Common Difficulties

Depression

Depression is extremely common and affects about one in five people at some point during their lives. There can be a number of reasons a person may become depressed.

  • Genetics. Some people inherit genes that make them more prone to developing depression. This may be particularly noticeable if other family members have suffered from it.
  • Chemical imbalance in the brain. Medication such as anti-depressants can help restore this imbalance. As a person recovers from depression, the chemical changes reverse and go back to normal.
  • Changes in physical symptoms. Fatigue, anxiety, lack of motivation and concentration or other physical changes can lead to negative thinking patterns which may lead to depression.
  • Difficult life experiences. Negative early life experiences such as neglect, bullying or abuse can result in depression. Additionally, difficult current life events such as a relationship breakdown, loss of job or bereavement can lead to reactive depression.

Everyone feels a bit depressed at times but knows we do not need to seek treatment as this feeling probably passes in a day or two. When depression is more severe, the depressed mood will continue and usually presents with other common symptoms.

Common symptoms might include

  • Anger and irritability
  • Lack of motivation
  • Changes in appetite
  • Feelings of hopelessness
  • Difficulty concentrating
  • Memory difficulties
  • Withdrawal from social activities
  • Changes in sleep patterns
  • Loss of interest in sex
  • Thoughts of death. Frequent or serious thoughts about suicide need to be addressed as soon as possible. A trained mental health professional will help support you whilst you talk through your difficulties and work towards a solution or better outcome.

Anxiety

Anxiety is the body's normal response to stress or danger. However, it can become a problem if left to get out of control. When it does, simple tasks can feel extremely difficult. Anxiety affects the way we think and behave as well as having a physical effect. A common response to anxiety is avoidance and using certain 'safety behaviours' such as seeking reassurance. Although this can give temporary relief, it keeps the anxiety cycle going.

  • Health Anxiety. Health anxiety is experiencing intense worry about your health. You may be convinced you are seriously ill, even though there is no evidence to suggest this and seek constant reassurance from your GP, medical journals or internet. You may find yourself focusing on your body more, becoming pre-occupied with any physical symptoms you are experiencing together with checking for any general changes. People who suffer from health anxiety may also avoid visiting their GP due to a fear of what the results of an examination might confirm.

  • Panic Disorder with or without Agoraphobia. Panic attacks can be extremely distressing. During a panic attack you may experience intense fear which appears to come on suddenly, often without warning. Although panic attacks do not generally last for very long, the result of one can stay with you for quite a long time afterwards. When experiencing a panic attack, many people think they may be having a heart attack or possibly suffocating. This is the result of the physical changes that occur when a panic attack is triggered. Whilst extremely distressing, a panic attack is not life threatening.

  • Social Phobia/Social Anxiety. Social phobia is a fear of social situations in which there is a 'perceived social danger' such as becoming embarrassed, making a fool of yourself, not knowing what to say etc. Social phobics focus inwards and lose the focus of what is going on around them. They become pre-occupied with their own negative thoughts concerning others evaluation of them and focus on their heightened physical responses, such as blushing, shaking etc.

  • Generalised Anxiety Disorder (GAD). "I'm a born worrier. If I wasn't worrying about something, I'd be worried". A predominant characteristic of GAD is worrying. Individuals with GAD will generally feel anxious most of the time and report worrying about "everything". Worry is experienced as distressing and comes in two forms. Type 1 worries are concerned with daily events such as relationships, finance, news etc. Type 2 worries focus on the consequences of the worry itself (eg. worrying about worrying).

  • Obsessive Compulsive Disorder (OCD). A primary feature of OCD is where a person experiences frequent intrusive and unwelcome obsessional thoughts, often followed by repetitive compulsions, impulses or urges. This can be extremely distressing for an individual and their family, as well as impacting heavily on day to day tasks. OCD can have a major negative impact on a person's life. There are various types of OCD:

    • Cleaning
    • Ordering
    • Hoarding
    • Counting
    • Checking
    • Pure 'O' (unwanted intrusive thoughts eg. violent, sexual)

      Please see ocduk.org for more information

Post Traumatic Stress Disorder (PTSD)

The National Institute for Clinical Excellence Guidelines for PTSD (NICE, 2005) states that up to 30% of people experiencing a traumatic event may develop PTSD either immediately after the event or indeed some many years after. Symptoms of PTSD are:

  • Flashbacks/re-experiencing events
  • Nightmares
  • Emotional numbing
  • Avoidance of reminders
  • Hyper-arousal (feeling 'on edge')
  • Hyper-vigilance (looking out for danger)
  • Anger and irritability

Part of the recommendations within the NICE guidelines for PTSD (2005:4) is the implementation of a course of trauma-focused psychological treatment of either trauma-focused cognitive behavioural therapy (CBT) or eye movement desensitisation and reprocessing (EMDR).

Rape or Abuse: emotional, physical or sexual

Not everyone who has experienced a traumatic event will develop PTSD. Some may have managed to put into place other coping strategies that have helped them move forward but may still be suffering the consequences of what has happened to them. Clients who have suffered any of these issues can sometimes take years before they find the courage to seek help, often wrongly blaming themselves in some way for what may have happened. Due to the sensitive nature of this work, counselling sessions usually take place over a longer timeframe to allow for the client to lead at a pace that feels comfortable to them.

Bereavement or Loss

Bereavement is the loss of someone or something that really matters both personally and emotionally. At some time in our lives we are all affected by grief, the emotional response of bereavement, whether through death, divorce, separation, redundancy or any other major loss. Whatever our loss, the emotional effects are the same and often come in waves as we deal with the different phases of grief.

  • Shock and Denial
  • Bargaining (eg. "I will do anything to make them better/have them back" etc).
  • Anger and Guilt
  • Depression and Loneliness
  • Acceptance

Work Related Stress

In today's society, more and more pressures are being put upon us at work. Whilst in an ideal world organizations could reduce its demands on employees, it is probable that each of us as an individual, contribute significantly to our stress and working on ourselves is therefore vital to reduce its affects.

Relationship Difficulties

All relationships whether intimate or not can have their ups and downs and often cover a broad range of problems. Often we can get stuck in certain patterns of behaviour and find them difficult to get out of. Exploring these with a therapist, either on a one to one basis or as a couple, can be helpful. Therapists who are 'Relate' trained in couples counselling and who have previously worked with Relate in this field are available.

Low Self-Esteem

Low self-esteem is having a low opinion of yourself. This can lead to a lack of confidence in situations and can affect both personal and working relationships. Low-self esteem usually stems from adverse childhood experiences or a traumatic experience as an adult. Such experiences may be receiving excessive criticism, being bullied, having unrealistic expectations put upon us or perhaps just being different to the people around us.

Changing Patterns of Behaviour

People have within themselves, the resources needed for personal change and growth. We all have certain patterns of behaviour which once recognised can be worked with, keeping the patterns we are happy with and changing the behaviour patterns that no longer fit.

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