Mental health is about how we think, feel and behave. One in four people in the UK have a mental health problem at some point in their lives, which affects their daily life, relationships or physical health.

 

Mental health problems can affect anyone, regardless of age, race, gender or social background. Without care and treatment, mental health problems can have a serious effect on the individual and those around him or her. Every year more than 250,000 people are admitted to psychiatric hospitals, and over 4,000 people commit suicide.

 

Mental health disorders take many different forms and affect people in different ways. Schizophrenia, depression and personality disorders are all types of mental health problem. Diseases such as Alzheimer's and dementia generally develop in old age, whereas eating disorders are more common in young people.

 

There is no single cause of mental health problems, the reasons they develop are as complex as the individual. Mental health problems are more common in certain groups, for example, people with poor living conditions, those from ethnic minority groups, disabled people, homeless people and offenders. Sometimes people with mental health problems are discriminated against. This can lead to social problems such as homelessness, and may make the mental health problem worse.

 

Particular mental health problems are also more common in certain people. For example, women are more likely than men to have anxiety disorders and depression. Drug and alcohol addictions are more common in men, and men are also more likely to commit suicide.

 

Mental health problems can also develop from difficult life events, such as moving house, losing your job or the death of someone special. Drinking too much alcohol over a long period of time and using illegal drugs can contribute to mental health problems, particularly in people who are already vulnerable.

 

People with mental health problems need help and support to enable them to cope with their illness. There are many treatment options, including medication, counselling, psychotherapy, complementary therapies and self-help strategies. It's important that people with mental illnesses are told about the options available so they can make a decision about what treatment suits them best.

 

Another important step in the recovery process is for the person to accept that they are ill, and to want to get better. This can take time, and it is important for family and friends to be supportive. There are also many support groups and charities that offer advice, confidential counselling and information about the types of treatment available and where to get help.

 

Dementia is a syndrome (a group of related symptoms) that is associated with an ongoing decline of the brain and its abilities. These include:

thinking, 

language, 

memory,   

understanding, and 

judgement. 

People with dementia may also have problems controlling their emotions or behaving appropriately in social situations. Aspects of their personality may change. Most cases of dementia are caused by damage to the structure of the brain.

How common is dementia?

Dementia is a common condition. In England alone, there are currently 570,000 people living with dementia. That number is expected to double over the next 30 years.

Usually dementia occurs in people who are 65 or over. The older you get, the more likely you are to develop it.

It is estimated that dementia occurs in:

1.4% of men and 1.5% of women aged between 65 and 69, 

3.1% of men and 2.2% of women aged between 70 and 74, 

5.6% of men and 7.1% of women aged between 75 and 79, 

10.2 % of men and 14.1% of women aged between 80 and 84, and 

19.6% of men and 27.5% of women aged 85 or over. 

 

Listed below are the different types of dementia.

Alzheimer's disease, where small clumps of protein, known as plaques, begin to develop around brain cells. This disrupts the normal workings of the brain. 

Vascular dementia, where problems with blood circulation result in parts of the brain not receiving enough blood and oxygen. 

Dementia with Lewy bodies, where abnormal structures, known as Lewy bodies, develop inside the brain. 

Frontotemporal dementia, where the frontal and temporal lobes (two parts of the brain) begin to shrink. Unlike other types of dementia, frontotemporal dementia usually develops in people who are under 65. It is much rarer than other types of dementia. 

This section focuses on vascular dementia, dementia with Lewy bodies and frontotemporal dementia. See Useful links for more information about Alzheimer’s disease.

Outlook

In clinical terms, the outlook for dementia is not good. In most cases, there is no cure and symptoms will get worse over time.

However, even if a person’s dementia cannot be cured, there are a number of effective treatments that can help them to cope better with their symptoms and improve their quality of life.

If you have dementia, it may affect your ability to drive. See Useful links for advice on informing the DVLA about your change in 

 

Alzheimer's disease is the most common form of dementia, which describes the loss of mental abilities, such as memory and reasoning.

Alzheimer's disease is a progressive condition, meaning it will continue to get worse as it develops. Unfortunately, there is no cure for the condition, although there is treatment that can slow down the development.

Early stages of the condition may begin with minor memory problems and difficulty saying the right words. These symptoms can then lead to frustration and mood swings.

Symptoms change as the condition develops, and it may lead to confusion, personality changes and a total change in behaviour.

What causes the symptoms of Alzheimer's disease?

Alzheimer's disease attacks nerves, brain cells and neurotransmitters (chemicals that carry messages to and from the brain). 

The destruction of these parts causes clumps of protein to form around the brain's cells. These clumps are known as 'plaques' and 'bundles'. The plaques and bundles then start to destroy more connections between the brain cells, which makes the condition worse.

How common is Alzheimer's disease?

Age plays a large part in the development of Alzheimer's disease, although it is not the only cause. 

It is most common in people over the age of 65, affecting around one person in 20. The risk increases with age, and people over 80 years old are thought to have a one in five chance of developing the condition.

It is rare for the condition to affect people below the age of 65, although it does occur in around one in every 1,000 people aged 65 or under.

It is estimated that around 417,000 people in the UK have Alzheimer's disease.

If you have Alzheimer's disease, it may have implications for driving. See the 'useful links' section for how to inform the DVLA about medical conditions.

 

Bipolar disorder - previously known as manic depression - is a condition that affects your moods, which can swing from one extreme to another. If you have bipolar disorder you will have periods, or ‘episodes’, of depression and mania.

Depression and mania

The depression and mania that are associated with bipolar disorder are characterised as follows:

depression - where you feel very low, and 

mania - where you feel very high; slightly less severe mania is known as hypomania. 

Both extremes of bipolar disorder have a number of other associated symptoms. Unlike simple mood swings, each extreme episode of bipolar disorder can last for several weeks or longer. The high and low phases of the illness are often so extreme that they interfere with everyday life.

The depression phase of bipolar disorder often comes first. Initially, you may be diagnosed with clinical depression before having a manic episode some time later (sometimes years later), after which your diagnosis might change. During an episode of depression, you may have overwhelming feelings of worthlessness which often lead to thoughts of suicide.

During a manic phase of bipolar disorder, you may feel very happy and have lots of ambitious plans and ideas. You may spend large amounts of money on things that you cannot afford. Not feeling like eating or sleeping, talking quickly, and becoming annoyed easily are also common characteristics of bipolar disorder.

During the manic phase, you may feel very creative and view mania as a positive experience. However, during the manic phase of bipolar disorder, you may also have symptoms of psychosis (where you see or hear things that are not there).

How common is bipolar disorder?

Bipolar disorder is a relatively common condition with around one person in 100 being diagnosed with the condition.

Bipolar disorder can occur at any age, although it often develops in people who are between 18-24 years of age. Both men and women, and people from all backgrounds, can develop bipolar disorder.

The pattern of mood swings in bipolar disorder varies widely between individuals. For example, some people will only have a couple of bipolar episodes in their lifetime, and will be stable in between, while others may experience many episodes.

Bipolar disorder and driving

If you have bipolar disorder, it may have implications for driving. You must inform the Driver and Vehicle Licensing Agency (DVLA) about any medical condition that could effect your ability to drive

 

Schizophrenia is a chronic mental health condition that causes a range of different psychological symptoms. These include:

hallucinations - hearing or seeing things that do not exist, and 

delusions - believing in things that are untrue. 

Hallucinations and delusions are often referred to as psychotic symptoms or symptoms of psychosis. Psychosis is when somebody is unable to distinguish between reality and their imagination.

The exact cause of schizophrenia is unknown. However, most experts believe that the condition is caused by a combination of genetic and environmental factors.

How common is schizophrenia?

Schizophrenia is one of the most common serious mental health conditions. One in 100 people will experience at least one episode of acute schizophrenia during their lifetime. Men and women are equally affected by the condition.

In men who are affected by schizophrenia, the condition usually begins between 15 and 30 years of age. In women, schizophrenia usually occurs later, beginning between 25 and 30 years of age.

Misconceptions about schizophrenia

Schizophrenia is often a poorly understood condition and many people hold a number of misconceptions about it. 

One misconception is that people with schizophrenia have a split or dual personality, acting perfectly normal one minute and then irrationally or bizarrely the next. However, this is totally untrue. Schizophrenia is a Greek word that means 'split mind', but the term was first used long before the condition was properly understood. 

It would be more accurate to say that people with schizophrenia have a mind that can experience episodes of dysfunction and disorder.

Another misconception about schizophrenia is that people who have the condition are violent. Again, there is little evidence to back this up. Acts of violence committed by people with schizophrenia get a great deal of high-profile media coverage, and this can give the impression that such acts happen frequently when they are in fact very rare.

A person with schizophrenia is far more likely to be the victim of violent crime, rather than the instigator. Experts at the Royal College of Psychiatrists estimate that if schizophrenia could be cured overnight, the rate of violent crime in England would only drop by 1%.

If you have schizophrenia, it may have implications for driving and you should inform the DVLA about such medical conditions.

 

Hearing impairment, or deafness, is when your hearing is affected by a disease, disorder, or injury.

The structure of the ear

The ear consists of three parts:

the outer ear, 

the middle ear, and 

the inner ear. 

The outer ear

The outer ear is made up of a number of parts including:

the visible part of the ear on the side of your head (the pinna), 

the ear canals that go into your head, and 

the eardrum - a thin layer of tissue that separates the outer ear from the middle ear. 

The middle ear

The middle ear is located directly behind the eardrum. It is made up of three tiny bones called ossicles that are also known as the:

stapes - a stirrup-shaped bone that transmits sound vibrations from the incus to the inner ear, 

incus - an anvil-shaped bone that transmits sound vibrations from the malleus to the stapes, and 

malleus - a hammer-shaped bone that transmits sound vibrations from the eardrum to the incus. 

The inner ear

The inner ear is made up of the:

cochlea - a coiled, spiral tube that contains two fluid-filled chambers, 

auditory nerve - the nerve that transmits sounds to the brain. 

How does hearing work?

Sound waves enter your ear and make your eardrum vibrate. The vibrations pass on to the three small bones (the ossicles) inside your middle ear. The ossicles amplify (intensify) the vibrations and pass them on to your inner ear. 

The cochlea, inside your inner ear, contains many tiny hair cells which move in response to the vibrations passed from the middle ear. The movement of the hair cells generates an electrical signal that is transmitted to your brain through the auditory nerve.

Types of hearing loss

There are two main types of hearing loss:

conductive hearing loss - where sounds are unable to pass from your outer ear to your inner ear, often as the result of a blockage, such as earwax, or a build-up of fluid, and 

sensorineural hearing loss - where the sensitive hair cells inside the cochlea, or the auditory nerve, are damaged, either naturally through aging, or as the result of an injury. 

Sometimes, both types of hearing loss may be present at the same time. This is known as mixed hearing loss. 

Facts

In the UK, hearing impairment is a common condition. The Royal National Institute for Deaf People (RNID) estimates that in the UK there are almost nine million hearing impaired people.

Approximately 28% of people who are hearing impaired are between 16-60 years of age, and 72% are over 60 years of age.

In terms of age-related hearing loss, about 71% of people who are hearing impaired are over 70 years of age. The severity of hearing impairment among this age group is as follows:

mild - 38%, 

moderate - 52%, and 

severe - 10%. 

Approximately 42% of people who are over 50 years of age have some kind of hearing impairment. The severity of hearing impairment among this age group is as follows:

mild - 52%, 

moderate - 41%, and 

severe - 7%. 

In the UK, each year, around 840 babies are born with a significant hearing impairment. About 1 in 1,000 children are deaf at three years of age.

Approximately 20,000 children between 0-15 years of age are moderately to severely deaf, and there are about 12,000 children between this age range who were born deaf.

Motor neurone disease (MND) is a rare, serious and incurable condition where over time, the nerves in the brain and spine experience a progressive loss of function (neurodegeneration). 

Specifically, nerve cells known as motor neurones are affected by MND.

What are motor neurones?

Motor neurones are specialised nerve cells that control important voluntary muscle activity, such as:

walking, 

speaking, 

breathing, and 

swallowing. 

Loss of motor neurone function can lead to weakness and wasting of the muscles, increasing loss of mobility in the limbs and difficulties with speech, swallowing and breathing.

How common is motor neurone disease?

MND is one of the rarest neurological conditions (conditions that affect the nervous system). For example, in England, it is estimated that there will be two new cases of MND each year for every 100,000 people.

MND mainly affects adults who are over 40 and most cases develop in people between 50 and 70 years of age. However, MND can affect adults under the age of 40.

Men account for 60% of all cases of MND, with women accounting for the remaining 40%.

The cause (or causes) of MND are unknown, but it seems likely that genes play a factor, at least in some people with the condition. This is because 10% of people who develop MND also have a close family relative with the condition.

Types of motor neurone disease

There are three main types of MND:

amyotrophic lateral sclerosis (ALS) - is the most common form of MND and accounts for 60-70% of cases, 

progressive bulbar palsy (PBP) - accounts for 20% of MND cases, and 

progressive muscular atrophy (PMA) - accounts for 10% of cases. 

The symptoms of all three forms of MND are similar, although there is a difference in how quickly each type progresses. 

There is also a very rare form of MND known as primary lateral sclerosis. Unlike other forms of MND, primary lateral sclerosis is not fatal, although there have been some cases when primary lateral sclerosis developed into ALS. 

Outlook

In terms of survival rates, the outlook for MND is very poor. The facts are that:

most people with ALS die within two to five years after the start of symptoms, 

most people with PBP die within six months to three years after the start of symptoms, and 

the outlook for PMA is slightly better, with an average survival rate of five to 10 years. 

Although the outlook for most cases of MND is poor, a minority of people with the condition survive much longer than the timescales stated above. For example, the scientist Steven Hawkings has MND, and was diagnosed over 40 years ago.

In terms of quality of life, the outlook for people living with MND is not as bleak as many people imagine. While MND cannot be cured, its symptoms can be treated and some people with the condition are able to maintain a fairly independent lifestyle for a number of years.

Common misconception 

A number of recent high-profile news stories have involved people with MND attempting to fight a legal battle in order to obtain the right to euthanasia or assisted suicide. This has led to a widespread misconception that people with MND face the prospect of a painful and traumatic death from choking, malnutrition or suffocation.

However, this is not the case. A recent study found that 98% of people in England with MND died peacefully in their sleep, and 50% of those people were able to die at home.

Multiple sclerosis (MS) is the most common neurological condition among young adults in the UK, affecting approximately 85,000 people. It is possible for MS to occur at any age, but in most cases symptoms are first seen between the ages of 20 and 40. Women are almost twice as likely to develop MS as men. 

MS is a condition of the central nervous system (the brain and spinal cord), which controls the body's actions and activities, such as movement and balance. 

Each nerve fibre in the central nervous system is surrounded by a substance called myelin. Myelin helps the messages from the brain travel quickly and smoothly to the rest of the body. In MS, the myelin becomes damaged, disrupting the transfer of these messages.

There are four main types of MS: benign MS, relapsing remitting MS, secondary progressive MS and primary progressive MS. 

The symptoms of the condition are numerous and unpredictable, and they affect each person differently. Some of the most common conditions include problems with mobility and balance, pain, muscle spasms and muscle tightness.

The exact cause of MS is not fully understood, although there is some evidence to suggest that it is caused by a combination of genetic and environmental factors. 

There is no cure for MS, but research is continuing into the condition and its causes. However, there are many treatments for MS, which aim to improve the symptoms and make them easier to live with. Treatments include medication and physiotherapy. 

MS is a life-long condition, but it is not terminal. People with MS can expect to live as long as anyone else. 

 

Huntington's disease is an inherited disease of the brain, for which there is no cure. 

The disease damages the nerve cells in the brain causing deterioration and gradual loss of function of areas of the brain. This affects movement, cognition (perception, awareness, thinking, judgement) and behaviour.

Huntington's disease was originally called Huntington's chorea, after the Greek word for dancing, as the associated involuntary movements can look like jerky dancing.

Who is affected?

Both men and women with a family history of Huntington's can inherit the disease and symptoms usually start to show in adulthood. There are approximately 6,000 people with the disease in   the UK. 

Twice as many people may have inherited the disease but have not yet developed symptoms. This group, who are unaware they carry the disease, may have had children and passed on the disease without realising.

Juvenile (children's) Huntington's disease develops before the age of 20 years. Only 5-10% of people with Huntington's develop the condition at a very young age, and the pattern of features may be different.

 

Parkinson's disease is a chronic (persistent) neurological condition that affects around 120,000 people in the UK. The condition is named after Dr James Parkinson, who first identified it in 1817.

Parkinson's disease affects the way the brain coordinates body movements, including walking, talking, and writing. 

Who is affected by Parkinson's disease?

Parkinson's disease affects both sexes, although, statistically, men are slightly more likely to develop the condition than women.

The risk of getting the condition increases with age, with symptoms usually appearing in those who are over 50 years of age. However, younger people can also be diagnosed with Parkinson’s disease. 

Young-onset Parkinson's disease

When the symptoms of Parkinson's disease occur in a person between 21 and 40 years of age, it is known as young-onset Parkinson's disease.

Juvenile Parkinson's disease

If a person is diagnosed with Parkinson's disease before 18 years of age, it is known as juvenile Parkinson's disease. However, this is very rare.

Of the 10,000 people diagnosed with Parkinson's disease each year, in the UK, one in 20 is under 40 years of age. 

If you have Parkinson's disease, it is likely to have implications for driving. See the 'useful links' section for how to inform the DVLA about medical conditions.

 

Respite care is any sort of help and support that allows you to take a break from the responsibility of caring for somebody else.

Examples of respite care are listed below.

Residential respite care is where the person you care for goes away to live and be looked after by somebody else for a while.  

Emergency respite care is when care is provided if you are unable to fulfil your caring responsibilities due to unforeseen circumstances, such as illness.  

Domiciliary care is where somebody comes into your home and takes over some of your responsibilities for a few hours.  

Day centre care is where the person you care for spends time at a centre while you have a few spare hours to yourself. 

 What is a carer?

When local authorities and other government organisations talk about carers they do not mean someone who is paid to provide care as part of a contract of employment, such as a care worker or care staff.

Carers are usually people who look after a relative or a friend who needs support because of their age, a physical or learning disability, or a health condition. This includes mental health conditions.

For example, a carer could be a parent with a child who requires additional help due to a long-term health condition.

Why is respite care important?

Although it may be unpaid, caring for somebody can be a full-time job. And, like any job, you sometimes need to take a break.

You may feel guilty or apprehensive about taking a break from the person you are looking after. However, it is important to remember that if you go too long without a proper break you may become ill, anxious or depressed, which can make life more difficult for you and the person you are caring for.