0:00:02 > 0:00:05This year, one in four of us will suffer from mental illness.
0:00:05 > 0:00:08I believed that I could heal people just by staring at them.
0:00:11 > 0:00:13In this film, we'll meet five young people
0:00:13 > 0:00:16who are struggling with some of the most common disorders.
0:00:18 > 0:00:20Ffion has anorexia.
0:00:20 > 0:00:23At one point, I thought bad things would happen to my family
0:00:23 > 0:00:25if I did eat.
0:00:25 > 0:00:27Wayne is living with social anxiety disorder.
0:00:27 > 0:00:29TOILET FLUSHES
0:00:29 > 0:00:32I'm fearful that I'll be shamed in public, you know,
0:00:32 > 0:00:34not being able to get to the toilet on time.
0:00:34 > 0:00:37And David suffers from OCD.
0:00:37 > 0:00:42I'd rather die than ever have to go through that.
0:00:42 > 0:00:46With access to cutting edge science and computer graphics,
0:00:46 > 0:00:49we'll travel inside the brain to discover what causes
0:00:49 > 0:00:51these mental illnesses...
0:00:51 > 0:00:53Feeling quite anxious at the moment.
0:00:53 > 0:00:54..explore how our bodies react
0:00:54 > 0:00:57when we panic or lose touch with reality...
0:00:57 > 0:01:01I used to believe that my mum and dad were "energy vampires".
0:01:01 > 0:01:03..and reveal some radical new treatments that could improve
0:01:03 > 0:01:05the lives of thousands of young people.
0:01:08 > 0:01:11This is the inside story of how mental illness works.
0:01:20 > 0:01:23For young people, life is often a struggle.
0:01:25 > 0:01:30Puberty, exams and relationships can all be stressful.
0:01:30 > 0:01:32And it's during these times that mental illness
0:01:32 > 0:01:33is most likely to strike.
0:01:35 > 0:01:37Among teenagers, depression and anxiety
0:01:37 > 0:01:41have rocketed by 70% in the last 25 years.
0:01:45 > 0:01:51And 1 in 100 young people can develop an extreme form of anxiety
0:01:51 > 0:01:54called obsessive-compulsive disorder.
0:01:58 > 0:02:0125-year-old David lives in Luton.
0:02:01 > 0:02:04He's been living with OCD since he was 13 -
0:02:04 > 0:02:07a common age for the condition to strike in men.
0:02:08 > 0:02:12I've been diagnosed with severe obsessive-compulsive disorder
0:02:12 > 0:02:17and it's a really horrible mental sensation.
0:02:17 > 0:02:19I've lost friends because of it.
0:02:19 > 0:02:24It's affected my work, it's affected my health,
0:02:24 > 0:02:26my relationships with family.
0:02:27 > 0:02:29Everything.
0:02:29 > 0:02:33Sufferers experience obsessions that force them to repeat behaviours
0:02:33 > 0:02:36which they feel will reduce their anxiety.
0:02:36 > 0:02:41But OCD is not only about endlessly washing hands or checking locks.
0:02:41 > 0:02:44Many are haunted by intrusive and irrational thoughts.
0:02:48 > 0:02:52Today, David is driving to the airport to pick up some relatives.
0:02:53 > 0:02:58He's terrified he will do something illegal and be sent to prison.
0:02:58 > 0:03:00I feel safe as a driver.
0:03:00 > 0:03:06But I just feel anxious about certain aspects of driving -
0:03:06 > 0:03:09if I was to break the law whilst driving
0:03:09 > 0:03:13or be blamed for injuring somebody.
0:03:13 > 0:03:15And the other fear is just hurting somebody.
0:03:15 > 0:03:18It's one of the worst things that I can imagine is hurt...
0:03:18 > 0:03:20especially a child, like,
0:03:20 > 0:03:23if you hit them in a car it would just be terrible.
0:03:23 > 0:03:26It's just this irrational fear I can't get over.
0:03:26 > 0:03:29Even though I know I'm safe, I don't believe it
0:03:29 > 0:03:32and I doubt constantly that other people are safe.
0:03:38 > 0:03:41Dr Claire Gillan from the University of Cambridge
0:03:41 > 0:03:45studies the neuroscience behind obsessive-compulsive disorder.
0:03:46 > 0:03:49Intrusive thoughts are incredibly common in the general population,
0:03:49 > 0:03:53we'll all have them at some time during our life.
0:03:53 > 0:03:56So you can have thoughts where you may have an urge
0:03:56 > 0:03:58to push someone off the railroad tracks
0:03:58 > 0:04:02or for yourself to jump off a bridge if you're standing on one.
0:04:02 > 0:04:05But you can also have really much more nasty thoughts,
0:04:05 > 0:04:08like you might cause harm to somebody in some way.
0:04:08 > 0:04:10In OCD, these thoughts linger
0:04:10 > 0:04:14and go over and over and over again in their minds,
0:04:14 > 0:04:17and what this does is kick-starts a very malicious cycle
0:04:17 > 0:04:20of reinforcing the beliefs and reinforcing the behaviours
0:04:20 > 0:04:24over and over again, until it just spirals out of control.
0:04:27 > 0:04:30David's OCD could be caused by a malfunctioning
0:04:30 > 0:04:33of a complex pathway in his brain.
0:04:34 > 0:04:36The way we respond to our environment
0:04:36 > 0:04:38is by instinctive actions
0:04:38 > 0:04:40triggered by the basal ganglia.
0:04:42 > 0:04:47These are controlled by the frontal cortex, which helps us think ahead.
0:04:47 > 0:04:49And the thalamus, a relay station
0:04:49 > 0:04:52that helps regulate the flow of information between the two.
0:04:54 > 0:04:58In OCD sufferers, it's thought that the whole circuit is faulty
0:04:58 > 0:05:01and the habits and behaviours formed by the basal ganglia
0:05:01 > 0:05:03spiral out of control.
0:05:06 > 0:05:09This would explain why David is plagued by unwanted thoughts.
0:05:14 > 0:05:16During the night, our remote camera
0:05:16 > 0:05:18captures David's compulsive behaviour.
0:05:20 > 0:05:22Some nights I don't even get to sleep at all, so...
0:05:22 > 0:05:25Combination of everything that happens during the day,
0:05:25 > 0:05:31like with the speed cameras and different things on the road...
0:05:31 > 0:05:34but mostly worries about my dad.
0:05:35 > 0:05:37The fear that his dad will die
0:05:37 > 0:05:40is another of David's persistent and irrational thoughts.
0:05:42 > 0:05:45When he was a boy, his father suffered from heart disease
0:05:45 > 0:05:47and this has haunted him ever since.
0:05:48 > 0:05:52David is convinced that carrying out compulsive rituals
0:05:52 > 0:05:54will help keep his dad safe.
0:05:54 > 0:05:57Making things parallel and tapping things...
0:05:57 > 0:06:02it makes me feel like I can stop anything bad happening.
0:06:02 > 0:06:05But if I don't do that, then there is a big, big, chance that
0:06:05 > 0:06:08that will directly cause his death.
0:06:08 > 0:06:11And if I lost my dad because I didn't do it,
0:06:11 > 0:06:13it would be the worst thing that's ever happened...
0:06:13 > 0:06:17and I would feel guilty for it, so I've got to do it.
0:06:17 > 0:06:20David's ritualistic behaviour
0:06:20 > 0:06:22could be due to another problem with the basal ganglia.
0:06:24 > 0:06:28Studies have shown this is often enlarged in sufferers of OCD
0:06:28 > 0:06:33which may also explain the desire to repeat actions over and over again.
0:06:34 > 0:06:36So we all form habits every day
0:06:36 > 0:06:39and it's a way of making our lives a little easier,
0:06:39 > 0:06:42so simple tasks can become automatic and easily performed.
0:06:42 > 0:06:44So, for example, I swipe this card every day
0:06:44 > 0:06:46before coming into the building.
0:06:51 > 0:06:53But in OCD what we think happens
0:06:53 > 0:06:56is this habit system in the brain is overactive,
0:06:56 > 0:07:00so habits are formed more quickly and they are more persistent -
0:07:00 > 0:07:04to the point where a patient with OCD will form many, many habits
0:07:04 > 0:07:06that can take over their whole life.
0:07:10 > 0:07:12David's OCD is so intense
0:07:12 > 0:07:14that he's convinced he's going to forget to pay a bill
0:07:14 > 0:07:16and be sent to prison.
0:07:18 > 0:07:21I can't...
0:07:21 > 0:07:23(I can't do it.)
0:07:26 > 0:07:28I can't...
0:07:28 > 0:07:30I can't...
0:07:30 > 0:07:32I just can't imagine what it would be like.
0:07:39 > 0:07:41I'd rather die
0:07:41 > 0:07:44than ever have to go through that.
0:07:45 > 0:07:48And just even the risk of it happening, I'd just...
0:07:48 > 0:07:50I'd rather die.
0:07:51 > 0:07:54Why someone like David develops OCD is complex
0:07:54 > 0:07:59but research shows up to 50% of our risk could be genetic.
0:07:59 > 0:08:02While many genes will make someone more vulnerable
0:08:02 > 0:08:03to developing the disorder,
0:08:03 > 0:08:07scientists have discovered a variation in one particular gene,
0:08:07 > 0:08:10SLC1A1, which alters the flow
0:08:10 > 0:08:14of certain neurotransmitters in the brain.
0:08:14 > 0:08:16And this is only seen in men who develop
0:08:16 > 0:08:18the condition at an early age.
0:08:19 > 0:08:21While there is no immediate cure for OCD,
0:08:21 > 0:08:23several treatments do exist,
0:08:23 > 0:08:26with 70% of sufferers showing improvements.
0:08:26 > 0:08:28How many times have you washed your hands?
0:08:28 > 0:08:32One of most effective is cognitive behavioural therapy,
0:08:32 > 0:08:35which helps you change the way you think and behave.
0:08:36 > 0:08:39I've tried anti-anxiety medication,
0:08:39 > 0:08:41antidepressants.
0:08:41 > 0:08:45CBT therapy treatment I have also already done twice now,
0:08:45 > 0:08:48and that does have some positive effects.
0:08:49 > 0:08:51Dinner is served.
0:08:52 > 0:08:54David lives with his partner Nathan
0:08:54 > 0:08:57and his OCD can put an enormous strain on them both.
0:08:59 > 0:09:02It does test a relationship.
0:09:02 > 0:09:04You have to be a very patient person
0:09:04 > 0:09:09because sometimes I feel...
0:09:09 > 0:09:12like you are doing it deliberately
0:09:12 > 0:09:17but I need to obviously not think that because I know you're not.
0:09:17 > 0:09:20No, I just wish that I was free of it
0:09:20 > 0:09:24but the more I go through life,
0:09:24 > 0:09:27the more I realise that this is normal for me.
0:09:27 > 0:09:28- Yeah.- This is me.
0:09:28 > 0:09:32It doesn't matter to me because obviously I love Dave
0:09:32 > 0:09:37and I'm with him regardless of OCD or whatever.
0:09:38 > 0:09:40Thank you.
0:09:43 > 0:09:46With the continued support from his partner Nathan,
0:09:46 > 0:09:48David is learning to overcome his OCD
0:09:48 > 0:09:50and to live a relatively normal life.
0:10:01 > 0:10:05Mental illness can strike anyone regardless of age, sex or ethnicity.
0:10:08 > 0:10:12In the UK, around one million people are affected by an eating disorder.
0:10:12 > 0:10:15Anorexia nervosa is one of the most common
0:10:15 > 0:10:18and most at risk are teenage girls.
0:10:20 > 0:10:2323-year-old Ffion lives in South Wales.
0:10:23 > 0:10:26At 13 she was diagnosed with the mental health condition.
0:10:29 > 0:10:32It affects me, like, the majority of every day, really,
0:10:32 > 0:10:33to one extent or another,
0:10:33 > 0:10:36to varying degrees throughout the last, like, ten years,
0:10:36 > 0:10:38it's completely dominated it.
0:10:38 > 0:10:41People with anorexia keep their weight as low as possible
0:10:41 > 0:10:43by restricting what they eat
0:10:43 > 0:10:46but they also have an irrational fear of food.
0:10:48 > 0:10:49Over the last ten years,
0:10:49 > 0:10:53Ffion has been in and out of hospital for life-saving treatment.
0:10:55 > 0:10:57She was last discharged four months ago
0:10:57 > 0:11:00but still needs to gain another stone to reach her healthy weight.
0:11:00 > 0:11:02And it's not easy.
0:11:02 > 0:11:04I am feeling anxious
0:11:04 > 0:11:08because today is wanting to make myself a piece of fruit
0:11:08 > 0:11:10with my cereal that's bigger than my usual pieces of fruit
0:11:10 > 0:11:12so that's making me nervous
0:11:12 > 0:11:15because I get really anxious about being, like, too full.
0:11:15 > 0:11:17And I'm going to go sit down.
0:11:17 > 0:11:20I guess it's the decision making, the portioning,
0:11:20 > 0:11:23and the kind of internal battle of, like, of feeling guilty
0:11:23 > 0:11:25about having something,
0:11:25 > 0:11:27or something that's bigger than I'm allowed to have,
0:11:27 > 0:11:30or that I should have, or that I deserve to have.
0:11:30 > 0:11:33Then if somebody else is having something
0:11:33 > 0:11:35it's, like, worrying I'm having more than them or too much...
0:11:35 > 0:11:37because I've kind of been like this for so long
0:11:37 > 0:11:39that I don't really know what normal is.
0:11:41 > 0:11:45Anorexia is one of the most deadly of all mental illnesses
0:11:45 > 0:11:48and as many as 20% of suffers die from it.
0:11:50 > 0:11:56It's... It feels like this like demonic, torturous thing
0:11:56 > 0:11:58that, like, has just set out to make you miserable.
0:12:00 > 0:12:01And it's really tiring.
0:12:03 > 0:12:05It's really tiring feeling anxious all the time,
0:12:05 > 0:12:07and constantly arguing with your head,
0:12:07 > 0:12:10and not being able to do the things that everyone else can do.
0:12:10 > 0:12:13Like this one basic thing which is to like eat, really,
0:12:13 > 0:12:16and I want it more than anything in the whole world.
0:12:22 > 0:12:24Jess McCelland from the Institute of Psychiatry
0:12:24 > 0:12:26has been carrying out cutting-edge research
0:12:26 > 0:12:29into the illness and busting the myths.
0:12:31 > 0:12:33There's a number of misconceptions
0:12:33 > 0:12:34about the illness,
0:12:34 > 0:12:37such as it's a lifestyle choice, or a diet taken too far,
0:12:37 > 0:12:40or brought on by sort of size-zero models. But, in reality,
0:12:40 > 0:12:44it can bring on a whole lot of other physical and psychological problems,
0:12:44 > 0:12:46things like severe food restriction
0:12:46 > 0:12:50and an intense fear of food and gaining weight.
0:12:50 > 0:12:53So something sort of as simple as a cappuccino for us would create
0:12:53 > 0:12:57quite a lot of anxiety and fear for someone who suffered from anorexia.
0:12:57 > 0:13:00Scientists are trying to understand the causes of anorexia.
0:13:02 > 0:13:06One possibility is that the condition is triggered by our genes.
0:13:07 > 0:13:10It's believed that multiple genes of small effect can increase
0:13:10 > 0:13:12the risk of developing the illness.
0:13:12 > 0:13:15Additionally, if someone has family members that have been affected
0:13:15 > 0:13:18by an eating disorder, or other psychiatric disorders,
0:13:18 > 0:13:21this can also render an individual more susceptible
0:13:21 > 0:13:22to developing anorexia.
0:13:24 > 0:13:26More recently, research has found that the illness
0:13:26 > 0:13:28might be rooted in the brain.
0:13:30 > 0:13:32Some neural pathways that transmit messages
0:13:32 > 0:13:36from one brain cell to another may be dysfunctional
0:13:36 > 0:13:39and this could be why sufferers experience such extreme anxiety
0:13:39 > 0:13:40when it comes to eating.
0:13:43 > 0:13:46Ffion's fear of food began when she was 12 years old.
0:13:46 > 0:13:49I wouldn't be around the kitchen in case I inhaled smells,
0:13:49 > 0:13:52and I thought you could inhale calories. I wouldn't drink at all.
0:13:52 > 0:13:54And I got into real trouble then
0:13:54 > 0:13:56because, obviously, you get very ill if you don't drink.
0:13:56 > 0:13:58I was really anxious, I used to pick my lips in anxiety
0:13:58 > 0:14:01until they started to bleed but I wouldn't put Vaseline on
0:14:01 > 0:14:04because I thought that the grease would get absorbed into my lips,
0:14:04 > 0:14:05and I'd put on weight through my lips.
0:14:08 > 0:14:12People with anorexia also display certain personality traits.
0:14:12 > 0:14:16They are often perfectionists, have low self-esteem
0:14:16 > 0:14:18and obsessive-compulsive tendencies.
0:14:19 > 0:14:23I used to drive myself to exercise in the snow and the rain
0:14:23 > 0:14:25and try and keep cold...
0:14:25 > 0:14:29anything that I could to burn calories.
0:14:29 > 0:14:30At one point
0:14:30 > 0:14:32I thought bad things would happen to my family
0:14:32 > 0:14:36if I did eat and I'd be punished in some way if I did eat.
0:14:37 > 0:14:40By 13, Ffion's weight had dropped to 5 stone
0:14:40 > 0:14:43and she stopped eating altogether.
0:14:44 > 0:14:48She was admitted to hospital, fed through a drip
0:14:48 > 0:14:50and given 24 hour mental health care.
0:14:52 > 0:14:55As Ffion starved her body, her bones began to deteriorate.
0:14:58 > 0:15:00This is a back support that I had
0:15:00 > 0:15:05because I fractured two vertebrae in my spine about six months ago,
0:15:05 > 0:15:08so they gave me one of these, which is
0:15:08 > 0:15:11something I can wear under my clothes just to help support by back a bit.
0:15:11 > 0:15:15The only way it's going to heal is if I don't move it much,
0:15:15 > 0:15:16but it's quite hard.
0:15:18 > 0:15:22Malnutrition causes levels of oestrogen to drop.
0:15:23 > 0:15:26It's thought the hormone helps produce bone cells,
0:15:26 > 0:15:29and girls lay down around half of their bone mass in their teens.
0:15:31 > 0:15:35But if these hormone levels are too low, fewer cells are produced
0:15:35 > 0:15:37and bones become weak and brittle.
0:15:40 > 0:15:45I've got full-blown osteoporosis, which has actually got worse
0:15:45 > 0:15:48since I was first diagnosed when I was 18.
0:15:48 > 0:15:51So that's really scary.
0:15:51 > 0:15:54And I may not feel it that much now,
0:15:54 > 0:15:56but in another, like, ten years' time,
0:15:56 > 0:15:59when I'm in my late 20s, I could be breaking hips and stuff.
0:15:59 > 0:16:02So, as much as I hate to admit it, unless you get to a healthy weight,
0:16:02 > 0:16:06your body won't work properly and it does bite you on the arse big time.
0:16:08 > 0:16:09For most women,
0:16:09 > 0:16:12their menstrual cycle is kick-started
0:16:12 > 0:16:14by chemical messengers in the brain.
0:16:14 > 0:16:18This triggers hormones, which race through the bloodstream
0:16:18 > 0:16:21and into the ovaries, where an egg is released.
0:16:23 > 0:16:27But when the brain is starved, it can't activate the sex hormones,
0:16:27 > 0:16:29so no eggs are released.
0:16:29 > 0:16:31Which is why Ffion has stopped having her periods.
0:16:34 > 0:16:36Where? Here?
0:16:36 > 0:16:39Ffion's mum has been a great support throughout her illness
0:16:39 > 0:16:43and weekly trips to the pool have helped them both.
0:16:44 > 0:16:47It's a nice thing that we do. We both really enjoy it.
0:16:47 > 0:16:48We have a bit of you and me time
0:16:48 > 0:16:50and we never invite her father or brother.
0:16:50 > 0:16:52It's a bit of time for the two of us.
0:16:54 > 0:16:59Another key symptom of anorexia is body dissatisfaction
0:16:59 > 0:17:03and, like many sufferers, Ffion is phobic about her looks.
0:17:05 > 0:17:08I don't...feel very comfortable in my own skin.
0:17:08 > 0:17:11I don't like the way that I look.
0:17:11 > 0:17:13I don't like mirrors,
0:17:13 > 0:17:16I don't like getting out of baths or showers.
0:17:16 > 0:17:20I don't look down, ever, and I don't like people looking at me.
0:17:20 > 0:17:23I feel really self-conscious a lot of the time.
0:17:24 > 0:17:29One theory is that this distorted body image is related to
0:17:29 > 0:17:32a malfunctioning in an area of the brain called the insula.
0:17:37 > 0:17:40This part of the brain is like an internet server -
0:17:40 > 0:17:43sending and receiving messages.
0:17:45 > 0:17:49It monitors anxiety, feelings of disgust, body awareness
0:17:49 > 0:17:51and self-image.
0:17:51 > 0:17:55But imaging studies have shown that in anorexics the insula
0:17:55 > 0:17:57is damaged, making it under fire.
0:17:59 > 0:18:02This could explain why many sufferers experience
0:18:02 > 0:18:04body image dissatisfaction.
0:18:06 > 0:18:10Ffion's illness has also had a huge impact on her family.
0:18:10 > 0:18:13They said she should've been dead several times by now.
0:18:13 > 0:18:16It's a miracle that she isn't. And there's no logic in it.
0:18:16 > 0:18:18She's an intelligent woman so there's no logic in it either.
0:18:18 > 0:18:20So you just have to stop looking for it.
0:18:20 > 0:18:22It's not something I can let go of.
0:18:22 > 0:18:24It drives me crazy when people say, "Why can't you let it go?"
0:18:24 > 0:18:27I can't. I would have done it ten years ago.
0:18:27 > 0:18:30It's just... It's ingrained.
0:18:30 > 0:18:32But you can deal with it a lot more now, you're able to control it.
0:18:32 > 0:18:35I have to, really. You just have to.
0:18:35 > 0:18:38The worst thing for the family is the absolute helplessness -
0:18:38 > 0:18:39we feel completely helpless.
0:18:39 > 0:18:43We've been stood alongside Ffion for the whole time, really,
0:18:43 > 0:18:46every minute of the way, but you feel totally helpless.
0:18:46 > 0:18:49But that's all you can do, really. you can't take it away from her,
0:18:49 > 0:18:52you can't do the horrible bit she needs to do or the tough bit now
0:18:52 > 0:18:55like trying to gain a stone so she can get to university and be well.
0:18:58 > 0:19:02For Ffion, her biggest worry is the future.
0:19:02 > 0:19:04I don't know whether I'm going to be able to have kids
0:19:04 > 0:19:05and that really frightens me,
0:19:05 > 0:19:08but that's something I can't really think about
0:19:08 > 0:19:09until I know the facts,
0:19:09 > 0:19:13and to know the facts I need to get healthy first.
0:19:13 > 0:19:16But that's a huge motivator as I'd really like to have kids one day.
0:19:24 > 0:19:29Anorexia is so ruthless that only 50% of people make a full recovery,
0:19:29 > 0:19:33so finding new ways to treat the illness is crucial.
0:19:35 > 0:19:38Today, Ffion has come to the Institute of Psychiatry
0:19:38 > 0:19:41in London to take part in a cutting-edge experiment
0:19:41 > 0:19:43run by Jess McClelland.
0:19:45 > 0:19:48- Hiya!- Hi.- How you doing?- I'm all right. How are you?- Good, thank you.
0:19:48 > 0:19:49Take a seat.
0:19:49 > 0:19:52This trial could result in a new treatment for the disorder.
0:19:52 > 0:19:56We are just going to do a couple of tasks first.
0:19:56 > 0:19:57Jess and the research team
0:19:57 > 0:20:01are trialling transcranial magnetic stimulation, or TMS,
0:20:01 > 0:20:05a therapy which fires magnetic pulses into the brain.
0:20:10 > 0:20:15First, Ffion is shown images of food and Jess measures her responses.
0:20:15 > 0:20:18So we're looking at the effects of the stimulation on some
0:20:18 > 0:20:22of the core symptoms of anorexia, things like urge to restrict,
0:20:22 > 0:20:24urge to exercise and levels of feeling full,
0:20:24 > 0:20:26levels of feeling fat, and anxiety.
0:20:28 > 0:20:30- Does that feel secure? - Yeah, that's fine.- Perfect.
0:20:32 > 0:20:34Then Jess takes some measurements
0:20:34 > 0:20:37so she can target a specific part of Ffion's brain with TMS.
0:20:39 > 0:20:41She's working on the theory that anorexia
0:20:41 > 0:20:44is caused by dysfunctional neural circuits.
0:20:45 > 0:20:48So the area of the brain that we are targeting with TMS
0:20:48 > 0:20:50is the dorsolateral prefrontal cortex.
0:20:50 > 0:20:53This is an area supposed to be involved in self-regulation
0:20:53 > 0:20:55and self-control problems
0:20:55 > 0:20:57that we see in anorexic patients.
0:20:57 > 0:20:59So we are hoping to target these
0:20:59 > 0:21:03to try and alter the symptoms and feelings related to eating and food.
0:21:06 > 0:21:09Brain scans have shown that sufferers of anorexia have changed
0:21:09 > 0:21:13activity in the reward centre - an area that helps us
0:21:13 > 0:21:15to feel pleasure or fear about food.
0:21:16 > 0:21:19Another circuit in the prefrontal cortex, which plays
0:21:19 > 0:21:23an important role in self-control could also be malfunctioning.
0:21:23 > 0:21:26Problems with these neural circuits may add to the severe
0:21:26 > 0:21:30restriction and intense fear of food felt by suffers of anorexia.
0:21:30 > 0:21:32Three, two, one...
0:21:32 > 0:21:34RAPID STACCATO CLICKING
0:21:34 > 0:21:38The theory is that these critical circuits can be altered
0:21:38 > 0:21:40by firing magnetic pulses into the brain.
0:21:42 > 0:21:47Knowing there could science behind her disorder gives Ffion hope.
0:21:47 > 0:21:51I blamed myself for a really long time for not being able to change
0:21:51 > 0:21:55and for getting ill and always thought it was my fault.
0:21:55 > 0:21:58I think for there to be some underlying reason
0:21:58 > 0:22:01it would help it all make a lot more sense, really.
0:22:06 > 0:22:09It's not painful, it's like having a little woodpecker
0:22:09 > 0:22:11tap at your skull for five seconds.
0:22:11 > 0:22:12Three, two, one.
0:22:12 > 0:22:14STACCATO CLICKING
0:22:16 > 0:22:18Fabulous. Well done.
0:22:22 > 0:22:25When the TMS session is over, Ffion repeats
0:22:25 > 0:22:29the questionnaire to record any change in her responses to food.
0:22:30 > 0:22:32Great, thank you very much.
0:22:32 > 0:22:34And the results are looking good.
0:22:34 > 0:22:38Ffion's reactions to food HAVE changed.
0:22:38 > 0:22:42Before the TMS, her feelings of fat and full were high.
0:22:42 > 0:22:45But after the treatment, they have dropped considerably,
0:22:45 > 0:22:47seen here in pink.
0:22:47 > 0:22:49There has been a reduction in these scores
0:22:49 > 0:22:50after the stimulation session,
0:22:50 > 0:22:53so there has been some effect on these two measures
0:22:53 > 0:22:55of feeling fat and feeling full.
0:22:56 > 0:23:00Ffion is part of a larger study which aims to show that TMS may be
0:23:00 > 0:23:04effective in reducing the symptoms of anorexia.
0:23:04 > 0:23:06So the research is in very early stages at the moment
0:23:06 > 0:23:08but we have had some promising findings so far.
0:23:08 > 0:23:11The next step would be to look at these findings in a larger trial
0:23:11 > 0:23:14with the hope that TMS may have the potential to be used
0:23:14 > 0:23:16with current treatments for anorexia.
0:23:18 > 0:23:22For Ffion, the research gives her hope there might be new ways
0:23:22 > 0:23:24to treat the illness in the future.
0:23:24 > 0:23:27But right now, she's managing to keep her anorexia under control.
0:23:27 > 0:23:30I've got a job now, a couple of jobs, and university in September,
0:23:30 > 0:23:34and I'm going on my first girlie holiday,
0:23:34 > 0:23:36and I'm climbing Snowdon for eating disorders,
0:23:36 > 0:23:38and I'm going to do a skydive in a few weeks,
0:23:38 > 0:23:42and everything seems to be a bit too good to be true, but I'm going with
0:23:42 > 0:23:45it anyway, so it feels really nice.
0:23:45 > 0:23:47It was hard... It was hard work but it's really nice.
0:23:47 > 0:23:51So as long as I can keep on top of things, I should be OK.
0:24:08 > 0:24:09Most of us get stressed out
0:24:09 > 0:24:12and sometimes find life hard to cope with.
0:24:15 > 0:24:18But for nearly 300,000 young people in the UK,
0:24:18 > 0:24:21their anxiety is so constant it rules their life.
0:24:26 > 0:24:28Wayne is 24, lives in Southam
0:24:28 > 0:24:31and works in his local superstore.
0:24:32 > 0:24:36Ten years ago he was diagnosed with social anxiety disorder.
0:24:36 > 0:24:38I suffer from anxiety.
0:24:38 > 0:24:41I've had it since I was a teenager.
0:24:41 > 0:24:45It means I find it hard to travel, maybe go out with friends,
0:24:45 > 0:24:49be in certain social situations.
0:24:50 > 0:24:52A huge anxiety for Wayne
0:24:52 > 0:24:55is that he will lose control of his bodily functions.
0:24:57 > 0:25:00I'm fearful that I'll be maybe shamed in public,
0:25:00 > 0:25:06not being able to get to the toilet on time and it being
0:25:06 > 0:25:08glaringly obvious that I've become incontinent
0:25:08 > 0:25:12and having people judge, I suppose.
0:25:14 > 0:25:17Today, Wayne's going bowling with his sister Pip and some friends,
0:25:17 > 0:25:22but his toilet anxiety is making it hard to leave the house.
0:25:22 > 0:25:24Just got 15 minute before we go,
0:25:24 > 0:25:29so I'm just making sure I feel all right before I go.
0:25:29 > 0:25:30I don't know how many times I need to go,
0:25:30 > 0:25:32I don't count or anything like that.
0:25:32 > 0:25:35I just... I just go as many times as I need to, really.
0:25:40 > 0:25:44Wayne's family have learnt to be patient of his condition.
0:25:44 > 0:25:47This is normal, but I don't know how he's going to be today.
0:25:47 > 0:25:49He might take 5 minutes, he might take 20 minutes,
0:25:49 > 0:25:52but he'll take as long as he needs to take.
0:25:52 > 0:25:55He won't be pushed by me, I don't think.
0:25:55 > 0:25:57TOILET FLUSHES
0:25:59 > 0:26:01Are you ready?
0:26:01 > 0:26:02No.
0:26:02 > 0:26:05Oh! I was going to say. That was quick.
0:26:08 > 0:26:11- OK. I'll just go one more time, then. - Yeah?
0:26:12 > 0:26:16Wayne's anxiety dominates his life.
0:26:16 > 0:26:18When I'm out, I spend most of my time anxious.
0:26:18 > 0:26:21I didn't go to university because of it.
0:26:21 > 0:26:22I pick my jobs around it.
0:26:22 > 0:26:25It can be extremely strong,
0:26:25 > 0:26:27overwhelming and potent.
0:26:27 > 0:26:31It can be really quite, well, terrifying, I suppose.
0:26:34 > 0:26:36For all of us, fear and anxiety
0:26:36 > 0:26:40are our body's normal response to danger or threat.
0:26:41 > 0:26:44If I was going to step out into this road without looking,
0:26:44 > 0:26:46then my body's fear response would be triggered.
0:26:46 > 0:26:49I might notice that my heart starts to race,
0:26:49 > 0:26:54my breathing becomes faster or more shallow, that my muscles tense up,
0:26:54 > 0:26:56that my vision becomes more acute
0:26:56 > 0:26:59and we might feel we want to empty our bladder or bowel,
0:26:59 > 0:27:02make our body as light as possible to run away.
0:27:02 > 0:27:05And those would all be useful things because they are our body's
0:27:05 > 0:27:09primitive survival mechanism that help to protect us all from danger.
0:27:13 > 0:27:15TOILET FLUSHES
0:27:15 > 0:27:18But for people like Wayne, the brain system that controls
0:27:18 > 0:27:20this mechanism switches on for no apparent reason.
0:27:22 > 0:27:24I am feeling very apprehensive.
0:27:24 > 0:27:27When we get scared, the amygdala,
0:27:27 > 0:27:30or fear centre inside our brain, springs into action.
0:27:31 > 0:27:35It sends out messages, which trigger the release of the hormone
0:27:35 > 0:27:38adrenaline into the bloodstream.
0:27:38 > 0:27:42And it's this that prepares the body to face up to danger.
0:27:43 > 0:27:47But in people suffering from anxiety, it's believed the amygdala
0:27:47 > 0:27:50is overactive and the part of the brain which helps to control it
0:27:50 > 0:27:52is malfunctioning.
0:27:53 > 0:27:56- You going to back up and I'll...?- Yeah?
0:27:57 > 0:28:00TOILET FLUSHES
0:28:06 > 0:28:09Pip, one second, one second.
0:28:11 > 0:28:13TOILET FLUSHES
0:28:15 > 0:28:18All right, Wayne?
0:28:18 > 0:28:20Now that Wayne's been to the toilet four times,
0:28:20 > 0:28:22he's finally ready to leave.
0:28:23 > 0:28:27But as he drives further from home, his anxiety rockets.
0:28:29 > 0:28:31Are you all right?
0:28:32 > 0:28:34Feeling quite anxious at the moment.
0:28:36 > 0:28:38Mouth's gone quite dry,
0:28:38 > 0:28:42heart's going quite a bit, feel quite tense...
0:28:45 > 0:28:49Inside Wayne's brain, his amygdala sets off the release of adrenaline.
0:28:51 > 0:28:54As it floods into his bloodstream, it makes his heart beat faster
0:28:54 > 0:28:57and his breathing increase.
0:28:57 > 0:28:58His body temperature soars,
0:28:58 > 0:29:03so glands in the skin release small droplets of sweat to cool him down.
0:29:03 > 0:29:07Stress hormones make his muscles contract and his pupils dilate.
0:29:08 > 0:29:13The adrenaline also affects Wayne's emotions - he feels terrified.
0:29:22 > 0:29:26The instant he reaches the bowling alley, Wayne checks out the toilets.
0:29:29 > 0:29:33I just like to have locks on the door working, and...
0:29:33 > 0:29:38It's not amazingly clean but it doesn't bother me that much.
0:29:38 > 0:29:40Make sure there is loo roll and stuff.
0:29:46 > 0:29:50Eventually, as Wayne gets used to his surroundings, he finally relaxes
0:29:50 > 0:29:53and can enjoy the evening.
0:29:53 > 0:29:54LAUGHTER
0:29:54 > 0:29:56It's good start. It's a good start.
0:29:56 > 0:29:59Much more relaxed now, much more relaxed, there is no
0:29:59 > 0:30:01anxiety any more.
0:30:01 > 0:30:03I feel just as comfortable as I would be at home, really.
0:30:04 > 0:30:07Wayne's physical symptoms have also calmed down.
0:30:08 > 0:30:10The adrenaline is subsiding,
0:30:10 > 0:30:13his heart is returning to a normal rhythm
0:30:13 > 0:30:15and his breathing is more regular.
0:30:16 > 0:30:18Thank God! HE LAUGHS
0:30:18 > 0:30:20You can tell he's a bit, like...
0:30:20 > 0:30:22twitchy and nervous when he starts
0:30:22 > 0:30:26but after a while, he becomes comfortable, and he speaks a lot more
0:30:26 > 0:30:30and...yeah, he's a lot more outgoing. I know he does suffer a lot from it
0:30:30 > 0:30:32but he tends to control it quite well.
0:30:34 > 0:30:35Like all mental illness,
0:30:35 > 0:30:39understanding why Wayne suffers from anxiety is not easy.
0:30:41 > 0:30:45Some of the factors that we think might influence a person
0:30:45 > 0:30:49developing an anxiety disorder could be...um, genetics, or could be
0:30:49 > 0:30:52biological factors in the brain, or the person's life experiences
0:30:52 > 0:30:54as they're growing up.
0:30:54 > 0:30:59One theory is that being fearful can be learned during childhood
0:30:59 > 0:31:02through a process known as conditioning.
0:31:02 > 0:31:06The idea of conditioning is that a particular stimulus or trigger
0:31:06 > 0:31:09might become associated in a person's mind
0:31:09 > 0:31:14with a feeling of anxiety, even if that trigger or stimulus
0:31:14 > 0:31:16is not actually dangerous.
0:31:16 > 0:31:18THEY CHUCKLE
0:31:18 > 0:31:21Oh! I AM strong, believe me!
0:31:21 > 0:31:25This idea came about at the beginning of the 20th century
0:31:25 > 0:31:28when a young psychologist, JB Watson, asked the question,
0:31:28 > 0:31:31are we born with fear or do we learn it?
0:31:33 > 0:31:36Then he carried out one of the most controversial experiments
0:31:36 > 0:31:40in human psychology involving a nine-month-old boy
0:31:40 > 0:31:41called Little Albert.
0:31:45 > 0:31:48First, Watson presented the baby with various items,
0:31:48 > 0:31:49including a white mouse.
0:31:51 > 0:31:52Albert was curious
0:31:52 > 0:31:55and showed no signs of being scared.
0:31:55 > 0:31:56But then, Watson did something
0:31:56 > 0:31:58completely unexpected.
0:31:58 > 0:32:00And what he did was, he repeatedly
0:32:00 > 0:32:03showed Albert a white mouse
0:32:03 > 0:32:07whilst at the same time making a loud noise to startle Little Albert
0:32:07 > 0:32:10and trigger his fear response.
0:32:12 > 0:32:16Finally, he showed Little Albert the mouse again.
0:32:16 > 0:32:20This time Albert was terrified, simply by the sight of it.
0:32:20 > 0:32:23SUPERIMPOSED BABY SCREAMS
0:32:24 > 0:32:28Watson's experiment shows us that we're not necessarily born
0:32:28 > 0:32:32with a fear response to everything that we, as adults,
0:32:32 > 0:32:35feel fearful of, but that we might have learned that fear response
0:32:35 > 0:32:36along the way.
0:32:39 > 0:32:42Wayne remembers a fearful event, which he feels
0:32:42 > 0:32:45may have contributed to his anxious state of mind.
0:32:47 > 0:32:51It started off in Year Six, really. We'd been set some homework
0:32:51 > 0:32:53and forgot to take it home, though.
0:32:53 > 0:32:55So when the Monday came around, I didn't have any homework
0:32:55 > 0:33:00and the teacher was really quite angry about it.
0:33:00 > 0:33:02I kind of got a good shouting at.
0:33:02 > 0:33:07I felt awful. You know, I was in tears in front of my classmates.
0:33:07 > 0:33:09I spent a lot of time off after that.
0:33:09 > 0:33:12I ended up being quite reclusive and missing quite a lot of school
0:33:12 > 0:33:13and not going at all.
0:33:13 > 0:33:16That was the first bout of bad anxiety I got
0:33:16 > 0:33:19but it may have been buried in me before that.
0:33:22 > 0:33:25The Little Albert experiment proved we can learn to be anxious,
0:33:25 > 0:33:27but that also means we can "unlearn" it.
0:33:29 > 0:33:34This is the theory behind cognitive behavioural therapy, or CBT -
0:33:34 > 0:33:37one of the most effective treatments for anxiety disorders.
0:33:38 > 0:33:42- Hi, Wayne.- Hi, you all right? - Do you want to come through?- Yeah.
0:33:42 > 0:33:45Wayne is using CBT to help him tackle his fears.
0:33:46 > 0:33:50Cognitive behavioural therapy helps people helps people
0:33:50 > 0:33:53to look at their thoughts and look at their behaviours
0:33:53 > 0:33:55and identify which thoughts or behaviours
0:33:55 > 0:33:58might be unhelpful in terms of maintaining their problem.
0:34:00 > 0:34:06For Wayne, Jo is using a CBT technique called exposure therapy.
0:34:06 > 0:34:09This helps him to keep his anxiety under control
0:34:09 > 0:34:10when he's stressed out.
0:34:10 > 0:34:12So, any change to what's going on now, or...?
0:34:12 > 0:34:17- Yes, I'm getting...getting worse. - OK. You're doing really well.
0:34:17 > 0:34:21Just going for a ten-minute walk will cause Wayne enormous anxiety
0:34:21 > 0:34:23because he has no idea where he is going,
0:34:23 > 0:34:26or whether there will be a toilet.
0:34:26 > 0:34:30- Just...- What's going on in terms of, um...
0:34:30 > 0:34:33- in your tummy? - Very tight, very tight.
0:34:33 > 0:34:36Feels like it's moving a lot.
0:34:36 > 0:34:38But Jo's trying to teach Wayne
0:34:38 > 0:34:41the more he faces frightening situations,
0:34:41 > 0:34:43the less anxious they will become,
0:34:43 > 0:34:46and she does this by distracting him.
0:34:46 > 0:34:50Shall we have a go at some of our distraction techniques, then,
0:34:50 > 0:34:52- and see the effect?- Yeah, sure.- OK.
0:34:52 > 0:34:55- So you start us off on boys' names. - Adam...
0:34:55 > 0:34:58- Ben...- Charlie...
0:34:58 > 0:35:00David...
0:35:00 > 0:35:02HE BREATHES DEEPLY
0:35:02 > 0:35:05Er...Edward...
0:35:05 > 0:35:06Fred...
0:35:06 > 0:35:10As Wayne calms down, his anxiety begins to disappear.
0:35:10 > 0:35:15The theory is each time he does this, the less fearful he will be.
0:35:17 > 0:35:20- Where's your anxiety at now? - It's much better now.
0:35:20 > 0:35:22OK, well done, well done.
0:35:22 > 0:35:25- Thank you.- I think we were at a point of almost giving up then!
0:35:25 > 0:35:28- I was pretty close!- OK, we'll just loop round and then we'll go...
0:35:31 > 0:35:34'I've lived with anxiety for most of my life
0:35:34 > 0:35:37'and the rest of my life, I imagine I'll have anxiety
0:35:37 > 0:35:38'to a certain degree.'
0:35:38 > 0:35:41The key is just managing how bad it is.
0:35:41 > 0:35:45I need to make sure that it stays as quiet as possible
0:35:45 > 0:35:47and keep on doing my CBT, and, hopefully,
0:35:47 > 0:35:50you know, I won't have to think about it so much.
0:35:57 > 0:35:59Around 3% of young people in the UK
0:35:59 > 0:36:02will experience a one-off psychotic episode.
0:36:04 > 0:36:06But if these episodes persist,
0:36:06 > 0:36:12it can develop into the mental illness schizophrenia.
0:36:12 > 0:36:1527-year-old Ross is a musician.
0:36:15 > 0:36:18Five years ago, he was diagnosed with schizophrenia.
0:36:18 > 0:36:23'I believed that I could heal people just by staring at them,'
0:36:23 > 0:36:26or I believed I could hear aliens talking to me
0:36:26 > 0:36:29through the sound of the computer.
0:36:29 > 0:36:33One thing I used to believe was that my mum and dad
0:36:33 > 0:36:38were "energy vampires" and they were sucking energy out of me.
0:36:38 > 0:36:42Schizophrenia usually begins in the early 20s,
0:36:42 > 0:36:44and young men are most at risk.
0:36:44 > 0:36:47Ross was 21 when his symptoms began.
0:36:47 > 0:36:53He became withdrawn and confused, and started to experience psychosis.
0:36:53 > 0:36:57The key symptoms are things like hallucinations,
0:36:57 > 0:37:00most commonly hearing things that aren't there,
0:37:00 > 0:37:01things like hearing voices,
0:37:01 > 0:37:04sometimes seeing things that aren't there.
0:37:04 > 0:37:06And the other key symptom's delusions.
0:37:06 > 0:37:08So having unusual beliefs
0:37:08 > 0:37:12that, on closer examination, don't seem to be grounded in reality.
0:37:14 > 0:37:18This feeling of absolute power.
0:37:18 > 0:37:22I literally thought that I could change the universe.
0:37:24 > 0:37:28During one psychotic episode, Ross decided to paint his bedroom
0:37:28 > 0:37:30and filmed the whole process.
0:37:32 > 0:37:36It's like poo! Poo, I say!
0:37:38 > 0:37:40'Poo!'
0:37:40 > 0:37:42Poo...eurgh!
0:37:42 > 0:37:46You see, I still remember what I was thinking at the time.
0:37:46 > 0:37:49I was, like, "this is going to be great, this awesome piece of artwork
0:37:49 > 0:37:51'"that I can have on my wall for ever."'
0:37:51 > 0:37:57Look at it. No...no sense, no order, no rhyme, nor reason.
0:37:57 > 0:38:00But the reason why I was doing it, really,
0:38:00 > 0:38:02was cos I was a little bit weird, and odd,
0:38:02 > 0:38:05and under the influence of psychosis at the time.
0:38:10 > 0:38:14Scientists don't know for sure why people suffer psychosis,
0:38:14 > 0:38:17but believe certain chemicals in the brain could play a role.
0:38:17 > 0:38:20So we know that people who are experiencing psychotic symptoms
0:38:20 > 0:38:23and schizophrenia have disregulated dopamine,
0:38:23 > 0:38:26so their dopamine system becomes a bit out of control.
0:38:27 > 0:38:30Dopamine is one of the many chemicals
0:38:30 > 0:38:32that transfer messages in the brain.
0:38:32 > 0:38:36It passes from one nerve cell to another through tiny receptors
0:38:36 > 0:38:38at junctions called synapses.
0:38:38 > 0:38:42Dopamine is the brain's way of communicating what's important
0:38:42 > 0:38:45in the world, like food, sexual attraction,
0:38:45 > 0:38:49or that something scary or surprising has happened.
0:38:49 > 0:38:50In people with psychosis,
0:38:50 > 0:38:54it's thought the levels of dopamine in their brain are too high.
0:38:55 > 0:38:57This means that thoughts are distorted
0:38:57 > 0:39:00and could explain why they lose a grip on reality.
0:39:03 > 0:39:06I think people find seeing people with psychotic symptoms scary
0:39:06 > 0:39:08because it seems like a huge departure from
0:39:08 > 0:39:11what it is to normally be a human being.
0:39:11 > 0:39:13What people need to be made aware of
0:39:13 > 0:39:15is that in the vast majority of cases,
0:39:15 > 0:39:17these people aren't in any way dangerous.
0:39:17 > 0:39:21These people are just quite profoundly distressed.
0:39:21 > 0:39:24Thanks very much for listening to me. I'll see you again soon.
0:39:32 > 0:39:36Ross's psychotic behaviour had a huge impact on his family.
0:39:36 > 0:39:39You were mad. It was mad times.
0:39:39 > 0:39:40You lot were all so stressed out
0:39:40 > 0:39:43and getting wound up by everything I was doing.
0:39:43 > 0:39:46When you were very psychotic,
0:39:46 > 0:39:50you had this thing about sleeping rough, wherever.
0:39:50 > 0:39:56And you know, your son sleeping on the streets, begging,
0:39:56 > 0:39:58it was pretty scary,
0:39:58 > 0:40:01because I didn't know anything about mental health issues.
0:40:01 > 0:40:04I was learning quickly, I went on courses and stuff.
0:40:05 > 0:40:07His dad was so desperate to help his son,
0:40:07 > 0:40:11he recorded Ross's behaviour as evidence for the doctors.
0:40:12 > 0:40:14ROSS SCREAMS: No, no, no!
0:40:19 > 0:40:21I've listened to them a lot
0:40:21 > 0:40:25and it still makes the hairs on the back of my neck stand up sometimes.
0:40:25 > 0:40:30I mean, how do you feel when you see them back again?
0:40:30 > 0:40:32Scary, really. You just think, "God," you know,
0:40:32 > 0:40:34I'm capable of that kind of...
0:40:34 > 0:40:37Or that happened and I was the one doing it.
0:40:37 > 0:40:42It's sort of like, "Was I really like that?" You know.
0:40:42 > 0:40:45I mean, that was very scary as a parent.
0:40:52 > 0:40:55Ross was finally diagnosed with schizophrenia
0:40:55 > 0:40:57and sectioned under the Mental Health Act.
0:40:57 > 0:41:01He was put on medication, which he still takes today.
0:41:03 > 0:41:08Like all mental illness, the exact cause of schizophrenia is complex.
0:41:08 > 0:41:11The current risk factors for psychosis and schizophrenia
0:41:11 > 0:41:14that we know about are things like a family history,
0:41:14 > 0:41:16so whether one of your relatives has had it,
0:41:16 > 0:41:19and also your genetics,
0:41:19 > 0:41:20things like whether you've
0:41:20 > 0:41:23experienced something traumatic in your childhood
0:41:23 > 0:41:25or stressful life events generally,
0:41:25 > 0:41:27whether you've grown up in an urban environment,
0:41:27 > 0:41:30people who live in urban environments are more likely
0:41:30 > 0:41:32to develop psychosis and schizophrenia,
0:41:32 > 0:41:36and also things like ethnicity, and on top of that,
0:41:36 > 0:41:39and perhaps the most modifiable risk factor, is cannabis use.
0:41:42 > 0:41:45Ross enjoyed partying when he was younger,
0:41:45 > 0:41:48and started smoking cannabis when he was a teenager.
0:41:51 > 0:41:57He was a lot more of a character, I'd say, then you are kind of now.
0:41:57 > 0:41:59It was quite strange, though, as well, because
0:41:59 > 0:42:02I think it was obvious that something wasn't right.
0:42:02 > 0:42:04I think a lot of people were trying to kind of,
0:42:04 > 0:42:09"Look, this isn't right," and try and make you get help and stuff.
0:42:09 > 0:42:11What do you think caused your psychosis?
0:42:13 > 0:42:16I reckon it was probably a combination of
0:42:16 > 0:42:22generally feeling insecure about myself and my identity,
0:42:22 > 0:42:24and then, oh, yeah, stress at uni,
0:42:24 > 0:42:28and smoking weed when I was just a little bit too young,
0:42:28 > 0:42:30so when I was about 14 or 15.
0:42:30 > 0:42:33So it just kind of all added together, really,
0:42:33 > 0:42:36the weed and stress and all these things just going round in my head.
0:42:39 > 0:42:44The exact link between cannabis and schizophrenia is still unclear
0:42:44 > 0:42:47but ground-breaking research at University College London
0:42:47 > 0:42:51suggests that some long-term users are more at risk.
0:42:51 > 0:42:5424-year-old Jonathan is one of the volunteers taking part
0:42:54 > 0:42:57in an experiment to see how cannabis affects the brain.
0:43:02 > 0:43:04- Hi there.- Hi, Jonathan.
0:43:05 > 0:43:08As part of the study, Celia Morgan is giving Jonathan
0:43:08 > 0:43:12pure delta-9-tetrahydrocannabinol, or THC.
0:43:12 > 0:43:16A relatively deep breath, and then I'm going to time you holding it...
0:43:16 > 0:43:18It's the most powerful ingredient in cannabis and causes
0:43:18 > 0:43:21many of the feelings people experience when they're stoned.
0:43:21 > 0:43:23So just take the kind of breath
0:43:23 > 0:43:25- you'd feel comfortable holding in for ten seconds.- Yeah.
0:43:25 > 0:43:28In the experiment today, we're giving people THC
0:43:28 > 0:43:30to see how it affects the brain,
0:43:30 > 0:43:33and how this might be related to psychosis.
0:43:33 > 0:43:36So whenever you're ready, at your own speed.
0:43:36 > 0:43:39Jonathan inhales the THC through a vaporiser.
0:43:42 > 0:43:46One, two, three...
0:43:51 > 0:43:54Just as it does when smoked in a joint,
0:43:54 > 0:43:58the THC travels to his lungs and is absorbed into his bloodstream.
0:44:05 > 0:44:08Within seconds, it has entered his brain...
0:44:11 > 0:44:14..attaches itself to receptors,
0:44:14 > 0:44:19and disrupts the flow of brain chemicals like dopamine.
0:44:19 > 0:44:20This could be why smoking weed
0:44:20 > 0:44:23alters the way we perceive the world.
0:44:25 > 0:44:29Eight, nine, ten.
0:44:29 > 0:44:34Around one in ten cannabis users will experience hallucinations,
0:44:34 > 0:44:36anxiety and paranoia.
0:44:36 > 0:44:39Do you want to have a seat? We'll just wait for it to take effect now.
0:44:39 > 0:44:42- Mm-hm.- And, um...
0:44:42 > 0:44:46- Feeling OK?- Yeah. Like, actually, I can't remember being this stoned
0:44:46 > 0:44:50- for as far back as I can remember. - Really?- Yeah.
0:44:50 > 0:44:54Celia wants to see if the THC is affecting Jonathan's mood
0:44:54 > 0:44:58and looks for signs of psychotic symptoms.
0:44:58 > 0:45:01Do things look different to you? Things in the world at all?
0:45:01 > 0:45:04Colours are more vibrant. Bit more sensitive to light.
0:45:04 > 0:45:07Do you feel that you're getting kind of insights?
0:45:07 > 0:45:11Yeah, just a feeling of presence and a sense of...
0:45:11 > 0:45:15them being here now, or...
0:45:16 > 0:45:18And that's meaning in itself.
0:45:18 > 0:45:20'So what we saw in today's experiment
0:45:20 > 0:45:24'were mild delusional thinking, what we call magical thinking,
0:45:24 > 0:45:27'and some thought disorder, so some kind of confused thinking,
0:45:27 > 0:45:30'inability to keep track of his thoughts.'
0:45:30 > 0:45:31So these are the symptoms
0:45:31 > 0:45:35people might get in the very early stages of developing psychosis.
0:45:38 > 0:45:42Celia and her team think that when THC enters the brain,
0:45:42 > 0:45:46it could also be bombarding receptors in the prefrontal cortex,
0:45:46 > 0:45:49the part of the brain which controls thoughts and behaviour.
0:45:51 > 0:45:55Here, it blocks the brain chemical anandamide, a neurotransmitter
0:45:55 > 0:45:59which controls the flow of brain chemicals like dopamine.
0:46:00 > 0:46:03With less anandamide keeping the brain in balance,
0:46:03 > 0:46:06massive levels of dopamine are released,
0:46:06 > 0:46:10and could explain the psychotic-like symptoms Jonathan is experiencing.
0:46:14 > 0:46:17But not everyone develops psychosis from getting high.
0:46:19 > 0:46:21'The majority of people who smoke cannabis
0:46:21 > 0:46:24'will do so without experiencing any long-term harm.'
0:46:24 > 0:46:27Even those who become a bit psychotic when they're stoned
0:46:27 > 0:46:29will just revert back to normal.
0:46:29 > 0:46:32A minority of people, particularly those who are vulnerable
0:46:32 > 0:46:35because of things like family history, might go on to develop it.
0:46:35 > 0:46:39Estimates are about 2 in every 100 people who smoke cannabis.
0:46:42 > 0:46:46And if you smoke under the age of 15, your odds go up even more.
0:46:48 > 0:46:51Scientists have also recently discovered
0:46:51 > 0:46:53a variation in the gene AKT1
0:46:53 > 0:46:57and people who carry this have up to seven times the risk
0:46:57 > 0:46:59if they smoke daily.
0:47:01 > 0:47:03And people who smoke skunk,
0:47:03 > 0:47:06which can contain five times as much THC as ordinary cannabis,
0:47:06 > 0:47:08are far more at risk.
0:47:14 > 0:47:16What we've shown in our research is
0:47:16 > 0:47:20that long-term heavy smoking of THC changes the levels of anandamide
0:47:20 > 0:47:25and this might change your brain's ability to regulate other chemicals
0:47:25 > 0:47:28in the long term, which might enhance your risk of psychosis
0:47:28 > 0:47:30if you are already vulnerable to it.
0:47:31 > 0:47:35Ross will never know for certain what caused his schizophrenia,
0:47:35 > 0:47:38but today he is fighting his illness
0:47:38 > 0:47:41and slowly weaning himself off his medication.
0:47:41 > 0:47:45'Really, I just want to see myself as a normal person,
0:47:45 > 0:47:48'and yes, I've had this past history of problems,
0:47:48 > 0:47:50'but I want to really move away from that.'
0:47:50 > 0:47:54Just because I've had this label attached to me
0:47:54 > 0:47:57of schizophrenia and depression, blah blah,
0:47:57 > 0:48:01that doesn't make me less of a human being, you know?
0:48:08 > 0:48:12Historically, there has always been a stigma attached to mental illness.
0:48:12 > 0:48:15- FILM:- 'Like many young and intelligent mental patients,
0:48:15 > 0:48:18'this girl doesn't mind us filming her at all.'
0:48:18 > 0:48:22During the 1950s, it was a big step to visit a psychiatrist.
0:48:22 > 0:48:24'She is asked what her symptoms are.
0:48:24 > 0:48:28'Depression, anxiety, or something more serious like hallucinations?'
0:48:28 > 0:48:32Usually, the only option for people with anxiety or depression
0:48:32 > 0:48:34was mind-numbing tranquillisers.
0:48:36 > 0:48:37Then, in the '70s,
0:48:37 > 0:48:40scientists discovered the benefits of a new drug
0:48:40 > 0:48:45originally invented to treat high blood pressure and obesity.
0:48:45 > 0:48:47When it was given to mild depressives,
0:48:47 > 0:48:50they showed a remarkable improvement.
0:48:50 > 0:48:55MUSIC: "Summer Breeze" by The Isley Brothers
0:48:55 > 0:48:58In the '80s, that drug was then marketed as Prozac.
0:48:58 > 0:49:02Hailed as a miracle cure for depression,
0:49:02 > 0:49:06it became the most highly sold antidepressant in history.
0:49:06 > 0:49:10Prozac also paved the way for a completely new wave of drugs,
0:49:10 > 0:49:14selective serotonin re-uptake inhibitors, or SSRIs.
0:49:17 > 0:49:20Serotonin is the body's feel-good chemical.
0:49:20 > 0:49:24It helps us regulate our moods and emotions and makes us feel happier,
0:49:24 > 0:49:26but it is thought in people suffering depression,
0:49:26 > 0:49:29their serotonin levels may be too low.
0:49:29 > 0:49:32When this chemical is released across synapses,
0:49:32 > 0:49:35it is usually re-absorbed to be used again.
0:49:36 > 0:49:39But SSRIs block this absorption,
0:49:39 > 0:49:42which allows more of the chemical to infiltrate the brain.
0:49:45 > 0:49:48Depression strikes 2% of young people,
0:49:48 > 0:49:52but for some, this can be one extreme of another mental illness
0:49:52 > 0:49:54called bipolar affective disorder.
0:49:57 > 0:49:5918-year-old Zemzem lives in London
0:49:59 > 0:50:02and is studying psychology at college.
0:50:02 > 0:50:05One year ago, she was diagnosed with bipolar,
0:50:05 > 0:50:07which affects 1% of people in the UK.
0:50:10 > 0:50:13I think I'm just a normal person, really.
0:50:13 > 0:50:15I don't think I'm different to anyone else,
0:50:15 > 0:50:18apart from the fact that I am bipolar,
0:50:18 > 0:50:22which, to me, I don't think is a major thing.
0:50:22 > 0:50:25It's just like introducing your name to me.
0:50:25 > 0:50:27Well, yeah, I think I'm pretty normal.
0:50:29 > 0:50:32This illness used to be called manic depression,
0:50:32 > 0:50:34and people with it suffer extreme moods.
0:50:36 > 0:50:40We all have changes in our moods, usually in response to life events,
0:50:40 > 0:50:43so, for example, if you have a bereavement,
0:50:43 > 0:50:46you feel sad for a few weeks or months,
0:50:46 > 0:50:49if something good happens, then you feel happy.
0:50:49 > 0:50:51The difference with bipolar is that
0:50:51 > 0:50:55the changes in mood happen over a longer period
0:50:55 > 0:50:58and they don't happen in response to life events.
0:50:58 > 0:51:01They seem to take a life of their own,
0:51:01 > 0:51:05so you have several months of feeling very depressed,
0:51:05 > 0:51:09and then several months of feeling manic, or very elated.
0:51:11 > 0:51:14Bipolar often strikes in your teens.
0:51:14 > 0:51:17Zemzem was at college when she first became ill.
0:51:20 > 0:51:25I was really stressed out. I had UCAS that needed to be handed in.
0:51:25 > 0:51:30I had, like, troubles with my friends and family, and stuff like that,
0:51:30 > 0:51:32and all of it just mounted into one.
0:51:32 > 0:51:34And I had so many deadlines to do.
0:51:34 > 0:51:39I had a drama play that I had to perform in front of my whole class.
0:51:39 > 0:51:42And all of that pressure just mounted up and just got bigger
0:51:42 > 0:51:44and bigger and bigger and bigger.
0:51:51 > 0:51:54Manic episodes can be similar to psychosis
0:51:54 > 0:51:56when you lose contact with reality.
0:51:56 > 0:51:59The day of my episode, I left my house
0:51:59 > 0:52:02and I walked towards this train station
0:52:02 > 0:52:05and it was just a really weird feeling.
0:52:05 > 0:52:08Everyone's voices and everything I could hear was just escalated
0:52:08 > 0:52:10and it was really, really loud.
0:52:10 > 0:52:12I kept getting off the train
0:52:12 > 0:52:16and getting on the train again and getting off the train. That's when...
0:52:16 > 0:52:19I think the high started to hit me. Little things would just bug me,
0:52:19 > 0:52:21like the train announcement and stuff like that,
0:52:21 > 0:52:27and then I ended up going to a random station and just asking for help.
0:52:29 > 0:52:33Zemzem was admitted to hospital, and three months later, aged 17,
0:52:33 > 0:52:36she was diagnosed with bipolar affective disorder.
0:52:37 > 0:52:40We don't fully understand why it is
0:52:40 > 0:52:44that the onset of bipolar tends to be around the adolescent years.
0:52:44 > 0:52:45One thing that we do know is that
0:52:45 > 0:52:49around the sort of late teens and early 20s,
0:52:49 > 0:52:53people generally are going through a lot of stressful experiences.
0:52:53 > 0:52:57The other thing is that the brain is still developing
0:52:57 > 0:52:59and the final stages of brain maturation
0:52:59 > 0:53:02don't occur until the early 20s.
0:53:03 > 0:53:07During adolescence, millions of connections between brain cells
0:53:07 > 0:53:09are fine-tuned to sharpen brain function.
0:53:11 > 0:53:14And it's during this complex process
0:53:14 > 0:53:16that many mental illnesses can kick in.
0:53:18 > 0:53:20Hi!
0:53:22 > 0:53:23This one's cute.
0:53:24 > 0:53:27Today, Zemzem is out shopping with her mate Myra,
0:53:27 > 0:53:30who's often helped her through the bad times.
0:53:30 > 0:53:32Such a fun-loving girl.
0:53:32 > 0:53:35It's a shame to see her when she's sad.
0:53:35 > 0:53:39What are the kind of things that trigger your condition?
0:53:39 > 0:53:40What makes you tick?
0:53:40 > 0:53:45Not sleeping properly, eating properly, that triggers it most
0:53:45 > 0:53:47because then I get into a spiral,
0:53:47 > 0:53:50everything will start piling up and piling up and piling up,
0:53:50 > 0:53:55and any sort of problem I'd have, I'd think, "This problem is because XYZ,"
0:53:55 > 0:53:57and it won't be related to that, do you know what I mean?
0:53:57 > 0:54:00To keep myself happy and calm, I need to stay away from stress
0:54:00 > 0:54:02and stressful people or stressful situations.
0:54:02 > 0:54:05Very positive female. Well done!
0:54:07 > 0:54:11One of the biggest risks for developing bipolar is genetic.
0:54:12 > 0:54:15The risk in the general population is about 1%,
0:54:15 > 0:54:18but if your first-degree relative,
0:54:18 > 0:54:22that means either your mother or father or your brother or sister,
0:54:22 > 0:54:26has bipolar disorder, then that risk goes up to about 10%.
0:54:27 > 0:54:30So while some of us might be hard-wired to become bipolar,
0:54:30 > 0:54:33the critical genes first have to be switched on,
0:54:33 > 0:54:37usually by stress or a traumatic event.
0:54:37 > 0:54:41But Zemzem's mental illness does have a positive side to it.
0:54:41 > 0:54:45To help her cope, she's begun writing poetry.
0:54:45 > 0:54:47In the town where the queen wears a crown,
0:54:47 > 0:54:49There are children crawling the streets
0:54:49 > 0:54:51Hunger pumping through their veins,
0:54:51 > 0:54:53Their eyes bloodshotted with pain
0:54:53 > 0:54:55Scribbling verses, trying to get some fame
0:54:55 > 0:54:57Cos you know the game is a tough one to play.
0:54:57 > 0:54:58I think it's quite useful for me
0:54:58 > 0:55:03because that's when my creative juices are flowing a bit more.
0:55:03 > 0:55:05If I'm angry, if I'm upset, I can just put pen to paper
0:55:05 > 0:55:09and I think that's quite helpful, especially for other people as well,
0:55:09 > 0:55:12just to, like, understand where I'm coming from as a person.
0:55:15 > 0:55:18Creativity has always been associated with mental illness.
0:55:20 > 0:55:24Van Gogh, Virginia Woolf, Stephen Fry and others
0:55:24 > 0:55:27have suffered from bipolar and other mental disorders,
0:55:27 > 0:55:31but finding a scientific link has been tricky until recently,
0:55:31 > 0:55:34when two studies showed there could be a connection.
0:55:34 > 0:55:38Recently, there has been some evidence emerging that showed
0:55:38 > 0:55:41that people with bipolar disorder,
0:55:41 > 0:55:43and also, interestingly, their relatives,
0:55:43 > 0:55:48were more likely to hold creative occupations.
0:55:48 > 0:55:50When people are manic,
0:55:50 > 0:55:54they often make very intuitive leaps of imagination,
0:55:54 > 0:55:56linking new ideas together.
0:55:56 > 0:55:59It may be that a little bit of mania
0:55:59 > 0:56:03might actually be quite good for creativity.
0:56:04 > 0:56:07Zemzem has taken the drug lithium to help stabilise her moods
0:56:07 > 0:56:11and accepted her mental illness as part of her life.
0:56:11 > 0:56:14I don't think bipolar affects me that much any more,
0:56:14 > 0:56:16so I don't dwell on it as much as I used to.
0:56:16 > 0:56:19I'm just taking the positive out of it rather than the negative.
0:56:19 > 0:56:22I'll be like, "Yeah, I'll get through this, just..."
0:56:24 > 0:56:25I think I'm a lot funnier now.
0:56:25 > 0:56:27SHE LAUGHS
0:56:27 > 0:56:29I try to be, anyway!
0:56:34 > 0:56:35Over the last decade,
0:56:35 > 0:56:40the understanding of mental health has been transformed by science.
0:56:40 > 0:56:45Genetics, understanding the role the brain plays,
0:56:45 > 0:56:47and psychological treatments
0:56:47 > 0:56:49are making huge leaps forward.
0:56:49 > 0:56:52Together, these advances could help change the lives
0:56:52 > 0:56:56of millions of young people who suffer from mental illness.
0:56:56 > 0:56:59MUSIC: "People Help The People" by Birdy
0:56:59 > 0:57:01# People help the people
0:57:01 > 0:57:07# And if you're homesick, Give me your hand and I'll hold it
0:57:09 > 0:57:14# People help the people
0:57:14 > 0:57:17# And nothing will drag you down
0:57:17 > 0:57:21# Oh, and if I had to break
0:57:21 > 0:57:24# Oh, and if I had to break... #
0:57:24 > 0:57:27Subtitles by Red Bee Media Ltd