We work with a range of common mental health problems using Cognitive Behavioural Therapy (CBT) techniques as well as Mindfulness and Behavioural Activation as stand alone therapies or in combination with CBT dependent on client needs.
It is common to have times where we feel a bit lower in mood than others, however sometimes this can last longer than usual or can begin to have significant effects on day to day life, developing into depression. The effects of depression can be wide and varied, and include negative thinking about ourselves, others and the world, as well as loss of motivation, energy or enthusiasm for life. There can also be behavioural changes where people isolate themselves and stop seeing friends or doing the things they enjoy. At these times, people often sleep more than usual or have difficulty sleeping, they may also overeat or lose their appetite and may often be more tearful than usual. The symptoms of depression can appear gradually or quite quickly, and can be caused by a number of things – there may or may not be a clear trigger for your low mood.
In CBT we work with depression by helping to identify and formulate how the depression started and what is maintaining it day to day. We then work using evidence based models that are adapted to individual needs to make gradual changes to unhelpful behaviours and negative thoughts, equipping the individual with a range of tools to enable them to manage their own mood both in the present and in the future.
Is best understood as an umbrella term that is used to describe a range of different problems which all present with the same physical symptoms of anxiety (increased heart rate, rapid shallow breathing, churning stomach, nausea, IBS, need to use the toilet often, shaking, sweating, increased temperature, muscle tension and pain, difficulty concentrating) but which are all triggered by different situations. The specific situations that trigger anxiety lead to a range of different terms used to describe anxiety and are described below.
In CBT we work with each anxiety disorder quite differently, as they are all caused by very different triggers but we are essentially looking to break the vicious cycles that keep these anxieties going in the short term and equip individuals with tools to be able to manage this for themselves in the future. Your therapist will discuss treatment options with you in more detail following your assessment session.
At times we all experience health difficulties and this can create some anxiety in us, however typically this anxiety will go once we have a clear treatment plan or good health returns. For those with health anxiety, they will feel this anxiety most of the time, even at times when there is nothing, or little, wrong with their health. This can result in frequent visits to GP’s and other health care specialists, and the person may often feel that they need to check their body to ensure nothing is wrong, or seek reassurance from others that they are ok. They may also carry out lots of research into health conditions and become very anxious if close family or friends become unwell also.
Social Anxiety Disorder
Although some people are naturally more shy in social situations than others, social anxiety is a more intense version of usual shyness, where the person becomes very anxious about having to meet new people or interact with people at all. Often in social situations, the person will feel that others are judging them or watching them, and will have a sense that they come across badly to others. Often the person will spend large amounts of time planning what to say in a conversation, and then analysing how the conversation went afterwards. This anxiety often leads people to becoming quite isolated and avoiding social interactions or situations where they may have to talk to people. This can have massive implications for relationships, ability to work etc.
Generalised Anxiety Disorder (GAD)
This type of anxiety is very common and describes someone who worries excessively about a number of daily life events. People who experience GAD will often find uncertain situations very difficult and will do many things to try and make life more certain and gain a sense of control over the outcome of events. This is a very difficult problem as it can be triggered very often due to the uncertainty that is often unavoidable in life.
Post-Traumatic Stress Disorder (PTSD)
When we experience daily life events, the brain takes that information and files it appropriately into our past memories. However, if we experience a traumatic event (e.g. a car crash), the brain struggles to deal with this large quantity of information. Due to this, memories of traumatic events are often not processed properly. This can have devastating effects for the person as when something triggers this memory, they may feel that they are back in the situation from the past, reliving the trauma with the same intensity of emotion as if it were happening all over again. This is knows as a flashback and can lead someone to avoiding any trigger situations and can result in a high level of anger or low mood or depression.
Obsessive Compulsive Disorder (OCD)
Most people experience intrusive thoughts of some kind (such as the thought that you could swerve your car off of the road whilst driving along), however, most of us also dismiss these as just another thought. This becomes more problematic in OCD as the quantity of intrusive thoughts are often greater and also create much anxiety in the person. This leads to what are known as compulsive behaviours that people do to try and reduce the anxiety they feel. These behaviours can be linked to an intrusive thought (e.g. If someone things “if I have left the cooker on by mistake then the house could burn down” they may then check the oven a number of times to ensure it is off). They may also be seemingly unlinked (e.g. if someone has an intrusive thought that “something bad is going to happen to my child” they may feel the need to wash their hands 5 times to ensure this will not happen). OCD has massive effects on people both because of the distressing nature of the intrusive thoughts and anxiety that comes with them and also the extreme amount of time it takes to complete rituals.
Panic attacks are an extreme manifestation of anxiety symptoms and occur for a very brief amount of time and can be very scary to the person experiencing them. Often the person may think that they are having a heart attack or that they are going to die. Panic attacks can be a feature of any of the other mental health problems we have described, but can also be a stand alone problem. Panic disorder is where an individual is so terrified if having a panic attack that they will avoid situations and things that may trigger these. They have also often developed a number of coping strategies to help them to manage if they do have panic attacks. Panic Disorder is often linked with agoraphobia.
This literally means ‘fear of the market place’ and describes people who become very anxious when they are in crowded situations that they cannot easily escape from. Often people will be very good at avoiding such situations or knowing exactly where the exits are and have clear escape routes planned in such situations. Agorophobia is often accompanied by Panic attacks.
Self-esteem describes the way we feel about ourselves, and affects our confidence to interact with others, stand up for our needs and deal with challenging situations. If someone experiences low self-esteem they will often be very self-critical, often spending much time focusing on their perceived negative qualities. They often compare themselves (unfavourably) to others and then try to take active measures to ensure that others don’t see these ‘bad’ qualities (this may include avoiding social situations / avoiding talking about themselves / not confronting others if they are upset about something). Low self-esteem is often linked with depression and poor assertiveness skills.
In CBT, we address low self-esteem by formulating and identifying where this may have come from and looking at current unhelpful patterns the person is stuck in. We then develop tools and strategies to look more objectively at situations and to change the focus of attention from only the negative (which is often over exaggerated) to taking account of the positive qualities they hold. This can have a huge impact on the individuals life as they can start to develop self-confidence and self-belief and feel more empowered to do the things they want to in life.
Poor assertiveness skills
Assertiveness is a tricky skill to master and many people struggle with this. There is a fine line between being passive, assertive and aggressive and often passive people try to be assertive, but without the correct skills, end up coming across as aggressive. This can have disastrous effects on someones ability to develop healthy, balanced, relationships and also get their needs met in life.
We work to develop assertiveness skills by understanding the difference between assertiveness, passiveness and aggression and by developing tools to enable the person to act in a more assertive way. This often allows people to feel that they can express themselves more effectively and therefore can get their needs met, rather than feeling that they always have to give in to others views.
Modern life can be very stressful and it can be hard to balance all of the demands that are put on us by work, family commitments, friends etc. At times, these demands can feel overwhelming and lead us to feel that we cannot deal with day to day tasks.
Stress can be managed using a range of techniques, including relaxation strategies, time scheduling, mindfulness, and even sometimes assertiveness skills (learning to say ‘no’ when something feels too much can be very powerful). This will vary from person to person depending on what is causing the stress and how they are currently dealing with this.