A – Z
Our A-Z Guide gives you useful information about a range of topics related to mental health. If you are searching for a topic we have not covered please get in touch with us and we will look into including it.
Attention Deficit Hyperactivity Disorder (ADHD)
Attention Deficit Hyperactivity Disorder (ADHD) is a medical condition that affects attention, concentration, and impulsivity. It is a genetically inherited condition that affects 5% of children and 2.5% of adults. There are three types: inattentive, hyperactive-impulsive, and combined.
Signs and symptoms
The main signs of people with the inattentive type:
- making careless mistakes – for example, in school or work
- appearing forgetful or losing things
- being unable to stick to tedious or time-consuming tasks.
- appearing to be unable to listen to or carry out instructions.
- constantly changing activity or task
- having difficulty organising tasks
The main signs of people with the hyperactive-impulsive type:
- being unable to sit still, especially in quiet surroundings.
- constantly fidgeting
- being unable to concentrate on tasks.
- excessive physical movement
- excessive talking
- being unable to wait their turn.
- acting without thinking
- interrupting conversations
- little or no sense of danger
The combined type involves aspects of the other two types and is the most common.
What Causes ADHD?
ADHD has biological origins that are not yet clearly understood. No single cause has been identified, but researchers are exploring a number of possible genetic and environmental links.
However, it is believed to be caused by poor transmission of messages in the brain, through low levels of the neurotransmitter dopamine and norepinephrine which carry messages from one neuron to another.
These neurotransmitters are associated with attention, organisation and managing emotions.
Is ADHD treatable?
The good news is that ADHD is treatable. In most cases, all types of ADHD are best treated with a combination of medications and behaviour therapy. Also, with the right kind of education and supports people with ADHD can reach their full potential and lead happy and successful lives.
Related conditions
ADHD can co-exist, to a greater or lesser degree, with disorders such as dyslexia, autism, dyspraxia, oppositional defiance disorder, depression, and anxiety
Resources and Supports
If you are concerned or would like to find out more, you can contact:
Personal Experience
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Alcohol
Mental health problems not only result from drinking too much alcohol. They can also cause people to drink too much. There is some evidence associating light drinking with improved health in some adults. Between one and three units daily have been found to help protect against heart disease, dementia and Alzheimer’s disease, and a small glass of red wine daily may reduce risk of stroke in women.
However there is much more evidence showing that drinking too much alcohol leads to serious physical and mental illnesses.
Put very simply, a major reason for drinking alcohol is to change our mood – or change our mental state. Alcohol can temporarily alleviate feelings of anxiety and depression; it can also help to temporarily relieve the symptoms of more serious mental health problems.
Alcohol problems are more common among people with more severe mental health problems. This does not necessarily mean that alcohol causes severe mental illness. Drinking to deal with difficult feelings or symptoms of mental illness is sometimes called ‘self-medication’ by people in the mental health field. This is often why people with mental health problems drink. But it can make existing mental health problems worse.
Evidence shows that people who consume high amounts of alcohol are vulnerable to higher levels of mental ill health and it can be a contributory factor in some mental illnesses, such as depression.
How Does Drinking Alcohol Affect Mental Health
When we have alcohol in our blood, our mood changes, and our behaviour then also changes. How these change depends on how much we drink and how quickly we drink it. Alcohol depresses the central nervous system, and this can make us less inhibited in our behaviour. It can also help ‘numb’ our emotions, so we can avoid difficult issues in our lives.
Alcohol can also reveal or magnify our underlying feelings. This is one of the reasons that many people become angry or aggressive when drinking. If our underlying feelings are of anxiety, anger or unhappiness, then alcohol can magnify them.
What About After Affects
One of the main problems associated with using alcohol to deal with anxiety and depression is that people may feel much worse when the effects have worn off. Alcohol is thought to use up and reduce the amount of neurotransmitters in the brain, but the brain needs a certain level of neurotransmitters needs to ward off anxiety and depression. This can lead some people to drink more, to ward off these difficult feelings, and a dangerous cycle of dependence can develop.
How Much is Too Much?
Current recommended ‘Sensible Drinking’ limits are three to four units a day for men and two to three units a day for women.
1 pint beer (5% vol) = 3 units
1 pint lager (3% vol) = 2 units
1 small glass wine (12% vol) = 2 units
1 measure spirit (40% vol) = 1 unit
1 pint beer (5% vol) = 3 units
1 pint lager (3% vol) = 2 units
1 small glass wine (12% vol) = 2 units
1 measure spirit (40% vol) = 1 unit
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”I get this bubble of rage.
I go wild. I feel like crying cos
I don’t know how to control
myself. It happens too quickly.
”I get this bubble of rage. I go wild. I feel like crying cos I don’t know how to control myself. It happens too quickly..
Anger
We all feel angry at times; it’s a natural response to threats and attacks, injustice and disappointment.
Anger is a powerful emotion and releasing the pressure that builds inside you can be essential to deal with problems and move on. But if anger isn’t dealt with in a healthy way, it can have a significant effect on your daily life, relationships, achievements and mental well-being.
What is Anger?
Anger is one of the most basic human emotions. It is a physical and mental response to a threat or to harm done in the past. Anger takes many different forms from irritation to blinding rage or resentment that festers over many years.
At any point in time, a combination of physical, mental and social factors interact to make us feel a certain way. It’s different for each of us. Our feelings are influenced by our emotional make-up, how we view the world, what happens around us and our circumstances. Like other emotions, anger rarely acts alone.
How Does Anger Work?
As we go about our lives, we’re constantly weighing up situations and deciding what we think about them: good or bad, safe or unsafe etc. How we interpret a situation influences how we feel about it. If we think we are in danger, we feel afraid. If we feel we have been wronged, we feel angry. These feelings determine how we react to the situation. We translate meanings into feelings very fast. With anger, that speed sometimes means that we react in ways we later regret.
How Do Our Bodies Respond To Anger?
Many of our emotions are linked to a particular physical response. Anger gets the mind and body ready for action. It arouses the nervous system, increasing the heart rate, blood pressure, blood flow to muscles, blood sugar level and sweating. It also sharpens the senses and increases the production of adrenalin, a hormone produced at times of stress.
At the same time as these physical changes, anger is thought to affect the way we think. When we are first faced with a threat, anger helps us quickly translate complex information into simple terms: ‘right’ or ‘wrong’ for instance. This can be useful in an emergency as we don’t waste valuable time weighing up information that doesn’t instantly affect our safety or well-being.
But it can mean that we act before we’ve considered what else is relevant and made a rational decision about how to behave. It may be that we need to take more time to look at the situation and deal with it differently. When anger gets in the way of rational thinking we may give way to the urge to act aggressively, propelled by the instinct to survive or protect someone from a threat.
Why Do We Get Angry?
Reasons for getting angry include:
- facing a threat to ourselves or our loved ones
- being verbally or physically assaulted
- suffering a blow to our self-esteem or our place within a social group
- being interrupted when pursuing a goal
- losing out when money is at stake
- someone going against a principle that we consider important
- being treated unfairly and feeling powerless to change this
- feeling disappointed by someone else or in ourselves
- having our property mistreated.
If we think someone has wronged us on purpose, this can make us angrier. If we’re having a bad day and are in a state of constant tension, we’re more likely to snap when something else goes wrong, even if it’s something that wouldn’t usually bother us.
We may feel angry immediately or only feel angry later when we go back over a situation. Anger can surface years later that has its roots in abuse or neglect long ago. Sometimes anger stays locked inside us for decades because it wasn’t dealt with sufficiently at the time.
How Do People Behave When They Get Angry?
Anger isn’t always negative. It can be a force for good. Moral outrage can drive people to campaign for change, right wrongs and enforce the rules that govern our society.
People often think of anger and aggression as the same thing, but they aren’t. Anger is an emotional state and aggression is just one of the ways that people behave when they are angry. Aggression often takes over when people act on their instinct to protect themselves or others. Alcohol can make some people act more aggressively and drug use can similarly lower our inhibitions.
People often express their anger verbally. They may:
- shout
- threaten
- use dramatic words
- bombard someone with hostile questions
- exaggerate the impact on them of someone else’s action.
Some people who are angry get their own back indirectly by making other people feel guilty and playing on that guilt. Others develop a cynical attitude and constantly criticise everything, but never address problems constructively.
Some people internalise their anger. They may be seething inside and may physically shake, but they don’t show their anger in the way they behave when they are around other people.
People who internalise their anger may self harm when they are angry as a way of coping with intense feelings they can’t express another way. This may give temporary relief from the angry feelings, but it doesn’t solve the problems in the long-term.
What Kind Of Problems Are Linked To Anger?
Anger in itself is neither good nor bad; it becomes a problem when it harms us or other people. Anger is the emotion most likely to cause problems in relationships in the family, at work and with friends. People with a long term anger problem tend to be poor at making decisions, take more risks than other people and are more likely to have a substance misuse problem.
Long term and intense anger has been linked with mental health problems including depression, anxiety and self-harm. It is also linked to poorer overall physical health as well as particular conditions, such as:
- high blood pressure
- colds and flu
- coronary heart disease
- stroke
- cancer
- gastro-intestinal problems.
How Can Managing My Anger Help Me?
Anger in itself is neither good nor bad; it becomes a problem when it harms us or other people. Anger is the emotion most likely to cause problems in relationships in the family, at work and with friends. People with a long term anger problem tend to be poor at making decisions, take more risks than other people and are more likely to have a substance misuse problem.
Long term and intense anger has been linked with mental health problems including depression, anxiety and self-harm. It is also linked to poorer overall physical health as well as particular conditions, such as:
- high blood pressure
- colds and flu
- coronary heart disease
- stroke
- cancer
- gastro-intestinal problems.
How Can I Manage My Own Anger?
Buy time
When you feel the first surge of anger boiling up inside you, pause for a moment. Think about what has made you angry, think about the consequences of exploding in a rage and then choose how to respond.
Even in the middle of an argument, it’s not too late to take a deep breath and choose to express your feelings differently. Give rational thinking time to kick in.
- Count to ten before you act.
- Drop your shoulders and breathe deeply to help you relax – your instincts may be telling your body to get ready to fight, but your rational self can reverse this message by telling your body to chill out.
- If you feel the urge to throw something or hit out, remove yourself from the situation and try taking it out on something soft like a cushion that you won’t damage and which won’t hurt you.
- Try screaming if it won’t disturb people near you or scream into a pillow to release your tension.
- Talk yourself down – imagine what your calmest friend would say to you and give yourself the same advice
- Imagine yourself in a relaxing scene.
- Distract yourself or take yourself out of the situation that made you angry – read a magazine, do a crossword, listen to soothing music, go for a walk.
- Pour out how you feel in writing or redirect your energy into another creative activity.
- Offload to a friend who will help you get perspective on the situation.
There are other activities which may help you almost immediately, later the same day or if you make them part of your lifestyle longer term.
- Work off your anger through exercise – channelling your energy into exercise instead will increase the release of feel good brain chemicals called endorphins which help us relax.
- Use relaxation techniques like yoga or meditation – techniques like these challenge the physical aspects of anger, such as the brain chemicals that prepare you to fight, before these chemicals lead you to act impulsively.
Be assertive
Being assertive is a healthy way to express anger. Take ownership of the situation and your feelings.
- Tell people that you are feeling angry and why.
- Talk slowly and clearly.
- Use the word “I” to make it about you, not about them.
- Make requests rather than demands or threats.
- Say “I could” and “I might” instead of “I must” or “I should”.
Good communication skills can help you get your message across. Keep the lines of communication open. Listen to other people’s point of view. Assuming you know where they stand can create a problem where there is none and escalate a situation from bad to worse.
Know yourself
In the longer term, it can be really helpful to work out what makes you angry and how it makes you behave. Think about it when you’re not feeling angry. Talk it through with someone who you trust and who knows you well.
- What triggers your anger?
- What signs tell you that you’re on the brink of uncontrolled anger?
- Have you fallen into any unhelpful patterns of behaviour?
- What have the consequences been?
- What works to calm you down?
- Are there any triggers in your daily routine or your environment that you could change?
Protect your mental health
People in good mental health are better able to cope when things go wrong; feeling stressed (link to MHI Stress Leaflet) makes it harder for us to cope with problems. The following are some of the things known to be good for our mental health.
- Keep physically active.
- Eat a balanced diet – some foods are more effective than others at supplying us with a steady flow of fuel to help us function well, while nutrients found in certain foods can affect mood in different ways.
- Drink sensibly, however tempted you may be to improve your mood with a drink or by using drugs.
- Keep in touch with friends and loved ones (link to plan to protect connect) – talk about your feelings with them and ask for help when you need it.
- Take time to relax and enjoy yourself.
- Accept who you are and do something you’re good at.
- Care for others
How Can I Deal With Other Peoples Anger?
Being on the receiving end of anger or just being a witness to it can be tough. If other people’s anger is having a bad effect on you, you shouldn’t have to put up with it.
Anger tends to be catching, but staying calm yourself can help both of you. If you get angry as well, things can quickly escalate.
- Bear in mind the tactics that calm people down – use them yourself and remind the other person what can help them relax or distract themselves.
- Help them to consider why they are angry and encourage them to explain it to you calmly.
- Explain that sometimes anger is justified, but it can also make people lose perspective – unnecessary aggression makes things worse.
It may help to take yourself away from an angry person. Give them time to cool down, wait a few minutes, then talk to them when they seem less agitated and may be more able to look at the situation neutrally.
No one needs to put up with violence. If you are afraid or feel threatened by someone’s anger, you should ask for help. If you have been assaulted, call the Gardai http://www.garda.ie/stations/default.aspx.
Where Can I Go For Further Help?
If you are worried about your own anger or another aspect of your mental health, go to your GP is a good place to start. They may be able to suggest ways you can manage your anger yourself or they may refer you for further support.
Talking therapies such as counselling or CBT (cognitive behavioural therapy) can help people explore what makes them angry, work out why anger has become a problem for them and learn how to change the way they respond to the situations that typically make them angry. Talking therapies are usually provided over a course of several weeks or months.
Anger management courses often involve counselling and group work with other people with similar problems. The courses take place either over a day or a weekend or in sessions over a period of weeks.
Domestic violence programmes help people whose anger leads them to violence against members of their family. They usually help people take responsibility for their actions and understand their impact on those close to them. They may also ask people to change other parts of their life such as addressing any problems with alcohol or drugs.
Local support groups can be a way for people with a problem in common to share their experiences and support and encourage each other to change their behaviour. They may be led by someone who has themselves had a problem with anger in the past.
Faith leaders or others of the same community can help people reflect and get perspective on a situation that has made them angry. They will help set the situation in the context of the values that the faith follows.
Anger management courses
Anger Management Ireland runs courses for people who want help dealing with their own anger and provide group and one-on-one counselling services. http://www.angermanagementireland.ie/
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Anxiety
Anxiety is a type of fear usually associated with the thought of a threat or something going wrong in the future, but can also arise from something happening right now.
Around 1 in 6 people in Ireland will experience a mental health problem like anxiety each year, which has steadily increased over the past 20 years. It is also likely that individuals do not seek help for significant levels of anxiety, meaning many remain without diagnosis or treatment.
Signs and Symptoms
Life is full of potential stressful events and it is normal to feel anxious about everyday things. There can be a single trigger or event that raises anxiety levels, but generally it’s be a number of things that increase anxiety levels, including exams, work deadlines, how we think we look, going on a first date or whether we feel safe travelling home late at night.
Anxiety has a strong effect on us because it’s one of our natural survival responses. It causes our mind and body to speed up to prepare us to respond to an emergency.
These are some of the physical things that might happen:
- Rapid and / or irregular heartbeat
- Fast breathing
- Weakened / tense muscles
- Sweating
- Churning stomach / loose bowels
- Dizziness
- Dry mouth
Anxiety also has a psychological impact, which can include:
- Trouble sleeping
- Lack of concentration
- Feeling irritable
- Feeling depressed
- Loss of self-confidence
It can be hard to break this cycle, but you can learn to feel less worried and to cope with your anxiety so it doesn’t stop you enjoying life.
Causes of Anxiety?
Feelings of anxiety can be caused by lots of things and vary according to what you’re worried about and how you act when you feel apprehensive. They depend on lots of things such as:
- your genes
- how you were brought up
- what’s happened to you in your life
- the way you learn and cope with things.
Just knowing what makes you anxious and why can be the first steps to managing anxiety.
Getting Help for Anxiety?
Fear and anxiety can affect all of us every now and then. Most people get through passing moments of anxiety with no lasting effect. People experiencing anxiety in their everyday lives often find the personal resources to cope through simple remedies.
Helping Yourself.
Talking it through
Although it can be difficult to open up about feeling anxious, it can be helpful to talk to friends, family or someone who has had a similar experience. Although you might feel embarrassed or afraid to discuss your feelings with others, sharing can be a way to cope with a problem and being listened to can help you feel supported.
Face your fear
By breaking the cycle of constantly avoiding situations that make you anxious, you are less likely to stop doing the things you want, or need, to do. The chances are the reality of the situation won’t be as bad as you expect, making you better equipped to manage, and reduce, your anxiety.
Know yourself
Make a note of when you feel anxious, what happens and the potential triggers. By acknowledging these and arming yourself with tips to deal with these triggers, you will be better prepared in anxiety-inducing situations.
Relax: Learning relaxation techniques can help you calm feelings of anxiety. Practices like yoga, meditation or massage will relax your breathing and help you manage the way you feel about stressful experiences.
Exercise
Even small increases in physical activity levels can trigger brain chemicals that improve your mood, wellbeing and stress levels. This can act as a prevention and treatment for anxiety as well as lead to improved body-image, self-esteem and self-worth.
Healthy eating
Eat lots of fruit and vegetables and try to avoid too much sugar. Very sweet foods cause an initial sugar ‘rush,’ followed by a sharp dip in blood sugar levels which can give you anxious feelings. Caffeine can also increase anxiety levels so try to avoid drinking too much tea or coffee too.
Avoid alcohol or drink in moderation
It’s very common for people to drink alcohol when they feel nervous to numb their anxiety, however the effect that alcohol has on how you feel is only temporary. When it wears off you feel worse, potentially more anxious, and your brain will be less able to deal with anxiety naturally.
Faith / spirituality
If you are religious or spiritual, it can help you feel connected to something bigger than yourself. It can provide a way of coping with everyday stress. Church and other faith groups can be a valuable support network.
Talking To Someone.
If you feel anxious all the time, for several weeks or if it feels like your anxiety is taking over your life, then it’s a good idea to ask for help.
Talking therapies
Talking therapies like counselling or Cognitive Behavioural Therapy (CBT) are very effective for people with anxiety problems, CBT helps people to understand the link between negative thoughts and mood and how altering their behaviour can enable them to manage anxiety and feel in control.
Mindfulness
Mindfulness is a variation of CBT focusing on changing the relationship between the individual and their thoughts. Using meditation can help people be ‘mindful’ of their thoughts and break out a pattern of negative thinking.
Guided self-help
Guided self-help is usually based on CBT methods and aims to help the person understand the nature of their anxiety and equip them with the necessary skills to cope with it. This works by educating the individual to challenge unhelpful thinking, evaluate their symptoms and gradually expose themselves to the source of their anxiety.
Medication
Medication is used to provide short-term help, rather than as a cure for anxiety problems. Drugs may be most useful when they are combined with other treatments or support, such as talking therapies.
Support groups
Support groups are designed for individuals to learn a lot about managing anxiety from asking other people who have experienced it. Local support or self-help groups bring together people with similar experiences to share stories, tips and try out new ways of managing their worries. Your doctor, library or local HSE office will have details of support groups near you.
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Art Therapy
Creative expression is helpful to healthy human development and recovery from mental distress. Formal arts therapies for people with mental health problems aim to help people draw on their inner, creative resources while exploring personal issues with a trained arts therapist in a safe, contained space, in order to achieve psychological change.
Arts therapies include Art, Dance Movement, Drama and Music. Practitioners are trained to post-graduate level and must be State Registered in order to practise.
More recently there has been growing interest in arts-in-health initiatives where the creative process itself is seen to have therapeutic value in promoting general well-being, including mental health. International and UK research has found that many people with mental health problems find arts therapies helpful, either on their own or as part of a range of therapies, which may include medication and talking treatments.
People who have used arts therapies say they provide a greater sense of choice and control than medication or talking therapies.
For further support
The Irish Association of Creative Art Therapist can provide information on services in your locality.
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Autistic Spectrum Disorder
Autistic Spectrum Disorder (ASD) is an umbrella term that covers everyone with conditions within the spectrum of autism. ASD is thought to affect around one in 200 children and adults, although this is likely to be an under-estimate.
There are differences between the subgroups but all children and adults with an ASD will have the following core difficulties.
Non Verbal and Verbal Communication
People with ASD have difficulty in understanding the communication and language of others and also in communicating themselves. Many are delayed in learning to speak and some do not develop speech.
Social Understanding and Social Behaviour
People with an ASD have difficulty in understanding the social behaviour of others and can behave in socially inappropriate ways. People with ASDs are very literal in how they think and interpret language and are unable to read social context. Children with an ASD often find it hard to play and communicate with other children, who may be confused by their behaviour and may avoid or tease them.
Thinking and Behaving Flexibly According To The Situation
People with an ASD tend to have special interests in particular topics or activities, which they may pursue obsessively. They may struggle to generalise skills to other activities. They will also have difficulty adapting to new situations and often prefer routine to change.
Sensory Perception and Responses
Some people with ASDs are either very sensitive or very insensitive to certain sounds, sights and textures. This can affect their responses to things like clothes or food and noise. They may also make unusual eye contact – ie. they may not talk and look at someone at the same time.
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