Welcome to the #AtoZChallenge on mental health, day 14. Today’s letter is N. Another late post, because I slept through the day yesterday so wasn’t able to schedule it. Here goes.
Neuropsychiatry is the branch of psychiatry specializing in the effects recognized brain diseases have on people’s mental health and behavior. Of course, mental illnesses have a biological component too, but neuropsychiatry is particularly interested in conditions like epilepsy, Parkinson’s Disease and brain injury. Some psychiatric institutions have specialized neuropsychiatric units or outpatient clinics. Mine has both. The inpatient unit is mostly for people with brain injury. In my institution, a neurologist is in charge of directing the care on this unit.
Neurotransmitters are chemicals that the brain cells use to communicate. They commonly have multiple functions, hence the side effects of psychiatric medications affecting neurotransmission. Well-known neurotransmitters are serotonin and dopamine.
Serotonin is thought to play an important role in mood. A deficiency in it can cause mood disorders, such as depression or bipolar disorder. Unfortunately, an excess of serotonin caused by antidepressant use can cause serotonin syndrome, which is a potentially life-threatening condition. Serotonin syndrome is particularly associated with a type of old-school antidepressants called MAOIs.
Dopamine plays a role in different physical and mental functions. Dopamine is necessary for movement. Parkinson’s Disease is caused by a degeneration in the dopamine-producing cells in the brain. On the other hand, an excess of dopamine is linked to psychotic symptoms. First-generation antipsychotics (such as Haldol) block the brain receptors for dopamine. Like I said however, dopamine is necessary in movement. Hence, peoople on first-generation antipsychotics commonly experience tremors and muscle stiffness similar to Parkinson’s patients. This movement disorder associated with antipsychotic use is called Parkinsonism.
Many people with mental illness smoke. Among people with schizophrenia, as many as 90% do. It is well-known among smokers that cigarette-smoking relieves stress. This coul be psychological dependence though. However, research shows that nicotine actually helps decrease psychotic symptoms specifically. It is not just a matter of psychological dependence on nicotine that causes people with schizophrenia to experience fewer symptoms after smoking. As such, schizophrenics might unknowingly use nicotine as self-medication.
Obviously, mental hospitals employ nurses as support staff. Their primary tasks are to observe and facilitate the patients’ day-to-day functioning. Obviously, administering medications is a common task. However, nurses also use psychosocial interventions.
Community psychiatric nurses (CPNs) are employed by outpatient clinics to help support patients in the community. They often do some form of psychosocial counseling and are also often employed as case managers. As such, they do some tasks formerly done by social workers.