Mental health conditions we treat

The far-reaching impact of family violence and trauma on the mental health of women is now well-established, and recognition of this by the patient and her practitioner is a critical step in mental illness recovery.

Adjustment disorder, sometimes referred to as situational depression, is a lengthy, abnormal, and excessively negative reaction to an identifiable life stressor. The reaction is more severe than would normally be expected and can result in significant impairment in social, occupational, or academic functioning.

Adjustment disorder is typified by symptoms such as:

• depression
• anxiety
• difficulty moving past a stressful event
• reckless behaviour

The extreme response may be linked to a single event such as:

• a natural disaster, such as severe flood or fire
• marriage
• divorce
• starting school
• losing a job, or starting a new job

Extreme response may also be linked to the concurrence of multiple events, such as marital problems coinciding with difficult business challenges.

Stress occurs when you feel you are not coping with life. One of the biggest causes of stress is change. Normal life events, such as moving or changing jobs, or unexpected events such as illness, loss of a job or an accident can all cause stress.

We all need a little stress to motivate us to achieve or get things done, but too much stress, particularly over an extended period, can take its toll on your health and sense of wellbeing. Extreme stress can be so overwhelming it causes physical reactions such as nausea, diarrhoea, overeating and undereating.

Think about what causes you stress, how you react to it, and if seeking some support may help you.

Burnout is another word for complete mental, physical and emotional exhaustion. If you are experiencing burnout, you may notice it is difficult to engage in activities you normally find meaningful. You may no longer care about the things that are important to you or experience an increasing sense of hopelessness.

Burnout is not caused solely by stressful work environments or too many responsibilities. It can be experienced by anyone with prolonged levels of chronic stress and pressure causing them to become overwhelmed by work or home demands.

People who have experienced trauma can frequently experience distressing emotional states, difficulty in relating to other people and self-harming behaviour. About two in every 100 people will develop the symptoms of trauma at some stage in their lives. These symptoms usually first appear in the mid to late teens or in early adulthood. Women are three times more likely to experience these than men. The trauma can be emotional, physical or sexual abuse.

Post-traumatic stress disorder (PTSD) is a set of reactions that can occur after someone has been through a traumatic event. About five to 10 per cent of Australians will suffer from PTSD at some point in their lives.

The main symptoms of PTSD are:

• Reliving the traumatic event through distressing, unwanted memories, vivid nightmares, and flashbacks. This can also include feeling upset or having intense physical reactions such as heart palpitations or being unable to breathe when reminded of the traumatic event.
• Avoiding reminders of the traumatic event, including activities, places, people, thoughts, or feelings that bring back memories of the trauma.
• Negative thoughts and feelings like fear, anger, and guilt or feeling flat or numb a lot of the time. A person might blame themselves or others for what happened during or after the traumatic event, feel cut off from friends and family or lose interest in day-to-day activities.
• Feeling wound-up. This might mean having trouble sleeping or concentrating, feeling angry or irritable, taking risks, being easily startled and/or being constantly on the lookout for danger.
• It is not unusual for people with PTSD to experience other mental health problems as well, like depression or anxiety. Some people may develop a habit of using alcohol or drugs as a way of coping.

Complex post-traumatic stress disorder (cPTSD) is a condition where people experience some symptoms of PTSD along with some additional symptoms, such as difficulties with forming and maintaining relationships, having extreme emotion swings or impulsive or self-destructive behaviours. Adult, sufferers of cPTSD experience severe interpersonal stress, frequent suicidal thoughts, mood instability, impulsivity and stress-related dissociation.

Women with cPTSD are subject to high mortality and morbidity and are frequent users of health services. Suicide risk is extremely high in this population; at least 75% of individuals with cPTSD attempt suicide, and 10% commit suicide. With suicide rates in this patient population alarmingly high and on the upward trend, clinical research that can be translated into practice quickly is imperative.

The poor knowledge about this condition and lack of tailored medications often lead to sufferers being prescribed many different medications, each with significant side effects. All these difficulties contribute to the intense stigma that sufferers encounter in the community, and even in the hospital setting.

cPTSD is far more complex than someone having a ‘difficult’ personality, and effective treatment and support is profoundly poor. Thus, a new and effective approach for this condition is vital for young women, their families and the broader community.

After a traumatic event, some people turn to alcohol or drugs to manage the distress they feel. Alcohol and drugs may help with painful emotions and memories in the short term, but they get in the way of recovery. In the short term, relying on alcohol or drugs can seem like a solution to painful trauma memories, feelings of anxiety or depression.

In the longer term, alcohol and drug use gets in the way of recovery and can result in a range of harms. Overusing alcohol and using non-prescribed drugs can worsen a person’s physical health, increase the risk of injury, affect sleep and mood, and worsen any existing mental health problems. Excessive alcohol and drug use can also seriously affect a person’s relationships with family and friends and their ability to perform at work and function daily.