{"id":361,"date":"2014-12-29T14:30:24","date_gmt":"2014-12-29T14:30:24","guid":{"rendered":"http:\/\/www.normanclaringbull.co.uk\/?p=361"},"modified":"2014-12-29T14:30:24","modified_gmt":"2014-12-29T14:30:24","slug":"blog-post-winter-2015","status":"publish","type":"post","link":"https:\/\/normanclaringbull.onplexaweb.co.uk\/index.php\/2014\/12\/29\/blog-post-winter-2015\/","title":{"rendered":"Blog Post – Winter 2015"},"content":{"rendered":"

DEPRESSION<\/p>\n

Christmas is over, the New Year celebrations a fading memory, it\u2019s cold, dreary, and freezing \u2013 welcome to winter, UK style! Sometimes, when we are struggling through these, the most depressing months of the year, it can be hard to find an upside to life. It\u2019s no wonder that so many of us occasionally feel a bit low, a bit depressed. \"depression\"<\/a>However, for most of us, most of the time, feeling a bit low is just a perfectly normal reaction to life\u2019s downsides. Things go wrong and we get fed up, sad even. That\u2019s all there is to it. That\u2019s life! However, when our gloomy reactions to life\u2019s adversities are excessive, (whatever the season), when they interfere with our lives, when they don\u2019t have an obvious cause, when they are long-lasting, then that\u2019s when depression becomes \u2018a matter of clinical concern\u2019.<\/p>\n

Mental health professionals recognise a number of different types of depression and classify them according to severity, frequency, and how long the symptoms have lasted. However, carrying out a detailed diagnostic evaluation of depression is an exacting and time-consuming job. Busy GPs cannot afford to be so finicky \u2013 they just don\u2019t have the time. In the UK most GPs diagnose depression using the National Institute for Health and Care Excellence, (NICE), Guidelines. However, some diagnosticians prefer to use the World Health Organisation\u2019s mental health check list. These two diagnostic protocols are very similar to each other, easy to use, take only moments, and are reasonably accurate, (at least to begin with). GPs who use the Nice Guidelines check their patients on a yes\/no basis against the following criteria.<\/p>\n

Key Symptoms:
\nPersistent sadness or low mood
\nMarked loss of interests or pleasure<\/p>\n

Associated Symptoms:
\nFatigue or loss of energy or slowing of movements
\nDisturbed sleep (decreased or increased compared to usual)
\nDecreased or increased appetite and\/or weight
\nPoor concentration or indecisiveness
\nFeelings of worthlessness or excessive or inappropriate guilt
\nSuicidal thoughts or acts<\/p>\n

The rough rule of thumb is that the more positives scored on the Associated Symptoms list, the more the patient is depressed. In the UK\u2019s National Health Service, depression is usually graded mild, moderate and severe. Treatment is usually offered on a stepped basis depending on how the patient\u2019s needs evolve.<\/p>\n

Step 1 No action, (most depressives recover within 6 months, treated or not)<\/p>\n

Step 2 Medication and low-intensity psychological therapy, (basic CBT)<\/p>\n

Step 3 Medication and high-intensity psychological therapy (advanced CBT)<\/p>\n

Step 4 Hospitalisation and multi-professional in-patient care<\/p>\n

Of course there are many mental health professionals who disagree with the NHS approach to treating depression. They would argue that depression is a much more complex condition than the NICE protocols suggest and therefore the treatments required are equally more complex. Nevertheless, if pushed, many of these dissenting professionals would probably accept that the NHS stepped-care system gives some relief to some people – at least on a short-term basis. However they would also claim that treatments based on medication and\/or CBT often only serve to alleviate the symptoms of depression; that they don\u2019t properly address the causes of depression.<\/p>\n

My own approach to depression is multi-faceted from the onset. Being what is known as a \u2018Pluralistic\u2019 or an \u2018Integrative\u2019 practitioner, I don\u2019t allow myself to be limited to any given treatment model for depression or to exclusively subscribe to any given causative theory. I prefer to tailor each individual\u2019s treatment plan to suit that person\u2019s needs. So, for any particular client I\u2019ll use whichever approach, (or package of approaches), that seem likely to be the most helpful. Not only that, but I will change my treatment plans if my patient\u2019s needs change. Flexibility is the name of the game.<\/p>\n

If a do-nothing, time-is-the-great-healer, approach, (NICE – Step 1) seems to be the right one then OK. However the patient\u2019s progress over the next few months needs to be properly monitored. It\u2019s not just \u2018file and forget\u2019. There is still a lot that therapist can do and should do to help. For example, carefully applied positive psychological reinforcements will at least encourage recovery and in many cases will help to speed it up. In all cases patients should be helped to review their lifestyles and to make suitable adjustments.<\/p>\n

Traditionally, psychotherapists and GPs have been at the opposite ends of the prescribing spectrum. Supposedly, GPs irresponsibly \u2018handed out pills like Smarties\u2019 and psychotherapists were far too \u2018holier than thou\u2019 to ever consider medication. Fortunately, these outdated, competing, professional orthodoxies have largely disappeared. Modern psychotherapists and doctors collaborate. I often refer patients who present with depression to their GPs. That\u2019s because it is not unusual for patients to need the \u2018chemical lift\u2019 that medication can provide before they can even begin therapy. Not only that, but therapists must always remember that all sorts of medical problems, (a defective thyroid for example), can cause depression-like symptoms in people. It is always good practice to get prospective clients medically checked first.<\/p>\n

In many cases my treatment model for depression includes medication and psychotherapy together. Have a look at the information leaflets supplied with any anti-depressant medication \u2013 they all say \u2018use pills and talk\u2019. It\u2019s also a good idea if both the doctors and psychotherapists are prepared to adopt a \u2018suck-it-and-see\u2019 approach. After all, different pills work, (or not), for different people and that\u2018s equally true for the wide variety of psychotherapeutic approaches that claim to have a positive impact on depression.. My advice to any patient is to shop around and find the treatment package that suits you and to stay away from any medic or \u2018ologist\u2019 who has a \u2018one-size-fits-all\u2019 attitude.<\/p>\n

So, in sum what I am saying about depression is this. It\u2019s OK, it\u2019s normal to feel low or sad, (generally dispirited), when the circumstances demand it. What is not OK is for those feelings to disrupt your life. So, when your life is getting a bit out of hand, when your life no longer has an upside, get some help \u2013 that\u2019s what psychotherapists are for.<\/p>\n","protected":false},"excerpt":{"rendered":"

DEPRESSION Christmas is over, the New Year celebrations a fading memory, it\u2019s cold, dreary, and freezing \u2013 welcome to winter, UK style! Sometimes, when we are struggling through these, the most depressing months of the year, it can be hard to find an upside to life. It\u2019s no wonder that so many of us occasionally […]<\/p>\n","protected":false},"author":1,"featured_media":359,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"wpm_timeformat":"","_wpm_styles":"","footnotes":""},"categories":[2],"tags":[],"class_list":["post-361","post","type-post","status-publish","format-standard","hentry","category-blog"],"yoast_head":"\nBlog Post - Winter 2015 - Norman Claringbull<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/normanclaringbull.onplexaweb.co.uk\/index.php\/2014\/12\/29\/blog-post-winter-2015\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Blog Post - Winter 2015 - Norman Claringbull\" \/>\n<meta property=\"og:description\" content=\"DEPRESSION Christmas is over, the New Year celebrations a fading memory, it\u2019s cold, dreary, and freezing \u2013 welcome to winter, UK style! 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