What is Bipolar mood disorder?
Bipolar disorders, formerly called manic depression, are brain disorders that cause unusual mood
swings which include emotional highs (mania or hypomania) and lows (depression).
These mood swings can affect daily functioning, sleep, energy, activity, judgment, behaviour and the
ability to think clearly.
Episodes of mood swings may occur rarely or multiple times a year.
Diagnosis:
There are three types of bipolar disorder. All three types involve clear changes in mood, energy, and
activity levels. These moods range from periods of extremely “up,” elated, irritable, or energized
behaviour (known as manic episodes) to very “down,” sad, indifferent, or hopeless periods (known
as depressive episodes). Less severe manic periods are known as hypomanic episodes.
- Bipolar I Disorder is defined by manic episodes that last at least 7 days, or by manic symptoms
that are so severe that the person needs immediate hospital care. Usually, depressive episodes
occur as well, typically lasting at least 2 weeks.
- Bipolar II Disorder is defined by a person having at least one major depressive episode and at
least one hypomanic episode. People return to usual function between episodes. People with
bipolar II often first seek treatment because of depressive symptoms, which can be severe.
People with bipolar II often have other co-occurring mental illnesses such as an anxiety disorder
or substance use disorder.
- Cyclothymic Disorder (also called Cyclothymia) is defined by a person experiencing emotional
ups and downs, but with less severe symptoms than bipolar I or II.
Cyclothymic disorder symptoms include the following:
- For at least two years, many periods of hypomanic and depressive symptoms (see
above), but the symptoms do not meet the criteria for hypomanic or depressive episode.
- During the two-year period, the symptoms (mood swings) have lasted for at least half
the time and have never stopped for more than two months.
- Other features of bipolar disorder
Signs and symptoms of bipolar I and bipolar II disorders may include other features, such as
anxious distress, melancholy, psychosis or others. In addition, bipolar symptoms may occur and
change seasons change.
People can experience both manic and depressive symptoms in the same episode. This kind of
episode is called an episode with
mixed features. People experiencing an episode with mixed
features may feel very sad, empty, or hopeless, while, at the same, time feeling extremely energized.
Bipolar disorder is typically diagnosed during late adolescence (teen years) or early adulthood.
Occasionally, bipolar symptoms can appear in children. Bipolar disorder can also first appear during
a woman’s pregnancy or following childbirth.
Definitions
Manic episode:
A manic episode is a period of at least one week when a person is very high spirited or irritable in an
extreme way most of the day for most days, has more energy than usual and experiences at least
three of the following, showing a change in behaviour:
- Exaggerated self-esteem or grandiosity
- Less need for sleep
- Talking more than usual, talking loudly and quickly
- Easily distracted
- Doing many activities at once, scheduling more events in a day than can be accomplished
- Increased risky behaviour (e.g., reckless driving, spending sprees)
- Uncontrollable racing thoughts or quickly changing ideas or topics
The changes are significant and clear to friends and family. Symptoms are severe enough to cause
dysfunction and problems with work, family or social activities and responsibilities. Symptoms of a
manic episode may require a person to get hospital care to stay safe. The average age for a first
manic episode is 18, but it can start anytime from early childhood to later adulthood.
Hypomanic episode:
A hypomanic episode is similar to a manic episode but the symptoms are less severe and need only
last for four days in a row. Hypomanic symptoms do not lead to the major problems that mania
often causes and the person is still able to function.
Major Depressive Episode:
A major depressive episode includes symptoms that are severe enough to cause noticeable difficulty
in day-to-day activities, such as work, school, social activities or relationships. An episode includes
five or more of these symptoms:
- Depressed mood, such as feeling sad, empty, hopeless or tearful (in children and teens, depressed mood can appear as irritability)
- Marked loss of interest or feeling no pleasure in all — or almost all — activities
- Significant weight loss when not dieting, weight gain, or decrease or increase in appetite (in children, failure to gain weight as expected can be a sign of depression)
- Either insomnia or sleeping too much
- Either restlessness or slowed behaviour
- Fatigue or loss of energy
- Feelings of worthlessness or excessive or inappropriate guilt
- Decreased ability to think or concentrate, or indecisiveness
- Thinking about, planning or attempting suicide
What causes BMD?
Researchers are studying the possible causes of bipolar disorder. Most agree that there is no single
cause and it is likely that many factors contribute to a person’s chance of having the illness.
Risk factors
Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include:
- Having a first-degree relative, such as a parent or sibling, with bipolar disorder
- 80-90 % of individuals with bipolar disorder have a relative with either depression or bipolar disorder
- Periods of high stress, sleep disruption or any serious traumatic event
- Drug or alcohol abuse
Complications
Left untreated, bipolar disorder can result in serious problems that affect every area of your life,
such as:
- Problems related to drug and alcohol use
- Suicide or suicide attempts
- Legal or financial problems
- Damaged relationships
- Poor work or school performance
Co-occurring conditions
If you have bipolar disorder, you may also have another health condition that needs to be treated
along with bipolar disorder. Some conditions can worsen bipolar disorder symptoms or make
treatment less successful. Examples include:
- Anxiety disorders
- Eating disorders
- Attention-deficit/hyperactivity disorder (ADHD)
- Alcohol or drug problems
- Physical health problems, such as heart disease, thyroid problems, headaches or obesity
Treatment
Proper diagnosis and treatment can help people with bipolar disorder lead healthy and active lives.
Talking with a doctor is the first step.
Mental health care providers usually diagnose bipolar disorder based on a person’s symptoms,
lifetime history, experiences, and, in some cases, family history. Accurate diagnosis in youth is
particularly important.
Medications
Certain medications can help manage symptoms of bipolar disorder. Some people may need to try
several different medications and work with their health care provider before finding medications
that work best.
Medications generally used to treat bipolar disorder include mood stabilizers and second-generation
(“atypical”) antipsychotics. Treatment plans may also include medications that target sleep or
anxiety. Health care providers often prescribe antidepressant medication to treat depressive
episodes in bipolar disorder, combining the antidepressant with a mood stabilizer to prevent
triggering a manic episode.
People taking medication should:
- Talk with their health care provider to understand the risks and benefits of the medication.
- Tell their health care provider about any prescription drugs, over-the-counter medications, or
- supplements they are already taking.
- Report any concerns about side effects to a health care provider right away. The health care
provider may need to change the dose or try a different medication.
- Remember that medication for bipolar disorder must be taken consistently, as prescribed, even
when one is feeling well.
Avoid stopping a medication without talking to a health care provider first. Suddenly stopping a medication may lead to a “rebound” or worsening of bipolar disorder symptoms
Psychotherapy
Psychotherapy can be an effective part of the treatment plan for people with bipolar disorder.
Psychotherapy is a term for a variety of treatment techniques that aim to help a person identify and
change troubling emotions, thoughts, and behaviours. It can provide support, education, and
guidance to people with bipolar disorder and their families.
Other Treatment Options
Some people may find other treatments helpful in managing their bipolar symptoms, including:
- Electroconvulsive Therapy (ECT): ECT is a brain stimulation procedure that can help people get
relief from severe symptoms of bipolar disorder. With modern ECT, a person usually goes
through a series of treatment sessions over several weeks. ECT is delivered under general
anaesthesia and is safe. It can be effective in treating severe depressive and manic episodes,
which occur most often when medication and psychotherapy are not effective or are not safe for
a particular patient. ECT can also be effective when a rapid response is needed, as in the case of
suicide risk or catatonia (a state of unresponsiveness).
- Regular Exercise: Regular aerobic exercise, such as jogging, brisk walking, swimming, or
bicycling, helps with depression and anxiety, promotes better sleep, and is healthy for your heart
and brain. There is also some evidence that anaerobic exercise such as weightlifting, yoga, and
Pilates can be helpful. Check with your health care provider before you start a new exercise
regimen.
- Keeping a Life Chart: Even with proper treatment, mood changes can occur. Treatment is more
effective when a patient and health care provider work together and talk openly about concerns
and choices. Keeping a life chart that records daily mood symptoms, treatments, sleep patterns,
and life events can help patients and health care providers track and treat bipolar disorder over
time. Patients can easily share data collected via smartphone apps – including self-reports, self-
ratings, and activity data – with their health care providers and therapists.
When to get emergency help
Suicidal thoughts and behaviour are common among people with bipolar disorder. If you have
thoughts of hurting yourself, call your local emergency number immediately, go to an emergency
room, or confide in a trusted relative or friend.
If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure
someone stays with that person. Call your local emergency number immediately. Or, if you think you
can do so safely, take the person to the nearest hospital emergency room.
Living with bipolar disorder can be challenging, but there are ways to help make it easier for
yourself, a friend, or a loved one.
- Get treatment and stick with it—recovery takes time and it’s not easy. But treatment is the best
way to start feeling better.
- Keep medical and therapy appointments and talk with the provider about treatment options.
- Take all medicines as directed.
- Structure activities: keep a routine for eating and sleeping, and make sure to get enough sleep
and exercise.
- Learn to recognize your mood swings and warning signs, such as decreased sleep.
- Ask for help when trying to stick with your treatment.
- Be patient; improvement takes time. Social support helps.
- Avoid misuse of alcohol and drugs.
Prevention
There's no sure way to prevent bipolar disorder. However, getting treatment at the earliest sign of a
mental health disorder can help prevent bipolar disorder or other mental health conditions from
worsening.
If you've been diagnosed with bipolar disorder, some strategies can help prevent minor symptoms
from becoming full-blown episodes of mania or depression:
- Pay attention to warning signs. Addressing symptoms early on can prevent episodes from
getting worse. You may have identified a pattern to your bipolar episodes and what triggers
them. Call your doctor if you feel you're falling into an episode of depression or mania.
Involve family members or friends in watching for warning signs.
- Avoid drugs and alcohol. Using alcohol or recreational drugs can worsen your symptoms
and make them more likely to come back.
- Take your medications exactly as directed. You may be tempted to stop treatment — but
don't. Stopping your medication or reducing your dose on your own may cause withdrawal
effects or your symptoms may worsen or return.
Alzheimer’s Disease
Forgetting things is a normal part of getting older and something we will all experience. However,
when forgetfulness starts to disrupt a person’s lifestyle or change their normal behaviour, it can
sometimes be a symptom of Alzheimer’s disease (AD).
Receiving a diagnosis and experiencing the first symptoms of AD can be a distressing and difficult
situation for both the person with the disease as well as for the carer.
However, it is important to stay positive and realise that with proper information, treatment, planning
and routines, living with AD can be manageable.
Alzheimer’s disease (AD) is a progressive illness that causes cell changes in the parts of the brain that
deal with memory, language, perception and behaviour. Initial symptoms of AD include difficulty
remembering, misplacing objects and a lack of concentration. Emotional symptoms such as
moodiness, restlessness or depression are also common, and behavioural disturbances such as
agitation and aggression can also become increasingly noticeable. Unlike the forgetfulness typical of
old age, Alzheimer’s is a disease that can be diagnosed by a doctor using both physiological and
cognitive tests, as well as brain imaging techniques.
As the disease progresses, the diagnosed person and his/her carer will find handling the activities of
daily living more and more difficult. Having more information is essential for coping with the disease,
as it will help to know what to expect and how to prepare for changes in lifestyle.
How common is AD?
Dementia is an umbrella term for a number of mental disorder that affects memory, thought
processes and behaviour. AD is the most common type of dementia. Worldwide, around 50 million
people have dementia, and there are nearly 10 million new cases every year.
What is the cause of AD?
The actual cause of AD has not yet been found. Current knowledge indicates that a progressive loss of
brain cells is related to the formation of abnormal ‘plaques’ of insoluble protein fragments in and
around the cells. Another characteristic sign of AD is the presence of ‘tangles’ within the brain cells,
formed by abnormal twists of tau, a vital protein in healthy cells. Although these formations may be
harmless by themselves, they may activate some kind of defence mechanism in the body that causes
cell degeneration in the affected areas. In fact, it is highly likely that AD is not caused by any single
factor, but by a number of factors that affect each person differently.
Dementia may be associated with Huntington’s disease, Parkinson’s disease or certain infectious
diseases. Damage to the brain from physical trauma, metabolic disorders, or toxins may also influence
development of the disease.
How does AD affect the brain?
Alzheimer’s disease causes cell damage in brain cells with eventual total loss of the affected cells. This
damage occurs in parts of the brain that control memory, thought and language. It is a progressive
disease, which means that as more brain cells become affected over time, more symptoms will appear.
Who is affected?
Getting older appears to be the most decisive cause of AD, but other factors such as gender and genes
may also increase the risk of developing the disease. In the majority of cases (95%), the disease
develops in people aged 65 years and older, which means that as people live longer and longer, the
number of people with the disease will increase.
The disease occurs across ethnic groups, social class and gender, although it is slightly more common
in women.
A small percentage of people develop the disease at an earlier age; between 35 and 60 years of age.
With this ‘early-onset’ AD, there is thought to be a link with genetics, as cases tend to cluster within
certain families.
Getting a diagnosis
AD is diagnosed by a doctor using both physiological and cognitive tests, as well as brain imaging
techniques in certain cases. Symptoms for the different forms of dementia may be very similar to
those of AD, so careful attention to symptoms described by family members will help to get an
accurate diagnosis and early. During the diagnosis and afterwards, those involved will need both
physical and emotional support from relatives and friends. Whether or not the final diagnosis is AD,
getting a professional opinion and the treatment needed will help all involved to cope.
What changes will take place?
Alzheimer’s disease affects people in different ways at different stages. The first symptoms that are
usually noticed are memory loss and forgetfulness. As time goes on, other abilities may be affected
which vary from person to person. From a clinical point of view, the symptoms of AD can be divided
into three main categories:
Cognitive:
Symptoms that affect the ability to understand, memory and language
Changes in cognition:
Often the first signs of AD, cognitive symptoms are those that affect non-emotional
mental processes such as reasoning, memory and judgment. In the early stages, the
person with the disease may be aware of a decline in their cognitive abilities, which
can lead to depression and/or anxiety.
Cognitive symptoms include:
- Forgetfulness: e.g. losing keys or wallet, forgetting food cooking in the oven.
- Indecisiveness: e.g. difficulties with rationalising and coming to a conclusion.
- Disorientation: e.g. getting lost in familiar places.
- Language difficulties: e.g. word-finding issues, vague speech.
- Lack of recognition: e.g. reduced ability to recognise familiar objects or even family members.
The symptoms of Alzheimer’s will affect both the person diagnosed with AD and the people
around them by posing challenges to everyday life. That’s why it’s important to seek and adhere
to treatment as soon as possible and start to create ways of making life easier. The value of any
improvement in symptoms will have a positive effect on quality of life for all concerned.
Behavioural:
Symptoms that affect mood and behaviour
Changes in behaviour:
One of the most distressing aspects of AD for family and carers are the changes in behaviour,
which occur as the disease affects different parts of the brain. When someone you love behaves
in an unusual way or appears to change personality, it can be very difficult to come to terms with.
Behavioural symptoms include:
- Mood changes: e.g. anxiety, agitation/aggression, irritability.
- Inappropriate behaviour: e.g. talking too loudly.
- Wandering: e.g. repeated attempts to leave the house or walking up and down in one area.
- Sleep disturbances: e.g. repeated waking during the night.
- Delusions: e.g. the belief that people are stealing belongings or that a spouse or carer is an impostor.
- Hallucinations: e.g. perceptions of intruders or misidentification of people.
Many of these behavioural changes will appear to affect the person’s overall personality, which
can be particularly distressing for family and friends. Some people with the disease may eventually
become very aggressive and appear unkind and accusatory. Often these symptoms can be
relieved with treatment. It is essential to remember that it is the disease that is causing these
changes; the person inside is still the same and is not behaving this way on purpose. Despite thesecomplicated symptoms, the ability to express feelings is often impaired in patients with AD.
Someone with AD might still be able to share joy, anger, fear and most importantly love.
Functional:
Symptoms that affect the ability to perform daily activities
Changes in ability to function:
AD will also cause difficulties in the way the person with the disease functions in terms of
performing basic daily activities. Undertaking tasks such as personal grooming and household
chores will therefore become increasingly demanding for the individual with AD, as a result, there
will be an increased need for care.
Functional symptoms include:
- Neglect of personal hygiene: e.g. not bathing or brushing teeth.
- Difficulty grooming and getting dressed: e.g. not brushing hair or being unable to button clothing.
- Difficulty handling money, shopping or doing hobbies: e.g. inability to give correct change in shops.
- Loss of control of posture and walking: e.g. slumped stance, impaired walking.
Some of these difficulties are associated with memory problems; the person might
simply forget to take care of everyday practical tasks. There may also be a problem
with understanding the order in which chores are performed. Over time, the disease
may also affect the patient’s ability to move in a coordinated way and many daily
activities may become physically awkward.
How is Alzheimer’s treated?
There is currently no cure for Alzheimer’s disease. However, there are several treatments that can
ease or slow the development of certain symptoms. Even small improvements in specific symptoms
can have a great effect on the ability to undertake everyday activities. An early diagnosis means that
treatment can be started as soon as possible, helping to improve the quality of everyday life for both
the individual with the disease and those around them.
What are the medical treatments?
Medical treatment for AD falls into two main categories:
- Acetylcholinesterase inhibitors (AChEIs)
Explained simply, AChEIs act to raise the levels of a chemical in the brain (acetylcholine) that is
known to be at low concentrations in the early
- N-methyl-D-aspartate (NMDA) receptor antagonists
The NMDA receptor antagonists act to protect the brain from over-stimulation by a chemical
(glutamate) that can damage and eventually kill brain cells. Memantine is the only drug in this
class and has been shown to improve various symptoms of AD related to cognition, function and
behaviour, even in the advanced stages of the disease.
How are these medical treatments taken?
These treatments are taken orally as tablets and can be easily taken every day at home. It is essential
to stick to the prescribed dose and keep in contact with the doctor to get the best effects of treatment.
As the person taking the medication may suffer from memory problems, it is important that someone
else checks that the medication is being taken regularly and according to the instructions. A journal
can help keep track of treatment given.
Getting the right dose
It is normal for a person to be started on a low dose of medication that is then gradually increased by
their doctor until the required level or ‘maintenance dose’ is reached. A minimum period, during
which cognitive, functional and behavioural status is monitored, should elapse before a decision
regarding the efficacy of the treatment is made. Response to the treatment should not be judged on
the basis of monitoring change in only one of the above domains, as symptoms vary from person to
person, so does the response to these treatments.
What about alternative treatments?
Substances such as Ginkgo biloba and Vitamin E are thought by some people to have some value in
treating AD. However, it is essential that all options are discussed with your doctor before taking any
alternative medications, as there maybe interactions with the prescribed medicines.
Treating symptoms associated with AD
Other medical treatments may also be prescribed to alleviate symptoms associated with the disease
such as anxiety and depression. These treatments may help by improving specific symptoms and
helping to retain and/or increase the quality of life for the person with AD and carer.
What kind of care is needed?
Initially, it may be possible for the person with AD to retain a fairly independent life. As time goes on
and more symptoms develop, it may become necessary for another person to help with certain issues
such as medication, financial matters and daily activities. Eventually the person with the disease may
require full-time care, which will be difficult for one person to cope with.
The type of care will also change over time. Initially, the person may need assistance with
remembering details such as names, dates, words, directions, and where things have been placed.
Daily activities such as cooking, cleaning and shopping may also require assistance, as may washing
and grooming. Changes in behaviour such as increased aggression or irritability can make caring more
and more difficult. As symptoms progress the physical side of the illness becomes apparent and help
may be needed with walking, toileting and other activities. At this point, outside help may be required.
Eventually a residential home where the person with AD can receive around-the-clock care may be
the best option.
Medical professionals and care workers can help identify what type of help is necessary and available
for each individual situation and may be able to provide contact details. In addition, Alzheimer’s
disease/Dementia associations and help-groups often offer this kind of information.
Providing care
Throughout the illness, the carer of the person with AD may face his or her own emotional and physical
challenges as the disease symptoms progress. It may help to have some outside support; carers should
try and recognise their own limits and feel able to ask for as much help as they need, in the form of
home visits from professionals or respite care in a day centre or nursing home. Sharing problems,
seeking advice and making time for individual needs will help the carer to manage the range of
emotions that may accompany the task of caring.
What legal issues should be dealt with?
From a legal point of view, it is helpful if the person with AD and their family make arrangements such
as a will, appointment of a power of attorney and other issues early on. This will ensure that the
individual with the disease has as much authority over their future as possible, while they retain their
independence.
Where can more information be found?
Refer to the website under resources for important local contact information on organisations that
have information about the disease and support groups as well as services available in your area.
Across the globe, there are many associations that can help with information and support for those
affected by Alzheimer’s disease. Alzheimer’s Disease International is an umbrella organisation of
Alzheimer’s associations around the world.
What is depression?
Depression is a severely disabling condition that has a profound effect on all aspects of a sufferer's
life. In a World Health Organisation (WHO) report from 2015, the proportion of the global population
with depression is estimated to be 4.4%. Suicide accounted for close to 1.5% of all deaths worldwide,
bringing it into the top 20 leading causes of death. Suicide occurs throughout the lifespan and was the
second leading cause of death amoung 15-29 year olds globally. In South Africa, the percentage of the
population with depression and anxiety disorders, was 4.6%. Depression is ranked by the WHO as the
single largest contributor to global disability (7.5% of all years lived with disability). Depression is also
a major contributor to suicide deaths, which number close to 800 000 per year. 1
Prevalence rates vary by age, peaking in older adulthood (above 7.5% among females aged 55-74 years,
and above 5.5% among males). Depression also occurs in children and adolescents below the age of
15 years, but at a lower level than older groups. 1
Depression impacts on the mood or feelings of affected persons: symptoms range in terms of their
severity (from mild to severe) and duration (from months to years) These disorders are diagnosable
health conditions, and are distinct from feelings of sadness, stress or fear that anyone can experience
from time to time in their lives. Depression can be long lasting or recurrent, substantially impairing an
individual's ability to function at work or school or cope with daily life. At its most severe, depression
can lead to suicide 1. Depression is an illness that can seriously impair all aspects of a person's life,
including personal relationships, performance at work and enjoyment of activities. 2
Cognitive dysfunction (impaired concentration, memory, decision making) is a common feature of
depression that can be easily identified in patients with depression, but it often overlooked and may
persist once other symptoms have resolved. Symptoms of cognitive dysfunction are predicative of
poor outcome if they are not fully treated and are associated with marked effects on the patients work
performance.
Symptoms
- Depressed mood most of the day, nearly every day, as indicated in the subjective report or in observation made by others
- Markedly diminished interest in pleasure in all, or almost all, activities most of the day and nearly every day
- Significant weight loss when not dieting or weight gain, for example, more than 5 percent of body weight in a month or changes in appetite nearly every day
- Insomnia or hypersomnia nearly every day
- Psychomotor agitation or retardation nearly every day
- Fatigue or loss of energy nearly every day
- Feelings of worthlessness or excessive or inappropriate guilt
- Diminished ability to think or concentrate, or indecisiveness nearly every day
- Recurrent thoughts of death
Diagnosis
According to the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), five or more of the symptoms must be present during the same 2 week time period that represents changes in functioning. At least one symptom is either a depressed mood or loss of interest. 4
Treatment
- Exercise
- Mindfulness which involves paying closer attention to the present moment, and focusing on your thoughts, feelings, bodily sensations and the world around you to improve your mental wellbeing
- Self-help/ support groups such as SADAG
- Psychotherapy/ Talking therapy. Your doctor may refer you to a psychologist or counsellor
- Antidepressants, which have to be prescribed by your doctor
The best treatment for depression is usually a combination of pharmacotherapy and psychotherapy.
What can you expect
Most people with moderate or severe depression benefit from antidepressants, but not everybody
does. You may respond to 1 antidepressant but not to another, and you may need to try 2 or more
treatments before you find one that works for you. When you start taking antidepressants, you should
see your GP or specialist every week or 2 for at least 4 weeks to assess how well they're working. If
they're working, you'll need to continue taking them for at least 6 months after your symptoms have
eased. If you have had episodes of depression in the past, you may need to continue to take
antidepressants for up to 5 years or more. Antidepressants are not addictive, but you may get some
withdrawal symptoms if you stop taking them suddenly or you miss a dose. It's very important to take
your antidepressants as prescribed, even if you start to feel better. If you stop taking them too soon,
your depression could return. 5
What is schizophrenia?
Schizophrenia is a brain illness that appears in many different forms involving thoughts, emotions, senses, behaviour and movement 1.
Schizophrenia is not a 'split/multiple personality' 3 , nor is it a result of a bad upbringing, weakness or laziness.
The illness begins in the late teens to mid-30's. Women have a slightly later onset (average age late-twenties) than men (early to mid-twenties) 1.
There are no racial or gender differences 1,3.
What causes schizophrenia?
We don't know the exact cause of schizophrenia. It seems there are a number of factors that may combine to cause the illness
1.
These factors include:
- Genes: if a member of your family has or has had schizophrenia, this will increase your risk 1
- Alcohol and drugs such as dagga/weed/marijuana, tik, crack and LSD 3
- Physical sickness and brain injury 3
What are the symptoms of schizophrenia?
Some symptoms may come and go while others may always be there. They may also vary in severity over the course of the illness.
Positive symptoms 2:
- Delusions: ideas that only the person with schizophrenia believe are real and cannot be changed by proof
- Hallucinations: such as hearing and seeing things that aren't there, for example, a voice repeating what you are thinking or a voice giving you strange commands
- Talking in a way that is difficult for other people to understand
- Strange behaviour such as making repeated movements for no reason
Negative symptoms 2:
- Low energy and little desire to do things such as brushing your teeth and not washing
- Not experiencing or showing feelings
- Not wanting to see friends and family
- Some people who have not had their schizophrenia treated may act violently because of their hallucinations and delusions. They are more likely to hurt themselves than other people
- Other symptoms such as depression and difficulty doing simple tasks such as shopping for groceries
How can I get help?
- There are no blood tests you can do, but a doctor will listen to what you say about symptoms and experiences 1.
- If you don't get treatment for schizophrenia, the illness will become worse 1.
- If you have symptoms of schizophrenia it is very important to seek help as soon as possible from a doctor, nurse, clinic or hospital. There are treatments that help with the symptoms of schizophrenia. The treatments are tablets, injections, support for your family, support for you and help in finding work 3.
- Rehabilitation programs can provide advice about finding work, money management andsocial skills for those who have difficulty in coming to terms with everyday problems 1.
How can I stay well?
- Educating your friends and family about what to expect can also alert them to the early signs of schizophrenia and help prevent further breakdowns 1
- Like asthma, diabetes and high blood pressure, it is very important to continue taking your medication, even if you feel better.
- You must go to the clinic/hospital/pharmacy regularly.
- If you have been given pills you will need to take them every day exactly as your doctor or pharmacist told you and not miss a day.
- If you have been given an injection, you will need to go back for another injection every 2-4 weeks 1.
- Take your medication exactly as you are told, and this will help you stay well.
- Not taking your medication may cause your illness to become worse and it may take longer to get better 1.
- Other things to keep you well include regular exercise, healthy diet, and spending time with loved ones 3.
- Find out if there are support groups close to you. Talking to people who have similar problems may be helpful 3.
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"Traffic
data" means any data processed for the purpose of conveyance of a
communication on an electronic communications network in respect of
that communication and includes data relating to the routing,
duration or time of a communication.
"Web
browser" means an application used to access and view this
website such as Internet Explorer, Google Chrome, Safari or any
other equivalent.
"Website"
means the internet website with the address
https://www.lundbeck.com/za/
or any website with a URL that is validly registered to Lundbeck.
"You"
/ "your" means the user of the website and the services offered
by Lundbeck on or through the website.
Purpose
of the Website
The
main purpose of the website is to provide relevant information about
Lundbeck to health care practitioners and the public.
Conditions
of Access and Use
To
avoid any confusion, you agree that the Website Terms and
Conditions apply to your use of the website, any third-party
website licensed to Lundbeck and any information accessed via the
website.
If
you use the website, you must keep your access details (including
your username and password) confidential and not allow other people
to use them. You
accept full responsibility for all activities that occur under your
access details or password and accept responsibility for sharing
your username and password.
Any
use of your access details shall be regarded as if you were the
person using such information.
Materials
from the website may be copied and distributed on a limited basis
for non-commercial purposes only, provided that any material copied
remains intact and that all copies include the following notice in
a clearly visible position:
"Copyright © 2020 Lundbeck
(South Africa) (Pty) Ltd.
All rights reserved."
These materials are for personal use only. Any copying or
redistribution for commercial purposes or for compensation of any
kind requires prior written permission from Lundbeck.
By
using the website, you guarantee that you will not and you will not
allow third parties on your behalf to
make
and distribute copies of the website;
attempt
to copy, reproduce, alter, modify, reverse engineer, disassemble,
decompile, transfer, exchange or translate the website; or
create
derivative works of the website of any kind whatsoever.
You
acknowledge that the terms of the agreement with your Internet
provider will continue to apply when using the website. As a
result, you may be charged by the Internet provider for access to
network connection services for the duration of the connection
while accessing the website or any such third-party charges as may
arise. You accept responsibility for any such charges that arise.
If
you are not the payer of the device being used to access the
website, you will be assumed to have received permission from the
payer for accessing and using the website.
Information
Protection
The
website contains confidential information, which is the property of
Lundbeck and/or its data subjects and/or its business partners.
Unauthorised
disclosure and/or use of this information may incur civil or
criminal liability.
Any
of your personal information available on the website and which you
supply to Lundbeck when using the website will be used by Lundbeck
in accordance with its Privacy Statement and subject to
legislation.
You
guarantee that all information provided by you on or via the
website is true, accurate, current and correct and you undertake to
update the information as and when required.
All
information that you provide to Lundbeck may be stored
electronically and with third parties, which parties are bound by
strict levels of confidentiality. These
electronic records shall be proof of the information unless you can
prove otherwise.
Lundbeck
takes all reasonable steps to protect your personal information and
maintain confidentiality, including by making use of encryption
technology. However,
Lundbeck cannot guarantee the security or integrity of any
information you transmit to it online and you agree that you do so
at your own risk.
Intellectual
Property
All
trademarks, copyright, database and other intellectual property
rights of any nature in the website together with the underlying
software code as well as any content made available on the website
(e.g. text, graphics, logos, images, etc.) are owned either
directly by Lundbeck or by Lundbeck's licensors unless expressly
stated otherwise.
You
do not obtain any trademark, copyright, database or any other
intellectual property right of any nature or licence by using the
website.
You
are not granted any license or right to use any trademark without
Lundbeck's prior written permission and/or that of any third
party.
Breach
If
you breach the Website Terms and Conditions, Lundbeck shall have the
right to claim damages of whatsoever nature from you, including
special, incidental, consequential or indirect damages. In addition,
Lundbeck shall have the right to claim loss of profits and loss of
business and to recover all legal costs on a scale as between
attorney and own client from you.
Termination
Lundbeck
may in its sole discretion terminate your use of the website at any
time by giving notice of termination to you, where this is
possible.
You
agree that the following actions shall constitute material breaches
of the Website Terms and Conditions that shall result in the
termination of your access to the website:
signing
in as, or pretending to be another person;
transmitting
material that violates, or could violate, the intellectual
property rights or the privacy of others;
using
interactive services in a way that is intended to harm, or could
result in harm to you or to other users of the website; or
gathering
information about others without obtaining prior written consent.
Upon
termination of use as contemplated in this clause 7, the rights
granted to you by the Website Terms and Conditions shall terminate.
Disclaimers
and Limitation of Liability
Lundbeck
tries to ensure that the most sophisticated technology protects the
information on the website. However, Lundbeck cannot be held
responsible for any consequences that may result from the unlawful
breach of copyright or unlawful dissemination of information by
third parties copying information off the website. If you suspect a
breach or where a breach may have taken place and this comes to
your knowledge, please contact Lundbeck or the webmaster as soon as
possible so that the problem can be addressed.
The
website and all information, content, tools and materials are
provided by Lundbeck "as is" and on an "as
available" basis without warranty of any kind.
Lundbeck
does not guarantee the operation of the website or the information
content, tools or materials on the website.
While
Lundbeck makes every effort to ensure that the content and
information on the website is complete, accurate and up-to-date, it
makes no guarantee about the suitability of the products and
services and provides no representation or warranty, express or
implied, regarding the accuracy, correctness and completeness of
information contained on the website.
Lundbeck
does not guarantee that the website, information, content, tools or
materials included on the website, Lundbeck's servers or any
electronic communications sent by it are free from viruses or other
harmful components.
The
views and opinions expressed on this website, links or attachments
hereto do not necessarily reflect the views and/or opinions of
Lundbeck. Regardless of the vast professional knowledge and
scientific expertise in the field of pharmaceutical products
related to the central nervous system that Lundbeck possesses, it
cannot inspect all information to determine the truthfulness,
accuracy, reliability, completeness or relevance thereof.
Although
Lundbeck is fully committed to providing you with the best possible
service, it shall not be responsible for:
any
interrupted, delayed or failed transmission, storage or delivery
of information due to a power failure, equipment or software
malfunction, natural disasters, fire, labour unrest, epidemics,
pandemics, or any other cause beyond the reasonable control of
Lundbeck, or
any
inaccurate, incomplete or inadequate information supplied by you
and obtainable from the website.
The
website and all of its component elements, including text,
graphics, images, hyperlinks and other materials supplied by third
parties, are for general educational purposes only and do not take
the place of professional medical advice. To the extent that
clinical information may be provided on the website, it is based on
best practice and/or current recommendations and guidelines, which
may change from time to time. The information provided does not
replace the advice of a registered health care practitioner. You
should not discontinue any treatment you may be receiving on the
basis of information reflected on this website without first
consulting your health care practitioner and you should seek
professional advice should any symptoms you may be experiencing
persist.
You
agree to use the website at your own risk.
Lundbeck,
its directors, contractors and website contributors shall not be
liable to you or any other person or entity for, and you agree to
indemnify them against, any claim or damages of any kind, including
for direct, indirect, special, incidental, punitive and/or
consequential damages as well as loss of profit or the like whether
or not in the contemplation of the parties, whether based on breach
of contract, delict (including negligence), product liability or
otherwise, arising from -
your
use of the website or from any information, content, tools or
materials included on or otherwise made available to you through
the website, including any damage or alteration to your equipment,
including but not limited to computer equipment, handheld devices
or mobile telephones;
for
any decision taken or acted upon as a result of reliance on the
information or philosophies contained or expressed on the website;
your
actions or omissions that result in a breach of the Website Terms
and Conditions;
any
links to other websites from the website. You also acknowledge
that Lundbeck cannot control the content of or the products and
services offered on those websites; and/or
a
denial of access to the website should Lundbeck have reason to
believe that you are conducting activities that are illegal,
abusive, would affect the integrity of the website or place
Lundbeck in disrepute, if possible.
Website
Analytics
You
may visit the website without providing any personal information. The
website servers will in such instances collect the IP address you
used to access the website, but not the e-mail address or any other
personal identifiable information. The information on IP addresses is
aggregated to measure the number of visits, the average time spent on
the website, pages viewed, etc. Lundbeck analyses non-identifiable
traffic data to improve our services, via a third-party programme,
Google Analytics.
Lundbeck
may collect, hold and use statistical information about website
visits to help us improve the website. Such information includes -
your
IP address (including the originating country and/or location
thereof);
the
research terms you used;
the
pages accessed on Lundbeck's website and the links visitors
clicked on;
the
date and time you visited the website;
the
referring website (if any) on which you clicked through to
Lundbeck's website;
the
type of device you accessed the website through; and
the
type of web browser you use.
The traffic
data is aggregated and is not personally identifiable. Our website
analysis will respect any "does not track" setting you may have
set on your web browser.
Cookies
Lundbeck
uses industry-wide technologies such as "cookies" to collect
information about the use of the website, your preferences and past
browsing history. "Cookies"
refer to information that is sent from the website to your hard
drive, where it is saved. This will allow Lundbeck to improve its
services and your experience when you use the website again. The
cookies do not collect any personal information about you. The
information obtained will be shared with persons or entities to the
extent necessary for them to administer and improve the website on
our behalf.
Jurisdiction
The
laws of the Republic of South Africa shall govern these Website Terms
and Conditions.
Amendments
to the Website Terms and Conditions
Lundbeck
may in its sole discretion amend the Website Terms and Conditions
from time to time without prior notice. The
latest Website Terms and Conditions available on the website shall at
all times take precedence over any other version of these Terms. It
is your responsibility to make sure you are satisfied with any
changes before continuing to use the website.
Further
Information
If you have
questions about these Website Terms and Conditions, please contact us
at +27 11 699 1600 south_africa@lundbeck.com.
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The information in this Cookie Policy is provided to you in an open and transparent way, so that you can see how cookies are used to enrich your visitor experience and make an informed choice to allow their usage. However, if you wish to delete cookies, this can be done via settings in your web browser. Below you can read more about our use of cookies.
Cookies
When you visit this website your online device will automatically receive one or several cookies, which are transferred from this website to your internet browser.
What is a cookie?
A cookie is a small text file. It does not contain any personal information and is not able to collect information. Two types of cookies can be used, "session-only" and "persistent". "Session-only" cookies are deleted when you end your browser session. "Persistent cookies" remain on your device for the time period set in the cookie after which time they delete themselves. However, these cookies may be renewed every time you visit the website.
Cookie types
It is common to distinguish between first-party cookies and-third party cookies. First-party cookies are allocated to the website that you visit while third-party cookies come from a third-party, such as a web analytics program.
Why do we use cookies?
We use cookies to assess content usage and to compile statistics about the use of the website in order to improve the user experience. This data may be used to define where the visitors come from, what content is viewed and for how long. This information cannot be used to identify a visitor as an individual. Both first-party and third-party cookies may be used on this website.
How long will cookies be stored on my computer?
Cookie lifetime may vary. Some cookies will disappear when you close the browser while others exist for longer. For more information on cookie expiry see the cookie declaration.
Can I still visit the website if the cookie-function is disabled?
Yes. Should you have cookies disabled on your online device, you will continue to have the same access to the website content as with cookies enabled. However, some functions such as surveys and tools might operate with reduced functionality or not at all.
How to avoid or delete a cookie?
Most browsers accept cookies by default. You can alter your browser settings to not accept cookies or delete the cookies from your computer. Different web browsers may use different methods for managing cookies. Please follow the instructions below, from the most common web browser manufacturers directly, to configure your browser settings*.
Microsoft Internet Explorer (IE)
Google Chrome
Safari
Firefox
* These links are to third party sites, over which we have no control - no liability can be claimed if they are inaccurate.
The cookie declaration is updated monthly by Cookie Information. If you have any questions please write to info@cookieinformation.dk.
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Date published
20.11.2018
The website (https://www.mysupport.co.za/) is owned and provided by:
Lundbeck SA- PTY LTD
Unit 9 Blueberry Office Park
Apple Street
Randpark Ridge
Johannesburg
South Africa
Company registration number: 1989/001987/07
Telephone number: +2711 699 1600
The following describes how we handle personal data when you sign-up to receive newsletters from Lundbeck via MySupport resource center as well as certain legal information regarding our practices for this website.
1. Processing of Personal Data
As a provider of this website and the MySupport resource center, Lundbeck is a data controller of any personal data collected. Lundbeck is firmly committed to protecting the privacy of information we may collect from our online visitors.
In processing, personal data, Lundbeck will always comply with applicable legislation.
Personal identifiable data, purposes and legal basis
Lundbeck collects personally identifiable data in the following situations:
| We collect and process the following types of personal data about you via the website: |
We process your personal data for the following purpose: |
We process your personal data on the following legal basis: |
| When you sign up to receive the MySupport newsletter via the website (or on paper e.g. on a congress) we collect your name, email address, profession, country, zip code, place of practice. We will also register information on whether you consent to receive news letters from Lundbeck. |
We process this personal data for the purpose of direct marketing, i.e. providing you with e-mail newsletters if you have consented to.
We ask you about your profession to ensure you are an HCP because the content of the e-mails (which contain solely non-promotional material) are most relevant for this segment and because local legislation and industry guidelines may require is to do so .
|
The legal basis is your consent. |
| When you use the MySupport website we collect personal data via cookies such as type of browser, your IP-address, including your network location and information about your computer. |
Necessary cookies: Necessary cookies help make a website usable by enabling basic functions like page navigation and access to secure areas of the website. The website cannot function properly without these cookies.
Functional cookies: Functional cookies enable a website to remember information that changes the way the website behaves or looks, like your preferred language or the region that you are in.
Statistics cookies: Statistic cookies help website owners to understand how visitors interact with websites by collecting and reporting information.
Marketing cookies: Marketing cookies are used to track visitors across websites. The intention is to display ads that are relevant and engaging for the individual user and thereby more valuable for publishers and third-party advertisers.
|
The legal basis is consent.
The legal basis for necessary cookies is Lundbeck's legitimate interest in providing the website and functionalities to users.
|
When we collect personal data directly from you when you sign up to receive the MySupport newsletter, you provide the personal data voluntarily. You are not obligated to provide the information to us. The consequences of not providing the personal data are that we cannot send you our newsletter.
When we collect personal data via cookies, the source is your device.
Recipients of personal data
Lundbeck uses data processors (IT service providers and hosting services) in relation to the website. These third party provides will be obligated to safeguard the confidentiality of your data and to take adequate technical and organizational measures to protect your data against accidental or unlawful destruction, loss or alteration, unauthorized disclosure or abuse, or other unlawful processing.
For cookies, please see our cookie policy for more information.
Storage of Data (Data Retention)
Lundbeck will keep your personal data only for as long as reasonably necessary for the purposes for which it was collected or received or to comply with any applicable legal or ethical reporting or document retention requirements.
Your rights as a data subject
Lundbeck has taken all necessary and adequate steps to protect your personal data and ensure your rights as a data subject.
You have certain rights described below. Please note that limitations may apply to your ability to exercise these rights, for example, when your right to obtain the information is found to be overwritten by essential considerations of private interests.
Right of access
You have the right to request access to the personal data Lundbeck processes about you.
Lundbeck must provide a copy of the personal data undergoing processing as a starting point free of charge or by electronic means, if the request has been submitted in a commonly used electronic form.
Right to rectification
You have the right to rectification of inaccurate personal data concerning you, including completion of incomplete personal data.
Right to erasure (right to be forgotten)
You have the right to the erasure of the personal data concerning you.
Right to restriction
You have the right to restrict Lundbeck's processing of personal data concerning you.
Right to data portability
Where processing is based on a consent or a contract and the processing is carried out by automated means, you have the right to receive the personal data concerning you in a structured, commonly used and machine-readable format. You have the right to transmit this personal data to a third party without hindrance from Lundbeck, if technically possible.
Object
You have the right to object, on grounds relating to your particular situation, at any time to processing of personal data concerning you which is based on legitimate interests as legal basis for the processing, including profiling based on this provision. Where you have exercised this right to object, Lundbeck must no longer process the personal data unless Lundbeck demonstrates compelling legitimate grounds for the processing, which override your interests, rights and freedoms, or if processing is necessary for the establishment, exercise or defence of legal claims.
Where your personal data are processed for direct marketing purposes, you have the right to object at any time to processing of personal data concerning you for such marketing, which includes profiling to the extent that it is related to such direct marketing. Where you object to processing for direct marketing purposes, Lundbeck must no longer process the personal data for such purposes.
If processing of your personal data is based on your consent, you may withdraw your consent at any time. Please note that this does not affect Lundbeck's processing of your personal data prior to the withdrawal of your consent.
If you want to exercise any of your rights as described above or have any question to that, please contact the Lundbeck Data Protection Officer (see contact information below)
Lundbeck Data Protection Officer
If you have any questions regarding Lundbeck processing of personal data, please contact the Lundbeck Data Protection Officer:
H. Lundbeck A/S
Attn: Data protection officer
Ottiliavej 9
2500 Valby
Denmark
Email address: dataprivacy@lundbeck.com
If you contact our Data Protection Officer, H. Lundbeck A/S will process the personal data you provide us with in your request with the purpose of processing and responding to your request. Please read our privacy notification regarding this processing activity on Lundbeck.com.
2. Direct communication
Any questions, comments, suggestions, etc. that you may forward or transmit via the website will - to the fullest extent permitted by applicable law - become and remain the property of Lundbeck and will be treated as non-confidential, non-proprietary information that Lundbeck may use at its own discretion.
3. Disclaimer of liability
Lundbeck ensures that reasonable care is being taken to ensure that the website content is accurate and up-to-date, but all information is provided ‘as is' and Lundbeck makes no warranties or representations of any kind as to accuracy, sequence, timeliness or completeness of the website content and may at any time at its sole discretion change or replace the information on the website and discontinue distributing the site without prior notice. The website may contain information on diseases and treatments: this information is intended for general guidance only and must never be a substitute for advice provided by a doctor or other qualified healthcare professional. To the extent permitted by mandatory law, Lundbeck shall not be liable for any direct, incidental, consequential, indirect or punitive damages arising out of access to or use of any content on this site, including viruses, regardless of the accuracy or completeness of any such content. If you suspect you have a health problem, we strongly recommend that you contact your physician.
4. Links to other websites
The website may contain links to third party websites. Lundbeck disclaims any control over, relationship with, or endorsement of these sites and shall not be liable for any damages or injuries arising from the content of such sites. Links to other websites are provided only as a convenience and Lundbeck encourages that you read these third party websites' Terms of Use and Privacy Statements.
5. Intellectual property rights
The content of the website is subject to copyright protection and other intellectual property rights. The company names, trade names, logos and all product names are trademarks owned by Lundbeck. Any misuse of these trademarks is expressly forbidden. The content of the website may not be copied other than for personal and non-commercial use, with all copyright or other proprietary notices retained. Except as expressly provided above, it is not permitted to copy, display, download, modify, reproduce or retransmit any information on this website without the express written consent of Lundbeck.
6. Children
This website is not intended or designed to attract children under the age of 18 years. We do not knowingly collect personally identifiable data from any person we know to be under the age of 18 years.
7. Governing law and venue
This disclaimer and the contents of this site shall be governed and interpreted by Danish law without regard to its conflict of law rules. Any dispute arising out of or in relation to this disclaimer shall, if it cannot be solved amicably, be decided exclusively by the Danish Courts in Copenhagen, Denmark.
8. Changes and questions
Any changes to this document will be communicated promptly on this page. If you have any further questions regarding this document or the website in general, please do not hesitate to contact us.
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