restoration of normal sleeping patterns. St. John’s Wort is available as tea, tincture, decoction, oil, and in capsule form. Teas should be made with 1-2 cups of flowers per 1 cup of boiling water. This tea can be drunk three times daily. The dosage of the tincture is 1/4 to 1 teaspoon up to three times daily. Perhaps most notable regarding St. John’s Wort extract for depression has been favorable comparisons to standard prescription antidepressive drugs. These include maprotiline hydrochloride and imipramine. In a multicenter trial, 135 patients with depression were given either St. John’s Wort (900 mg/day) or imipramine (75 mg/day) for six weeks. Therapeutic success was determined using the HAMD, Clinical Global Impression (CGI), and Depression Scale according to Zerssen. HAMD score improved by 56% in the St. John’s Wort group versus 45% for the imipramine group. Differences on the CGI and Zerssen scales were slightly better for St. John’s Wort although not significantly different. Adverse reactions were reported in 16% of patients taking imipramine while only 12% of those taking St. John’s Wort experienced side effects. Precautions Dr. Donald Brown of Bastyr University recommends that persons with fair skin avoid exposure to strong sunlight and other sources of ultraviolet light when taking St. John’s Wort because of some cases of photosensitivity that have been reported. He also advises avoiding foods that contain tyramine, alcoholic beverages, and medications such as tyrosine, narcotics, amphetamines, and over-the-counter cold and flu remedies while taking St. John’s Wort. St. John’s Wort should not be taken while also taking prescription antidepressants. It is also Dr. Brown’s opinion that St. John’s Wort should not be used during pregnancy or lactation. According to Jonathan Zuess, MD (author of The Natural Prozac Program), tyramine seems to primarily be a problem if a person has high blood pressure. This is due to St. John’s Wort working in a similar way to drugs that are monoamine oxidase inhibitors (MAOIs). However, studies done in the 1990’s have shown that the MAOI-like effect of St. John’s Wort is negligible when it’s used in normal doses. So it is unlikely that it would react with tyramine. In Germany, where doctors have had the most experience with St. John’s Wort, it is considered safe to use in patients with high blood pressure. Nonetheless, if you have high blood pressure, and your doctor agrees to your use of St. John’s Wort for depression, the following precautions should be taken:

  1. Have your blood pressure checked at least weekly for the first six weeks, and at least monthly thereafter.
  2. Do not eat foods containing tyramine.

Even if you do not have high blood pressure, do not take St. John’s Wort with amino acid supplements (especially phenylalanine and tyrosine). Amino acids are a form of monoamines, which can pose a danger when mixed with St. John’s Wort. The monoamines that you get in your diet (such as the amino acids in meat) are less concentrated and are not a hazard