Get Information

This is where you'll find information about various mental illnesses and treatments.

You can also find a list of sites with information in our 'Useful Links' section or at the Department of Health and Ageing's website at www.health.gov.au/internet/main/publishing.nsf/Content/mental-links

Please note that this information is intended only as a guide and should never replace advice from your own healthcare professional. We can't provide health and medical advice by email or phone. Always check with your own doctor if you have any questions about your health.

 

About mental illnesses
 
There are many mental illnesses or psychiatric conditions which are unfairly stigmatised. Often this stigma has come about due to ignorance, lack of understanding and lack of knowledge about the cause, treatment and outcomes for people with mental illness. 
 
MAPrc aims to discover new understanding and treatments for mental illnesses thereby helping to remove some of the stigma, fear and confusion about mental illness.
 
In this section, we provide brief insight and helpful information about a variety of mental illnesses. 
 
 
About treatments
 
Discovering new treatments for mental illnesses through the application of neuroscience breakthroughs is one of the major roles that MAPrc has undertaken. 
 
Mental illnesses of all types can be successfully treated. We are able to provide “state of the art” innovative, world first treatments for people suffering from a variety of mental illnesses.  Our new treatments integrate biological discoveries with psychological and social treatment strategies. 
 
New treatments at MAPrc are delivered by a multidisciplinary team of clinical research professionals.  MAPrc is always seeking people with and without current mental health problems who can take part in our research projects. See our Treatment trials section for more information.

2021 MAPrc Research Projects

 For further information on any of the trials below, please email info.maprc@monash.edu detailing which Project you   are interested in. 

CLINICAL TRIALS TEAM PROJECTS

CHIEF INVESTIGATOR/S

STATUS

Protocol: PRAX-114-213 Project Number: 760/20

Title: A Phase 2/3 Double-Blind, Placebo-Controlled Clinical Trial to Evaluate the Efficacy and Safety of PRAX-114 in Participants with Major Depressive Disorder

Prof Jayashri Kulkarni

Current

Protocol: ALTO-300-001 Project Number: 63/21

Title: Agomelatine in Depression: An Open-Label Study of Agomelatine in Adults with  Major Depressive Disorder

Prof Jayashri Kulkarni

Current

Protocol: BI-1402-0012 Project Number: 491/20

Title: A phase II randomized, double-blinded, placebo-controlled parallel group trial to examine the efficacy and safety of 4 oral doses of BI 1358894 once daily over 12 week treatment period in patients with borderline personality disorder

Dr Leo Chen

Current

Protocol: BI-1346-0038 Project Number: 437/20

Title: A phase II randomized, double-blinded, placebo-controlled parallel   group trial to examine the efficacy and safety of BI 425809 once daily with   adjunctive Computerized Cognitive Training over 12 week treatment period in   patients with Schizophrenia.

Dr Leo Chen

Current

Protocol: BI-1402-0011 Project Number: 482/20

Title: A Phase II, 6-week, multicenter, randomized, double-blind, double-dummy, placebo-controlled, parallel group trial with a quetiapine arm to evaluate the   efficacy, tolerability and safety of oral BI 1358894 in patients with Major   Depressive Disorder with inadequate response to antidepressants.

Dr Leo Chen

Current

Project Number: 204/14 Title: The Alison Project: A randomised double-blind placebo controlled investigation of adjunctive memantine in the treatment of   symptoms of complex trauma disorder (also known as borderline personality   disorder).

Prof Jayashri Kulkarni

Current

Project Number: 534/17 Title: A randomised placebo controlled trial of estradiol for the treatment of women with borderline personality disorder.

Prof Jayashri Kulkarni

Current

Project Number: 545/19 Title: Double-Blind Randomised Investigation of Bazedoxifene and conjugated estrogen for Depression in Menopausal Women.

Prof Jayashri Kulkarni

Current

Project Number: 546/19 Title: Bazedoxifene – A New Selective Estrogen Receptor Modulator Treatment for Men with Schizophrenia: a double-blind,   randomized, placebo-controlled trial.

Prof Jayashri Kulkarni

Current

Project Number: 17/19 Title: Bazedoxifene – A New Selective Estrogen Receptor Modulator Treatment for Women with Schizophrenia: a double-blind,  randomized, placebo controlled trial.

Prof Jayashri Kulkarni

Current

Project Number: 285/17 Title: Women’s Mental Health Clinic Database

Prof Jayashri Kulkarni

Current

CLINICAL TRIALS TEAM STUDENTS PROJECTS

INVESTIGATOR/S

STATUS

 

 

 

 

About Autism

Autism is a neuro-developmental disorder that becomes evident before the age of three. Autism is characterised by marked impairment in social interaction and communication.

There is a broad spectrum of severity in the disorder and milder forms can sometimes be termed Asperger's syndrome. Persons with autism spectrum disorders commonly have very restricted and repetitive behaviours and can become fixated on certain objects or activities.
 
What is autism?
Autism is a childhood-onset condition that is characterised by severe impairments in social interaction, language, communication and behaviour.
 
Autism is a neurodevelopmental condition, which means that it impacts upon the development of the brain. Although it is usually diagnosed in early childhood (around 3-5 years), autism is a life-long condition. The number of people being diagnosed with autism appears to be increasing, and current estimates suggest that between 1 and 2 people in 1000 are affected. There are around 6-8 times more males with autism than females.
 
There are no established medical treatments that target the core symptoms of autism, but interventions are provided by a number of health professionals, including psychiatrists, psychologists, speech therapists, occupational therapists and special educators.
Symptoms
There are three main features of autism, which together are often referred to as the 'core triad of impairments'. These are described below.
Social relating
Autism involves reduced or abnormal social and emotional behaviours (e.g., eye contact, gesturing) and a failure to seek shared experiences with other people. There is often a lack of enjoyment or interest in social interactions. People with autism appear to have a reduced capacity for understanding what other people are thinking and feeling, and this may underlie many of their social symptoms.
Language and communication
People with autism have significant delays in the acquisition of spoken language, and some people with autism fail to develop speech altogether. Additional language abnormalities include repetitive or idiosyncratic speech and difficulties in engaging in conversation.
Stereotyped/repetitive behaviours
People with autism often have special interests to which they devote a great deal of their time and energy. This can include simple repetitive motor behaviours (e.g., hand flapping) or preoccupations with a particular subject matter (e.g., train timetables). People with autism also typically prefer to do things a particular way, and can become upset or distressed if a routine is broken.
 
There are also a number of associated features of autism; these are commonly present, and are therefore thought to be related to autism, but are not necessary for a diagnosis to be made. These include intellectual disability (which affects 50-80% of people with autism), motor and physical coordination impairments, sensory impairments, and epilepsy (which is more common when intellectual disability is also present). People with autism are also more likely to experience depression and anxiety.
Causes
The cause of autism is not clear, but we do know that it is not due to bad parenting or the effects of immunisation. Recent research suggests that genetic factors do appear to be involved (with twin studies demonstrating heritability rates as high as 90%), but we are only in the early stages of understanding the genetics of autism. A single genetic factor is unlikely to explain all (or perhaps any) instances of autism. While environmental factors have been investigated (e.g., mercury), again there is no conclusive evidence and further research is needed.
 
Studies of the brain have revealed a number of factors that are associated with autism. This includes reduced activity of certain chemical messengers, enlarged overall brain size (particularly in early childhood), and abnormalities in the structure and function of specific brain cells. Brain imaging studies have indicated abnormal activity levels in specific parts of the brain, such as those responsible for social understanding and processing emotion. More recent brain research suggests that autism may involve excellent short-range communication between brain cells, but relatively poor long-range communication (which is crucial for processing social information).
 
None of these brain-related changes, however, are present in all people with autism, and at this stage they cannot be used to provide a diagnosis of autism. 
Related conditions
There are several neurodevelopmental conditions that seem to be related to autism in that they present with very similar symptoms. Together with autism these conditions are often referred to under the label 'autism spectrum disorders' (ASD). Perhaps the most well known of these is Asperger’s syndrome, which is similar to autism in that it involves impairments in social relating and stereotyped/repetitive behaviours. Unlike autism, however, there is no language delay (although there may be communication impairments). In addition, intellectual disability is not present in Asperger’s syndrome, with IQ generally in the above or above average range. The prevalence of ASD also appears to be increasing, and it has been suggested that as many as 1 in 150 children will be diagnosed with an ASD.
Treatments for autism
There are currently no established medical treatments that target the core symptoms of autism. Nonetheless, medications are sometimes used for associated features including depression, anxiety and behavioural problems.
 
Psychological and behavioural interventions are the most common treatments for autism, but the needs of individuals with autism and related disorders vary greatly. These interventions use a range of techniques for developing social abilities, coping strategies and general living skills, but will depend on the needs of the individual. Interventions often also target problematic behaviours and attempt to replace them with more appropriate and prosocial behaviours.
Many interventions for autism are aimed at children, and provided in a classroom setting. There are now a number of specialist schools that cater solely for children diagnosed with autism.
 
Unfortunately, many interventions for autism, while potentially useful, have not been subjected to rigorous scientific evaluation. We therefore do not know about their true effectiveness.
 
From a biomedical perspective, researchers are currently investigating a range of new medical treatments for autism. This includes diet modification, hormonal treatments (e.g., oxytocin), and non-invasive brain stimulation (e.g., transcranial magnetic stimulation). The next decade should see some exciting advances in the treatment of autism, both for children and adults.

About Bipolar Disorder

Bipolar disorder (formerly called manic depression) is a condition experienced by approximately 2% of people that is characterised by episodes of mania.  Mania is an emotional state of heightened reality during which the person may feel extraordinarily energetic, optimistic, self-confident and productive. Persons experiencing mania can often go days without sleeping, busily planning grandiose schemes or indulging in exorbitant shopping sprees (sometimes spending millions of dollars.) Many people experiencing bipolar alternate between periods of mania and deep depression. These mood swings can cycle over the course of months or years.

To find out what projects are currently being conducted in bipolar disorder, please click here

What is bipolar disorder?

In everyday life we all experience ups and downs. Bipolar disorder, sometimes referred to as manic-depression, is a disorder where there are extreme shifts in mood.

It affects about 1% of the population and typically develops in late adolescence or early adulthood. Bipolar disorder can be very disruptive to the person’s life and is associated with a high suicide rate. Like diabetes or high blood pressure, bipolar disorder is a long-term illness that requires careful ongoing management. Treatment, involving prescribed medication, combined with effective coping skills that focus on symptom management and quality of life, may reduce the incidence of relapses and contribute to the person's wellbeing.
 
Symptoms
Bipolar disorder causes dramatic shifts in mood from overly happy and/or driven or irritable, to sad, lethargic and hopeless, sometimes with normal moods in between. These changes in mood are accompanied by changes in thinking and behaviour. The periods of highs and lows are called episodes of mania and depression respectively.
 
Symptoms of a manic episode include (adapted from DSM IV) :

Elevated, expansive or irritable mood, lasting at least a week or being very disruptive to daily functioning. During this period at least 3 of the following symptoms (4 if mood is irritable) are seen:

a) Inflated self-esteem or unrealistic belief in one’s abilities or power

b) Decreased need for sleep

c) More talkative than usual or need to keep talking

d) Jumping from one idea to another or racing thoughts

e) Distractibility, can’t concentrate very well

f) Increased energy

g) Excessive involvement in activities without regard for risks such as buying sprees or sexual indiscretions

Psychotic symptoms such as delusions (false, strongly held beliefs not influenced by logic or a person’s culture) and hallucinations (seeing or hearing things that are not really there) may occur in mania.
 
Symptoms of a depressive episode include (adapted from DSM IV) :

Depressed (sad/empty/irritable) mood or loss of interest or pleasure and at least four of the following symptoms have been present during the same two weeks:

a) Fatigue or loss of energy

b) Can’t sleep or sleeps too much

c) Marked decrease or increase in appetite; significant weight loss when not dieting, or significant weight gain

d) Feelings of worthlessness or helplessness or excessive guilt

e) Slowed down or lethargic or very restless

f) Can’t concentrate and/or more indecisive than usual

g) Recurrent thoughts about death or suicide

Psychotic symptoms such as delusions and hallucinations may occur in severe depression.
 

 Treatments
With proper treatment most people with bipolar disorder can achieve good stabilisation of their mood swings and related symptoms. Medications known as "mood stabilisers" (e.g. lithium and certain anticonvulsant medications) are usually prescribed as a long-term treatment to help control bipolar disorder in acute episodes and also to prevent relapse. Other medications are added when necessary. Antipsychotic medication can be useful, not only if psychotic symptoms are present ,but also in the treatment of mania, and can help with anxiety, restlessness, or sleep problems linked with the illness. Antidepressants are sometimes prescribed to treat depression in bipolar disorder,but are seldom used alone, as they have been associated with triggering an episode of mania, hypomania or rapid cycling. However, in some cases they may be useful. Electroconvulsive therapy (ECT) is sometimes also used to treat acute severe conditions. While some herbal or natural supplements might potentially be useful in the treatment of bipolar disorder, little is known about their effectiveness as they have not been well studied.

Psychosocial interventions address stressful triggers of bipolar disorder and problems that can occur after episodes. Psychosocial treatments may be individual, group or family based. They can be helpful in providing support and information, and assisting in the development of effective coping skills. They can provide assistance both to people with bipolar disorder and their families. Psychosocial interventions that are commonly used include cognitive
behavioural therapy (CBT), psychoeducation, family therapy and interpersonal and social rhythm therapy.

 

 Causes
Research suggests that there is no single cause of bipolar. Rather bipolar disorder involves a number of factors including:

Genetic factors

In terms of genetic vulnerability, on average, there is an 8% risk of a person's first-degree relatives (parents, children, siblings) having bipolar disorder compared to 1% in the general population. Scientists are trying to find
what genes may contribute to bipolar disorder and when they do, more precise diagnosis and treatments may be available.

Chemical Imbalance

Bipolar disorder is thought to occur when there is a problem with the production and breaking down of certain brain chemicals such as adrenaline, dopamine, acetylcholine, serotonin, and GABA. Research also suggests people with mood disorders (such as bipolar) have problems with the production of certain hormones that influence brain function. Mood stabilisers prescribed for bipolar disorder  target these imbalances. Brain imaging studies suggest there may be certain differences in particular areas of the brain when comparing people with and without bipolar disorder. Scientists are still trying to work out how to refine these techniques and what these differences mean.

Stress

People who have a biological vulnerability to bipolar disorder may find that certain stressors set off or trigger symptoms of illness. Such stressors include major life events, disruption to the person's sleep/wake cycle and family conflict. Managing these stressors can be an important part of managing the illness. 
 

 SOME TERMS AND DEFINITIONS
 
Typical mixed episode

A mixed episode involves at least one week when the person experiences some symptoms of both manic and depressive episodes nearly every day. Sometimes the person experiences rapid mood swings (happy, sad, irritable); they can’t sleep, their appetite is affected, they are restless or uptight and may have delusions and suicidal thinking. These symptoms cause significant disruption to daily living. The person may need to be admitted to hospital.

Hypomania

Hypomania is similar to mania, only milder and although this means the person is able to carry out their normal daily activities, the changes in behaviour are obvious enough to be noticed by others. The symptoms must last for at least 4 days to be classifed as hypomania.

Bipolar I

This is a type of bipolar disorder that involves one or more full manic or mixed episode(s). Often the person has had one or more major depressive episodes as well.

Bipolar II

This type of bipolar disorder involves both one or more episodes of hypomania and one or more episodes of major depression.

Cyclothymic disorder

This refers to a pattern involving hypomanic symptoms and mild depressive symptoms that have been happening for two years
or more. Although 'milder' than Bipolar I or II, the symptoms of Cyclothymic Disorder are still severe enough to cause difficulties in work, education, employment and relationships.

Rapid cycling

When a person experiences 4 or more episodes of mood disturbance (mania, hypomania, major depression or mixed episodes)
within a 1-year period, they are said to have a bipolar pattern which is "rapid cycling".
 
 
 
Additional Resources
 
Australian treatment guide for consumers and carers

Beyond Blue Bipolar fact sheet

Black Dog Institute Bipolar fact sheets

British Psychological Society: Understanding Bipolar

About Depression

Everyone feels sad, worthless and/or disinterested in normal activities at some stage throughout their life. However, one in five of us will experience these emotions intensely, for a prolonged period of time and often for no identifiable reason.

This is a condition known as clinical depression and is a serious illness with brain chemical and circuitry changes.

To find out what projects are currently being conducted in depression, please click here 
 
Note, depression occurring around the menopausal transition, known as Perimenopausal Depression, has a different clinical presentation compared with other types of depression. Anger, irritability, poor concentration, memory difficulties, poor self-esteem, poor sleep and weight gain make up this depression. The Meno- D is a rating scale to detect depression in menopause. It can be completed as a self-report scale or completed by a clinician. The general reference point for each item is the individual’s pre-menopausal level or state.

 

Additional resources

Australian Treatment Guide for consumers and carers

Beyond Blue Depression fact sheet

Black Dog Institute Depression fact sheets

Well ways: Understanding depression

 
 

  

About Schizophrenia

 
Schizophrenia is a complex brain illness in which sufferers experience some degree of loss of contact with reality. Common symptoms of schizophrenia include hallucinations, delusions, impaired thinking and memory and emotional disturbances. Schizophrenia is diagnosed in approximately 1% of the population.
 
To find out what projects are currently being conducted in schizophrenia, please click here 
 

What is Schizophrenia?

Contrary to popular belief, schizophrenia is not described as a split personality.
 
Schizophrenia is a mental illness characterised by two or more of the following symptoms, often called symptoms of psychosis:
  • delusions
  • hallucinations
  • disorganised speech
  • seriously disorganised or catatonic behaviour
  • negative symptoms (see below).
 
Before schizophrenia can be diagnosed, these symptoms must impair social and occupational functioning and be continuously present for at least 6 months.
 
Symptoms
People with schizophrenia experience a number of positive and negative symptoms.
 
Positive symptoms
A delusion is a firmly held belief that causes significant distress to the person.
 
A hallucination is characterised by seeing, hearing, feeling, and/or smelling something that is not actually there. For example, a person who experiences auditory hallucinations may hear voices when no one is talking.
 
When a person has disorganised speech, their words or sentences are not connected properly.
 
A thought disorder is the inability to carry through a line of thinking in a way that makes sense to other people. This may result in speech that is disconnected, illogical and jumbled.
 
Negative symptoms
These may include:
 
  • lack of motivation
  • social withdrawal
  • lack of insight
  • reduced emotion or interest in things
  • inappropriate responses
 
The person may not show all of the above symptoms.
 
Early changes
A person may experience the following early changes before more obvious symptoms of psychosis develop:
 
Changes in mood: depression and lack of interest or drive; fear, anxiety and tension; irritability, quick temper or aggression.
 
Changes in behaviour: decreased appetite, social withdrawal, sleeping problems, unusual rituals, reduced attendance at school or work.
 
Changes in Thinking: concentration or memory problems, preoccupation with one or two things, ruminations on themes.
 
How common is schizophrenia?
The prevalence of psychotic disorders (the category of mental illness that includes schizophrenia) amongst adults in urban areas of Australia ranges from 4 to 7 cases per 1000 people.
 
It is estimated that schizophrenia and schizoaffective disorder comprise over 60% of these cases.
 
What causes schizophrenia?
There are a number of theories about what causes schizophrenia. Schizophrenia tends to run in families. A first-degree relative (parent, brother or sister, child) of someone with schizophrenia has approximately 10% chance of developing the disease, compared to 1% chance for someone in the general population.
 
Generally though, a range of factors have to be present for schizophrenia to develop.
 
Stressful events may increase the chance of symptoms developing in someone who is already vulnerable to developing schizophrenia. Many researchers believe that an excess of a certain neurotransmitter - a chemical that is responsible for communication between brain cells - plays a part in the development of schizophrenia. Increased levels of the neurotransmitter, dopamine, may be linked to some of the psychotic symptoms.
 
There is some evidence that recreational use of drugs such as cannabis, ecstasy and amphetamines can mimic the symptoms of psychosis. Use of these substances has also been associated with triggering episodes of the illness.
 

 

Treatment for Schizophrenia

 
Because schizophrenia can impact on many areas of a person’s thinking, behaviour and mood, treatment has to be multifaceted.
 
Early identification of symptoms is a priority since the person often lacks insight into their symptoms. Family members, friends and colleagues may need to initiate contact with a general practitioner or mental health service to organise an assessment.
 
Once the diagnosis has been confirmed, pharmacological AND non-pharmacological treatments are used.
 
Pharmacological treatments are necessary to treat the symptoms of schizophrenia. Antipsychotic medications are used to treat the positive and negative symptoms during the acute phase and also to prevent subsequent relapse. Other medications may be needed to treat mood or anxiety symptoms. Injectable antipsychotic medications may be useful if adherence to antipsychotic medication is a challenge for people who do not have insight into their symptoms, 
 
Non-pharmacological treatments aim to maximise the level of functioning in the community, by returning the person to education or work, and to achieve stable remission. This may include psychoeducation, family interventions, vocational rehabilitation, cognitive-behaviour therapy, and other forms of therapy, especially for comorbid conditions, such as substance abuse, depression and anxiety.   Assistance for accommodation, finances and employment may be required. 
 
A multidisciplinary team approach with a consultant psychiatrist centrally involved is the ideal model of care in the acute phase of the illness. Shared care of the person with a general practitioner is important in the long term maintenance of good physical and mental health and prevention of relapse.  
 
 
Additional resources
 
Australian Treatment Guide for Consumers and Carers
Sane Australia Schizophrenia Fact Sheet
Well ways: Understanding Schizophrenia 

Family Violence

MAPrc is involved in multiple aspects of clinical work and research to reduce the impact of family violence across our community. The far-reaching impact of family violence and trauma on the mental health of women is now well-established, and recognition of this – by patient and her practitioner – is a critical step in mental illness recovery.

The severe mental health impacts of family violence and trauma are common presentations at MAPrc’s Women’s Mental Health Clinic, led by Professor Jayashri Kulkarni. Professor Kulkarni continues to provide expert opinion and present as an invited speaker to numerous conferences to advocate for the safety of women and the impact of violence on trauma and mental illness, and provided a witness statement to the Royal Commission into Family Violence in 2015.

 

Professor Kulkarni, along with the Women’s Mental Health Team, are using several research and training approaches to improve outcomes for women and children who suffer from family violence.

 

We currently have several studies underway to better understand:

- Health practitioners’ current practices and barriers to identifying and responding to family violence suffered by their patients

- The extent to which mental health clinicians elicit a history of previous trauma in female psychiatric patients

- The association between early life trauma and polycystic ovary syndrome in patients with borderline personality disorder (complex trauma disorder)

- The effects of a new medical treatment approach to improve symptoms of borderline personality disorder, or complex trauma disorder.

 

We also hold an annual conference to improve medical practitioner's knowledge about women's mental health, and the management of complex issues resulting from family violence and trauma across the lifespan.

We have developed a resource for health practitioners, for use in the course of their work when family violence is suspected (click on the toolkit below for full-text pdf).

 

 

 

Other Mental Illnesses

To find out what projects are currently being conducted about these illnesses, please click here

Anxiety Disorders 

Anxiety disorders are the most commonly diagnosed type of psychological disorder in Australia, with more than 25% of people experiencing them at some stage in their lives. There are many different types of anxiety disorders, which can be characterised by symptoms such as panic attacks, difficulty sleeping, irritability, severe avoidance behaviour and chronic worrying.
 
 

Body image is a person's perception of the relative attractiveness of their body. Often, people see themselves as dramatically different than they actually appear to others. There are a number of different body image disorders.

Anorexia Nervosa

Anorexia Nervosa (AN) is a chronic eating disorder that is readily recognised by significant weight loss and extreme dissatisfaction with body weight and shape. Although this disorder has been in the public eye for many years again little is known about the causes of this chronic disabling condition. MAPrc in conjunction with Body Image and Eating Disorders Treatment and Research Service (BETRS) are completing detailed investigations to undercover the underlying mechanisms of this disorder.
 

Body Dysmorphic Disorder

Body Dysmorphic Disorder (BDD) is defined as a pre-occupation with an imagined or very slight defect in physical appearance which causes significant distress to the individual.  BDD is a chronic psychiatric condition that causes severe emotional distress which goes beyond vanity and is not something that individuals can either ‘forget about’ or ‘get over’. BDD is not a rare disorder, only an under-recognised one, which affects women and men from all walks of life.
 
People who suffer from BDD dislike an aspect of their appearance to such a degree, that they can’t stop thinking and worrying about it. To others, these reactions may seem excessive, as the perceived ‘problem’ may not even be noticeable or relates to a very minor mark such as a mole or very mild acne scarring which anyone else may not even notice. However, to the BDD sufferer, the defects are very real, very obvious and very severe.
 
BDD often begins as early as adolescence and may remain undiagnosed for many years. It is estimated to affect between 1-2% of the population and appears to affect roughly equal numbers of males and females. Research data suggests that BDD usually persists for years, sometimes worsening over time, unless appropriately treated.

Symptoms

Most people spend only a few minutes each day thinking about their appearance, but the BDD sufferer may spend hours pre-occupied by how he or she looks.
 
Some say they are obsessed and find it hard to stop thinking about the particular aspects of their appearance which concern them. One aspect of BDD that can be especially troubling is the feeling that other people take special notice of this perceived defect, and that people stare at it or make fun of it or laugh behind their backs when in reality, no one may even notice it. Many sufferers feel ashamed and fear being rejected by others. They often isolate themselves so other people can’t see them.
 
Another feature of this disorder is what people do to try to reduce their feelings of distress. Most people with BDD perform one or more repetitive and often time consuming behaviours known as ‘rituals’, which are usually aimed at examining, ‘improving’ or hiding their perceived flaw.
 
BDD sufferers usually spend a lot of time checking themselves in the mirror to see if their ‘defect’ is noticeable or has changed in some way, or they will frequently compare themselves with others. Many hours are spent grooming themselves by applying make-up, changing clothes or re-arranging their hair to ‘correct’ or cover up ‘the problem’. Some people approach cosmetic surgeons or dermatologists seeking surgery or medical treatments. Others attempt to camouflage or hide their defect by wearing a hat or a scarf or sunglasses. Some sufferers will repeatedly ask family or friends for reassurance that they look okay, or alternately try to convince them of their ugliness.
 
This behaviour can be frustrating for family members because the BDD sufferer is usually not reassured no matter how much support, time and reassurance they are given. Some people with BDD manage to function well despite their distress. Others, however, are severely impaired by their symptoms, often becoming socially isolated by not attending school or work, and in extreme cases, refusing to leave their homes for fear of embarrassment about their appearance.
 
It is not uncommon for people with BDD to feel depressed about their problem and the negative impact it has had on their life. Relationship problems are common, and many sufferers have few friends and often become socially isolated. BDD is not yet widely recognised and health professionals may not be familiar with the disorder so it can be misdiagnosed. What distinguishes normal appearance concerns from BDD is:
 
• the extent of the preoccupation with the perceived defect
 
• the amount of distress it causes
 
• the extent to which it interferes with the person’s life.
 
Many people with BDD often suffer from depression at some stage and there is often a high rate of depression in their families. BDD sufferers can present with other symptoms as well such as obsessive-compulsive disorder (OCD), eating disorders, anxiety disorders and trichotillomania (hair pulling).

What causes BDD?

At this stage, the causes of BDD are unknown. In most cases, there are likely to be multiple biological, psychological and socio-cultural factors which contribute to its cause. There is some suggestion that an imbalance in the chemical seretonin in the brain may make some people more likely to express the symptoms of BDD. It is also possible that excessive teasing during childhood or family pressures regarding appearance might be risk factors in some cases.

Treatments for BDD

Medication
Seretonin-reuptake inhibitors (SRIs) are a group of medications that appear to be useful and effective for people with BDD. The SRIs are a type of anti-depressant used successfully in the treatment of depression and obsessive-compulsive disorder (OCD).
 
People who respond to SRI therapy generally spend less time obsessing about their ‘defect’, and if they start to think about it, it is easier to push the thoughts aside and think of other things. Self-consciousness and feelings of anxiety, depression and suicide often diminish and self-esteem and body image often improve. Treatment response often takes some months.
Psychotherapy
Cognitive Behaviour Therapy (CBT) appears to be another effective treatment of BDD, where the aim over time is to decrease distress involved with the particular situation of the person having to expose their ‘defect’ in situations which they would usually avoid.
 
 

 

 

Protecting Mental Health during the COVID-19 outbreak

Protecting Mental Health during the COVID-19 outbreak

 

Click here to complete our survey on Mental Health Responses during COVID-19

Click here for the full explanatory statement

   


 

  


COVID-19 and mental health: findings from the MAPrc survey

Please click here to download a lay summary of initial findings from our survey and reference for the published paper.

 




FOR WORKPLACES: team leaders or managers

  


 

WHEN TO SEEK PROFESSIONAL HELP

If stress or anxiety worsens and begins to impact everyday life for yourself, a family member or someone in your workplace, seek help from a psychologist, your GP or a psychiatrist.  You may be able to see a professional via telehealth and you might be eligible for a medicare rebate.  To access a psychologist you can use the Australia-wide “Find a Psychologist” service. Go to findapsychologist.org.au or call 1800 333 497. 

For people with existing mental ill health conditions, the current situation may trigger an exacerbation of symptoms.  It is important to seek help from your treating team at these times.  If you don’t have a current treating team, seek help from your GP who may be able to refer you to a psychiatrist.   


USEFUL RESOURCES

Mental Health resources

Lifeline: 13 11 14

Suicide Call Back Service: 1300 659 467

Life in Mind

Australian Psychological Society: 1800 333 497


MAPrc COVID-19 RELATED PUBLICATIONS

https://ccsmonash.blogspot.com/2020/10/humour-and-acceptance-most-helpful.html

https://www.monash.edu/medicine/news/latest/2020-articles/humour-and-acceptance,-not-venting-and-denial,-are-helping-us-get-through-lockdown


Official COVID-19 Information Sources

Department of Health Coronavirus Health Information Line: 1800 020 080  

World Health Organization

Useful Links

 

Mental health: government, research, education and support organisations
 
Health Line - Connect to better health
http://www.healthline.com/health/bipolar-disorder
 
SANE Australia
www.sane.org
SANE is a national charity working for a better life for people affected by mental illness, through campaigning, education and research. The site provides information, news, contacts and links.
 
Beyond Blue
www.beyondblue.org.au
Beyond Blue is a national organisation working to address issues associated with depression, anxiety and related substance misuse disorders in Australia.
The site provides a wide variety of information and resources.
 
Black Dog Institute
www.blackdoginstitute.org.au
The Black Dog Institute offers information resources and support for depression and bipolar disorder.
 
Australian Government Department of Health and Ageing – mental health section
www.health.gov.au
Information and links about mental health in Australia
 
Australian Government Department of Health and Ageing
www.health.gov.au
This is the main government health website which contains information resources and links to departments such as Medicare and the PBS.
 
Health Direct
www.healthdirect.gov.au
This is a government initiative designed to provide consumers with a reliable source of health information about numerous topics.
 
Better Health Channel
www.betterhealth.vic.gov.au
A range of information about health and healthy living provided by the Victorian Government. Everything from fact sheets to recipes and quizzes.
 
Reach Out
http://au.reachout.com/
Reach Out is a web-based service that inspires young people to help themselves through tough times, and find ways to boost their own mental health and well being. They aim to improve young people’s mental health and well being by building skills and providing information, support and referrals in ways we know work for young people.
 
Rehabcenter.net
http://www.rehabcenter.net/free-mental-health-addiction-resources/
Mental health and addiction resources
 
Malvern Private Australia's Leading Treatment Addiction Facility 
http://malvernprivate.com.au/MalvernPriv.asp
Malvern Private is Australia’s leading provider of Drug and Alcohol Treatment Options.
 
Illicit Drugs Glossary
testcountry.com/pages/all-you-need-to-know-about-by-drug
 
 
Women's Health, Pregnancy and Child Health
 
Perinatal Psychotropic Medication Information Service (PPMIS)
www.ppmis.org.au
PPMIS provides up-to-date, evidence based and peer-reviewed information on the use of psychotropic medicines in the peri and post natal period. This website contains medicine profiles, summaries of individual psychotropic medicines along with articles on congenital malformation, pregnancy and neonatal outcomes and postnatal and breastfeeding information; patient medicine information fact sheets and links to other resources.
  
Australian Government Department of Health and Ageing – maternal and child health section
http://www.health.gov.au
Information and details of programs for pregnant women and babies
 
HealthInsite Pregnancy page
www.healthinsite.gov.au/
Information about pregnancy and the health of pregnant women and unborn children.
 
Better Health Channel – baby care section
http://www.betterhealth.vic.gov.au
Information, useful telephone numbers and links to help with caring for babies.
 
Australian Government Immunise Australia Program
www.immunise.health.gov.au
Information about immunisations and the free immunisation program for babies and adults, provided by the Australian Government.
 
 
Autism
 
Autism Victoria
www.autismvictoria.org.au
 
Asperger Syndrome Support Network
home.vicnet.net.au/~asperger/whatis.htm
 
Autism Spectrum Australia (Aspect)
www.aspect.org/au

Useful link for more information about Autism
www.startlocal.com.au/articles/educational_autism.html