The Psychiatric Medical Model

1. The Psychiatric Medical Model There are four key areas under what is deemed the ‘Psychiatric Model’ • Psychosis • Neurosis/Affective Disorder • Physical • Personality Other factors can distort the model… Drugs (prescribed and street), Alcohol, Addictions, Stress & Trauma (eg. Seeking asylum or abuse), Learning Disability, Behavioural

2. Psychosis • Primary characteristic is a loss of contact with reality. Individuals are unable to distinguish between delusions or hallucinations (internal) and the real world (external), and have no insight regarding their condition!.

3. Psychosis - Schizophrenia PRIMARY SYMPTOMS • Hallucinations (voices, smells etc) • Distorted understanding of the relationship with the outside world. • Delusions • Disordered Thinking • Disturbance of Feelings SECONDARY SYMPTOMS • Loss of energy and motivation • Deterioration in self care • Withdrawal from social relationships

4. Psychosis - Mania SYMPTOMS • Very elated or over active behaviour, rapid speech • Expansive Ideas • Extravagance (often around money) • Loss of Inhibitions • No awareness of change of behaviour • Irritable and easily angered Manic Depression/Bi-polar Disorder is a condition where the individual experiences profound disturbance of mood, either high (mania) or low (depression)

5. Neurotic/Affective Disorders • Neurotic disorders are generally considered to relate to stress and emotional problems and are deemed less serious than Psychotic disorders. The can nonetheless be extremely disabling and can cause great distress to the sufferer. People suffering from Neurosis can have considerable insight into their condition, yet still be unable to do anything about it.

6. Neurotic/Affective Disorders - Depression There are two main types of depression: Endogenous Depression has no immediate or obvious cause and is more difficult to treat Reactive Depression is a condition related to a life event (eg bereavement, loss, abuse etc) and is sometimes know as ‘mild depression’ DEPRESSION SYMPTOMS • Overwhelming despair, sadness, unexplained guilt and feelings of unworthiness • Extreme apathy, lethargic, agitated, social withdrawal • Deterioation in self care • Disturbed patterns of eating & drinking, loss of appetite, weight loss/gain • Disturbed sleep patterns • Loss of libido • Difficulty making decisions or helping self • Thoughts of suicide and death

7. Neurotic/Affective Disorders - Anxiety • GENERAL ANXIETY – Feeling anxious most of the time • PANIC ATTACKS – Rapid build-up of anxiety, leads to feeling of faintness, pounding heart and a fear of losing control • PHOBIAS – Exaggerated fears related to particular situations or stimuli (eg claustrophobia, agoraphobia, arachnophobia, aerophobia) • OBSESSIONS – Repetitive thoughts which intrude without good reason and which the person recognizes as unreasonable • OBSESSIVE-COMPULSIVE DISORDER – Acting on obsessive thoughts (eg continual hand washing, repetitive behaviour, checking doors locked, turning tins in cupboards) • ANOREXIA – Weight reduction caused by under-eating and sometimes excessive exercise. Sufferer often has distorted body image seeing themselves as fat even when in reality they are very thin. • BULIMIA – Body weight often normal. Characterized by binge eating, outside usual meal times and in secret. Sufferer eats until physically uncomfortable, then takes laxatives or makes themselves vomit • COMPLUSIVE OVEREATING – Sufferer can’t stop eating , even though they know they are over doing it.

8. Neurotic/Affective Disorders - Anxiety SYMPTOMS OF ANXIETY – IN THE MIND • Feeling worried all the time • Feeling tired • Unable to concentrate • Feeling irritable • Sleeping badly • Feeling depressed SYMPTOMS OF ANXIETY – IN THE BODY • Fast/irregular heartbeat, sweating, pale face, dry mouth • Muscle tension, trembling, numbness, dizziness, faintness • Breathing fast, indigestion, nausea, stomach cramps, diarrhoea

9. PHYSICAL/ORGANIC DISORDERS Sometimes physical illnesses can cause changes to mental health: • Acute infections can cause delirium. Person becomes confused and agitated and may experience hallucinations • Vitamin deficiency can cause dementia • Thyroid disorders can disrupt usual brain function • Brain tumours and strokes can cause various symptoms, which also occur in mental illness • Drug abuse can produce psychotic symptoms. Long term alcohol abuse can damage short-term memory and cause disorientation in space and time • Temporal lobe epilepsy can produce symptoms similar to schizophrenia • Alzheimer's disease – progressive loss of brain function, usually in old age, leading to impaired memory and confusion • AIDS – the later stages can lead to dementia (brain function deteriorates)

10. PERSONALITY DISORDER This term is used to describe problems (usually of behaviour) which seem to stem from a persons basic personality being flawed in some way. Such a diagnosis usually means that the person is seen as untreatable and because of this, many psychiatrists will not keep someone with this diagnosis on their books. Probably the best known category of personality disorder is Psychopathic disorder. The term is used to describe those most difficult and/or damaged people whose behaviour is likely to cause problems for others Psychopaths are often considered to be lacking in personal warmth, manipulative and unable to form emotionally satisfying relationships. There has been lots of media interest associated with this area,

11. PERSONALITY DISORDER - SYMPTOMS Personality refers to the enduring pattern of thoughts, feelings and outward behaviour that makes each person an individual. As such, a diagnosis does not sit easily within the medical model. However certain characteristics are often noted: • Long lasting inflexible and limited range of attitudes and behaviour • Marked deviation from expected social and cultural norms • Distress to the individual or others • Often first noticeable during adolescence or early adulthood • Higher risk of suicide and other negative social indicators

12. TREATMENTS • Psychosurgery (leucotomy – previously known as lobotomy) • Electro Convulsive Therapy (ECT) • Medication • Talking Treatments (psychotherapy, behavioural therapy, counselling) • Complementary Therapies (aromatherapy, herbalism, massage, reflexology etc) • User-led approaches (self help groups, Hearing Voices Network Experts by Experience)