Alzheimer’s disease or dementia of Alzheimer’s type is a disease of the mind which affects memory and other brain faculties. It is more prevalent in older people (over 65s), but is seen rarely in younger adults in the 40s and 50s age group. There is a huge amount of good quality information available in the following sites:

RCPsych.ac.uk
Alzheimers.co.uk

I offer a one stop comprehensive assessment and management service for people who are getting concerned about memory problems. I can request MRI brain scans and interpret the results appropriately to arrive at a diagnosis, initiate and monitor treatments for dementia and for associated mental health conditions such as depression, education and aggression that can accompany it.

For more inforamtion, please refer the URL :-  https://www.alzheimers.org.uk

Vascular dementia is a dementia that is either caused by a stroke or occurs in the presence of diabetes, uncontrolled high blood pressure and heart disease, all of which can predispose one to stroke. Diagnosis is established by means of a careful history of the cause of illness and by interpreting brain scans. In vascular dementia the role of dementia specific treatment is less but the risk of depression and other mood disturbances is high and requires correct identification and management. Equally important is to control the risk factors of vascular disease such as weight, alcohol, smoking, high blood pressure and diabetes through appropriate medication and life style changes.

I can help to arrive at a clear diagnosis, assess risks comprehensively and increase your understanding of managing them adequately.

For more information on Vascular Dementia please see:

RCPsych.ac.uk/vascular dementia
Alzheimers.co.uk/vascular dementia

When memory and higher brain faculties start to deteriorate in a patient with Parkinson’s disease, one needs to consider the possibility of Dementia in Parkinson’s disease. Other causes such as depression and effect of medications need to be ruled out. Correct and early identification of this dementia helps in preventing avoidable complications and getting the best help and care organised.

Excessive alcohol use can cause a brain condition called “Wernicke’s encephalopathy”. This is believed to occur as a direct result of vitamin B deficiency and can progress to a more permanent damage in the form of Korsakoff Syndrome/psychosis. The inability to learn new information is a core feature of Korsakoff Syndrome and a dementia associated with alcohol use. Correct establishment of the diagnosis can help with organisation of appropriate care for patients with this type of dementia.

Alcohol-related brain damage (ARBD) is a brain disorder caused by regularly drinking too much alcohol over several years. The term ARBD covers several different conditions including Wernicke-Korsakoff syndrome and alcoholic dementia. None of these is actually a dementia, but they may share similar symptoms. However, in contrast to common causes of dementia such as Alzheimer’s disease, most people with ARBD who receive good support and remain alcohol-free make a full or partial recovery. In addition, there is a good possibility that their condition will not worsen.

Patterns of drinking in Great Britain have changed over the past 10 years. Middle-aged people are now the age group which consumes the most alcohol and they are drinking more than in the past, especially middle-aged women. In contrast, younger people (aged 16-24) are now drinking less, particularly when it comes to binge drinking. Against this background, ARBD is an under-recognised and growing problem.

Alcohol as a risk factor for dementia

Drinking more than the recommended limit for alcohol increases a person’s risk of developing common types of dementia such asAlzheimer’s disease and vascular dementia. The NHS recommended limits are now a maximum of 14 units each week for men and women, spread over 3 or more days – although lower limits have been suggested for older people because their bodies handle alcohol differently. A small 125ml glass of wine is typically about 1.5 units and a pint of beer, lager or cider is usually 2-2.5 units.

It seems that repeated binge drinking – heavy drinking in one session, often leading to drunkenness – is particularly harmful. Binge drinking is dangerous because it raises the amount of alcohol in the blood to a high level very quickly.

This increased risk of dementia is greatest at higher levels of alcohol consumption – the more you drink, the higher your risk. But you do not need to be an alcoholic or get drunk often to be at increased risk of developing dementia. Regularly drinking even a little above recommended levels probably increases your risk. It also increases your risk of other conditions such as stroke, heart and liver disease, and cancer.

Regularly drinking above recommended limits is seen as one risk factor that contributes towards dementia, rather than being a direct cause. Other lifestyle risk factors that raise a person’s chances of developing dementia include smoking, lack of exercise and unhealthy diet.

As explained below, regularly drinking at much higher levels than recommended can directly cause problems similar to dementia and so is different.

If you are concerned that you or someone you know is drinking too much alcohol and might need help, see the GP for advice. There are other organisations and charities that also provide support and advice for people with alcohol problems and their families (see ‘Other useful organisations’).

For more information, please refer :- https://www.alzheimers.org.uk/site/scripts/documents_info

Depression is a human emotion that is universally experienced. However, depression as a mental illness is prevalent in 10-20% of the adult population (1 in 5), according to the Office for National Statistics UK in reference 2013.

There are mild, moderate and severe grades of depression based on severity and number of symptoms. The milder grades are best treated by support, counselling and psychotherapy, while physical treatment such as medication are more effective for moderate to severe forms. There are a range of psychotherapy and counselling approaches and a certain fit between the therapist, kind of therapy and patient is required for the treatment options available. There is a certain fit required between the patient and the treatment for it to work well. Then there are complications such as existing physical illnesses, medications which need to be considered before recommendind a certain treatment option.. These make the job of psychiatrists like myself, very interesting and challenging. I would endeavour to take you through this journey with care and sensitivity, offering the best support and advice individually tailored to you and agreed with you.

Depression
Feeling low at times of personal loss, or during other stressful periods does not necessarily constitute Depression as a clinical condition. To be given a diagnosis of depression, you need to have a number of symptoms which are present every day for at least two weeks, according to the Standard Diagnosis guidelines such as the ICD 10 ( International Classification of Diseases ) and DSM 5 (Diagnostic and Statistical Manual of Mental Disorders )

symptoms of depression
persistent sadness,
loss of interest or pleasure in the things that he/she used to enjoy
a lack of energy.
Poor drive/ motivation

There may be
associated symptoms which include

problems sleeping, poor concentration, low self-confidence, poor or increased appetite, suicidal tendencies, agitation or slowing of movements, guilt or self-blame. The more of these associated symptoms the depressed person has, the more severe thedepression.

For someone to be diagnosed with depression, these symptoms will have been present daily and for most of the day for at least a fortnight.

Why do people get depressed?
One can get depressed because of external factors such as stress and traumatic events or without any reason. Depression is a disease of the mind and is likely a complex mix of interactions between our genes, body chemistry, the wiring of our brains and life experiences. Depression certainly isn’t a weakness or something you can fight off at will.Although a positive hopeful and even a fighting spirit can help one get better.Sometimes having a family memberwho has or had depressive illness, can increase one’s risk of getting the illness.

Anxiety and worry are ubiquitous conditions, but when they are occur as mental illnesses they can become severely disabling. Anxiety may be constant and unremitting or occur in brief distressing bursts or take the form of nagging worry about health or safety of self or others. It needs to be correctly identified, investigated and treated effectively so that it does not consume your life. While reassurance is hardly ever sufficient, knowledge of the anxiety mechanism itself can help to master it. There are a range of physical and psychological treatments that are available. I will help to tease the problem out and help you choose the option most acceptable and effective for you.

Anxiety
Anxiety Illness is a commonly occurring condition. It is mildly uncomfortable or can be severely disabling.

symptoms of anxiety
There may be physical, emotional and behavioural symptoms.

Common physical symptoms of anxiety include a pounding heart, sweating, knots in the stomach, fatigue, insomnia, shaking, hot flushes, muscle tension, dry mouth, feeling sick and tension headaches.

Emotional symptoms are in the form of irrational and excessive fear and worry, trouble concentrating, irritability, anticipating the worst and thinking that you may lose control and/or go “mad”. Sometimes individuals may experience episodes of severe anxiety referred to as panic attacks.

Behavioural symptoms especially in those who suffer panic attacks is avoidance. They can take the form of agitation, obsessive and compulsive behaviours

Treatments

What is obsessive-compulsive disorder (OCD)?
(taken from NICE clinical Guidelines WWW.NICE.ORG.UK/GUIDELINES/CG31)

Obsessive-compulsive disorder (or OCD for short) is the name given to a condition in which a person has obsessions and/or compulsions, but usually both. An obsession is a thought, image or impulse that keeps coming into a person’s mind and is difficult to get rid of. There are lots of different obsessions that can affect someone with OCD, but a few examples are:

1. being afraid of contamination by dirt and germs
2. worrying that something is not safe, such as an electrical appliance
3. thoughts and fears of harming someone else
4. wanting to have things in a particular order or arrangement (such as in a symmetrical fashion).

A compulsion is a feeling that a person has that they must repeat physical actions or mental acts. Usually people do this in response to an obsessive thought (for example, if a person is worried about dirt they might clean something repeatedly). People with OCD may use these actions to help deal with an obsessive thought or ‘neutralise’ it. There are lots of different compulsions that can affect someone with OCD (sometimes called ‘rituals’), but a few examples are:

1. excessive washing and cleaning
2. checking things repeatedly (for example, that a door is locked or that an electrical appliance is switched off)
3. keeping objects that other people might throw away (called ‘hoarding’)
4. repeating acts
5. repeating words or numbers in a pattern

From time to time, almost everyone has a disturbing thought or checks more than once they have locked the door. For most people these thoughts and actions can be forgotten. But if a person has OCD, the thoughts and feelings of discomfort can take over and they will feel anxious until they have done something to help them to deal with the thought. People with OCD may realise that their thoughts and actions are irrational or excessive, but they will not be able to help themselves from thinking the obsessive thoughts and carrying out compulsions. OCD can affect people in different ways. Some people may spend much of their day carrying out various compulsions and be unable to get out of the house or manage normal activities. Others may appear to be coping with day-to-day life while still suffering a huge amount of distress from obsessive thoughts. Some people with OCD may carry out their rituals and compulsions in secret or make excuses about why they are doing something. People with OCD may not realise that repeated thoughts, such as a fear of harming other people, are common symptoms of OCD and do not mean that they will carry out these thoughts.

When someone seeks help for their OWhen someone seeks help for their OCD, healthcare professionals will consider how distressing the symptoms are for that person and how much their life is affected. This will help them work out whether someone has mild OCD (symptoms are distressing but manageable and the person seems able to carry on with everyday life) or more severe or very severe OCD (symptoms are very distressing and seriously restrict the person’s everyday life). It will also help the healthcare professional work with the person with OCD to identify the most suitable treatment. It is thought that about 1–2% of the population in the UK may have OCD and it can affect people of any age, from young children to older adults. Some people with OCD also have depression.

What is bipolar disorder?
( taken from Royal College of Psychiatrists Leaflet on Bipolar disorders)

Bipolar disorder used to be called ‘manic depression’. As the older name suggests, someone with bipolar disorder will have severe mood swings. These usually last several weeks or months and are far beyond what most of us experience. They are:

Low or ‘depressive’
feelings of intense depression and despair

Mixed
feelings of extreme happiness and elation for example, depressed mood with the restlessness and overactivity of a manic episode

How common is bipolar disorder?
About 1 in every 100 adults has bipolar disorder at some point in their life. It usually starts between the ages of 15 to 19 – and it rarely starts after the age of 40. Men and women are affected equally.

What types are there?
Bipolar I
If you have had at least one high or manic episode, which has lasted for longer than one week.
You may only have manic episodes, although most people with Bipolar I also have periods of depression.
Untreated, a manic episode will generally last 3 to 6 months.
Depressive episodes last rather longer – 6 to 12 months without treatment.
Bipolar II
If you have had more than one episode of severe depression, but only mild manic episodes – these are called ‘hypomania’.
Rapid cycling
If you have more than four mood swings in a 12 month period. This affects around 1 in 10 people with bipolar disorder, and can happen with both types I and II.
Cyclothymia
The mood swings are not as severe as those in full bipolar disorder, but can be longer. This can develop into full bipolar disorder.

What is schizophrenia?
( taken from Royal College of Psychiatry leaflet on Schizophrenia)

A disorder of the mind that affects how you think, feel and behave. Its symptoms are described as ‘positive’ or ‘negative’.

‘Positive’ symptoms
These are unusual experiences. Many people have them from time to time and they need not be a problem. In schizophrenia, they tend to be much more intense, troublesome, pre-occupying and distressing.

Introduction
( Taken from Royal College of Psychiatrists leaflet on PTSD )

In our everyday lives, any of us can have an experience that is overwhelming, frightening, and beyond our control. We could find ourselves in a car crash, be the victim of an assault, or see an accident. Police, fire brigade or ambulance workers are more likely to have such experiences – they often have to deal with horrifying scenes. Soldiers may be shot or blown up, and see friends killed or injured.

Most people, in time, get over experiences like this without needing help. In some people, though, traumatic experiences set off a reaction that can last for many months or years. This is called Post-traumatic Stress Disorder, or PTSD for short.

Complex PTSD
People who have repeatedly experienced:

severe neglect or abuse as an adult or as a child
severe repeated violence or abuse as an adult, such as torture or abusive imprisonment
can have a similar set of reactions. This is called ‘complex PTSD’ and is described later on in this leaflet.

How does PTSD start?
PTSD can start after any traumatic event. A traumatic event is one where you see that you are in danger, your life is threatened, or where you see other people dying or being injured. Typical traumatic events would be:

serious accidents
military combat
violent personal assault (sexual assault, physical attack, abuse, robbery, mugging)
being taken hostage
terrorist attack
being a prisoner-of-war
natural or man-made disasters
being diagnosed with a life-threatening illness.
Even hearing about the unexpected injury or violent death of a family member or close friend can start PTSD.

When does PTSD start?
The symptoms of PTSD can start immediately or after a delay of weeks or months, but usually within 6 months of the traumatic event.