{"id":583,"date":"2019-11-25T12:18:53","date_gmt":"2019-11-25T12:18:53","guid":{"rendered":"http:\/\/www.normanclaringbull.co.uk\/?p=583"},"modified":"2019-11-25T12:18:53","modified_gmt":"2019-11-25T12:18:53","slug":"blog-post-winter-2020","status":"publish","type":"post","link":"https:\/\/normanclaringbull.onplexaweb.co.uk\/index.php\/2019\/11\/25\/blog-post-winter-2020\/","title":{"rendered":"BLOG POST – Winter 2020"},"content":{"rendered":"\n

DEPRESSION\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/a><\/p>\n\n\n\n

It\u2019s cold, dreary, and freezing \u2013 welcome to winter, UK style! \u00a0Sometimes, 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. 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\n\n\n

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

Key Symptoms:<\/strong>\n<\/p>\n\n\n\n

Persistent sadness or low mood<\/p>\n\n\n\n

Marked loss of interests or pleasure<\/p>\n\n\n\n

Associated Symptoms:<\/strong>\n<\/p>\n\n\n\n

Fatigue or loss of energy or slowing of\nmovements<\/p>\n\n\n\n

Disturbed sleep (decreased or increased\ncompared to usual)<\/p>\n\n\n\n

Decreased or increased appetite and\/or\nweight<\/p>\n\n\n\n

Poor concentration or indecisiveness<\/p>\n\n\n\n

Feelings of worthlessness or excessive\nor inappropriate guilt <\/p>\n\n\n\n

Suicidal thoughts or acts<\/p>\n\n\n\n

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

            Step\n1             No action, (most depressives\nrecover within 6 months, treated or not)<\/p>\n\n\n\n

            Step\n2             Medication and low-intensity\npsychological therapy, (basic CBT) <\/p>\n\n\n\n

            Step\n3             Medication and\nhigh-intensity psychological therapy (advanced CBT)<\/p>\n\n\n\n

            Step\n4             Hospitalisation and\nmulti-professional in-patient care<\/p>\n\n\n\n

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

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

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

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

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

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

DEPRESSION\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 It\u2019s cold, dreary, and freezing \u2013 welcome to winter, UK style! \u00a0Sometimes, 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. However, for most […]<\/p>\n","protected":false},"author":1,"featured_media":462,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"wpm_timeformat":"","_wpm_styles":"","footnotes":""},"categories":[2],"tags":[],"class_list":["post-583","post","type-post","status-publish","format-standard","hentry","category-blog"],"yoast_head":"\nBLOG POST - Winter 2020 - 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\/2019\/11\/25\/blog-post-winter-2020\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"BLOG POST - Winter 2020 - Norman Claringbull\" \/>\n<meta property=\"og:description\" content=\"DEPRESSION\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 It\u2019s cold, dreary, and freezing \u2013 welcome to winter, UK style! \u00a0Sometimes, 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. 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