Conditions We Treat

The symptoms of attention deficit hyperactivity disorder (ADHD) can be categorised into 2 types of behavioural problems:

• inattentiveness (difficulty concentrating and focusing)

• hyperactivity and impulsiveness

Many people with ADHD have problems that fall into both these categories, but this is not always the case.

For example, around 2 to 3 in 10 people with the condition have problems with concentrating and focusing, but not with hyperactivity or impulsiveness.

This form of ADHD is also known as attention deficit disorder (ADD). ADD can sometimes go unnoticed because the symptoms may be less obvious.

ADHD is more often diagnosed in boys than girls. Girls are more likely to have symptoms of inattentiveness only, and are less likely to show disruptive behaviour that makes ADHD

symptoms more obvious. This means girls who have ADHD may not always be diagnosed.

Attention Deficit Hyperactivity Disorder - ADHD

Symptoms in adults

In adults, the symptoms of ADHD are more difficult to define. This is largely due to a lack of research into adults with ADHD.

As ADHD is a developmental disorder, it's believed it cannot develop in adults without it first appearing during childhood. But symptoms of ADHD in children and teenagers often continue into adulthood.

The way in which inattentiveness, hyperactivity and impulsiveness affect adults can be very different from the way they affect children.

For example, hyperactivity tends to decrease in adults, while inattentiveness tends to remain as the pressures of adult life increase.

Adult symptoms of ADHD also tend to be far more subtle than childhood symptoms.

Some specialists have suggested the following as a list of symptoms associated with ADHD in adults:

• carelessness and lack of attention to detail

• continually starting new tasks before finishing old ones

• poor organisational skills

• inability to focus or prioritise

• continually losing or misplacing things

• forgetfulness

• restlessness and edginess

• difficulty keeping quiet, and speaking out of turn

• blurting out responses and often interrupting others

• mood swings, irritability and a quick temper

• inability to deal with stress

• extreme impatience

• taking risks in activities, often with little or no regard for personal safety or the safety of others – for example, driving dangerously.

Related conditions in adults with ADHD

As with ADHD in children and teenagers, ADHD in adults can occur alongside several related problems or conditions.

One of the most common is depression. Other conditions that adults may have alongside ADHD include:

• Anxiety disorders

• Sleep disorders

• bipolar disorder 

• obsessive compulsive disorder (OCD) 

The behavioural problems associated with ADHD can also cause problems such as difficulties with relationships and social interaction.

Diagnosis in adults

Diagnosing ADHD in adults is more difficult because there's some disagreement about whether the list of symptoms used to diagnose children and teenagers also applies to adults.

In some cases, an adult may be diagnosed with ADHD if they have 5 or more of the symptoms of inattentiveness, or 5 or more of hyperactivity and impulsiveness, listed in diagnostic criteria for children with ADHD.

As part of your assessment, the specialist will ask about your present symptoms. However, under current diagnostic guidelines, a diagnosis of ADHD in adults cannot be confirmed unless your symptoms have been present from childhood.

If you find it difficult to remember whether you had problems as a child, your specialist may wish to see your old school records, or talk to your parents, teachers or anyone else who knew you well when you were a child.

For an adult to be diagnosed with ADHD, their symptoms should also have a moderate effect on different areas of their life, such as:

• underachieving at work or in education

• driving dangerously

• difficulty making or keeping friends

• difficulty in relationships with partners

If your problems are recent and did not occur regularly in the past, you're not considered to have ADHD. This is because it's currently thought that ADHD cannot develop for the first time in adults.

Treatment for attention deficit hyperactivity disorder (ADHD) can help relieve the symptoms and make the condition much less of a problem in day-to-day life.

ADHD can be treated using medicine or therapy, but a combination of both is often best.

Treatment is usually arranged by a specialist, such as a paediatrician or psychiatrist, although the condition may be monitored by a GP.

Medicine

There are 5 types of medicine licensed for the treatment of ADHD:

• methylphenidate

• lisdexamfetamine

• dexamfetamine

• atomoxetine

• guanfacine

These medicines are not a permanent cure for ADHD but may help someone with the condition concentrate better, be less impulsive, feel calmer, and learn and practise new skills.

Some medicines need to be taken every day, but some can be taken just on school days. Treatment breaks are occasionally recommended to assess whether the medicine is still needed.

If you were not diagnosed with ADHD until adulthood, a GP and specialist can discuss which medicines and therapies are suitable for you.

If you are prescribed one of these medicines, you'll probably be given small doses at first, which may then be gradually increased. You or your child will need to see a GP for regular check-ups to ensure the treatment is working effectively and check for signs of any side effects or problems.

It's important to let the GP know about any side effects and talk to them if you feel you need to stop or change treatment.

Your specialist will discuss how long you should take your treatment but, in many cases, treatment is continued for as long as it is helping.

Methylphenidate

Methylphenidate is the most commonly used medicine for ADHD. It belongs to a group of medicines called stimulants, which work by increasing activity in the brain, particularly in areas

that play a part in controlling attention and behaviour.

Methylphenidate may be offered to adults, teenagers and children over the age of 5 with ADHD.

The medicine can be taken as either immediate-release tablets (small doses taken 2 to 3 times a day) or as modified-release tablets (taken once a day in the morning, with the dose released throughout the day).

Common side effects of methylphenidate include:

• a small increase in blood pressure and heart rate

• loss of appetite, which can lead to weight loss or poor weight gain

• trouble sleeping

• headaches

• stomach aches

• feeling aggressive, irritable, depressed, anxious or tense

Lisdexamfetamine

Lisdexamfetamine is a medicine that stimulates certain parts of the brain. It improves concentration, helps focus attention and reduces impulsive behaviour.

It may be offered to teenagers and children over the age of 5 with ADHD if at least 6 weeks of treatment with methylphenidate has not helped. 

Adults may be offered lisdexamfetamine as the first-choice medicine instead of methylphenidate.

Lisdexamfetamine comes in capsule form, taken once a day.

Common side effects of lisdexamfetamine include:

• decreased appetite, which can lead to weight loss or poor weight gain

• aggression

• drowsiness

• dizziness

• headaches

• diarrhoea

• nausea and vomiting

Therapy

As well as taking medicine, different therapies can be useful in treating ADHD in children, teenagers and adults. Therapy is also effective in treating additional problems, such as conduct or anxiety disorders, that may appear with ADHD.

Here are some of the therapies that may be used.

Psychoeducation

Psychoeducation means you will be encouraged to discuss ADHD and its effects. It can help make sense of being diagnosed with ADHD and can help you to cope and live with the

condition.

Cognitive behavioural therapy (CBT)

CBT is a talking therapy that can help you manage your problems by changing the way you think and behave. A therapist would try to change how you, or your child feels about a situation, which would in turn potentially change their behaviour.

CBT can be carried out with a therapist individually or in a group.

Other possible treatments

There are other ways of treating ADHD that some people with the condition find helpful, such as cutting out certain foods and taking supplements. However, there's no strong evidence this work, and they should not be attempted without medical advice.

Diet

People with ADHD should eat a healthy, balanced diet. Do not cut out foods before seeking medical advice.

Some people may notice a link between types of food and worsening ADHD symptoms. If this is the case, keep a diary of what you eat and drink, and what behaviour follows. Discuss this with a GP, who may refer you to a dietitian (a healthcare professional who specialises in nutrition).

Supplements

Some studies have suggested that supplements of omega-3 and omega-6 fatty acids may be beneficial for people with ADHD, although the evidence supporting this is very limited.

It's advisable to talk to a GP before using any supplements, because some can react unpredictably with medicine or make it less effective.

You should also remember that some supplements should not be taken long term, as they can reach dangerous levels in your body.

The charity AADD-UK has a list of support groups across the UK, including groups for adults, parents and carers.

Adults with ADHD

If you're an adult living with ADHD, you may find the following advice useful:

• if you find it hard to stay organised, then make lists, keep diaries, stick up reminders and set aside some time to plan what you need to do

• let off steam by exercising regularly

• find ways to help you relax, such as listening to music or learning breathing exercises for stress

• if you have a job, speak to your employer about your condition, and discuss anything they can do to help you work better

• if you're at college or university, ask about what adjustments can be made to support you, such as extra time to complete exams and coursework

• talk to a doctor about your suitability to drive, as you'll need to tell the Driver and Vehicle Licensing Agency (DVLA) if your ADHD affects your driving

• contact or join a local or national support group – these organisations can put you in touch with other people in a similar situation, and can be a good source of support, information and advice

Read about living with ADHD on the AADD-UK website. AADD-UK is a charity specifically for adults with ADHD.

AADD-UK also has a list of support groups across the UK, including groups for adults, parents and carers.

How can BHC help?

Comprehensive assessment towards diagnosis of Adult ADHD will be completed by BHC clinicians, which includes part1 by Clinical Psychologist and part2 by Consultant Psychiatrist.

Total fee would be £695 which includes report and the first prescription of ADHD medication if found eligible. Call us on 0207 183 1229 to book an appointment or click the below button to book an appointment online.

Obsessive-Compulsive Disorder (OCD)

People with OCD may experience symptoms of obsessions, compulsions, or both. These symptoms often interfere with all aspects of life, work, education, and personal relationships.

Signs and Symptoms

Obsessions are repeated thoughts, urges, or mental images which cause anxiety. Common symptoms include:

• Fear of germs or contamination

• Unwanted forbidden or taboo thoughts involving sex, religion, or harm

• Aggressive thoughts towards others or oneself

• Having things symmetrical or in a perfect order

Compulsions are repetitive behaviours a person with OCD feels an urge to do in response to an obsessive thought. Common compulsions include:

• Excessive cleaning and/or handwashing

• Ordering and arranging things in a particular and precise way

• Repeatedly checking on things, such as repeatedly checking to see if the door is locked or that the oven is off

• Compulsive counting

Not all rituals or habits are compulsions, everyone double checks things sometimes. A person with OCD generally:

• Cannot control their thoughts or behaviours, even when those thoughts or behaviours are recognized as excessive

• Spends at least one hour each day on these thoughts or behaviours

• Does not get pleasure when performing the behaviours or rituals, but may feel brief relief from the anxiety provoked by the thoughts

• Experiences significant problems in their daily life due to these thoughts or behaviours

Some individuals with OCD also have experience tic disorder. Motor tics are sudden, brief, repetitive movements, such as eye blinking and other eye movements, facial grimacing, shoulder shrugging, and head or shoulder jerking. Common vocal tics include repetitive throat-clearing, sniffing, or grunting sounds.

Symptoms may come and go, ease over time, or worsen. People with OCD may try to help themselves by avoiding situations which they have identified as triggering obsessions or may use alcohol or drugs to calm themselves. 

Treatments and Therapies

OCD is typically treated with medication, psychotherapy, or a combination of the two. Although most patients with OCD respond to treatment, some patients continue to experience symptoms. Sometimes people with OCD also have other mental disorders, such as anxiety, depression, and body dysmorphic disorder (a disorder in which someone mistakenly believes that a part of their body is abnormal).

Medication

Serotonin reuptake inhibitors (SRIs), which include selective serotonin reuptake inhibitors (SSRIs) are used to help reduce OCD symptoms. SRIs often require higher daily doses in the treatment of OCD than of depression and may take 8 to 12 weeks to start working, but some patients experience more rapid improvement. If symptoms do not improve with these types of medications, research shows that some patients may respond well to an antipsychotic medication.

Psychotherapy

Psychotherapy can be an effective treatment for adults and children with OCD. Research shows that certain types of psychotherapy, including cognitive behaviour therapy (CBT) and other related therapies (e.g., habit reversal training) can be as effective as medication for many individuals. Research also shows that a type of CBT called Exposure and Response Prevention (EX/RP), spending time in the very situation that triggers compulsions (e.g., touching dirty objects) but then being prevented from undertaking the usual resulting compulsion (e.g., handwashing) is effective in reducing compulsive behaviours in OCD.

Other Treatment Options

In 2018, the FDA approved Transcranial Magnetic Stimulation (TMS) as an adjunct in the treatment of OCD in adults. New approaches include combination and add-on (augmentation) treatments, as well as novel techniques such as deep brain stimulation (DBS).

How can BHC help?

Experienced Neuropsychiatrists, Neurologists and Neuropsychologists help with comprehensive assessment, diagnosis and management and towards effective treatment. Initial assessments starting from £495 per hour and psychology sessions at £145 per hour. Call us on 0207 183 1229 to book an appointment or Click here to Book an Appointment.

Anxiety is the main symptom of several conditions, including:

• Panic disorders

• Phobias, such as agoraphobia or claustrophobia

• Post-traumatic stress disorder (PTSD)

• Social anxiety disorder (social phobia)

Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) usually involves a persistent feeling of anxiety or dread, which can interfere with daily life. It is not the same as occasionally worrying about things or experiencing anxiety due to stressful life events. People living with GAD experience frequent anxiety for months, if not years.

Symptoms of GAD include:

• Feeling restless, wound-up, or on-edge

• Being easily fatigued

• Having difficulty concentrating

• Being irritable

• Having headaches, muscle aches, stomach aches, or unexplained pains

• Difficulty controlling feelings of worry

• Having sleep problems, such as difficulty falling or staying asleep

Panic Disorder

People with panic disorder have frequent and unexpected panic attacks. Panic attacks are sudden periods of intense fear, discomfort, or sense of losing control even when there is no clear danger or trigger. Not everyone who experiences a panic attack will develop panic disorder.

During a panic attack, a person may experience:

• Pounding or racing heart

• Sweating

• Trembling or tingling

• Chest pain

• Feelings of impending doom

• Feelings of being out of control

People with panic disorder often worry about when the next attack will happen and actively try to prevent future attacks by avoiding places, situations, or behaviours they associate with panic attacks. Panic attacks can occur as frequently as several times a day or as rarely as a few times a year.

Social Anxiety Disorder

Social anxiety disorder is an intense, persistent fear of being watched and judged by others. For people with social anxiety disorder, the fear of social situations may feel so intense that it seems beyond their control. For some people, this fear may get in the way of going to work, attending school, or doing everyday things.

People with social anxiety disorder may experience:

• Blushing, sweating, or trembling

• Pounding or racing heart

• Stomach aches

• Rigid body posture or speaking with an overly soft voice

• Difficulty making eye contact or being around people they don’t know

• Feelings of self-consciousness or fear that people will judge them negatively

Phobia-related disorders

A phobia is an intense fear of, or aversion to, specific objects or situations. Although it can be realistic to be anxious in some circumstances, the fear people with phobias feel are out of proportion to the actual danger caused by the situation or object.

People with a phobia:

• May have an irrational or excessive worry about encountering the feared object or situation

• Take active steps to avoid the feared object or situation

• Experience immediate intense anxiety upon encountering the feared object or situation

• Endure unavoidable objects and situations with intense anxiety

There are several types of phobias and phobia-related disorders:

Specific Phobias (sometimes called simple phobias): As the name suggests, people who have a specific phobia have an intense fear of, or feel intense anxiety about, specific types of objects or situations.

Some examples of specific phobias include the fear of:

• Flying

• Heights

• Specific animals, such as spiders, dogs, or snakes

• Receiving injections

• Blood

Social anxiety disorder (previously called social phobia): People with social anxiety disorder have a general intense fear of, or anxiety toward, social or performance situations. They worry that actions or behaviours associated with their anxiety will be negatively evaluated by others, leading them to feel embarrassed. This worry often causes people with social anxiety to avoid social situations. Social anxiety disorder can manifest in a range of situations, such as within the workplace or the school environment.

Agoraphobia: People with agoraphobia have an intense fear of two or more of the following situations:

• Using public transportation

• Being in open spaces

• Being in enclosed spaces

• Standing in line or being in a crowd

• Being outside of the home alone

People with agoraphobia often avoid these situations, in part, because they think being able to leave might be difficult or impossible in the event they have panic-like reactions or other embarrassing symptoms. In the most severe form of agoraphobia, an individual can become housebound.

Separation anxiety disorder: Separation anxiety is often thought of as something that only children deal with; however, adults can also be diagnosed with separation anxiety disorder. People who have separation anxiety disorder have fears about being parted from people to whom they are attached. They often worry that some sort of harm or something untoward will happen to their attachment figures while they are separated. This fear leads them to avoid being separated from their attachment figures and to avoid being alone. People with separation anxiety may have nightmares about being separated from attachment figures or experience physical symptoms when separation occurs or is anticipated.

Selective mutism: A somewhat rare disorder associated with anxiety is selective mutism. Selective mutism occurs when people fail to speak in specific social situations despite having normal language skills. Selective mutism usually occurs before the age of 5 and is often associated with extreme shyness, fear of social embarrassment, compulsive traits, withdrawal, clinging behaviour, and temper tantrums. People diagnosed with selective mutism are often also diagnosed with other anxiety disorders.

Treatments and Therapies

Anxiety disorders are generally treated with psychotherapy, medication, or both

Cognitive Behavioural Therapy

Cognitive Behavioural Therapy (CBT) is an example of one type of psychotherapy that can help people with anxiety disorders. It teaches people different ways of thinking, behaving, and reacting to situations to help you feel less anxious and fearful. CBT has been well studied and is the gold standard for psychotherapy.

Exposure therapy is a CBT method that is used to treat anxiety disorders. Exposure therapy focuses on confronting the fears underlying an anxiety disorder to help people engage in activities they have been avoiding. Exposure therapy is sometimes used along with relaxation exercises.

Acceptance and Commitment Therapy

Another treatment option for some anxiety disorders is acceptance and commitment therapy (ACT). ACT takes a different approach than CBT to negative thoughts. It uses strategies such as mindfulness and goal setting to reduce discomfort and anxiety. Compared to CBT, ACT is a newer form of psychotherapy treatment, so less data is available on its effectiveness.

Medication

Medication does not cure anxiety disorders but can help relieve symptoms. Healthcare providers, such as a psychiatrist or primary care provider, can prescribe medication for anxiety. The most common classes of medications used to combat anxiety disorders are antidepressants, anti-anxiety medications (such as benzodiazepines), and beta-blockers.

Antidepressants

Antidepressants are used to treat depression, but they can also be helpful for treating anxiety disorders. They may help improve the way your brain uses certain chemicals that control mood or stress. You may need to try several different antidepressant medicines before finding the one that improves your symptoms and has manageable side effects.

Antidepressants can take several weeks to start working so it’s important to give the medication a chance before reaching a conclusion about its effectiveness so its advisable not to stop without seeking medical advice. A provider can help slowly and safely decrease dosage. Stopping them abruptly can cause withdrawal symptoms.

Anti-anxiety Medications

Anti-anxiety medications can help reduce the symptoms of anxiety, panic attacks, or extreme fear and worry. The most common anti-anxiety medications are called benzodiazepines. Although benzodiazepines are sometimes used as first-line treatments for generalized anxiety disorder, they have both benefits and drawbacks.

Benzodiazepines are effective in relieving anxiety and take effect more quickly than antidepressant medications. However, some people build up a tolerance to these medications and need higher and higher doses to get the same effect. Some people even become dependent on them. To avoid these problems, healthcare providers usually prescribe benzodiazepines for short periods of time.

If people suddenly stop taking benzodiazepines, they may have withdrawal symptoms, or their anxiety may return. Therefore, benzodiazepines should be tapered off slowly. A provider can help slowly and safely decrease dose.

Beta-blockers

Although beta-blockers are most often used to treat high blood pressure, they can help relieve the physical symptoms of anxiety, such as rapid heartbeat, shaking, trembling, and blushing. These medications can help people keep physical symptoms under control when taken for short periods. They can also be used ‘as needed’ to reduce acute anxiety, including to prevent some predictable forms of performance anxieties.

Choosing the Right Medication

Some types of drugs may work better for specific types of anxiety disorders, so people should work closely with a healthcare provider to identify which medication is best for them. Certain substances such as caffeine, some over-the-counter cold medicines, illicit drugs, and herbal supplements may aggravate the symptoms of anxiety disorders or interact with prescribed medication. People should talk with a health care provider, so they can learn which substances are safe and which to avoid.

Choosing the right medication, medication dose, and treatment plan should be done under an expert’s care and should be based on a person’s needs and their medical situation. A provider may try several medicines before finding the right one for the individual.

How BHC can help:

Highly experienced psychologists and psychiatrists can diagnose and treat the anxiety disorders effectively with starting initial assessment fee of £495 per hour and psychology sessions at £145 per hour. Call us on 0207 183 1229 to book an appointment or Click here to Book an Appointment.

Autism Spectrum Disorder in Adults

Main signs of autism

Common signs of autism in adults include:

• finding it hard to understand what others are thinking or feeling

• getting very anxious about social situations

• finding it hard to make friends or preferring to be on your own

• seeming blunt, rude or not interested in others without meaning to

• finding it hard to say how you feel

• taking things very literally – for example, you may not understand sarcasm or phrases like "break a leg"

• having the same routine every day and getting very anxious if it changes

You may also have other signs, like:

• not understanding social "rules", such as not talking over people

• avoiding eye contact

• getting too close to other people, or getting very upset if someone touches or gets too close to you

• noticing small details, patterns, smells or sounds that others do not

• having a very keen interest in certain subjects or activities

• liking to plan things carefully before doing them

Autism in women and men: Autism can sometimes be different in women and men

Autistic women may:

• have learned to hide signs of autism to ‘fit in’ - by copying people who don’t have autism

• be quieter and hide their feelings

• appear to cope better with social situations

• show fewer signs of repetitive behaviours

This means it can be harder to tell you're autistic if you're a woman

benefits of getting a diagnosis?

• Getting a professional diagnosis may help you to receive any appropriate funding, support and help you might need.

• Your family, friends and work colleagues (if you choose to tell them) may have a better understanding of you and your needs – and it may allow them to support you more effectively.

• You may have a greater sense of self-identify if you understand yourself – and the spectrum – better.

• You may have a better understanding of your experiences as a child or adolescent.

• You may have increased confidence knowing you are part of a larger group of adults that may be like-minded.

• Some adults find that by having a better understanding of the challenges associated with autism, they can use their strengths and develop strategies to support these

Seeking a diagnostic assessment

Getting started

• You’ve decided to seek an assessment to determine if you or an adult you love has autism, so, what are the next steps?

• Assessments for adults involve appropriately qualified health professionals gathering and considering a range of developmental, historical and current information against the criteria for autism

So you want to be assessed for autism?

There are a number of ways that you may have arrived at this decision. It may be that your child has been diagnosed with autism and you recognise a few behavioural similarities. Perhaps your significant other or a close friend has suggested that you are on the spectrum? Or perhaps you’ve had the feeling of ‘being different’ and have long suspected you might be on the

spectrum?

Whatever the reason, this page will help you to prepare for an assessment, and give you more information about what to expect

Assessment process

• The diagnostic criteria for autism in adults and children are the same, however the ways symptoms are assessed against the criteria can be quite different depending on your age.

What diagnostic criteria is used?

• There are two sets of autism spectrum diagnostic criteria commonly used throughout United Kingdom:

• The main criteria used is the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (currently in its fifth edition – DSM-5). The DSM- 5 requires professionals to assess for the symptoms of autism and the impact these have on a person’s life. Symptoms are identified in two ‘domains’ – social communication and social interaction, and restricted and repetitive behaviours. It requires a range of considerations, including co-occurring diagnosis. This information can help clinicians in their diagnostic decision-making and identification of support needs.

What does it cost to get an autism assessment?

BHC offers comprehensive assessment at total cost of £695, which includes part 1 assessment with Clinical Psychologist and Part2 with Consultant Psychiatrist along with report

How do professionals make an autism assessment?

• Assessment tools often use a series of questions, in-person observations and interactions to support a professional diagnosis of autism.

• Depending on your needs, health professionals will gather information around your medical and health history as well as the following:

• Developmental and educational history: You will be asked about your development as a child and teenager. This may cover a wide range of developmental areas.

• Autism-specific signs and/or symptoms: You will be asked about behaviours relating to social communication and interaction and restricted, repetitive patterns of behaviour.

• Other relevant behaviours, signs and/or symptoms: You will be asked about the presence of any co-occurring condition and/or differential diagnosis.

• The professional may also discuss your mental health. It is important that you answer these questions as honestly and openly, so that your assessor can get a full understanding of your health

When will I get my result?

The qualified assessing professional (or professionals) that you choose to see will advise whether they think you are on the spectrum, or not. They might do this on the day of your

assessment, or at a follow-up appointment. A written report should be provided after the assessment.

Call us on 0207 183 1229 to book an appointment or Click here to Book an Appointment.

Depression

Depression (also called major depressive disorder or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working.

There are different types of depression, some of which develop due to specific circumstances.

• Major depression, which includes symptoms of depression most of the time and for at least 2 weeks which typically interfere with one’s ability to work, sleep, study, and eat.

• Persistent depressive disorder (also called dysthymia), which often includes less severe symptoms of depression that last much longer, typically for at least 2 years.

• Perinatal depression, which occurs when a woman experiences major depression during pregnancy or after delivery (postpartum depression).

• Seasonal affective disorder (SAD), which comes and goes with the seasons, typically starting in late fall and early winter and going away during spring and summer.

• Depression with symptoms of psychosis, which is a severe form of depression where a person experiences psychosis symptoms, such as delusions (disturbing, false fixed beliefs) or hallucinations (hearing or seeing things that others do not see or hear).

Individuals with bipolar disorder (formerly called manic depression or manic-depressive illness) also experience depressive episodes, in which they feel sad, indifferent, or hopeless, combined with a very low activity level. However, a person with bipolar disorder also experiences manic episodes, or unusually elevated moods in which the individual might feel very happy, irritable, or “up,” with a marked increase in activity level.

Examples of other types of depressive disorders newly added to the diagnostic classification of Diagnostic and Statistical Manual of Mental Disorders include disruptive mood dysregulation disorder (diagnosed in children and adolescents) and premenstrual dysphoric disorder (PMDD).

The Centre for Disease Control and Prevention (CDC) has recognized that having certain mental disorders, including depression and schizophrenia, can make people more likely to get severely ill from COVID-19. Learn more about getting help and finding a health care provider on NIMH's Help for Mental Illnesses webpage.

Signs and Symptoms

If you have been experiencing some of the following signs and symptoms most of the day, nearly every day, for at least two weeks, you may be suffering from depression:

• Persistent sad, anxious, or “empty” mood

• Feelings of hopelessness, or pessimism

• Feelings of irritability, frustration, or restlessness 

• Feelings of guilt, worthlessness, or helplessness

• Loss of interest or pleasure in hobbies and activities

• Decreased energy, fatigue, or feeling ‘slowed down’

• Difficulty concentrating, remembering, or making decisions

• Difficulty sleeping, early morning awakening, or oversleeping

• Changes in appetite or unplanned weight changes

• Thoughts of death or suicide, or suicide attempts

• Aches or pains, headaches, cramps, or digestive problems without a clear physical cause that do not ease even with treatment

• Suicide attempts or thoughts of death or suicide

Not everyone who is depressed experiences every symptom. Some people experience only a few symptoms while others may experience many. Several persistent symptoms in addition to low mood are required for a diagnosis of major depression; people with only a few, but distressing, symptoms may also benefit from treatment. The severity and frequency of symptoms and how long they last will vary depending on the individual and their particular illness. Symptoms may also vary depending on the stage of the illness.

Depression can happen at any age, but often begins in adulthood. Depression is now recognized as occurring in children and adolescents, although it sometimes presents with more prominent irritability than low mood. Many chronic mood and anxiety disorders in adults begin as high levels of anxiety in children.

Depression, especially in midlife or older adults, can co-occur with other serious medical illnesses, such as diabetes, cancer, heart disease, and Parkinson’s disease. These conditions are often worse when depression is present, and research suggests that people who have depression and another medical illness tend to have more severe symptoms of both illnesses. Sometimes medications taken for these physical illnesses may cause side effects that contribute to depression. A doctor experienced in treating these complicated illnesses can help work out the best treatment strategy.

Treatment and Therapies:

Depression, even the most severe cases, can be treated. The earlier treatment begins, the more effective it is. Depression is usually treated with medications, psychotherapy, or a combination of the two. If these treatments do not reduce symptoms, electroconvulsive therapy (ECT) and other brain stimulation therapies may be options to explore.

Medication:

Antidepressants are medicines commonly used to treat depression. They may help improve the at patient’s brain uses certain chemicals which control mood or stress. An individual may need to try several different antidepressant medicines before finding the one that improves their symptoms, with manageable side effects. A medication which has helped the individual or a close family member in the past past will often be considered.

Antidepressants take time, usually 4 to 8 weeks, to work. Often symptoms such as sleep, appetite, and concentration problems improve before mood lifts; it is important to give medication a chance before deciding whether it works.

Psychotherapies:

Examples of evidence-based approaches specific to the treatment of depression include cognitive-behavioural therapy (CBT) and interpersonal therapy (IPT)

Brain Stimulation Therapies

If medications do not reduce the symptoms of depression, electroconvulsive therapy (ECT) may be an option to explore.

Other more recently introduced types of brain stimulation therapies used to treat medicine-resistant depression include repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS) and vagus nerve stimulation (VNS). Other types of brain stimulation treatments are being studied.

How can BHC help:

Highly experienced psychologists and psychiatrists can diagnose and treat depression effectively with starting initial assessment fee of £495 per hour and psychology sessions at £145 per hour. We are able to refer for non-invasive brain stimulation interventions in addition to effective medication and psychotherapy intervention.

Call us on 0207 183 1229 to book an appointment or Click here to Book an Appointment.

**Signs and Symptoms** People with bipolar disorder experience periods of unusually intense emotion, changes in sleep patterns and activity levels, and engage in behaviours which are out of character for them; often without recognizing their likely harmful or undesirable effects. These distinct periods are called mood episodes. Mood episodes are very different from the person’s usual moods and behaviours. During an episode, the symptoms last every day for most of the day. Episodes may also last for longer periods, such as several days or weeks. Sometimes people have both manic and depressive symptoms in the same episode, and this is called an episode with mixed features. During an episode with mixed features, people may feel very sad, empty, or hopeless while at the same time feeling extremely energized. A person may have bipolar disorder even if their symptoms are less extreme. For example, some people with bipolar II disorder experience hypomania, a less severe form of mania. During a hypomanic episode, a person may feel very good, be able to get things done, and keep up with day-to-day life. The person may not feel that anything is wrong, but family and friends may recognize changes in mood or activity levels as possible symptoms of bipolar disorder. Without proper treatment, people with hypomania can develop severe mania or depression. **Diagnosis** Receiving the right diagnosis and treatment can help people with bipolar disorder lead healthy and active lives. Talking with a healthcare provider is the first step. **Bipolar disorder and other conditions** Many people with bipolar disorder also have other mental disorders or conditions such as anxiety disorders, attention deficit hyperactivity disorder (ADHD), misuse of drugs or alcohol, or eating disorders. Sometimes people who have severe manic or depressive episodes also have symptoms of psychosis, which may include hallucinations or delusions. **Treatments and therapies** Treatment can help many people, including those with the most severe forms of bipolar disorder. An effective treatment plan usually includes a combination of medication and psychotherapy, also called talk therapy. Bipolar disorder is a lifelong illness. Episodes of mania and depression typically come back over time. Between episodes, many people with bipolar disorder are free of mood changes, but some people may have lingering symptoms. Long-term, continuous treatment can help people manage these symptoms. **Medication** Certain medications can help manage symptoms of bipolar disorder. Some people may need to try different medications and work with their healthcare provider to find the medications that work best for them. The most common types of medications that healthcare providers prescribe include mood stabilizers and atypical antipsychotics. Mood stabilizers such as lithium or valproate can help prevent mood episodes or reduce their severity. Lithium also can decrease the risk of suicide. Healthcare providers may include medications that target sleep or anxiety as part of the treatment plan. Although bipolar depression is often treated with antidepressant medication, a mood stabilizer must be taken as well; taking an antidepressant without a mood stabilizer can trigger a manic episode or rapid cycling in a person with bipolar disorder. Because people with bipolar disorder are more likely to seek help when they are depressed than when they are experiencing mania or hypomania, it is important for healthcare providers to take a careful medical history to ensure that bipolar disorder is not mistaken for depression. **Psychotherapy** Psychotherapy, also called talk therapy, can be an effective part of treatment for people with bipolar disorder. Cognitive behavioural therapy (CBT) is an important treatment for depression, and CBT adapted for the treatment of insomnia can be especially helpful as part of treatment for bipolar depression. **Other treatment options** Some people may find other treatments helpful in managing their bipolar symptoms: - **Electroconvulsive therapy (ECT)**: A brain stimulation procedure that can help relieve severe symptoms of bipolar disorder. Healthcare providers may consider ECT when a person’s illness has not improved following other treatments, or in cases which require rapid response, such as with people who have a high suicide risk or catatonia (a state of unresponsiveness). - **Repetitive transcranial magnetic stimulation (rTMS)**: A type of brain stimulation that uses magnetic waves to relieve depression over a series of treatment sessions. Although not as powerful as ECT, rTMS does not require general anaesthesia and has a low risk of negative effects on memory and thinking. - **Light therapy**: The best evidence-based treatment for seasonal affective disorder (SAD), and many people with bipolar disorder experience seasonal worsening of depression or SAD in the winter. Light therapy may also be used to treat lesser forms of seasonal worsening of bipolar depression. **How can BHC help?** Highly experienced psychiatrists and psychologists can diagnose and treat bipolar disorder effectively with the starting initial assessment fee of £495 per hour and psychology sessions at £145 per hour. Psychiatrists can work collaboratively with a patient’s GP for monitoring and follow-up for medications such as Lithium. Call us on 0207 183 1229 to book an appointment or [Click here to Book an Appointment](#).

**Signs of Sleep Problems** An individual may: - Find it difficult to fall asleep - Lie awake for long periods at night - Wake up several times during the night - Wake up early and be unable to get back to sleep - Feel down or have a lower mood - Have difficulty concentrating - Be more irritable than usual - Feel like they have not slept well when they wake up in the morning **Long-term sleep problems can lead to:** - Feeling relationships are suffering - Struggling to maintain a social life - Having a hard time doing everyday tasks - Feeling hungrier and snacking more - Feeling tired during the day **What are sleep disorders?** Sleep disorders are conditions that disturb normal sleep patterns. There are more than 80 different sleep disorders. Some major types include: - **Insomnia**: Being unable to fall asleep and stay asleep. This is the most common sleep disorder. - **Sleep apnea**: A breathing disorder in which an individual stops breathing for 10 seconds or more during sleep. - **Restless leg syndrome (RLS)**: A tingling or prickly sensation in one’s legs, along with a powerful urge to move them. - **Hypersomnia**: Being unable to stay awake during the day. This includes narcolepsy, which causes extreme daytime sleepiness. - **Circadian rhythm disorders**: Problems with the sleep-wake cycle, making an individual unable to sleep and wake at the right times. - **Parasomnia**: Acting in unusual ways while falling asleep, sleeping, or waking from sleep, such as walking, talking, or eating. - **REM sleep disorder**: The deep part of one’s sleep called Random Eye Movement (REM) is affected, resulting in acting-out dreams and limb movements. Some people who feel tired during the day have a true sleep disorder. **What causes sleep disorders?** There are different causes for different sleep disorders, including: - Other conditions, such as heart disease, lung disease, nerve disorders, and pain - Mental illnesses, including depression and anxiety - Medications - Genetics - Sometimes the cause is unknown **How are sleep disorders diagnosed?** To make a diagnosis, your healthcare provider will use your medical history, your sleep history, and a physical examination. A person may also engage in a sleep study (polysomnogram). The most common types of sleep studies monitor and record data about the body during a full night of sleep. The data includes: - Brain wave changes - Eye movements - Breathing rate - Blood pressure - Heart rate and electrical activity of the heart and other muscles **What are the treatments for sleep disorders?** Treatments depend on the disorder being experienced and may include: - Good sleep habits and other lifestyle changes, such as a healthy diet and exercise - Treatment of the underlying brain condition can help with sleep enhancement as well, for instance, effective treatment of ADHD and the associated REM sleep disorder - Cognitive behavioural therapy or relaxation techniques to reduce anxiety about getting enough sleep - CPAP (continuous positive airway pressure) machine (for sleep apnea) - Bright light therapy (in the morning) - Medication, including sleeping pills. Usually, providers recommend these are used for a short period of time. - Natural products, such as melatonin. These products may help some people but are generally for short-term use. A healthcare provider should be consulted prior to use. **How can BHC help?** Experienced Neuropsychiatrists, Neurologists, and Neuropsychologists help with comprehensive assessment, diagnosis, and management. Initial assessments start from £495 per hour and psychology sessions at £145 per hour. Call us on 0207 183 1229 to book an appointment or [Click here to Book an Appointment](#).

Functional Neurological Disorder (FND): a problem with how one’s brain receives and sends information to the rest of the body.

It's often helpful to think of a brain as a computer. Where someone has FND, there's no damage to the hardware, or structure, of the brain. The software, or program running on the computer, that isn't working properly.

The problems in FND are occurring in a level of the brain one cannot control.

Symptoms

There are many symptoms of FND which vary from one to person to another. Some people experience

few and others many symptoms.

1. Functional limb weakness: when an arm or leg Is not functioning as we would expect. In FND, this occurs due to a problem with how the nervous system is functioning and can cause a range of symptoms, including:

• problems walking

• heaviness down one side

• dropping things

• feeling like a limb isn't part of you

Functional limb weakness can often look like symptoms of a stroke or multiple sclerosis. Scans of a patient with FND show no damage to the brain to explain the weakness. A specialist will diagnose functional limb weakness based on specific clinical features found on examination.

2. A Functional Seizure (aka dissociative seizure): an episode where someone loses either awareness of, or their ability to interact with, their surroundings. It may look like an epileptic seizure or a faint. Neurologists use the term non-epileptic attack disorder (NEAD). A functional seizure can appear as:

• uncontrolled shaking

• suddenly going motionless and unresponsive

• staring without responding to surroundings

Some people are aware that seizures are about to happen, while others experience them without warning.

A specialist will ask the patient, their friends and family for details of the seizure, watch any available videos capturing the seizure to make a clinical assessment of either epilepsy, fainting or a functional seizure.

3. Functional Tremor: uncontrollable shaking of part of the body. Most often found in the arms and legs. Functional tremors can be intermittent through the day and change in speed and strength. A specialist will diagnose functional tremor based on specific features of the symptoms found during examination.

4. Functional Dystonia: a type of muscle spasm which causes part of the body to become stuck in an unusual position.

This can be for a short or a long period of time. Someone with functional dystonia will often present with curled fingers, a clenched hand, or an ankle that turns in.

5. Functional Gait Disorder: describes the problems with walking a patient may experience as part of FND.

One may experience a dragging leg, or feel unsteady when walking, or exhibit excessive movements when walking. A specialist will diagnose functional gait disorder based on clinical features, for example walking changes when doing different activities.

6. Functional Facial Spasm: where someone experiences muscle spasms in the face.

These can lead to problems such as narrowing of the eye or the pulling of the mouth or jaw upwards, downwards or to the side.

7. Functional Tics: a fast repetitive movement or sound which happens suddenly. Functional tics can be a symptom of FND.

Functional tics may look like the tics in Tourette's syndrome. A specialist will look at the clinical features of a person’s tics to make a diagnosis. It's quite common to have both functional tics and Tourette's syndrome.

8. Functional Jerks and Twitches: in essence when someone makes sudden movements.

Everyone experiences random jerks occasionally, for example, jolting awake whilst drifting off to sleep.

In FND, however, these uncontrolled jerks and twitches can become much more frequent.

9. Functional Drop Attacks: when someone falls to the ground suddenly without losing

consciousness.

10. Functional Sensory Symptoms: numbness, pins and needles or a feeling that a limb is not part of the body.

11. Functional Cognitive Symptoms: memory or concentration problems can be a symptom of FND.

examples include:

• lose track while doing things, for example being unable to remember why you went into a room

• go blank, for example when trying to recall your pin number

• lose track during conversations

• misplace important things, like your keys or phone

• forget words

Although normal to experience these things occasionally. A person with functional cognitive symptoms will experiences them to such an extent they interfere with work and home life.

The cognitive symptoms of FND are sometimes mistaken for dementia. Specialists will look for features that are typical of functional cognitive symptoms when diagnosing FND.

12. Functional Speech and Swallowing; difficulties can be a symptom of FND. Someone might experience:

• slurred speech

• a new stutter

• difficulties finding the right word

• unintentionally mixing words up

• whispering or hoarse speech (dysphonia)

• difficulty swallowing, including feeling like there's something stuck in your throat

A specialist will diagnose functional speech and swallowing difficulties based on specific features.

13. Persistent Postural Perceptual Dizziness (PPPD) (aka functional dizziness, triple PD or 3PD): typically experienced constantly, and gets worse while walking or in crowded environments.

There are many causes of dizziness. Most people with PPPD have another cause of dizziness at the same time. A specialist will diagnose PPPD based on specific features identified during assessment.

14. Functional Visual Symptoms; experienced with changes in vision, such as:

• blurred vision

• double vision

• photophobia (sensitivity to light)

• reduced vision

A specialist will diagnose functional visual symptoms based on specific features found during examination.

15. Dissociative Symptoms: common in FND, although there are many other causes. These symptoms can be hard to describe, but are often described as feeling:

• Body is not connected

• Body does not belong

• disconnected from the world around

• spaced out

• floating feeling

• out-of-body experience

Someone may be able to hear what’s going on around them, but not be able to respond.

It can be helpful to know that these experiences are called dissociation and can link into other FND symptoms.

Common associated symptoms or conditions:

There are other symptoms or conditions that are commonly associated with FND. Including:

• chronic pain, including fibromyalgia, back and neck pain, and complex regional pain syndrome

• persistent fatigue

• sleep problems including insomnia (not sleeping enough) and hypersomnia (sleeping too much)

• migraines and other types of headaches and facial pain

• irritable bowel syndrome and other problems with the function of your stomach and bowel

• anxiety and panic attacks

• depression

• post-traumatic stress disorder

• chronic urinary retention despite all tests being normal (which may be diagnosed as Fowlers syndrome)

• dysfunctional breathing

What causes FND?

We know that the symptoms of FND happen because there is a problem with how the brain is sending and receiving messages to itself and other parts of the body. Using research tools, scientists can see that certain circuits in the brain are not working properly in people with FND. However, there's still a lot of research to be done to understand how and why FND happens.

Why does FND happen?

FND can happen for a wide range of reasons. There's often more than one reason, and the reasons can vary hugely from person to person.

Some of the reasons why the brain stops working properly in FND include:

• the brain trying to get rid of a painful sensation

• a migraine or other neurological symptom

• the brain shutting down a part or all of the body in response to a situation it thinks is threatening

Some people experience FND due to stress, whereas for others stress is not relevant, In some people, stressful events in the past or present can be relevant to FND. In others, stress is not relevant. The risk of developing FND increases if you have another neurological condition.

Diagnosing FND:

When diagnosing FND, a clinician will carry out an assessment to see if there are typical clinical features of FND. A healthcare provider may still choose to test for other diseases and conditions before diagnosing FND. This is because many conditions share the same symptoms and, in around a quarter of cases, FND is present alongside another neurological condition. Someone can have both FND and conditions like sciatica, carpal tunnel syndrome, epilepsy, or multiple sclerosis (MS). The diagnosis of FND, however, should be given because should someone exhibit clinical features of FND. It shouldn't be given just because there's no evidence of other conditions or illnesses.

Due to the face the symptoms of FND are not always present a healthcare provider may ask someone to video symptoms

Treatments:

FND is a variable condition. Some people have quite short-lived symptoms. Others can have them for many years. There are treatments available that can manage and improve FND. These treatments are all forms of rehabilitation therapy, which aims to improve ability to carry out everyday activities. Many of these treatments are designed to "retrain the brain". Some people with FND benefit a lot from treatment and may go into remission. Other people continue to have FND symptoms despite treatment.

Physiotherapy:

Specialised physiotherapy can be useful in treating FND, by helping to remind the body how it should move. It can also help you build up strength and stamina you may have lost.

Occupational Therapy:

Helpful in treating FND, an occupational therapist will work with a patient to plan treatment goals, and gradually build confidence and ability to reach them.

Psychological Therapy:

Psychological therapists can help you learn to manage low mood, anxiety, and the ups and downs of an intermittent problem like FND. They can also help patients with gaining a better understanding of their condition. Should there be traumatic events preventing recovery, focused therapy can sometimes be helpful.

Speech, Language and Swallowing Therapy:

Speech and language therapists are available to help patients who are struggling with speaking or swallowing. They have a range of techniques, designed to help with specific problems. These might include helping a patient to shape certain sounds, or to practice breathing patterns whilst trying to talk.

Medication:

Medication can play a role in treating some of problems associated with FND, for example; pain, depression, anxiety. A healthcare provider will help decide if medication is right for an individual. Many medications can make FND worse, including opiates such as morphine, dihydrocodeine and codeine. It may be worth a patient discussing current medications with a healthcare provider.

How can BHC help?

Experienced Neuropsychiatrists, Neurologists and Neuropsychologists help with comprehensive assessment, diagnosis and management and towards multi-disciplinary interventions towards rehabilitation. Initial assessments starting from £495 per hour and psychology sessions at £145 per hour.

Call us on 0207 183 1229 to book an appointment or Click here to Book an Appointment.

Neuropsychiatry of Alzheimer’s Disease

Alzheimer's disease is a progressive neurodegenerative disorder that primarily affects the memory and cognitive abilities of older adults. In addition to these hallmark symptoms, individuals with Alzheimer's disease may also experience a range of neuropsychiatric symptoms. This article will explore the neuropsychiatry of Alzheimer's disease, including the symptoms, causes, diagnosis, treatment options, medication options, and prevention.

Symptoms:

The neuropsychiatric symptoms of Alzheimer's disease can include a range of cognitive, emotional, and behavioral changes. These may include:

• Mood disturbances, such as depression, anxiety, or apathy

• Psychotic symptoms, such as delusions or hallucinations

• Behavioral changes, such as agitation, aggression, or wandering

• Sleep disturbances, such as insomnia or daytime sleepiness

• These symptoms can significantly impact the quality of life for individuals with Alzheimer's disease, as well as their caregivers and family members.

Causes:

The underlying causes of neuropsychiatric symptoms in Alzheimer's disease are complex and not fully understood. However, it is thought that the abnormal accumulation of beta-amyloid and tau proteins in the brain, which are characteristic of Alzheimer's disease, may also affect other areas of the brain that regulate mood, behavior, and cognition. Additionally, other factors such as genetics, environmental factors, and comorbid conditions may contribute to the development of these symptoms.

Diagnosis:

Diagnosing neuropsychiatric symptoms in Alzheimer's disease can be challenging, as many of these symptoms can be caused by other factors such as medication side effects or other comorbid conditions. A thorough evaluation by a healthcare professional with expertise in Alzheimer's disease and neuropsychiatry is essential. This may include a neurological exam, imaging studies, and neuropsychological testing.

Treatment Options:

The treatment of neuropsychiatric symptoms in Alzheimer's disease may involve a combination of medication, psychotherapy, and lifestyle modifications. The goal of treatment is to reduce symptoms and improve quality of life.

Medication Options:

Medications that are commonly used to treat Alzheimer's disease may also be effective in managing some neuropsychiatric symptoms. However, some medications may worsen these symptoms or have unwanted side effects, so careful monitoring is essential. Other medications, such as antidepressants or antipsychotics, may be used to manage mood or behavioral changes.

Prevention:

While there is no known cure for Alzheimer's disease, there are some lifestyle modifications that may help reduce the risk of developing this condition. These may include:

• Maintaining a healthy diet and exercise regimen

• Engaging in intellectually stimulating activities, such as reading or playing games

• Managing chronic conditions such as high blood pressure or diabetes

• Avoiding smoking and excessive alcohol consumption

In Summary:

The neuropsychiatric symptoms of Alzheimer's disease can significantly impact the quality of life for individuals with this condition, as well as their caregivers and family members. A comprehensive approach that includes medication, psychotherapy, and lifestyle modifications may be necessary to effectively manage these symptoms. Early recognition and treatment of these symptoms is essential in improving outcomes for those living with Alzheimer's disease in the UK. Additionally, efforts to reduce the risk of developing this condition through lifestyle modifications may be beneficial.

How BHC can help:

Highly experienced neuropsychiatrists can diagnose and treat effectively the Neuropsychiatry manifestations associated with Mood disorders, with initial assessment fee of £495 per hour and follow-up sessions at £250 per hour.

Call us on 0207 183 1229 to book an appointment or Click here to Book an Appointment.

Neuropsychiatry of Dissociative Disorders

Dissociative disorders are a group of mental health conditions that involve a disruption in an individual's consciousness, memory, identity, or perception of their surroundings. Dissociation is a coping mechanism that occurs when an individual experiences overwhelming or traumatic experiences, and the mind separates from the experience in order to protect itself. However, in dissociative disorders, this process becomes persistent and disruptive, causing significant distress and functional impairment.

There are several different types of dissociative disorders, including dissociative amnesia, depersonalization/derealization disorder, and dissociative identity disorder (DID). Dissociative amnesia involves the inability to recall important personal information, typically related to a traumatic or stressful event. Depersonalization/derealization disorder involves feeling detached from oneself or one's surroundings, often described as feeling like one is watching themselves from outside of their body. DID, formerly known as multiple personality disorder, involves the presence of two or more distinct identities or personalities within one individual.

In this article, we will explore the neuropsychiatry of dissociative disorders, including the symptoms, causes, diagnosis, treatment options, medication options, and prevention, with a focus on data from the United Kingdom.

Symptoms:

The symptoms of dissociative disorders can vary widely depending on the specific type of disorder. Common symptoms may include memory loss, a feeling of detachment from oneself or one's surroundings, and changes in perception. Individuals with dissociative disorders may also experience mood swings, anxiety, and depression.

Causes:

The causes of dissociative disorders are not fully understood, but researchers believe that traumatic experiences, such as childhood abuse or neglect, may play a role in their development. Other potential factors that may contribute to the development of dissociative disorders include genetics, brain chemistry imbalances, and coping mechanisms for stress.

Diagnosis:

The diagnosis of dissociative disorders typically involves a comprehensive evaluation by a healthcare professional with expertise in psychiatry. This may include a physical exam, lab tests, imaging studies, and a psychiatric evaluation. The healthcare professional will also assess for other potential causes of the symptoms, such as substance abuse or other medical conditions.

Treatment Options:

The treatment of dissociative disorders typically involves a combination of medication and therapy. The goals of treatment are to reduce symptoms, improve quality of life, and prevent relapse. Therapy may include cognitive-behavioral therapy or psychodynamic therapy, which can help individuals with dissociative disorders learn coping strategies and improve their social and interpersonal skills.

Medication Options:

There are several different classes of medications that may be used to treat dissociative disorders. Antidepressants and anti-anxiety medications may be prescribed to manage symptoms such as anxiety and depression. Additionally, mood stabilizers may be used to help regulate mood swings.

Prevention:

Preventing dissociative disorders can be challenging, as many of the risk factors are beyond an individual's control. However, early intervention in the event of traumatic experiences or mental health conditions may help to reduce the risk of developing dissociative disorders. Additionally, lifestyle modifications such as stress reduction techniques and healthy coping mechanisms may be beneficial.

In Summary:

Dissociative disorders are complex mental health conditions that can significantly impact an individual's quality of life. A comprehensive approach that includes medication and therapy is typically required to effectively manage these disorders. Early recognition and treatment are essential in improving outcomes for those living with dissociative disorders in the UK. Additionally, efforts to reduce the risk of developing dissociative disorders through early intervention and lifestyle modifications may be beneficial. A healthcare professional with expertise in psychiatry can provide a thorough evaluation and develop an individualized treatment plan for those living with dissociative disorders in the UK.

How BHC can help:

Highly experienced neuropsychiatrists can diagnose and treat effectively the Neuropsychiatry manifestations associated with Dissociative disorders, with initial assessment fee of £495 per hour and follow-up sessions at £250 per hour.

Call us on 0207 183 1229 to book an appointment or Click here to Book an Appointment.

Neuropsychiatry of Epilepsy

Epilepsy is a neurological condition characterized by recurrent seizures, which can be caused by abnormal electrical activity in the brain. While seizures are the hallmark symptom of epilepsy, many individuals with this condition also experience a range of neuropsychiatric symptoms. This article provides the basic information about neuropsychiatry of epilepsy, including the symptoms, causes, diagnosing, treatment, and medication.

Symptoms:

Neuropsychiatric symptoms in epilepsy can include a wide range of cognitive, emotional, and behavioural changes. These may include:

• Mood disturbances, such as depression, anxiety, irritability, or euphoria

• Psychotic symptoms, such as hallucinations or delusions

• Cognitive dysfunction, including problems with memory, attention, language, or executive functioning

• Behavioural changes, such as impulsivity, aggression, or hypersexuality

• These symptoms can significantly impact the quality of life for individuals with epilepsy, and may also affect their ability to manage their seizures effectively.

Causes:

The underlying causes of neuropsychiatric symptoms in epilepsy are complex and not fully understood. However, it is thought that the abnormal electrical activity in the brain that leads to seizures may also affect other areas of the brain, leading to changes in mood, behaviour, and cognition. Additionally, some medications used to treat epilepsy may also have neuropsychiatric side effects.

Diagnosing:

Diagnosing neuropsychiatric symptoms in epilepsy can be challenging, as many of these symptoms can be caused by other factors such as medication side effects or other comorbid conditions. A thorough evaluation by a healthcare professional with expertise in epilepsy and neuropsychiatry is essential. This may include a neurological exam, imaging studies, and neuropsychological testing.

Treatment:

The treatment of neuropsychiatric symptoms in epilepsy may involve a combination of medication, psychotherapy, and lifestyle modifications. The goal of treatment is to reduce symptoms and improve quality of life. Medications that are commonly used to treat seizures may also be effective in managing some neuropsychiatric symptoms. However, some medications may worsen these symptoms or have unwanted side effects, so careful monitoring is essential.

Psychotherapy, such as cognitive-behavioural therapy, may be helpful in managing mood disturbances, anxiety, or other behavioural changes. Lifestyle modifications, such as stress management, regular exercise, and a healthy diet, may also be beneficial.

Medication:

The medications used to treat neuropsychiatric symptoms in epilepsy will depend on the specific symptoms and underlying cause. Anticonvulsant medications, which are used to treat seizures, may also be effective in managing some neuropsychiatric symptoms. Other medications, such as antidepressants or antipsychotics, may be used to manage mood or behavioural changes.

It is important to note that some medications used to treat epilepsy may have neuropsychiatric side effects, and careful monitoring is essential. Additionally, some medications may interact with other medications, so it is important to work closely with a healthcare provider to develop a treatment plan that is safe and effective.

In conclusion, the neuropsychiatric symptoms of epilepsy can significantly impact the quality of life for individuals with this condition. A comprehensive approach that includes medication, psychotherapy, and lifestyle modifications may be necessary to effectively manage these symptoms. Early recognition and treatment of these symptoms is essential in improving outcomes for those living with epilepsy in the UK.

How BHC can help:

Highly experienced neuropsychiatrists and Neurologists can diagnose and treat effectively the Neuropsychiatry manifestations associated with Epilepsy, with initial assessment fee of £495 per hour and follow-up sessions at £250 per hour.

Call us on 0207 183 1229 to book an appointment or Click here to Book an Appointment.

Neuropsychiatry of Mood Disorders

Mood disorders are a group of mental health conditions that involve significant changes in an individual's mood or emotional state. These conditions can affect how an individual feels, thinks, and behaves, and can impact their daily functioning and quality of life. There are several different types of mood disorders, including major depressive disorder, bipolar disorder, and persistent depressive disorder. In this article, we will explore the neuropsychiatry of mood disorders in the United Kingdom, including symptoms, causes, diagnosis, treatment options, medication options, and prevention.

Symptoms:

The symptoms of mood disorders can vary depending on the specific condition and the individual. However, common symptoms of mood disorders include:

• Feelings of sadness, emptiness, or hopelessness

• Loss of interest or pleasure in activities that were once enjoyable

• Fatigue or lack of energy

• Changes in appetite or weight

• Difficulty sleeping or oversleeping

• Restlessness or irritability

• Difficulty concentrating or making decisions

• Thoughts of self-harm or suicide

Causes:

The exact causes of mood disorders are not fully understood, but research suggests that a combination of genetic, environmental, and biological factors may contribute to the development of these conditions. Additionally, stress, trauma, and substance abuse may increase the risk of developing a mood disorder.

Diagnosis:

Diagnosing mood disorders can be challenging, as many of the symptoms overlap with other mental health conditions. A healthcare professional with expertise in psychiatry will typically conduct a thorough evaluation, including a physical exam and laboratory tests, to rule out any underlying medical conditions that may be contributing to the symptoms. Additionally, the healthcare professional may use various assessment tools, such as questionnaires or interviews, to evaluate the individual's symptoms and develop an accurate diagnosis.

Treatment options:

There are several treatment options available for mood disorders, including psychotherapy, medication, and lifestyle modifications. Psychotherapy, such as cognitive-behavioral therapy, can help individuals learn coping strategies and improve their social and interpersonal skills. Additionally, medication, such as antidepressants or mood stabilizers, may be prescribed to manage symptoms. Lifestyle modifications, such as exercise and stress reduction techniques, may also be beneficial in managing symptoms.

Medication options:

Several medications are available for the treatment of mood disorders, including selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and mood stabilizers. The specific medication prescribed will depend on the individual's symptoms and diagnosis. It is essential to work closely with a healthcare professional to determine the most effective medication and dosage for an individual's specific needs.

Prevention:

Preventing mood disorders can be challenging, as many of the risk factors are beyond an individual's control. However, early intervention in the event of stressful or traumatic experiences, as well as early recognition and treatment of mental health conditions, may help to reduce the risk of developing mood disorders. Additionally, lifestyle modifications such as stress reduction techniques and healthy coping mechanisms may be beneficial in managing symptoms and reducing the risk of developing mood disorders.

In Summary:

Mood disorders are common neuropsychiatric conditions that can have a significant impact on an individual's quality of life. These conditions can be caused by a variety of factors, including genetic and environmental factors. Symptoms may include changes in mood, appetite, and sleep patterns, as well as feelings of hopelessness and worthlessness. Treatment options may include psychotherapy, medication, and other therapies, such as ECT and TMS. While it may not be possible to prevent mood disorders entirely, individuals can take steps to reduce their risk, such as maintaining a healthy lifestyle and managing stress. If you are experiencing symptoms of a mood disorder, it is important to seek treatment as soon as possible.

How BHC can help:

Highly experienced neuropsychiatrists can diagnose and treat effectively the Neuropsychiatry manifestations associated with Mood disorders, with initial assessment fee of £495 per hour and follow-up sessions at £250 per hour.

Call us on 0207 183 1229 to book an appointment or Click here to Book an Appointment.

Neuropsychiatry of Multiple Sclerosis (MS)

Multiple Sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system, and it is estimated that over 130,000 people in the UK live with the condition. While physical symptoms such as muscle weakness, balance issues, and fatigue are commonly associated with MS, it is important to recognize the impact of neuropsychiatric symptoms on the lives of those affected by the disease.

Symptoms:

Neuropsychiatric symptoms in MS are common and can include depression, anxiety, irritability, mood swings, cognitive dysfunction, and fatigue. According to a study conducted in the UK, up to 50% of people with MS experience depression at some point during their illness, and approximately 30% experience anxiety. These symptoms can be particularly challenging for individuals with MS, as they can negatively impact daily activities, relationships, and overall quality of life.

Cause:

The exact cause of neuropsychiatric symptoms in MS is not fully understood, but it is believed to be related to the underlying inflammation and degeneration of nerve fibres in the brain and spinal cord. Changes in neurotransmitter levels, such as serotonin and dopamine, have also been implicated in the development of these symptoms.

Diagnosing:

Diagnosing neuropsychiatric symptoms in MS can be challenging as they are often multifactorial and can result from the disease process itself, medication side effects, and comorbidities. Clinical evaluation and a detailed patient history are essential in making an accurate diagnosis. Neuropsychological testing may also be necessary to assess cognitive function.

Treatment:

The treatment of neuropsychiatric symptoms in MS is often multimodal and may involve lifestyle interventions, psychological interventions, and pharmacotherapy. Studies in the UK have shown that cognitive-behavioural therapy (CBT) can be an effective psychological intervention in managing depression and anxiety in people with MS. Other psychological interventions such as mindfulness and exercise-based interventions may also be helpful.

Medication:

Several medications have been shown to be effective in managing neuropsychiatric symptoms in people with MS. Selective serotonin reuptake inhibitors (SSRIs) are commonly used to treat depression and anxiety. Other medications, such as mood stabilizers and antipsychotics, may be used in more severe cases. However, it is important to note that medication should not be the sole focus of treatment and that a comprehensive approach that takes into account the individual needs of each person with MS is essential.

In summary:

Neuropsychiatric symptoms are common in people with MS and can have a significant impact on quality of life. The treatment of these symptoms requires a holistic approach that includes lifestyle interventions, psychological interventions, and medication. Collaboration between healthcare providers, patients, and their families is essential in developing and implementing effective treatment strategies that meet the individual needs of those living with MS in the UK.

How BHC can help:

Highly experienced neuropsychiatrists and Neurologists can diagnose and treat effectively the Neuropsychiatry manifestations associated with Multiple Sclerosis (MS),with initial assessment fee of £495 per hour and follow-up sessions at £250 per hour.

Call us on 0207 183 1229 to book an appointment or Click here to Book an Appointment.

The Neuropsychiatry of Parkinson's Disease

Understanding the Connection between Mental Health and Movement Disorder

Parkinson's disease is a progressive neurological disorder that affects the brain's ability to control movement. However, the disease also has a significant impact on mental health, and many people with Parkinson's disease experience neuropsychiatric symptoms that can be just as debilitating as their motor symptoms.

Neuropsychiatric symptoms refer to a range of mental health issues that can arise as a result of Parkinson's disease. These symptoms include anxiety, depression, apathy, hallucinations, delusions, and impulse control disorders.

Anxiety and Depression:

Anxiety and depression are common neuropsychiatric symptoms of Parkinson's disease. Anxiety is characterized by feelings of worry, fear, and unease, while depression is characterized by feelings of sadness, hopelessness, and loss of interest in activities.

Research shows that people with Parkinson's disease are at a higher risk of developing anxiety and depression than the general population. These symptoms can be caused by the stress of dealing with the disease, changes in the brain's chemistry, or side effects of medications.

Apathy:

Apathy is another common neuropsychiatric symptom of Parkinson's disease. Apathy refers to a lack of motivation or interest in activities that were once enjoyable. It is often mistaken for depression, but the two are distinct conditions.

Apathy can be caused by changes in the brain's dopamine levels, which are responsible for motivation and reward. Apathy can significantly impact a person's quality of life and may require treatment with medication or psychotherapy.

Hallucinations and Delusions:

Hallucinations and delusions are less common neuropsychiatric symptoms of Parkinson's disease, but they can still occur in some people with the disease. Hallucinations refer to seeing or hearing things that are not there, while delusions refer to false beliefs that are not based in reality.

These symptoms can be caused by changes in the brain's dopamine levels or side effects of medication. Treatment may include reducing medication dosages or switching to different medications.

Impulse Control Disorders:

Impulse control disorders refer to a group of conditions that involve an inability to resist urges or impulses that are harmful or disruptive. These disorders can include behaviours such as compulsive gambling, shopping, or eating.

Impulse control disorders are more common in people with Parkinson's disease who are taking medications that affect dopamine levels in the brain. Treatment may include reducing medication dosages or switching to different medications.

In Summary:

Parkinson's disease is a complex condition that affects both movement and mental health. Neuropsychiatric symptoms can have a significant impact on a person's quality of life and may require treatment with medication or psychotherapy. If you or a loved one are experiencing neuropsychiatric symptoms related to Parkinson's disease, it is important to speak with a healthcare provider to determine the best course of treatment. With the right treatment plan, people with Parkinson's disease can manage their symptoms and maintain their independence and quality of life.

How BHC can help:

Highly experienced neuropsychiatrists can diagnose and treat effectively the Neuropsychiatry manifestations of Parkinson’s disease, with initial assessment fee of £495 per hour and follow-up sessions at £250 per hour.

Call us on 0207 183 1229 to book an appointment or Click here to Book an Appointment.

Neuropsychiatry of Psychosis

Psychosis is a mental health condition that affects a person's ability to perceive and interpret reality. It is a complex condition that can be caused by a range of factors and can manifest in a variety of ways. In this article, we will explore the neuropsychiatry of psychosis, including the symptoms, causes, diagnosis, treatment options, medication options, and prevention, with a focus on data from the United Kingdom.

Symptoms:

The symptoms of psychosis can include hallucinations, delusions, disorganized speech, and disorganized behaviour. Other symptoms may include social withdrawal, decreased motivation, and a lack of emotional expression. These symptoms can significantly impact an individual's ability to function in daily life and can lead to a decreased quality of life.

Causes:

The causes of psychosis are complex and not fully understood. Some of the factors that have been linked to the development of psychosis include genetics, environmental factors, drug use, and brain chemistry imbalances. Additionally, other mental health conditions such as bipolar disorder or schizophrenia may increase the risk of developing psychosis.

Diagnosis:

The diagnosis of psychosis typically involves a comprehensive evaluation by a healthcare professional with expertise in psychiatry. This may include a physical exam, lab tests, imaging studies, and a psychiatric evaluation. The healthcare professional will also assess for other potential causes of the symptoms, such as substance abuse or other medical conditions.

Treatment Options:

The treatment of psychosis typically involves a combination of medication and therapy. The goals of treatment are to reduce symptoms, improve quality of life, and prevent relapse. The most commonly used medications for psychosis are antipsychotics, which can help to reduce the intensity and frequency of hallucinations and delusions. Therapy may include cognitive-behavioural therapy or family therapy, which can help individuals with psychosis learn coping strategies and improve their social and interpersonal skills.

Medication Options:

There are several different classes of medications that may be used to treat psychosis. Antipsychotics are the most commonly used class and can be effective in reducing the intensity and frequency of symptoms. Other medications, such as mood stabilizers or antidepressants, may be used in conjunction with antipsychotics to manage other symptoms or comorbid conditions.

Prevention:

Preventing psychosis can be challenging, as many of the risk factors are beyond an individual's control. However, some lifestyle modifications may help to reduce the risk of developing psychosis. These may include avoiding drug use, maintaining a healthy diet and exercise regimen, and engaging in intellectually stimulating activities.

In Summary:

Psychosis is a complex mental health condition that can significantly impact an individual's quality of life. A comprehensive approach that includes medication and therapy is typically required to effectively manage this condition. Early recognition and treatment are essential in improving outcomes for those living with psychosis in the UK. Additionally, efforts to reduce the risk of developing psychosis through lifestyle modifications may be beneficial. A healthcare professional with expertise in psychiatry can provide a thorough evaluation and develop an individualized treatment plan for those living with psychosis in the UK.

How BHC can help:

Highly experienced neuropsychiatrists can diagnose and treat effectively the Neuropsychiatry manifestations of Psychosis, with initial assessment fee of £495 per hour and follow-up sessions at £250 per hour.

Call us on 0207 183 1229 to book an appointment or Click here to Book an Appointment.

Neuropsychiatry of Schizophrenia Spectrum Disorders

Schizophrenia spectrum disorders are a group of mental health conditions that affect a person's perception of reality, thoughts, and emotions. These disorders are complex and can manifest in a variety of ways. In this article, we will explore the neuropsychiatry of schizophrenia spectrum disorders, including the symptoms, causes, diagnosis, treatment options, medication options, and prevention, with a focus on data from the United Kingdom.

Symptoms:

The symptoms of schizophrenia spectrum disorders can include hallucinations, delusions, disorganized speech, and disorganized behaviour. Other symptoms may include social withdrawal, decreased motivation, and a lack of emotional expression. These symptoms can significantly impact an individual's ability to function in daily life and can lead to a decreased quality of life.

Causes:

The causes of schizophrenia spectrum disorders are not fully understood. However, research suggests that genetics, brain chemistry imbalances, and environmental factors may all play a role in the development of these conditions. Additionally, stressful life events, substance abuse, and other mental health conditions may increase the risk of developing schizophrenia spectrum disorders.

Diagnosis:

The diagnosis of schizophrenia spectrum disorders typically involves a comprehensive evaluation by a healthcare professional with expertise in psychiatry. This may include a physical exam, lab tests, imaging studies, and a psychiatric evaluation. The healthcare professional will also assess for other potential causes of the symptoms, such as substance abuse or other medical conditions.

Treatment Options:

The treatment of schizophrenia spectrum disorders typically involves a combination of medication and therapy. The goals of treatment are to reduce symptoms, improve quality of life, and prevent relapse. The most commonly used medications for schizophrenia spectrum disorders are antipsychotics, which can help to reduce the intensity and frequency of hallucinations and delusions. Therapy may include cognitive-behavioural therapy or family therapy, which can help individuals with schizophrenia spectrum disorders learn coping strategies and improve their social and interpersonal skills.

Medication Options:

There are several different classes of medications that may be used to treat schizophrenia spectrum disorders. Antipsychotics are the most commonly used class and can be effective in reducing the intensity and frequency of symptoms. Other medications, such as mood stabilizers or antidepressants, may be used in conjunction with antipsychotics to manage other symptoms or comorbid conditions.

Prevention:

Preventing schizophrenia spectrum disorders can be challenging, as many of the risk factors are beyond an individual's control. However, some lifestyle modifications may help to reduce the risk of developing these disorders. These may include avoiding drug use, maintaining a healthy diet and exercise regimen, and engaging in intellectually stimulating activities.

In Summary:

Schizophrenia spectrum disorders are complex mental health conditions that can significantly impact an individual's quality of life. A comprehensive approach that includes medication and therapy is typically required to effectively manage these disorders. Early recognition and treatment are essential in improving outcomes for those living with schizophrenia spectrum disorders in the UK. Additionally, efforts to reduce the risk of developing these disorders through lifestyle modifications may be beneficial. A healthcare professional with expertise in psychiatry can provide a thorough evaluation and develop an individualized treatment plan for those living with schizophrenia spectrum disorders in the UK.

How BHC can help:

Highly experienced neuropsychiatrists can diagnose and treat effectively the Neuropsychiatry manifestations of Schizophrenia spectrum disorders, with initial assessment fee of £495 per hour and follow-up sessions at £250 per hour.

Call us on 0207 183 1229 to book an appointment or Click here to Book an Appointment.