Examples of common behaviour changes

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Week 3

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From the previous sections it is clear that behavioural changes are often the first sign of the move from mental health to mental illness, but that the underlying processes might have been going on for a while before the behaviours are manifest. This section is about the commonest manifestations of mental illness in terms of the behaviours that might become apparent. We have used people's own stories to illustrate these, as they demonstrate or discuss the behaviours with a clarity that we cannot achieve by text alone.

With grateful thanks to the Mental Health team at City University for their help with this week's resources.

 

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Depression

Clinical depression is determined on the basis of severity and persistence of symptoms. It requires one or both of 'low mood' and 'loss of pleasure or interest' to be present for most of the day, for most days for at least two weeks, together with other symptoms from lack of energy; loss of confidence or self-esteem; disturbed sleep; disturbed appetite; poor concentration or decision-making; agitation or slowing down; feelings of guilt or worthlessness; and thoughts of suicide (making at least 5 in total). 

This TED video lasts about 30 minutes. It is writer Andrew Solomon describing his depression in a very clear way. It is well worth watching if you have time.

Anxiety Disorders

Anxiety behaviours include worrying, feeling on edge, low concentration, restlessness, headaches, trembling, inability to relax, sweating, increased heart rate, dry mouth, stomach upsets, dizziness, and light-headedness. All of which are normal depending on the circumstances. In anxiety disorders these behaviours are prolonged, severe or inappropriate responses to the situation.

Anxiety Disorders include Generalised Anxiety Disorder (GAD); Panic Disorder (with or without agoraphobia); Phobias (especially social phobia); Obsessive Compulsive Disorder (OCD); Post Traumatic Stress Disorder (PTSD)

Mood Self Assessment Quiz Links to an external site. The NHS mood self-assessment quiz uses questions taken from tests often used by GPs to assess whether someone is anxious or depressed.

This short NHS Video is Lisa French telling her story about post-traumatic stress.

Eating Disorders

Anorexia is regarded as when the Body Mass Index (BMI) less than 17.5 or 15% below expected weight. Weight loss is self induced, including avoidance and/ or purging. There might be body image distortion; a morbid fear or fatness; amenorrhea, endocrine disorders, and depression is common.

Bulimia is characterised by binge eating followed by compensatory weight less. There is likely to be purging by self-induced vomiting, or the use of laxatives. Usually there is a normal weight. It is more common than anorexia, mostly (90%) female. 

This short video is Katie Metcalfe telling her story about anorexia. 

Personality Disorders

Personality is described as 'patterns of thinking, feeling and behaving that is persistent across time and situations'. Personality disorders are usually classified as: Cluster A (odd or eccentric disorders): schizoid, schizotypal, paranoid; Cluster B (dramatic, emotional or erratic disorders): antisocial, borderline, histrionic, narcissistic; and, Cluster C (anxious or fearful disorders) avoidant, dependent, obsessive compulsive. 

Borderline personality disorders can manifest as unstable replationships; unstable self image; being highly reactive or having an unstable mood; impulsivity; poor planning or problem solving; poor tolerance for frustration and inability to control anger; and, deliberate self-harm.

In this TED video, Eleanor Langden talks about her schizophrenia.

Dementia

Dementia is a progressive neurodegenerative disease with an increased prevalence after the age of 65. It's features include memory loss, (both short term and long term); mood changes; communication difficulties; declining ability to carry out activities of daily living; and, physical frailty. The main types are Alzheimer's disease and vascular dementia.

In the following TED video, Alanna Shaikh talks about preparing for Alzheimer's having cared for her father.

Acute confusion or delirium

It is important to recognise acute confusion or delirium as this always has an underlying physical cause rather than being a mental health issue. Acute confusion has an acute onset and a fluctuating course. It is characterised by reduced attention; perceptual abnormalities; impaired memory; disorientation; disorganised thinking; and, an altered sleep - wake cycle. All of these features have been mentioned in the various disorders described above and so it is easy to see why health and social care professionals might take acute confusion to be something else.

 tab.png References and Further Reading

Time-to-change Links to an external site. is England's biggest programme to challenge mental health stigma and discrimination, which is a led by 'Mind' and 'Re think Mental Illness'. This is a good resource to look at for more information and personal blogs on depression. 

Patient Links to an external site. is the UK’s leading independent health site which is run by a number of doctors. The site has many different forums on mental health and in particular depression.