Areas of Expertise
Attention deficit/hyperactivity disorder (ADHD)
Symptoms start in early childhood and include difficulty concentrating (sometimes even on activities the person enjoys), getting easily distracted by the environment and thoughts, procrastinating, difficulties finishing tasks, zoning out in conversations and being very forgetful. Other signs are hyperactivity and impulsivity, the latter really refers to excessive talking, interrupting conversations, and impatience.
I often see adults who have struggled with ADHD which has gone undiagnosed from childhood. There is often a family history of ADHD that may have also gone undiagnosed.
I also see a lot of female ADHD clients who prior to diagnosis and treatment, have had to go to great efforts to compensate for or mask their symptoms which can be exhausting.
Anxiety
This is the most common mental illness in Australia. 1 in 7 Australians between the age of 18 and 85 are living with some form of anxiety disorder.
This can range from generalised anxiety where you worry about everyday events and problems to obsessive compulsive disorder and phobias.
It is normal to have worries and concerns about various aspects of our lives, but it can become a problem when it starts to dominate all thinking and it becomes difficult to stop. This can result in problems with concentrating and sleeping because the worrying does not turn off. This can be associated with physical manifestations of anxiety, including palpitations, shaking, hot flushes and difficulty breathing, to name but a few.
The treatment for most anxiety disorders is the same, this can include antidepressant medication and psychological therapy, for example, cognitive behavioural therapy.
Depression
This is second most common mental illness in Australia. 1 in 12 Australians between the age of 18 and 85 are living with some form of depression.
Symptoms include low mood which does not go away, feeling tired all the time, and a diminished experience of pleasure or enjoyment. Physiological symptoms are also common, including problems sleeping and changes in appetite (which can result in weight loss or weight gain).
The treatment includes antidepressant medication and psychological therapy, for example, cognitive behavioural therapy.
Bipolar affective disorder
1% of adults in Australia have this disorder. This is sometimes referred to as manic depression and in America, bipolar 1 (predominately manic episodes) or bipolar 2 disorder (predominantly depressive episodes and some hypomanic episodes). Bipolar affective disorder can often be mistaken for emotionally unstable personality disorder which makes getting the diagnosis essential because the treatments are completely different. The difference is the lows and highs in bipolar affective disorder typically last weeks or months.
Contrary to popular belief, depression is the most common presentation and often the most difficult part of the condition to treat. The highs, referred to as hypomania (people can usually still function when hypomanic), and mania (resulting in severe and debilitating impairments and loss of insight), are usually easier to treat. Hypomania and mania are usually very obvious to outside observers, where the impulsive and out of character behaviour during these episodes can cause significant distress to the person and others around them.
It is not uncommon for there to be a family history of bipolar affective disorder which may have gone undiagnosed.
There are excellent treatments for bipolar affective disorder, including mood stabilising medications.
Psychosis
Up to 64,000 adults or 0.5% of adults between 18 and 64 in Australia are living with some form of psychosis. Psychosis, which includes schizophrenia has been widely stigmatised for a number of years but there are ongoing movements and campaigns to challenge this and stigma is reducing.
Psychosis is simply a term to describe where people lose touch with what is real and what is not.
The signs of psychosis can be subtle and take years to develop. These signs can include social withdrawal, diminished communication, and changes in a person’s warmth and reactivity. Other symptoms include delusions (paranoia is very common) and hallucinations (such as hearing voices).
It is important to diagnose psychosis as early as possible and to closely monitor when treatment is needed. Treatment is often needed where symptoms cause distress and dysfunction. Intervening as early as possible at this stage produces the best outcomes. There are a range of new and very effective medications to treat psychosis which have far less side effects than the medications we used in the past.
It also is not uncommon for there to be a family history of psychosis which may have gone undiagnosed.
Post-traumatic stress disorder and complex post-traumatic stress disorder
This can occur in response to a serious traumatic event where feared or actual serious injury has occurred or a person has been subject to severe trauma.
Symptoms include flashbacks and nightmares or dreams of the trauma, avoidance of things that remind the person of the trauma, negative changes in a person’s mood and thinking about themselves, irritability, problems sleeping, and physical manifestations of anxiety, such has palpitations, shaking, sweating and difficulty breathing.
Treatment is usually with an antidepressant and a trauma focused psychologically therapy, such as eye movement desensitisation and reprocessing therapy (EMDR), or trauma focused cognitive behavioural therapy.
Complex post-traumatic stress disorder can occur when the person has experienced childhood trauma and usually over a prolonged period. As well as the above post-traumatic stress disorder symptoms, they can also go onto develop borderline or emotionally unstable personality symptoms as well. This usually starts during their teens (see borderline or emotionally unstable personality disorder).
Borderline or emotionally unstable personality disorder (BPD/EUPD)
This can be mistaken for bipolar affective disorder and it is important to make the correct diagnosis because the treatments are completely different. Unlike bipolar affective disorder, changes in mood are rapid (from seconds to hours) and usually occur without warning or a trigger. Other common symptoms, include impulsive behaviour which the person usually later regrets, a tendency to argue with others, difficulty controlling anger, and impulsive acts of self-harm. More deeply seated symptoms include an uncertainty in how the person views themselves and how they fit into the world and with those around them, and feelings of emptiness. Symptoms usually trace their origins back to a person’s teens.
The best long-term treatment is with psychological therapy such as dialectical behavioural therapy or schema therapy to help the person better manage distressing emotions, mood instability, impulsivity and to better control anger.
