Behavioural Problems in Huntingtons Disease
by Dr Julie S Snowden
The following article by Dr Julie S Snowden has been
taken from Issue 50 - Winter 1996 edition of the Huntingtons Disease Association
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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. Patients 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).
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.