Talking Therapies, what are they?

Talking therapies can help you work out how to deal with negative thoughts and feelings and make positive changes. 

They can help people who are feeling distressed by difficult events in their lives as well as people with a mental health problem. 

This information is for anyone who wants to know more about different types of talking therapy or hear the experiences of people who have used them. It advises how to find a therapist who is right for you and suggests where to look for more information. 

The information mainly uses the words 'talking therapy' and 'therapist', although the words that other people use may be different.

 Talking about your thoughts and feelings can help you deal with times when you feel troubled about something. If you turn a worry over and over in your mind, the worry can grow.
But talking about it can help you work out what is really bothering you and explore what you could do about it.
Talking is an important part of our relationships. It can strengthen your ties with other people and help you stay in good mental health. And being listened to helps you feel that other people care about you and what you have to say. 

What are talking therapies?

We often find it helpful to talk problems through with a friend or family member, but sometimes friends and family cannot help us and we need to talk to a professional therapist. 

Talking therapies involve talking to someone who is trained to help you deal with your negative feelings. They can help anyone who is experiencing distress. You do not have to be told by a doctor that you have a mental health problem to be offered or benefit from a talking therapy. 

Talking therapies give people the chance to explore their thoughts and feelings and the effect they have on their behaviour and mood. Describing what’s going on in your head and how that makes you feel can help you notice any patterns which it may be helpful to change. 

It can help you work out where your negative feelings and ideas come from and why they are there.
Understanding all this can help people make positive changes by thinking or acting differently. 

Talking therapies can help people to take greater control of their lives and improve their confidence.
Talking therapies may also be referred to as:

• talking treatments
• counselling
• psychological therapies or treatments
• psychotherapies

The various terms used to describe talking therapies often mean different things to different people.
Some people use them to describe the level of training of the professional delivering the therapy. But sometimes there is no link between a therapist’s training and the name of the therapy they offer.

What kinds of talking therapy are there?

Different talking therapies are called a confusing mix of names and some therapies have several names. Don’t let the jargon put you off! Behind every technical term is a way of working with people that is designed to help. 

Therapies are usually divided into several broad types. But even therapists who offer the same kind of therapy will have a slightly different way of working from each other because all therapists have a personal style as well. 

Some therapists train in more than one kind of therapy. They may decide to combine a few approaches if that will help you best. 

The National Institute for Health and Clinical Excellence (NICE)  recommends certain therapies for certain problems, but other therapies might work for you just as well.

• Cognitive behavioural therapies (CBT)
• Dialectic behaviour therapy (DBT)
• Psychodynamic therapies
• Humanistic therapies
• Other kinds of talking therapy
• Support and information

Cognitive behavioural therapies (CBT)

How do they work?
By looking at how we can react differently to our thoughts and feelings (for example, challenging negative thoughts) and how changing the way we behave can help us feel better (for example trying new activities). 

What are they based on?
They are based on scientific methods. 

What form do they take?
Sessions are clearly structured. The therapist directs the conversation. They are focused on current problems and practical solutions.
 
How long do they take?
Treatment is usually short-term and for a set length of time (between six and 24 one-hour sessions).
 

What are they helpful for?
A range of problems including depression, anxiety, obsessive compulsive disorder, managing long-term illnesses, eating disorders, post-traumatic stress and schizophrenia. NICE recommends CBT for all these.
 
Who will they suit?
People who want a therapy that works towards solutions, with clear goals and using practical techniques.

What are some of the variations?
Cognitive therapy, behaviour therapy, cognitive behavioural therapy, rational emotive behaviour therapy.
"CBT was amazing – it was so simple. My diagnosis is bi-polar disorder and I had very low self-esteem and lack of confidence in my future. I had about 15 sessions over a year. The psychologist showed me how to notice what I was thinking and then how I felt afterwards, and to realise you can choose your own thoughts. I thought they were just random thoughts there to make my life a misery. But I learnt that at any time I could stop and say: 'Why am I thinking that?'"
"I had a CBT therapist but I think she probably used lots of different things - in fact it didn’t feel like she was 'using' anything - it felt like a natural process rather than anything very medical or clinical."

Dialectic behaviour therapy (DBT)

DBT combines some of the methods of CBT with meditation techniques. It involves individual therapy and group therapy. NICE recommends DBT for persistent binge eating disorder and people with personality disorders who self-harm.

Psychodynamic therapies

How do they work?
By exploring how your personality and early life experiences influence your current thoughts, feelings, relationships and behaviour. Once you have this extra understanding, you can practise more helpful ways of dealing with difficult situations. 

What are they based on?
Originally the ideas of the neurologist and psychotherapist Sigmund Freud, with many changes over the last 100 years.
 
What form do they take?
The therapist works with you to understand your thoughts, feelings, relationships, behaviour, dreams and fantasies.
 
How long do they take?
Usually between several months and several years, although shorter-term versions are available.
 
Where are they practised?
Often privately, and in some charities. They are available on the NHS in some areas.
 
What are they helpful for?
Depression, anxiety, post-traumatic stress, long-term physical health problems, eating disorders and addictions. NICE recommends psychodynamic therapy for people experiencing depression alongside other complex illnesses.
 
Who will they suit?
People interested in self-exploration who are willing to devote lots of time and energy to it.
 
What are some of the variations?
Psychoanalysis, psychoanalytic psychotherapy, psychodynamic psychotherapy, analytical psychology, Jungian or Freudian analysis, focal psychodynamic therapy (NICE recommends this for treating anorexia nervosa). 

"I was quite severely depressed as a teenager. I tried various antidepressants and some CBT-based stuff, but nothing was helping. Finally, my GP suggested that I try psychotherapy at my local mental health unit. 

"At first I was sceptical. I couldn’t see how sitting in a room with a stranger was going to help. I was quite a nightmare, trying to prove to my therapist and myself that the therapy would fail. But with psychodynamic therapy, the therapist is prepared to sit and wait out that part with you. She started helping me link the way I was thinking, feeling and behaving to what might have gone on when I was younger and that really made sense."

Humanistic therapies

How do they work?
By taking a whole-person approach to your problem, using a range of theories and practices to help you develop. 

Where did they come from?
They were developed to offer an alternative to psychodynamic and behavioural therapies, focused on developing your full potential.
 
What form do they take?
These therapies explore your relationship with different parts of yourself (such as your body, mind, emotions, behaviour and spirituality) and other people (for example family, friends, society or culture) and support you to grow and live life to the full.
 
How long do they take?
Therapy can be short or long-term depending on the issues you need to cover, but usually at least several months.
 
Where are they practised?
Therapists working for the NHS or charities and private therapists offer these therapies.
 
What are they helpful for?
Humanistic therapies tend to treat specific problems – such as depression, anxiety or addiction - as chances for you to develop and grow. Therapists work with any issue causing difficulties in your life.
 
Who will they suit?
They will suit people interested in exploring their lives and looking at their problems from a wide range of angles.
 
What are some of the variations?
Person-centred counselling (NICE recommends this for children and young people with mild depression and sometimes for people with schizophrenia), transpersonal psychology, body psychotherapy, gestalt therapy, psychosynthesis, integrative psychotherapy, existential psychotherapy, transactional analysis, psychodrama and personal construct therapy. 

"I was referred to a unit that deals with people who turn to alcohol because of psychological problems. I was in a state of constant panic and had been drinking to keep those feelings at bay. There wasn’t a set formula to the sessions. We’d just go and get a cup of coffee and I’d talk about what was bothering me. With person-centred counselling the therapist steers you through finding out more about yourself and developing confidence."

Other kinds of talking therapy

Group therapies
In groups led by a facilitator (someone who helps to introduce members of the group to each other and who helps the conversation to flow), people find solutions together and learn from each other. NICE recommends group therapy for people with obsessive compulsive disorder and for children and young people with mild depression.

"In group therapy you don’t just talk about yourself, you’re listening to other people - that takes the burden off your problems. You realise you’re not the only one."
 
Couples, relationship or family therapies
Couples or families work with a therapist to sort out difficulties in their relationships. NICE recommends family therapy for anorexia nervosa, depression in children and families of people with schizophrenia. NICE recommends 'couples therapy' if partners have tried individual therapy and this has not helped.
 
Interpersonal therapy
This explores how to link mood with the way you relate to the people close to you. NICE recommends this for people with eating disorders and various forms of depression.

Mindfulness-based therapies
A therapy that combines talking therapies with meditation. It helps people reduce stress, switch off from difficult thoughts and feelings and make changes. NICE recommends this treatment to prevent people who have had depression from experiencing the same problems again. Other versions of this treatment include mindfulness based stress reduction and mindfulness-based cognitive therapy. See our Be Mindful website for more information.
 
Eye movement desensitisation and reprocessing (EMDR)
A way of stimulating the brain through eye movements which seems to make distressing memories feel less intense. It is used for a range of traumas, including past sexual, physical or emotional abuse, accidents and injuries, phobias, addictions and fear of performing in public. NICE recommends for post-traumatic stress disorder.
 
Life coaching This uses empowering, motivational methods to help you reach goals or make changes.
 
Arts therapies
These therapies encourage you to express how you feel through art (painting, drawing, music, theatre or dance). Art can help you work out how to tackle difficulties, release emotions and understand yourself better.
 
Telephone counselling
This offers an easy way of talking to a therapist if you do not want to meet a face-to-face counsellor or if you can’t find one. It is sometimes provided by employers and charities. Online or e-mail counselling is another option.
 
Computerised cognitive behavioural therapy
No talking required! You work through a series of exercises on your computer screen and learn self-help techniques for managing problems in your life. NICE recommends 'Beating the Blues' for mild to moderate depression, and 'FearFighter' for panic and phobia.
 
Bibliotherapy
Health professionals 'prescribe' self-help books which you can borrow from your local library. They will usually offer you these alongside other treatment. NICE recommend these for anxiety and obsessive compulsive disorder, and sometimes for depression.

What is it like to have a talking therapy and when can it be helpful?

The length of a therapy varies depending on what type it is and on your individual needs. Some people have just a few sessions. Other people see a therapist a few times a week for several years.
A course of CBT, for instance, is usually between six and 24 sessions, with each session following a structured agenda. 

In contrast, a client receiving counselling is encouraged to talk freely and the course of therapy may be extended depending on the client's progress.
Talking therapies are not therapies that are 'done' to you by someone else. You play an active part in the therapy. That can be empowering at a time when you may feel you have lost control over part of your life.
If you are determined to get the most from the therapy, it is more likely to work.
Talking therapies require you to be completely honest with yourself and that can be difficult. It may mean facing up to your fears, recalling distressing memories or talking about intimate topics and private thoughts and feelings.
There may be tasks to do between sessions, such as trying out new ways of behaving or keeping a diary. It may be a while until you feel the results, but you get out what you put in.

When can talking therapies be helpful?

Talking therapies can be helpful in many different situations.
They can help people with depression, anxiety, eating disorders or addictions and are often used alongside drugs your doctor prescribes.
They can also help people with problems such as schizophrenia or bi-polar disorder.
Talking therapies can also help people deal with difficult life events such as bereavement, relationship issues, problems at work or physical illness.
They can help people with a long-term physical condition, such as diabetes, who are at high risk of depression. Talking therapies can help them manage their condition more effectively and reduce its burden on them and their family.
A very wide range of people can benefit from talking therapies, but no one type of therapy works for everyone. Different kinds of therapy work well for different people.
  
"What I found really good was being able to talk about what was happening and have someone who was listening - she was really good at giving me space, listening to what had happened and discussing what might have caused it - not in a deep way but trying to help me piece the whole picture together."
 
A good therapist concentrates on you – what you think is important in your life, what you want to achieve, what steps you could take to get there. They shouldn’t tell you what to do. Your therapist may be highly trained and very experienced, but you are the expert on you. 

It's worth taking time to build a trusting relationship with your therapist. Remember therapy is a two-way process. If you have any questions, ask them. If you are worried that you could become dependent on them, say so. A good therapist will help you deal with your worries and work out how you will manage when the therapy comes to an end. 

- by Mental Health Foundation
source: http://www.mentalhealth.org.uk/help-information/mental-health-a-z/T/talking-therapies/

Depression... Does it hide among us?

You may know someone who is depressed and not know they’re depressed. People expect someone who is depressed to cry a lot, stay in bed all day, mope, or sound like Eeyore from Winnie the Pooh. But depression isn’t always this obvious.
 
Some people can totally fake it. They can smile and laugh; they can act like everyone else, even while they are in excruciating emotional pain inside. Occasionally people who can do this end up killing themselves, and no one can believe it. People who can act like they’re not depressed may not confide in anyone. Usually they find a way to spend time alone crying or letting down the facade and then go back to acting when they have to be with people. I’ve had clients who lived with their families and only found time to cry after everyone went to sleep, and only in the bathroom. The rest of the time they were acting like someone who wasn’t in pain. On top of the pain they already feel, acting happy is emotionally exhausting, and having this secret is isolating. So, faking it can even increase the depression.

Others funnel their pain into anger and people see them rage, abuse, shame, or react with annoyance or irritation to whatever happens around them. They may or may not themselves know they’re depressed, but others often don’t guess how much devastating emotional pain they are in. People may fear them, despise them, or dismiss them as mean. It is very difficult to feel sympathy for someone who is hurting people, and it is difficult to see their vulnerability, so their depression goes unnoticed.

Still others are addicted to something, and the depression is obscured by the addiction. People with addictions spend most of their time and energy relating to the addiction. They plan to do it, anticipate doing it—these phases excite them and elevate their mood temporarily. Then they use whatever they are addicted to and it boosts their mood. But then the thrill wears off, and they are depleted by the effects of the addiction and may also feel remorse or shame, so the depression descends on them, pulling them down like a cement jacket. They begin the cycle again to try to feel better—plan and anticipate…. Their whole life is about running from depression, but it becomes centered around the more dramatic force of addiction, and the depression can be unrecognized.

 I am not saying that all addicts are driven by depression—depression can also be caused by addiction. But addiction can be a form depression takes that is not easy to identify as depression. I include eating disorders in this category. I also include people who work most of their waking hours.

Depression isolates people. Whether they are hiding from the world in bed, preoccupied with an addiction, pushing people away with anger, or keeping their real thoughts and feelings inside while pretending to be okay, people with depression usually feel very alone. 

Depression also has a built-in isolating fog quality that makes it very difficult to feel connected to people. Even when people feel safe to express exactly how they feel, it is very difficult for people who haven’t experienced a deep depression to understand how that feels. 

How can anyone who hasn’t experienced it understand a pain that is as intense as any open-heart surgery without anesthesia, with no cuts or bruises to show? How can anyone who hasn’t experienced it understand the complexity of pain that is not only unbearably intense itself but also complicated by many painful factors like the stigma of mental illness and the confusion of the fact that unlike other illnesses, depression causes behavior changes. People attribute behavior to the moral character of the person, rather than to the illness.

The pain is also complicated by the fact that depression attacks a person’s thoughts and feelings, rather than liver or lungs. Depression can cause a person to think she hates herself or is unhappy in her relationships. It can cause someone to believe everyone would be better off without him, or even that others would be better off dead. It can cause people to feel sad, angry, guilty, numb, or rageful, even when none of this is how they feel when they aren’t depressed.

So what can you do to help people you love who are depressed, if you can’t tell they’re depressed? Ask questions very kindly and listen to the answers very carefully. Empathize with their emotional pain—even if you have to guess at what it might be. Let them know you are there to listen and understand for as long as it takes, and you aren’t taking no for an answer. Of course if you aren’t trustworthy—if you judge them, or talk to others about what they tell you, or interrupt, get impatient, or misunderstand them, then it is better for them to talk to someone who can really listen without any of this. Being a reliable, trustworthy, patient, nonjudgmental listener is the best thing you can do in most cases with someone who is depressed.

A couple of caveats: I am talking about adults—children and teens require some variations. Also, addictions cloud the picture of depression and require their own, very different intervention. Nonjudgmental listening is still essential but may need to be combined with some firm boundary-setting and professional treatment for the addiction.

Source: http://www.goodtherapy.org/blog/depression-hidden-symptoms-addiction-0814124

The Benefits Of Massage

What exactly are the benefits of receiving massage or bodywork treatments? Useful for all of the conditions listed below and more, massage can:

• Alleviate low-back pain and improve range of motion.
• Assist with shorter, easier labor for expectant mothers and shorten maternity hospital stays.
• Ease medication dependence.
• Enhance immunity by stimulating lymph flow—the body's natural defense system.
• Exercise and stretch weak, tight, or atrophied muscles.
• Help athletes of any level prepare for, and recover from, strenuous workouts.
• Improve the condition of the body's largest organ—the skin.
• Increase joint flexibility.
• Lessen depression and anxiety.
• Promote tissue regeneration, reducing scar tissue and stretch marks.
• Pump oxygen and nutrients into tissues and vital organs, improving circulation.
• Reduce postsurgery adhesions and swelling.
• Reduce spasms and cramping.
• Relax and soften injured, tired, and overused muscles.
• Release endorphins—amino acids that work as the body's natural painkiller.
• Relieve migraine pain.

 
A Powerful Ally
 
There's no denying the power of bodywork. Regardless of the adjectives we assign to it (pampering, rejuvenating, therapeutic) or the reasons we seek it out (a luxurious treat, stress relief, pain management), massage therapy can be a powerful ally in your healthcare regimen.

Experts estimate that upwards of ninety percent of disease is stress related. And perhaps nothing ages us faster, internally and externally, than high stress. While eliminating anxiety and pressure altogether in this fast-paced world may be idealistic, massage can, without a doubt, help manage stress. This translates into:

• Decreased anxiety.
• Enhanced sleep quality.
• Greater energy.
• Improved concentration.
• Increased circulation.
• Reduced fatigue.

Furthermore, clients often report a sense of perspective and clarity after receiving a massage. The emotional balance bodywork provides can often be just as vital and valuable as the more tangible physical benefits.

 
Profound Effects
 
In response to massage, specific physiological and chemical changes cascade throughout the body, with profound effects. Research shows that with massage:

• Arthritis sufferers note fewer aches and less stiffness and pain.
• Asthmatic children show better pulmonary function and increased peak air flow.
• Burn injury patients report reduced pain, itching, and anxiety.
• High blood pressure patients demonstrate lower diastolic blood pressure, anxiety, and stress hormones.
• Premenstrual syndrome sufferers have decreased water retention and cramping.
• Preterm infants have improved weight gain.

Research continues to show the enormous benefits of touch—which range from treating chronic diseases, neurological disorders, and injuries, to alleviating the tensions of modern lifestyles. Consequently, the medical community is actively embracing bodywork, and massage is becoming an integral part of hospice care and neonatal intensive care units. Many hospitals are also incorporating on-site massage practitioners and even spas to treat postsurgery or pain patients as part of the recovery process.

 
Increase the Benefits with Frequent Visits
 
Getting a massage can do you a world of good. And getting massage frequently can do even more. This is the beauty of bodywork. Taking part in this form of regularly scheduled self-care can play a huge part in how healthy you'll be and how youthful you'll remain with each passing year. Budgeting time and money for bodywork at consistent intervals is truly an investment in your health. And remember: just because massage feels like a pampering treat doesn't mean it is any less therapeutic. Consider massage appointments a necessary piece of your health and wellness plan, and work with your practitioner to establish a treatment schedule that best meets your needs.

Source: http://www.massagetherapy.com/learnmore/benefits.php

Oh well, it is only words... really?

by Costa Alecrim

A bruised body will often heal faster than a bruised mind. The next time you’re tempted to say something hurtful to someone just because you’re angry, you may want to consider the saying: “Sticks and stones may break my bones but words will never hurt me"

Well, let’s consider for a moment the following…

“Once upon a time, there was a boy who had a very bad temper. His father noted it and gave him a bag of nails and told him that every time he lost his temper, he must hammer a nail into the back of the fence.

The first day the boy drove 40 nails into the fence. As time went by, he learned to control his temper so the number of nails hammered gradually reduced too, as he found out it was easier to keep his temper than to hammer those nails to the fence...

However, there was one day when the boy didn’t lose his temper at all, so he told his father about it. The father was pleased, and to further teach his son a lesson he suggested that the boy should pull out one nail for each day. That way he would be able to keep his temper. The days passed and the kid was finally able to tell his father that all the nails were gone.

The father took his son by the hand and showed him the fence and said “you have done very well son, but look at the holes in the fence. The fence will never be the same. When you say things in anger, they leave a scar… just like this one.

The kid then understood how powerful his words were. He looked up at his father and said “I hope you can forgive me, Father, for the holes I have put in you”.

Okay, okay, we don’t know the full circumstances that led the boy to behave that way… As I used to say, there are always two sides to every story: the boy might have learned those behaviours at home by watching his parents… or he might have been a victim of bullying, so he was in pain… and potentially frustrated… or maybe he might have been scared... or threatened...  loads of 'maybes', I know…

All these elements put together, might have resulted in the kid's aggressive behaviour towards his father…maybe ...

Every day, when we watch the news, most of the stories are based on incidents which might have been, to a certain extent, fueled by anger, frustration and aggression. How do we recognise them? They come in many shape and forms. I just could name a few of them:

-         Assaults (verbal and physical)...

-         Gossips...

-         Rebellious (anti social behaviour, refusal to talk)

-         Bullying…

I think that our worst enemies, are always the ones we cannot see... the invisible ones... the ones we cannot prove, such as gossips and bullying, for instance. The latter has always had its place in society and like my parents and I, there are thousands and thousands of people who have also been bullied somewhere, somehow… by somebody, of course! It can take place anywhere: school, home, club, work.

Bullying causes harm, alarm and distress... not to mention fear! It affects our conditions of worth, our self-esteem and confidence, and so on. Some people can just easily ‘brush it off’ the comments and simply get on with life… but others not so easily. As our story says “The fence will never be the same. When you say things in anger, they leave a scar” . 

Bullying leaves deep marks on us: some victims may develop anxiety… others PTSD… but others might not be so lucky: they may take their own lives!  It deeply saddens me to see in the news cases such as the 15-year old Jadin Bell, who was in hospital in Portland, Oregon, as he tried to take his own life for being bullied…

So please remember: a bruised body will often heal faster than a bruised mind. The next time you’re tempted to say something hurtful to someone just because you’re angry, you may want to consider the saying: “Sticks and stones may break my bones but words will never hurt me"

 Costa is Hypnotherapist, Psychotherapist and writer
 www.hypnotherapyinbuxton.co.uk www.hypnotherapyinnewmills.co.uk


Read more on Work Place behaviours 
                  

About Pediatric Bipolar Disorder

Bipolar disorder (also known as manic-depression) is a chronic brain disorder marked by bouts of extreme and impairing changes in mood, energy, thinking, and behavior. The most outwardly apparent symptoms are behavioral; however, the illness often has less visible, but serious, cognitive, cardiac, and metabolic effects. Symptoms may emerge gradually or suddenly during childhood, adolescence, or adulthood. Researchers have identified cases of bipolar disorder in every age group studied, including preschoolers.
  
Here, The Balanced Mind Foundation examines bipolar disorder that emerges in childhood or adolescence. Bipolar disorder does not affect every child in the same way. The frequency, intensity, and duration of a child’s symptoms and the child’s response to treatment vary dramatically. As the child grows up, bipolar disorder may affect the size, shape, and function of brain regions and networks. Recent research suggests that pediatric bipolar disorder is a neurodevelopmental disorder. Parts of the brain mature (or come online) at different rates and times; brain maturation is not complete until an individual is 25 or so. Consequently, the symptoms and diagnosis of a psychiatric illness may change as the child grows. 

Children and adolescents can have bipolar disorder. Some of our ill children meet the textbook definition of bipolar disorder. Some of our ill children with severe mood dysregulation might not meet the textbook definition because they don't have distinct episodes of a certain duration or have few clear periods of wellness between episodes. They might have rapid and severe cycling between moods or they might present in a mixed state that produces chronic irritability. Experts have not yet reached consensus as to whether children with chronic irritability and clear mood swings, but without mania, should be classified as having bipolar disorder.  The Balanced Mind Foundation urges the research community to agree on a common terminology and a way to communicate with each other and with families about the full spectrum of the severe illness(es) impairing our children. It is imperative that we work together to alleviate the terrible suffering that this disorder wreaks.

Bipolar I. In this form of the disorder, the individual experiences one or more episodes of mania. Episodes of depression may also occur, but are not required to diagnose bipolar disorder. 
Symptoms of mania include:

• euphoria (elevated mood)—silliness or elation that is inappropriate and impairing
• grandiosity
• flight of ideas or racing thoughts
• more talkative than usual or pressure to keep talking
• irritability or hostility when demands are not met
• excessive distractibility
• decreased need for sleep without daytime fatigue
• excessive involvement in pleasurable but risky activities (daredevil acts, hypersexuality)
• poor judgment
• hallucinations and psychosis

For an episode to qualify as mania, there must be elevated mood plus at least three other symptoms, or irritable mood plus at least four other symptoms.
Symptoms of depression include:

•  lack of joy and pleasure in life
• withdrawal from activities formerly enjoyed 
• agitation and irritability
• pervasive sadness and/or crying spells
• sleeping too much or inability to sleep
• drop in grades or inability to concentrate
• thoughts of death and suicide
• fatigue or loss of energy
• feelings of worthlessness
• significant weight loss, weight gain or change in appetite

Stable periods occur between episodes of mania and depression. An episode must last at least one week, or, if hospitalization is necessary, may be of any duration.

Bipolar II. In this form of the disorder, the individual experiences recurrent periods of depression with episodes of normal mood (euthymia) or hypomania between episodes. Hypomania is a markedly elevated or irritable mood accompanied by increased physical and mental energy. Hypomania can be a time of great creativity and energy and may, but not always, progress into full-blown mania if not treated. Some people with bipolar disorder never develop full-blown mania. 

Bipolar Disorder NOS (Not Otherwise Specified).Doctors may make this diagnosis when there is severe mood dysregulation with serious impairment, but it is not clear which type of bipolar disorder, if any, is emerging.  Perhaps the individual has always been impaired, with cycling apparent since infancy. Maybe there have been no discernable periods of wellness. Perhaps the child is experiencing the emergence of another neurodevelopmental illness and the symptoms of that disorder have not yet been fully expressed. The inability to pinpoint a diagnosis should not be taken as a dismissal of the severity of the child’s symptoms. 

Bipolar disorder is often accompanied by symptoms of other psychiatric disorders (those other disorders are said to be "comorbid" with the bipolar disorder). In some children, proper treatment for bipolar disorder clears up the symptoms thought to indicate another diagnosis. In other children, bipolar disorder may explain only part of a more complicated case that includes neurological, developmental, and other components. An accurate diagnosis of a child or teen presenting with severely troubled behavior is perhaps the most problematic issue facing families.
Diagnoses that mimic, mask, or co-occur with pediatric bipolar disorder include:  

• Attention-deficit hyperactivity disorder (ADHD)* 
• Depression** 
• Oppositional-defiant disorder (ODD) 
• Conduct disorder (CD) 
• Pervasive developmental disorder (PDD) 
• Generalized anxiety disorder (GAD) 
• Panic disorder 
• Obsessive-compulsive disorder (OCD) 
• Tourette's syndrome (TS) 
• Seizure disorders 
• Reactive attachment disorder (RAD)

read more: http://www.thebalancedmind.org/learn/library/about-pediatric-bipolar-disorder?page=1

One in ten Britons now being treated for depression as economic woes push number of cases past five million

One out of every ten people in the UK is suffering from depression - making it the country's most common illness, according to a poll of GPs.

Over the last 12 months the number of people being diagnosed with the mental illness has risen to 5.1million, up from 4.9million over the course of the previous year.

Figures gathered from 8,000 GP practices and published by the Health and Social Care Information Centre suggest that those with depression are no longer suffering in silence.
There has been a steady rise in the number of adults being diagnosed over the last five years, suggesting that understanding and attitudes may be changing.

One out of every ten people in the UK is suffering from depression making the condition the country's most common illness, according to a poll of GPs.

However, experts say the rise in the number of diagnosed cases may also be related to increased financial pressures being placed on people during the downturn.

Beth Murphy of the charity Mind said many people were struggling to cope, as job insecurity, unemployment and financial worries all had a negative impact on mental health.

Patients are treated for the illness with antidepressant tablets and counselling and the figures also revealed that the most prevalent condition, as opposed to disease was high blood pressure which is suffered by 7.6million people - the majority of whom are over 45.

 

More...

• Leading psychiatrist urges caution over women of childbearing age being given anti-depressants
• A third of patients say their GPs are so rushed they are worried they will be misdiagnosed
• Put the economy on a war footing: Lord Heseltine calls for a National Growth Council

The news comes just days after a leading psychiatrist urged caution about women of childbearing age being prescribed anti-depressants and anti-psychotic drugs.

Because half of pregnancies are unplanned, drugs that have serious side effects for pregnant women or their unborn children should not be given to women who could become pregnant, Professor Louise Howard said.

 

Over the last 12 months the number of people being diagnosed with the mental illness has risen to 5.1million, up from 4.9million over the course of the previous year

Professor Howard, head of women's mental health at the Institute of Psychiatry, King's College London said: 'If drugs are contraindicated during pregnancy then it is best that they are avoided in women of reproductive age in general - because per cent of pregnancies are unplanned.'

However she stressed the risks were minimal.

'The risks of taking most antidepressants are very, very small, and only a small number of treatments for severe mental health problems are known to cause significant side effects. 

'Clinicians are careful to give women information to weigh up the risks of the illness against the risk and benefits of treatments.'

For instance, sodium valproate, which is used as a mood stabiliser for bipolar patients, can cause foetal malformations and can lead to a child having a lower IQ, she said.

Professor Howard added that women needed to weigh up the risks and benefits of taking drugs when they were planning to get pregnant.

Read more: http://www.dailymail.co.uk/health/article-2225587/GPs-treating-Brits-depression-number-diagnosed-illness-tops-5m.html#ixzz2BvyuOvvs

Mental Health Statistics - you are not alone!

Mental Health affects us all. How we think and feel about ourselves and our lives impacts on our behaviour and how we cope in tough times.

It affects our ability to make the most of the opportunities that come our way and play a full part amongst our family, workplace, community and friends. It’s also closely linked with our physical health.

Whether we call it well-being, emotional welfare or mental health, it’s key to living a fulfilling life.

 

The facts and figures around Mental Health in the UK are alarming. 

• 1 in 4 people will experience some kind of mental health problem in the course of a year

• Mixed anxiety and depression is the most common mental disorder in Britain

• Women are more likely to have been treated for a mental health problem than men

• About 10% of children have a mental health problem at any one time

• Depression affects 1 in 5 older people

• Suicides rates show that British men are three times as likely to die by suicide than British women

• Self-harm statistics for the UK show one of the highest rates in Europe: 400 per 100,000 population

• Only 1 in 10 prisoners has no mental disorder

  
 For further information go to: http://www.mentalhealth.org.uk/help-information/mental-health-statistics/

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The types of therapy

Talking therapy is a broad term. It covers all the psychological therapies that involve a person talking to a therapist about their problems.

You may have heard of counselling, cognitive behavioural therapy (CBT) or psychotherapy. These are all different types of talking therapy, but they share some common features.  
For some problems and conditions, one type of talking treatment may be better than another. Different talking treatments also suit different people. A particular one may be best for you and your situation.
To help you decide which one would be most suitable for you, talk to your GP about the types of talking therapy on offer (let them know if you prefer a particular one). Below is a brief explanation of each talking treatment and how they can help.

Counselling

Having counselling is probably the best-known talking therapy and the one most readily available at your GP surgery.
Counselling on the NHS usually consists of 6 to 12 sessions, each an hour long. You talk in confidence to a counsellor about how you feel about yourself and your situation. The counsellor supports you and offers practical advice.
Counselling is ideal for people who are basically healthy but need help coping with a current crisis, such as:

• anger
• relationship issues
• bereavement
• redundancy
• infertility
• the onset of a serious illness

Read more about counselling.

Cognitive Behavioural Therapy (CBT)

The aim of CBT is help you think less negatively, so that instead of feeling hopeless and depressed, you cope better with and even start to enjoy the situations you face.
In CBT, you set goals with your therapist and carry out tasks between sessions. A course typically involves between 6 and 15 sessions, which last about an hour each.
Like counselling, CBT deals with current situations more than events in your past or childhood.
There has been a lot of research done on CBT and it’s been shown to work for a variety of mental health problems. However, this doesn't mean that it's better than other therapies, but simply that others may not have been studied as much.
In particular, CBT can help:

• depression
• anxiety
• panic attacks
• phobias
• obsessive compulsive disorder (OCD)
• post-traumatic stress disorder
• some eating disorders, especially bulimia

CBT is available on the NHS for people with depression or any other mental health problem that it has been shown to help. There are also self-help books and computer courses which use the concepts of CBT to help you overcome common problems like depression. Read more about self-help therapies.
Find out more about cognitive behavioural therapy.

Psychotherapy

Unlike counselling and CBT, psychotherapy involves talking more about your past to help you overcome problems you’re having in the present. It tends to last longer than CBT and counselling. Sessions are an hour long and can continue for a year or more.
There are different types of psychotherapy, but they all aim to help you understand more about yourself, improve your relationships and get more out of life. Psychotherapy can be especially useful in helping people with long-term or recurring problems to find the cause of their difficulties.
There's some evidence that psychotherapy can help depression and some eating disorders.
NHS psychotherapists normally work in a hospital or clinic, where you'll see them as an outpatient. Private psychotherapists often work from home.

Family therapy

This may be offered when the whole family is in difficulty.
In family therapy, a therapist (or pair of therapists) meets the whole family. The therapist explores their views and relationships to understand the problems the family is having. It helps family members communicate better with each other.
Sessions are between 45 minutes and an hour-and-a-half long, and usually take place several weeks apart.
Family therapy is useful for any family in which a child, young person or adult (a parent or a grandparent) has a serious problem that’s affecting the rest of the family. Many types of cases are seen by family therapists, including:

• child and adolescent behavioural problems
• mental health conditions, illness and disability in the family
• separation, divorce and step-family life
• domestic violence
• drug or alcohol addiction

Couples therapy

Couples therapy can help when a relationship is in crisis (after an affair, for example). Both partners talk in confidence to a counsellor to explore what has gone wrong in the relationship and how to change things for the better. It can help couples learn more about each other's needs and communicate better.
Ideally, both partners should attend the weekly hour-long sessions, but they can still help if just one person attends.

Group therapy

In group therapy, up to around 12 people meet, together with a therapist. It’s a useful way for people who share a common problem to get support and advice from each other. It can help you realise you’re not alone in your experiences, which is itself beneficial.
Some people prefer to be part of a group or find that it suits them better than individual therapy.

source: http://www.nhs.uk/Conditions/stress-anxiety-depression/Pages/types-of-therapy.aspx

Anxiety and depression big problems among children

Most of us think childhood to be a time associated with a fun, carefree way of life. However, most children these days are being affected by problems like anxiety and depression. Increased competition that has increased performance anxiety and stress has been held responsible for this by the doctors.

To mark the ongoing mental health week, city branches of the Indian medical Association and Indian Psychiatric Society organized a conference to discuss the most prevalent mental health issues. Anxiety and depression among children was one of these topics.

"In the last two decades, there has been a tremendous rise in psychological problems in children. This is mainly because increased parental and personal expectations because of the competitive environment. Now-a-days, a child is not satisfied by topping the class through his hard work. He has to top the state or the country to be really happy about his achievement as there is globalization of competition too," said psychiatrist Dr Kausar Abbasi, adding "Teachers and the education system have become very demanding."

Dr Nilesh Shah, professor and head of the psychiatry department of Sion Hospital, Mumbai, believes that more than depression, anxiety has become a common affliction among children. "In every class, one or two children can be found who suffer from over-anxiety.

These children get worked up about small things specially before important events like examinations or outings, keep seeking reassurances, lose temper easily and can't sleep well. Relaxation techniques like yoga, meditation, aroma therapy can be used to help them relax when anxiety is triggered," he said.

Some of the other types of anxiety which are not very common include school phobia, separation anxiety disorder when a child does not wish to separate from a parent for the smallest amount of time, social anxiety disorder where social situations and selective mutism where certain special circumstances or people trigger anxiety in the child, he informed.

One of the reasons that the children are suffering from such problems is the comparatively easy life they have. "The frustration tolerance and tolerance limits of children are very low these days as they are getting all they want from a very early age. Anxiety in children can also manifest through behavioral problems like bed wetting and parents should be on the watch out for them," said psychiatrist Dr Rajiv Palsodkar.

source: http://timesofindia.indiatimes.com/city/nagpur/Anxiety-and-depression-big-problems-among-children/articleshow/16716332.cms

Does Massage Reduce Depression?

While massage is not a depression cure, it can help decrease depressed feelings. One of the best-known benefits of massage therapy is its ability to enhance feelings of well-being, and studies show promise in the area of depression. 

 When you're depressed, your brain produces less neurotransmitters, such as serotonin, endorphins and dopamine – the feel-good hormones. Although the root causes are not fully understood, a physiological marker of depression is a low level of the neurotransmitter, serotonin. Serotonin is responsible for the transmission of nerve messages and helps to sustain feelings of well-being. Massage releases both serotonin and endorphins. The serotonin acts as a calming mediator for the body while the endorphins act as a happy stimulator for the brain.

Read more...

Understanding and Treating Depression

Depression is a disturbance in mood characterized by varying degrees of sadness, disappointment, loneliness, hopelessness, self-doubt, and guilt. Most people tend to feel depressed at one time or another, but some people may experience these feelings more frequently or with deeper, more lasting, effects. In some cases, depression can last for months or even years. The most common type of depression is what is referred to as “feeling blue” or “being in a bad mood.” These feelings are usually brief in duration and have minimal or slight effects on normal everyday activities.
In the next level of depression, symptoms become more intense and last for a longer period of time. Daily activities may become more difficult…but the individual is still able to cope with them. It is at this level, however, that feelings of hopelessness can become so intense that suicide may seem the only solution.
A person experiencing severe depression may experience extreme fluctuations in moods or even a desire for complete withdrawal from daily routine and/or the outside world.

Symptoms of Depression

Depression may affect one’s life in any of the following ways:
Crying spells or, at the other extreme, lack of emotional responsiveness.

Changes in Feelings and/or Perceptions

• Inability to find pleasure in anything.
• Feelings of hopelessness and/or worthlessness.
• Exaggerated sense of guilt or self-blame.
• Loss of sexual desire.
• Loss of warm feelings toward family or friends.

Changes in Behavior and Attitudes

• Lack of interest in prior activities and withdrawal from others.
• Neglect of responsibilities and appearance.
• Irritability, complaints about matters previously taken in stride.
• Dissatisfaction about life in general.
• Impaired memory, inability to concentrate, indecisiveness, and confusion.
• Reduced ability to cope on a daily basis.

Physical Complaints

• Chronic fatigue and lack of energy.
• Complete loss of appetite, or at the other extreme, compulsive eating.
• Insomnia, early morning wakefulness, or excessive sleeping.
• Unexplained headaches, backaches, and similar complaints.
• Digestive problems including stomach pain, nausea, indigestion, and/or change in bowel habits.

 

Causes of Depression

Depression is often the result of an unhappy event such as the death of a loved one. When the source of depression is readily apparent and the person is fully aware of it, the individual can expect the reaction to moderate and then fade away within a reasonable amount of time. In cases where feelings of depression exist with no apparent source or the source is unclear, the depression may get worse because the person is unable to understand it. This sense of loss of control may add to the actual feelings of depression.
Any number of stressors may be involved in depression. These can include personality, environmental, or biomedical factors. Shortages or chemical imbalances in the brain may play a significant role in some cases of depression. Such imbalances may be created by illness, infections, certain drugs (including alcohol and even prescribed medications) and improper diet and nutrition. In general, depression may be viewed as a withdrawal from physical or psychological stress. Identifying and understanding the underlying causes of such stress is a necessary step in learning to cope with depression.

Helping Yourself

Being honest with yourself about changes in mood or the intensity of negative feelings as they occur will help you identify possible sources of depression or stress. You should examine your feelings and try to determine what is troubling you — relationships with family or friends, financial responsibilities, and so forth. Discussing problems with the people involved or with an understanding friend can sometimes bring about a resolution before a critical stage of stress is reached. Even mild depression should be dealt with if it interferes with your effectiveness. You might also try to:

• Change your normal routine by taking a break for a favorite activity or something new — even if you don’t feel like it;
• Exercise to work off tension, improve digestion, help you relax, and perhaps improve your ability to sleep;
• Avoid known stressors;
• Avoid making long-term commitments, decisions, or changes that make you feel trapped or confined — it is better to put them off until you feel you are better able to cope; and
• See your G.P. especially if physical complaints persist.

Helping a Depressed Friend

Since severely depressed individuals can be very withdrawn, lethargic, self-ruminating, and possibly suicidal, a concerned friend can provide a valuable and possibly life-saving service. Talking candidly with the individual regarding your concern for his or her well being will often bring the problems out into the open.

Trying to help...

 As you talk to a depressed person do not...

• Do not try to “cheer up” the individual.
• Do not criticize or shame, as feelings of depression cannot be helped.
• Do not sympathize and claim that you feel the same way as he or she does.
• Try not to get angry with the depressed individual.

Your primary objective is to let the person know you are concerned and willing to help.
If feelings of depression appear to turn to thoughts of suicide, urge the individual to seek professional help. If the person resists such a suggestion and you feel that suicide is likely — seek professional help yourself, so you will know how to best handle the situation.

When Professional Help is Necessary

Depression is treatable and needless suffering of those who experience it can be alleviated. A mental health professional should be consulted when an individual experiences any of the following circumstances:

• When pain or problems outweigh pleasures much of the time;
• When symptoms are so severe and persistent that day-to-day functioning is impaired; and/or
• When stress seems so overwhelming that suicide seems to be a viable option.

Qualified mental health professionals can help identify the causes and sources of depression and can help the individual find ways to overcome them.

If in doubt you can find more information on the NHS website.