We spoke to Professor Hugh Rickards, a Neuropsychiatrist, about the brain, symptoms and Huntington's disease.

Professor Hugh Rickards is Chair of the Huntington's Disease Association and a Neuropsychiatrist who specialises in those affected by Huntington's disease. We asked the community if they had any questions for a Neuropsychiatrist and Hugh has kindly answered them for us.

What does a Neuropsychiatrist do?

"A neuropsychiatrist is a doctor who specialises in conditions that have both neurological and psychiatric symptoms. Huntington's disease is a good example of that."

What's the easiest way to explain how Huntington's disease affects the brain?

"People with Huntington's disease make a protein in their brain cells which gets in the way of them (the cells) doing their normal jobs."

What are the main symptoms of Huntington's disease and how do they affect the way I think?

"The main symptoms are problems with thinking, planning and understanding.  There can also be problems with other areas like balance, coordination and speaking."

How does Huntington's disease affect mood, behaviour and personality over time?

"Often people with Huntington's disease find it difficult to plan for future scenarios and to weigh up multiple bits of information at the same time.  They can also find it hard to read other people's emotions."

How do I know what are symptoms of depression and anxiety or what are symptoms of Huntington's disease?

"If you're getting low mood with lack of enjoyment of all everyday things lasting for more than a couple of weeks then that's likely to be depression. Sometimes people with Huntington's disease can look depressed because they don't seem to be doing much but it's possible that some people with Huntington's can do very little and be content."

How does Huntington's disease impact memory?

"Memory for things that have happened in the past is normally reasonable in people with Huntington's disease. Working memory  (keeping something in your head for a minute while you do something else) can often be a problem."

What strategies can be employed to help patients with cognitive decline?

"There are lots of good strategies for helping people with cognitive decline. Sometimes other people or devices can be brought in to get over the practical problems. Certain things, like physical activity, probably slow cognitive decline."

How do you support patients who are experiencing hallucinations or delusions due to Huntington's disease?

"Dealing with hallucinations and delusions can be tricky. The most important thing is to get the diagnosis right as hallucinations can have a number of causes. Medicines can be useful.  hallenging the hallucinations is not always helpful but that depends on the individual situation."

Can Huntington's disease lead to conditions like obsessive-compulsive disorder?

"Sometimes Huntington's can lead to OCD. However, perseveration is something like OCD which is much more common. This means people getting stuck in an idea or an action. OCD is a little bit different in that people can often have the feeling that a catastrophe will occur if they don't check or repeat something. Perseveration (common in Huntington's) is not accompanied by that feeling about a catastrophe happening."

What advice do you have for managing stress for both the patient and their caregivers, given the emotional and psychological toll of Huntington's?

"There are lots of techniques for managing stress.  Getting good information and understanding of how the illness affects personality and relationships is a very good antidote to stress.  If you've got a really good understanding of the disease, then it's easier to develop good coping strategies.  My other advice for coping with stress is sharing the burden with others if that's possible."

Thank you so much to Hugh for answering those questions for us.