Torofy Blog

Depression and Heart Disease

1. Mental Illness Overview

There’s two main areas where mental illness evolves and that’s in illness of thought or illness of mood. So, illnesses of thought are the processing and illnesses where you have something like Schizophrenia, which is characterized by positive
and negative symptoms. So, the positive symptoms added to a person
they’re… symptoms like delusions, hallucinations or paranoia and negative symptoms, which are
taken away from the person so, their ability for social functioning and some of their advanced cognitive processing and some of their self-care might be changed; and that’s the classic thing that some people might notice to identify somebody with a mental illness. Disorders of mood have the classic and bipolar illness, which has highs and lows, or just a depressive process where we have a quite common illnesses depression where quite a number of people in the community have depression, and sometimes with anxiety that goes with it. And their sort of the main illnesses that we see, as well as anxiety is its own disorder. We see personality disorders, which is where somebody develops, and their personality structure develops they might find that particular
facets of their personality, and evolved to a point that it becomes a disorder. Somebody can overvalue themselves or, can be a quite black and white, or rigid in their processing of how their interacting with others. Somebody’s either with really with them, or really against them or, different things like that. Psychosis is where somebody’s perspective on what’s happening isn’t either processing correctly, or they’re misinterpreting the information and it’s characterized as a positive symptom for like anyone else like Schizophrenia and Psychosis can come in many different forms as in a delusion, which is a firm fixed unshakable belief and that person might believe that there’s somebody else that might believe that people are talking about the more they’re saying things that aren’t true or that there is statements’ effect are true when they’re not, or and it could be true when there’s evidence to the contrary. They might believe that, for say, they have three million dollars in the bank when they don’t or that somebody’s stolen it, or that somebody might be impersonating them, or that somebody else isn’t actually who they seem. Illnesses are quite treatable and with the range of medication that we use, somebody can have an active episode of their illness, and could rid them with the term we use as relapse, so they can relapse, have an episode of their illness but with successful treatment, with medication they can often return to work, or the term we use as Recovery, which is the person makes the most out of the circumstance that they’re in, and is able to return to a particular level of functioning that with that medication, they can function in society and can perhaps work or interact with others and lead a meaningful life. Mood disorders can be quite interesting, because we have often encountered clients that have been through the legal system when they’ve been elevated, and that’s menace so that think they have overvalued ideas, and the term we use is “Too much Behavior”. Say that, they might believe that they’re entitled to particular benefits, or money or things that they… they’re actually not; and they have an overvalued belief that they will often seek legal supporting, meeting these beliefs that they have and so, having a good a critical look at the person if they seem to be having “Too much behavior” they’re elevated, they’re physically overactive, they’re speaking very fast, they have many, many ideas and great business ideas they think that they can do That on a reasonable critical analysis look, quite implausible they usually are. And the opposite is true that when somebody is depressed, they may actually be avoiding dealing with matters that they actually have to. People can get significantly in-debt by not attending to their bills or their accounts, or not keeping their affairs in order to the point where it becomes into the legal systems for either collection over to offer and managing that person to fears. Stigma’s one of the most difficult issues
that we do with within mental health. There’s a lot of misrepresentation of mental illness within the media, within movies; It’s there’s a lot of unfortunate history within
mental health that we’re working past and given that the ever the opinion of most people
of mental illness when it’s not something that you can actually see; there’s people have the misunderstanding that people with a mental illness are a greater risk of violence when they usually far more a risk to themselves than to anybody else. And the stigma that’s attached to it often discourages people from actually disclosing any of their mental health concerns, or of talking about it. It is important for lawyers to be aware of
the sort of wide spectrum of what is mental health and what is mental illness and, and how that changes over time and because you know when you’re doing for example, a capacity assessment whether it might be very different on one day versus another day so, people’s mental state changes, people circumstances change. It’s about understanding the sort of nature of the condition and what it means to that person. Someday, somebody with a very
severe mental illness may be actually spot-on in very coherent and have full capacity, and another day, if they may not and you have to understand that sort of change with time the change with different treatments and also this other complexities when you have a complex mental illness is often associated with multiple medical conditions or with multiple neurological disabilities that you can have questions where what’s due to the mental illness, what is due to
the disability, what’s due to the medical condition or what’s due to the treatment; and those are complex questions and while the lawyer doesn’t need to get involved in the intricacies of those questions that you need to appreciate that there’s lots of those subtle nuances, and those nuances are important for them to appreciate what needs to happen for that patient and
to improve their care. What Harry’s described as the dynamic nature of capacity particularly for people with the mental illness, in that it’s changeable and fluctuating, and therefore, the lawyer’s job is each and every time there with the person is to just check out with a person’s understanding and following the conversation. And also, realizing the impact of that of the persons not as coherent on that particular days, they have been other times, maybe it’s not the time to have those conversations and to rebook for another
time and just check-in, you know there might be another time that suits you better. Another thing to consider is that when person’s capacity’s fluctuating if you’ve got concerns that
they don’t have capacity today, well then you know what decisions really have to be
made today; so putting things off if, it didn’t have to be today. So, for example, capacity to give instructions or capacity, you know, that might be something that has to be finalized
today, because we’re about to go to the tribunal and/or capacity to make financial decisions that
can fluctuate and, but it might not be an issue for right here and right now, and can be put off
for another day. The difficulty some people experience with their mental illness concerns, is that they’re not willing to talk about it to people, they don’t want to disclose; perhaps that, lets say they’ve had depression or they’re having depression ongoing, and because they’re concerned about what other will people think and they’re often just acknowledging that the
person like, if you have depression or that you have anxiety that you’re an average member
of society, and a lot of people actually have those concerns, and that it’s manageable and many people are living with it and working and living completely fulfilling lives, whilst
having reasonable treatment for at the time. People with mental illness aren’t stupid. They’re an average member of society that has for that point in time, some functional differences in how their
brain is working, that is treatable and often isn’t very successfully treated to keep that
person functioning quite well; and in fact in my career, working in mental health admits
an exceptionally bright and exceptionally smart people that even when they have been
unwell, is still would be really articulate and manage their affairs well, whilst dealing with whatever other things that’s happening. For mental health client, often the illness
in the medication and the health perspective is only but a minor part of their life. Any of the other complicating events, accommodation dealing with centerlink, dealing with a Mental Health Review Tribunal, dealing with legal services, dealing with the police, dealing with Department of Housing, dealing with insurance companies, any of the frameworks that which
all of us have to deal with, but if you’re stressed and having difficulty with functioning as well as you normally would, it’s gonna to be extremely difficult to go through with that and so, if all of the organizations that are involved are fairly open about involving themselves with
other parts of that organization, with the whole point of it being the best outcome for the client, for what the client wants out of it, that’s going to get the best outcome for that person and that’s going to give them the most meaningful life.

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