Welcome To Cumberland Mountain Community Services Board's Question & Answer Page. Below Are Some Common Questions & Answers About Mental Health.

What Is Post-Traumatic Stress? What Is Depression?
How To Survive The Holidays? How To Relieve Depression?
What Is Schizophrenia? What Causes Schizophrenia?
How Is Schizophrenia treated?

POST-TRAUMATIC STRESS

Understanding The Syndrome

A tornado roars through a rural town, leveling what had just moments before been a thriving community. Elsewhere, a commuter bus goes out of control in a busy rush-hour intersection, hitting pedestrians and sideswiping parked cars. In both cases, rescue workers say it looks like a war zone. But in spite of their own emotions, the emergency teams work to save the living. Only later might they consider the horrible scene.

The Emergency Reaction

In order to function in an emergency, it’s necessary for us to put our own feelings and normal human reactions aside. Our conscious mind swiftly denies that we even have such feelings and we set about to act. That denial is not permanent, however, and sooner or later we will have to acknowledge our feelings. Most of the time this process takes place and we come to terms with the situation without our really being aware of it.

The Delayed Reaction

When we delay reactions to an emergency situation in order to act or because the situation is shocking, we are possible candidates for post-traumatic stress syndrome (PTSS). First identified during World War I as shell shock, it was later brought to public attention after the Vietnam War. But PTSS is not limited to soldiers or to emergency workers. Anyone who is involved in a stressful emergency, even as a witness, can develop PTSS.

The Reality

Sometimes the event is so overwhelming that coming to terms with its reality is very difficult. We replay the scene over and over in our minds. It’s difficult to stop thinking, or talking about it . It intrudes in our sleep in the form of nightmares. This can continue for weeks or months after the actual event and signifies a deeper emotional trauma which comes to the surface only when the process of denial ends.

Stress And PTSS

One of the keys to understanding PTSS is to understand that each of us reacts differently to stress. We have no way of knowing in advance what kind of situation will affect us adversely. What upsets one person may not upset another to the same degree or at all. It is no reflection on the "strength" or "toughness" of the individual.

Available Help

Professional counseling immediately after the incident is important to head off PTSS before it starts. People often need to be given permission to discuss their feeling. Counseling soon after the onset of PTSS is very effective, and with time the syndrome can be treated successfully.

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DEPRESSION

Understanding The Disorder

Depression is no mere slump in mood. Unlike "the blues," which tend to clear up in a few days, depression frequently is both prolonged and recurring. It cannot be ignored, and it can’t be joked or whistled away. Sufferers of depression are likely to experience:

  • Prolonged loss of interest in home, work and personal appearance.
  • Loss of interest in sexual activity.
  • Sudden changes and excesses in eating or sleeping habits.
  • Frequent, uncontrollable crying.
  • Lingering, unfocused nervousness or grouchiness.
  • Persistent feelings of hopelessness and futility.

There are both physical and psychological causes of depression. Illness and chemical imbalances are physical causes. Psychological or emotional causes include distressing or threatening changes (death of a loved one, divorce or loss of job) and continuing problems of emotional dependency and inadequate self-esteem.

Untreated, depression can be debilitating and can lead to suicide. It is a serious condition requiring serious treatment.

Treatment For Depression

If you suspect you suffer depression, having a medical check-up is your first step. Even depressions with emotional causes may call for treatment with medication, and that is a decision that must be made by a physician who, in turn, must know the state of your physical health. Get a check-up.

If your depression has a physical cause, treating the underlying illness may be the cure. Depression resulting from chemical imbalance can also be treated medically. Especially among elderly persons, chance combinations of medications taken for various medical needs can produce depression. A doctor will want to get a complete list of all medicines you’ve been taking.

If your depression is traceable to an event or situation, professional counseling or therapy may be helpful. The doctor who does your physical check-up can refer you to such a counselor or therapist.

Self-Care Tips

In addition to seeking professional help, there are some things you can do which may help you to feel better. Follow a healthy, well-rounded diet, and get regular exercise. Aerobic exercise, such as walking, bicycling and swimming, is recommended. Scientists theorize that such exercise releases "feel-good" hormones in the brain which can lift your spirits and help you to feel more optimistic and emotionally in control. Again, these are often beneficial, but they are not an alternative to professional attention. Talk to a health professional.

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RELIEVING DEPRESSION

Healthy Steps

Depression might be the temporary sadness that follows a loss or it might be a more disruptive illness that interferes with the ability to enjoy work and family life. Often the depressed person is overwhelmed by feelings of hopelessness and inaction which make it difficult for the person to reach out to others. But depression can be treated with a combination of support, medical intervention and self-help.

Get Support

Talk to a trusted loved one or friend. Don’t be afraid to ask for help. Talking out the feelings of hopelessness and isolation is the first step to recovery.

See A Doctor

Seeing a doctor helps determine the cause of depression. If you’re not sure of the cause, start with your family physician. If you know that your depression is brought on by a life situation, ask your family physician for a referral to a psychiatrist or psychologist. If a referral is not available, call your community mental health organization for a referral or for treatment.

Therapy Can Help

Talking out problems with a mental health professional can be helpful in treating depression. No matter how trivial you consider your problems to be, or how hopeless you feel in doing anything about them, a mental health professional takes your problems seriously and gives you undivided attention and direction. It will take time for the depression to lift, but the experience of safety and understanding from a mental health professional can be a positive step on the road to recovery.

Medication Is Available

Some types of depression respond well to medication. This must be decided by a doctor, usually a psychiatrist. Treatment of depression with medication, if used, is almost always in conjunction with therapy.

Begin Self-Help

Sometimes depression, especially one caused by a life situation, can be alleviated by following a healthy diet and getting regular exercise, especially aerobic exercise such as walking, bicycling or swimming. Scientists theorize that such exercise releases "feel-good" hormones in the brain that , in turn, can lift your spirits and help you feel more optimistic and in control. This approach can be useful, especially when taken with another form of therapy.

Toward Recovery

Almost everyone who experiences a depression recovers and feels good again. It’s a step-by-step process, but the first small step leads to the next one and, with help, you’ll be able to cope with life again.

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HOLIDAY BLUES

How To Survive The Holidays

Has the holiday season arrived without you? Since we can’t control the season’s arrival, it’s not unusual for adults to feel out-of-synch with the holiday crowd. These tips might help you pick up your spirits and see you through.

Start New Traditions

Since the carrying on of "tradition" is one of the hallmarks of the holidays, you might feel most acutely sad if it’s not possible to carry out some of your usual traditions. If you’ve recently lost a loved one, if the holiday season is the anniversary of such a loss, or if your living situation has changed in the past year and you are away from loved ones, remember that you can start new holiday traditions. They may not seem like much at first, but if you are able to repeat them over the next few years, they’ll begin to feel comfortable.

Participate When You Can

If you’re feeling blue, it’s difficult to have much enthusiasm for social expectations such as gift-giving or party-going. Participate at a level that feels comfortable to you, but try not to isolate yourself entirely. A little participation might pick up your spirits.

Take Care Of Yourself

Holiday media messages can be overwhelming at the height of the season. This might be a good time to spend evenings with a good book or quiet music instead of watching television. Write letters to friends and loved ones instead of sending cards. By staying involved in some activity you might find your mood lifting a little.

Volunteer Your Time

There are many social service programs for people in need over the holidays. Taking time to participate, if only for a few hours, can be a good way out of holiday doldrums and help bring season’s greetings to others.

Talk Things Out

Many adults experience holiday blues. If you’re not able to compensate for it in some other way, or feel that the "blues" might be drifting into depression, get professional help through your physician or your community mental health agency.

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What is schizophrenia?

Schizophrenia is a serious and life long brain disorder. It is a disease which makes it difficult for a person to tell the difference between what is real and what is not, to think logically, to have reasonable emotional responses to others, and to behave appropriately in social situations. Unlike the way in which it is presented on television, schizophrenia is not a "split personality" or being more than one person at the same time. Also, schizophrenia is not caused by bad parenting, family problems, personal weakness, or laziness. Schizophrenia is a biological disease with a physical cause, like heart disease or cancer.

As one of the most common major mental illnesses, schizophrenia affects 1% of the world’s population, such that in the United States there are 2.5 million people with this disease. Schizophrenia most commonly begins to reveal itself between the ages of 15 and 25, with some types of the disease occurring even later. Although it strikes men and women equally, the symptoms may appear later in women than in men. Only very rarely, the symptoms of schizophrenia appear before the age of 12. Such childhood schizophrenia has a more chronic disease course and involves poor early language development.

The symptoms of schizophrenia usually fall into two large categories, referred to as positive and negative symptoms. Positive symptoms include paranoia, auditory hallucinations, and bizarre behavior. These are the more obvious and easily seen symptoms. Examples of positive symptoms include disordered thinking, where the person’s thoughts jump from subject to unrelated subject. Delusions, which are false beliefs with no basis in reality, and hallucinations, which are hearing, seeing or feeling things that are not there are other positive symptoms. Negative symptoms include the lack of energy and initiative and the inability to relate to others that often results in persons with schizophrenia withdrawing from society.

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What causes schizophrenia?

Schizophrenia is a very complex and puzzling illness. Even today we are not exactly sure what causes schizophrenia. One possible cause may be heredity or genetics. Experts think that some people inherit a tendency towards schizophrenia. In fact, the disorder tends to "run" in families, but only among blood relatives. If both biologic parents have schizophrenia, there is a 40% chance that their child will get it also. This happens even if the child is adopted and raised by mentally healthy adults. On the other hand, children whose biologic parents are mentally healthy, even if their adoptive parents have schizophrenia, have about a 1% chance of getting the disease. This is about the same risk as for the general population. Therefore, schizophrenia is not passed on directly and other conditions are necessary, because other factors are involved. Otherwise, schizophrenia would always develop in both identical twins, since they have the same heredity.

Some researchers believe that schizophrenia is triggered by events in the person’s environment. Some studies have shown that influenza infection or improper nutrition during pregnancy and complications during birth may increase the risk that the baby will develop schizophrenia later in life. Therefore, many researchers believe that schizophrenia is likely caused by a complex combination of genetic and environmental factors. Certain people are born with a tendency to develop the disease. But, the disease only appears if these people are exposed to unusual stresses or traumas.

People with schizophrenia may have a chemical imbalance in the brain. They may either be very sensitive to or produce too much of a chemical called dopamine. Dopamine is one of several brain chemicals that allow nerve cells to send messages to each other. New brain scanning technologies have indicated that there is an enlargement of the fluid filled cavities of the brain, called ventricles, in people with schizophrenia. Similarly, there is a decrease in the size of the part of the brain called the hippocamus. Other brain tests have shown that there is less activity in the prefrontal cortex, which is the part of the brain that governs thought and higher mental functions.

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How is schizophrenia treated?

Schizophrenia is treated by a combination of medication, counseling, education and support services. At this time there is no cure for schizophrenia. People with schizophrenia may need to go to the hospital during an acute crisis phase of their illness. The overall goal of treatment is to reduce symptoms and to help prevent a relapse. With a combination of proven effective treatment approaches most people with schizophrenia can lead stable, productive and socially active lives. Psychosocial rehabilitation programs, such as the Tazewell House, O.U.R. House and the Riverside House provide significant opportunities for social integration and vocational rehabilitation.

The role of antipsychotic medications are central to the effective control of the symptoms of schizophrenia. Because each person with schizophrenia has a unique mix of symptoms, no single medication works best for all people. Finding the most effective medication for each person at the lowest effective dosage with the fewest side effects is the goal of the treating psychiatrist. Understanding the importance of the role of medication to control schizophrenia is important for the patient and family. Education which helps in understanding the phases of the illness helps to gain treatment compliance. Newer classes of medications offer hope for people with schizophrenia who showed little progress before. These drugs include clozapine, risperidone, and olanzapine.

This material was modified from "Understanding Schizophrenia: A Guide For People With Schizophrenia And Their Families" A NARSAD Research brochure, 1996. For a complete copy of this brochure contact CMCS at (276) 964-6702.

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