Ask the doctor - mental health

Read expert medical advice with doctors' questions and answers from Prima, SHE and Good Housekeeping

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How can I find help with my elderly mother?

I've cared for my mother, who has severe arthritis, for years and now
she's developing early dementia. I want to encourage her to do as much for herself as she can. But how do I find out more about what services I might need?

You're not alone - there are about 6 million carers in the UK, with about 5,500 joining the group of unsung heroes every day. Your first ports of call are your and her GP - GPs now offer an annual assessment of carers' needs, but only if they know you are one! Your mother should be eligible for a Social Services assessment that can ascertain her present needs, but constraints on services often make it hard for them to plan ahead. There are many voluntary organisations that provide advice, local support groups and help for people in your position. Boots has just launched a new website, with comprehensive details and advice
about everything from carer/dependent support and end-of-life care to lasting powers of attorney, which allow you to take legal responsibility for your mother's affairs if she's not capable. Visit www.boots.com and search for Caring Made Easier.

Dr Sarah Jarvis, Good Housekeeping (Oct 09) 

 

My vomiting phobia is wrecking my life

My phobia of vomiting has become so bad that I hardly go out socially any more because I'm terrified I, or someone near me, might be sick. What can I do?

Although not common, this phobia is by no means unknown and I do sympathise with the impact it is having on your life. By definition, a phobia is a fear of something that is out of proportion to the real danger it poses. The fear is usually so profound that you alter your behaviour to avoid any possible exposure to it. Fortunately, a fear of vomiting can often be dealt with very effectively with the same form of treatment as other phobias - namely cognitive behavioural therapy (CBT). This kind of therapy does not look at past reasons for your problems, but focuses on your thought processes and how you react to them. The idea is that certain thought patterns can trigger or perpetuate a vicious cycle of anxiety, depression or fear. CBT helps you to understand, challenge and change such thought patterns and the behaviours they result in. It is usually done weekly for about an hour over several weeks. It may not be available on the NHS, but
it's definitely worth talking to your GP about it.

Dr Sarah Jarvis, Good Housekeeping (Sept 09)

 

My mother has Alzheimer's and I've heard that there are trials for a new drug called Rember. How can I apply for her to take part?

 

The results of Rember's patient trials have so far proved very promising. In fact, a relatively small study suggested that it could be more than twice as effective as any treatment currently available. However, bigger trials are needed before we can be sure just how good it is and whether there are any serious side effects.

If all goes well, it's hoped that it will be on the market in 2012. Meanwhile, more research is being conducted at Aberdeen University and bigger trials are planned, but these haven't started yet, nor has patient recruitment begun.

All psychiatrists dealing with Alzheimer's sufferers will be able to refer patients to the trial team, so it would be a good idea to talk to your mother's specialist about the possibility of putting her name forward. There are, however, strict criteria for those taking part in the trials. For more details, visit the Aberdeen University website at abdn.ac.uk.

At present, there is no cure for Alzheimer's, but there are a number of drugs that may slow the progress of the disease. Talk to your mother's specialist about the options available to her. You may also wish to contact a support network, which can provide important advice on caring for a loved one with dementia. Get in touch with the Alzheimer's Society at www.alzheimers.org.uk or call the helpline on 0845 300 0336.

Dr Louise Selby, SHE

 

 

My mother has Alzheimer's disease, so I'm doing all I can to prevent myself from developing the illness. However, my partner is a smoker and I have read that this can increase the likelihood of Alzheimer's. Is this true?

 

Recent research suggests that both smokers and passive smokers have a slightly higher risk of Alzheimer's.  Obviously, you are very concerned that you'll inherit Alzheimer's from your mother. However, the chances of this are low if she didn't get it until she was over 65. This is because it is thought that a person's genes may contribute to the development of the disease but not cause it. But if your mother had Alzheimer's before the age of 65, your risk of getting it will be higher. To fight against the chances of contracting dementia, try to follow the ‘use it or lose it' rule: stimulating your brain with mentally challenging pursuits, staying socially active and keeping physically fit have all been shown to cut the risk of Alzheimer's. A healthy diet is also vital. Stick to low-sugar, low-fat food, but increase your intake of omega 3 fats (found in oily fish and flax oil) and green, leafy vegetables. Find more information at www.alz.co.uk.
Dr Louise Selby, SHE

 

Cannabis and mental illness

My son has used cannabis for several years, so I was relieved when it was ‘downgraded’ to a class C drug, as I thought this meant new research had shown it was safer. But I’ve heard cannabis has been linked to mental illness, so should I still be worried?

Cannabis has been linked to mental illnesses such as schizophrenia and depression. It doesn't have these effects on everyone who takes it - but it's difficult to predict who will be affected. Factors such as the age at which you start, the amount you smoke, the form you use (one form of marijuana, known as ‘skunk', is particularly dangerous) and your natural vulnerability to mental illness may all play a part. As well as this unpredictable risk, it's thought three marijuana joints a day can do as much damage as 20 cigarettes. So while, for most people, the risks of cannabis aren't nearly as great as those associated with heroin, cocaine, etc, I'm afraid the downgrading doesn't mean you can be complacent. Dr Sarah Jarvis, Good Housekeeping

 

Ginseng

I swear by ginseng to help me concentrate, but my sister says its worth has never been proved and I’m wasting my money. Is she right?

No, you are, because when taken regularly at a standard dose of 400mg a day, ginseng has been proved to help mental concentration. It may also help with tiredness and resistance to viral illnesses. It's fairly safe at this standard dose, as long as you don't take it for more than 12 weeks at a time. Taking high doses for longer than this can cause quite marked side effects, including high blood pressure, skin rashes and sleep disturbance. So feel free to carry on using it with caution.
Dr Sarah Jarvis, Good Housekeeping
 

Psychologist, psychiatrist and a psychoanalyst

I find the job titles of psychologist, psychiatrist and psychoanalyst very confusing. What’s the difference?

I have to admit it can be desperately difficult to work through all the jargon in medicine, and medical titles can be particularly baffling. Psychiatrists, psychologists and psychoanalysts all look at the workings of the mind. However, psychiatrists are medical doctors. They do basic medical training, then specialise in psychiatry, which makes them medically qualified to treat diseases or disorders of the mind. Psychologists have studied, and are qualified in, psychology. Clinical psychologists often advise people who are going through a difficult time about self-help mechanisms and coping techniques to help them overcome their problems. Psychoanalysis was developed specifically to study psychiatric disorders - that is, disorders of the mind. The basis of psychoanalysis is that these disorders can be traced back to forgotten events or subconscious ideas in the patient's mind. The psychoanalyst tries to bring these back to the patient's conscious memory, in order to treat the disorder.
Dr Sarah Jarvis, Good Housekeeping
 

Panic attacks

Why does breathing in and out of a brown paper bag help during panic attacks? I’ve sworn by it for years, but my family think I’m just being silly.

It's amazing how well low-tech solutions work, isn't it? When you're having a panic attack, you breathe too fast, which means you breathe out too much carbon dioxide - and that can make you feel dizzy. Re-inhaling air you've exhaled into a paper bag replaces some of the carbon dioxide, creating an instant air balance and stopping the dizziness. If you're having panic attacks frequently, though, discuss them with your GP.
Dr Sarah Jarvis, Good Housekeeping

 

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The answers to specific problems may not apply to everyone and are not substitutes for professional medical advice. If you're worried, see your GP. For more information, visit www.netdoctor.co.uk