Behavioural Problems:
Action and Reaction

There is no doubt that the behavioural changes described above are an integral part of the condition, arising as a direct consequence of physical changes which take place in the brain. However, HD patients have to contend with a whole host of obstacles as a consequence of the disease: loss of a job, reduced independence, impoverished social life, impaired mobility, lack of understanding and tolerance from others. It is not surprising that patients should feel frustrated and even angry at the apparent injustice. Patient’s behaviour often represents an interaction between the direct effects of the disease and the reaction to its consequences: a patient, for example, who assaults someone who falsely accuses him of being drunk, is showing an understandable feeling of anger at being victimised and falsely accused (reaction to consequence of illness), combined with the lack of emotional control resulting from HD itself (effect of disease).

Understanding HD

HD is a disabling condition which creates significant difficulties for the patient. Nevertheless, the traditional notion of the ‘mental’ charges associated with HD as ‘global’ is both misleading and inaccurate. HD damages selective parts of the brain, leading to specific difficulties in thinking, which in turn give rise to specific and predictable changes in behaviour.

Some aspects of patients’ mental or ‘intellectual’ functioning remain well preserved even when the condition is advanced: patients can, for example,see and hear, and understand the meaning of what they see and hear. The task for carers and professionals working with HD is both to recognise patients’ abilities so these can be harnessed most effectively, and to understand patients’ limitations, so that these can be compensated for. Behavioural changes in HD represent the greatest challenge. The profound impact od disordered behaviour on families is at last being recognised by professionals.

Researchers into new treatments for HD recognise that improving mobility and reducing involuntary movements is not enough. Treatments must also be directed at improving behavioural aspects of the condition.