Tele-psychiatry

Technology!
So much technology and so much bad press.
But here is a good use of social media.
Medicine by social media has a long history. Queensland has been investing in tele-psychiatry for over twenty years and legislation covers its use, validity and re-reimbursement through Medicare.
This allows quick, easy access to specialist services across the nation which is especially good for rural and remote, even regional areas where specialist services either do not exist or are limited. It provides support to local doctors and allied health professionals.
Although it is never as good as meeting F2F, the picture and sound quality is very good these days. I use Skype as it is free to use and download and anyone with a computer and Internet connection can use it. Most doctor's surgeries have the capacity to use Skype and people can access services here if they do not have their own computer.



Image thanks to Skype.
If you want to look at Skype- www.skype.com/‎
It allows help for housebound people and those who have difficulty travelling.

One can have privacy of their own home and with a few twiddles of the dials, a family can be seen together if needs be. 

 

Photo courtesy of Skype.

Should this seem like a useful tool for you- contact your family doctor for a referral

contact us at drjoycearnold6120a@gmail.com 

or phone 07 32215371.

add me to your Skype address book, joyce.arnold

Don't we live in an amazing world?

Synthetic drug ban

News of a Government crackdown on synthetic drugs is welcome
http://www.theaustralian.com.au/news/nation/national-ban-imposed-on-synthetic-drugs/story-e6frg6nf-1226664529398
How sad for the family of the young man who took these drugs and subsequently became acutely psychotic and died. What a waste of a precious young life. My condolences to the family.
However I am perplexed that the government is shamed to act on this problem that on the case of one person they should act so quickly when they have the statistics of huge numbers of people who die from acute psychosis from alcohol abuse, and yet do not act.
Now clearly these are legalised, taxed drugs and one can become cynical and say this is due to economics and vote gathering. The alcohol and tobacco lobby is huge and the taxes important to our economy. But decisions need to be made based on care rather than money or votes.The experience of prohibition showed us that outlawing something does not work. It just forces the problem underground, to the criminal element who increase their operations. People can easily make their own. The case of four people who died of acute alcohol poisoning in Queensland this week, is a case in point.So many people die of tobacco use and yet no ban.here.
Education seems to have universally failed and in fact education in schools seems to have increased the rate of alcohol abuse, suicide and unsafe sex behaviours in young people.
I don't have an answer but all citizens in a democratic process needs to have input into these issues, not just a knee-jerk reaction by political parties.

Representation for children

Over one third of our community are under eighteen years of age, but do not have the right to vote. No , I am not about to advocate that two year olds get to vote. This one third has many of the same mental health problems as adults, plus a range of childhood specific ones. They often do not have the maturity to cope with mental health issues as an adult can. They certainly do not have the access to help that adults have. They are not aware they have problems and often see illness as shameful, scary and blameworthy. I can only report one person under eighteen years of age who made an appointment  and asked for help all by themselves in over thirty years of work with young people. Most children resist treatment, just as they have elementary fears about seeing a doctor, have been threatened for a long time that if they don't behave they will be taken to see the doctor. Most children then enter the doctor's office very bravely facing their punishment. Luckily many parents prepare their children well to cope.
Children, like us all, are affected by family conflict, illness, financial problems, marital conflict,domestic violence. Most adults have good coping mechanisms to deal with these issues and if needed can leave or find a safe place. Children do not have these skills, capacity or rights,so they are very much in the victim position in these problems.
Children have to cope with academics, social skills and the competitiveness of school life as well. Bullying and conflict here often reflect home based problems. The school community can also have its own problems as teachers, administration, parent bodies, government inputs and organisational issues all intermingle with the child's mind.  Children who move schools or home school have added issues.
So this is a plea to understand that our most vulnerable citizens, with the least capacity to deal with problems, often have more issues to deal with than adults. Yet, they have no say and little access to help without parental approval. As they don't vote, they have no say and can be forgotten as we all try to deal with the everyday problems in life.

Male depression

After many years of understanding that depression is ten times more common in women, the balancing act has revealed more details. Who would have thought that men were different to women but it is true for depression. Women internalise, get sad and cry, blaming themselves. Men externalise, get angry and blame others. Men are more likely to drink alcohol to self manage depression, not understanding that alcohol is a depressant.
If you add the numbers of angry men who abuse alcohol to the list, men and women suffer depression in equal numbers but express them differently. Now such a sweeping statement needs a little closer look. Women with depression also use alcohol to self medicate . Of the two emotions, anger and sadness, women are more likely to have anger than sadness too when they are depressed. Men also commonly feel sad when they suffer depression. Anger seems to be one of the first symptoms of depression. As the illness progresses, people become more withdrawn and sad. In its worst stage, people withdraw and have no feelings, just empty, wooden dullness. As people improve they become angry, always a good sign.
Alcohol, well it is a seducer. It offers a temporary relief as it stimulates endorphins, the happy chemicals in our brain. That lasts about 20 minutes. Then it causes many hours to days of depression.That of course stirs people to drink more and so you get caught in the cycle. Of course socially, economically, health wise, legally you may have complications from the alcohol which then generates more depression.
So when men are depressed, they traditionally get buoyed up by having a drink with a mate. The company is always helpful.
Men are more physically able. Not all men and some women of course are physically stronger but it is a truism. That means that when men decide that suicide is their only way to cope, rather than get help, they are more likely to do something more lethal than women. They are more likely to die than women of their suicide attempt. So for many who fail to see that they have depression, suicide is a last attempt for release or help seeking but men are least likely to survive in order to obtain treatment. Sadly we know this is more true for young men as they are more impulsive. Older people take more time to consider most things in their life so often find other solutions to problems. Men in the rural areas of Australia are more likely to die by suicide as they have more access to guns but also less social supports.
Have you heard of tele-psychiatry? Anywhere in the world, using technology which is often free, you can access a psychiatrist in Australia. Clearly not as good as seeing one in person but provides access to mental health care for everyone.

Obsessive compulsive disorder

The great hidden disorder.
Obsessions are intrusive thoughts embarrassingly silly but cause great anxiety- did I leave the electricity on? Are there some germs I left on my hands? Will asbestos filter through the door and infect me?
Compulsions are behaviours designed to reduce anxiety and appease the obsessional thoughts, like checking the doors, switches,washing hands, counting magic numbers.
Hidden disorder because most of those who suffer realise that other people will think they are silly.
It is highly related to hoarding disorders, tics and Gilles de la Tourette syndrome, trichotillomania (hair pulling) as well as habits like nail biting and skin picking.
It is often confused with a totally unrelated issue - the obsessional person. This person is a born neat person, likes to be a perfectionist but this is not the same as OCD.
Most people are so embarrassed that they do not seek help. A pity really as treatments work well and there is no need to suffer. Treatments include psychological approaches and some people may .need medications.
What causes OCD? It has genetic links to family members who suffer the same. Interestingly there is evidence of some cases caused by the immune system attacking the brain (basal ganglia) sometimes after a sore throat. Stressful events can bring on an attack and psychoanalytic theories discuss repressed anger as the source of the problem.
Seek help if you suffer this disorder. Not only do you suffer but your family does too.