Coping with Behavioural Disturbances in Huntingtons Disease
by Pete Ellis
Department of Psychological Medicine
Wellington School of Medicine
A presentation delivered to the Wellington Conference 1997
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Speaking to the experts
I would like to start by pointing out that the
greatest expertise in how to cope with behavioural problems in the home lies in the
collective experience of those who are doing this every day, both sufferers and their
supporters. The Huntingtons Associations play a crucial role in passing on effective
strategies to others, as do other professionals, but we all need your help in having new
ways of coping brought to our attention.
In general, an ounce of prevention is worth a pound
of cure, but even with the most favourable circumstances in the world, prevention is not
always possible.
In this talk. I will start off by defining what I
mean by behavioural disturbances and how they may arise. I will then describe some of
these briefly, and outline some ways of coping with them. To start with some definitions,
Definitions
Behavioural disturbance is a vague term and can
cover a range of different problems. These problems can be due to a number of different
causes, and it is important to identify these so that treatment of management is
appropriate. The cause include the effects of psychiatric illness, the effects of
Huntingtons disease on the brain, the effects of personality, both the persons
long standing personality and changes in this due to disease, effects of circumstances,
such as relationship problems, money problems, tragedies in the family or community, and
also the effects of clear decisions which others may not agree with. For example, most
parents do not agree with everything their adolescent sons do, but not all of it would be
behavioural disturbance - I hope!
Effects of Huntingtons Disease
It is interesting that although there is a
clear relationship between the severity of movement disorder and memory problems, there is
no clear relationship between these and the severity of emotional problems. There are two
ways of looking at this. The first is that perhaps some of the emotional distress
associated with the disease is not inevitably part of the condition, and that with less
stigma, more information and more support we might be able to make some difference to
this. On the other hand we must remember that The more clear cut psychiatric problems are
now being associated with changes in particular areas of the brain, so that some of the
problems may well be part of the genetic condition. Even so, they dont affect
everyone.
Now, when thinking about emotional problems I think
it is useful to bear in mind both general problems that can affect everyone with a serious
illness before looking at the specific issues related to Huntingtons.
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