Efficacy™

How to Spot the Signs of Depression

Famous TV presenter Ant McPartlin, most commonly known as one half of Ant and Dec, has announced he was entering rehab for treatment for depression, anxiety as well as prescription drug and alcohol abuse.

Revealing his decision to the Sun on Sunday, the Britain’s Got Talent star said: “I’ve spoken out because I think it’s important that people ask for help if they’re going through a rough time and get the proper treatment to help their recovery.” Depression is a common, highly preventable illness that affects millions of people across the world, yet according to the Journal of the American Medical Association, only 28 per cent of sufferers seek help.

What is depression?

There is a common misconception that depression is merely feeling “down” or “sad”, when the reality of the illness is far more severe and wide-ranging. Depression is a persistently low mood often associated with extreme despondency and apathy and can last for weeks, months or even years.

The causes vary dramatically. Often, life-changing events can be a trigger – and not necessarily negative moments. Anything from “bereavement, losing your job or even having a baby, can bring it on”, says the NHS. Furthermore, people with a family history of depression or anxiety, a similar but distinct condition, are far more likely to suffer it at some point in their lives.

However, the truth of the matter is that depression can strike for no reason at all, so it is always worth being vigilant about your mental wellbeing and that of those near to you.

More doctors are using ketamine to treat severe depression in patients who haven't responded to other treatments.

How do I know if I’ve got it?

Due to its often slow onset, depression can sometimes be hard to spot and can creep up on people almost without them noticing. Doctors advise people to seek help if they feel they’re going through a sustained period of tiredness, low energy or mental fatigue and are unable to enjoy things they previously found pleasurable or interesting.

For an illness for which so few seek treatment, a staggering one in ten people in the UK suffer from it at some point in their life. It also can hit anyone of any age, race or gender.

Other symptoms include a loss of appetite and sex drive, sleeping problems, difficulty concentrating, feelings of guilt and hopelessness and a loss of self-confidence. If these symptoms begin to interfere with your daily life, it is possible you are suffering from depression and should speak to your GP.

How can I get treatment?

For sufferers of moderate and severe depression, a combination of therapy and medication can be prescribed. Cognitive behavioural therapy (CBT), which aims at changing negative patterns of thinking, is often used in conjunction with antidepressants.

 

Words by The Week Magazine

Unique ID: NHS_GP_LAYCOCK ST_GP CONSULT 94 Caption: The consultation room. A doctor writing patient notes, and a woman seated with him.  Restrictions:  Copyright: ©

The General Practitioner Health Service (NHS GP Health) and Efficacy are delighted to launch their joint service for the new national England-wide NHS GPH . Efficacy and the NHS Practitioner Health Programme (NHS PHP) have worked together for 6 years in the Greater London area to treat NHS dentists, hospital doctors and GPs requiring psychological therapies and are now extending their partnership to encompass all NHS GPH England-wide referrals.

GPs who are unable to access confidential care through mainstream NHS routes due to the nature of their role and/or health condition will be able to access a range of options for clients that follows NICE guidance for evidence-based treatments.

The multi-channel care reflects the best in mental health provision and recognizes the need to provide choice to its GP Clients. This includes remote delivery of therapies as well as face to face appointments. The remote models have been designed with GPs in mind understanding that they require consistently high quality therapy delivered by accredited senior therapists together with anonymity and schedule flexibility.  Clients will be offered the chance to receive therapy over the telephone, skype and with a therapist-supported programme with the gold standard SilverCloud software platform.

“Our experience of GPs suffering with mental health problems is that being treated in a confidential service is important to manage their access to therapy and engagement in a much-needed treatment” explains Lee Grant, Clinical Director at Efficacy Ltd. “we are honoured to work with such a critical group of people and look forward to supporting these clients back to health, and back to work.”

“Our England-wide service is extremely important in understanding the human side to GPs by recognizing that sometimes they do become unwell” says Lucy Warner, CEO of PHP. “Providing our GP clients, a high-quality range of treatment options, both remote and face-to-face reflects modern clinical practice in mental health and supports our goal of delivering accessible and confidential services”

The NHS GPH service is a self-referral service only and can offer support to any GP or GP trainee who is registered on the National Performers List in England or who is looking to return to clinical practice after a period of absence and has mental health or addiction concerns.

For more information, please contact Shamira Graham, on 0207 9297911 or 07932 909369 or shamiragraham@efficacy.org.uk.

Cognitive behavioural Therapy (CBT) delivered online is effective for treating depression in adults concludes a new meta-analysis presented at the Annual Meeting for the Psychiatric Association in the United States.

CBT, a type of talk therapy, has been shown to be effective in treating depression in adults with mild to moderate depression. However, a number of barriers, including cost, availability and stigma prevent many from accessing these services. Delivering CBT over the Internet (iCBT) may help address some of the barriers.Laptop man iCBt

Researchers led by Charles Koransky, M.D., a psychiatric resident at the University of Maryland, sought to assess whether iCBT for adults with depressive symptoms leads to a reduction in these symptoms. They identified and reviewed 14 random and controlled studies published between 2005 and 2015 in which iCBT was used with adults with depression.

They found the Internet-delivered CBT was effective in reducing depressive symptoms. iCBT also maintained the positive effects on symptoms for six months after the therapy. The study found no statistically significant difference in depressive symptoms between studies where clinicians participated in the iCBT program and those without clinician assistance in the iCBT treatment.

The researchers conclude that online CBT is effective in reducing depressive symptoms and may be a good treatment modality for individuals unable to access traditional face-to-face therapy.

Words by the Medical Press

Depression is now the leading cause of ill health and disability in the world, according to the World Health Organisation (WHO), following a huge spike in the number of people who report living with the condition.

The condition has overtaken lower respiratory disease as the biggest global health problem, with latest figures showing more than 300 million people worldwide have a diagnosis of depression, an increase of more than 18 per cent between 2006 and 2015.  The organisation said it hopes the figures will lead to improved availability of effective treatment for the condition which carries a huge human cost as well as costing the world economy billions. WHO Director-General, Dr Margaret Chan, said: “These new figures are a wake-up call for all countries to re-think their approaches to mental health and to treat it with the urgency that it deserves.”

Dr Skekhar Saxena of the WHO said lack of understanding of the condition and prejudice towards those who suffer from it remain barriers to effective treatment. “For someone living with depression, talking to a person they trust is often the first step towards treatment and recovery,” he said ahead of the launch of the WHO’s “let’s talk” campaign. According to researchers, even in high income countries, nearly 50 per cent of people with depression do not receive treatment and drugs prescribed are often ineffective.

On average, just three per cent of government health budgets is invested in mental health, varying from less than one per cent in low-income countries to around five per cent in high-income countries including the UK.

Depression

 

Prime Minister Theresa May has pledged to create parity of esteem between mental and physical health in the UK, but critics have suggested the motivation is purely economic, with an aim of “fixing” people and finding them fit for work as quickly as possible. But some mental health professionals and campaigners say the human cost of the condition is immeasurable and the focus should not be exclusively on the estimated cost to the economy and on getting people “back to work” because this is not always helpful and can lead to further problems.

According to mental health charities in the UK, mixed anxiety and depression is the most commonly diagnosed mental health problem in the country, with 7.8 per cent of the population meeting the criteria for the condition, which is believed to account for one fifth of all days taken of work. There is a clear link between depression and suicide, which is the leading cause of death in men under 35. The number of unexpected patient deaths reported by mental health trusts in England has risen by 50 per cent in the last three years, according to figures obtained by the BBC under the freedom of information act.

Demand for mental health services has reached an unprecedented level, while funding for mental health services fell by 8 per cent between 2010 and 2015, according to statistics from 43 trusts. Theresa May delivered a much-publicised speech in January pledging to end the stigma around mental health, but did not promise significant extra funding to deal with the surge in demand for treatment.

 

Words by Rachel Roberts

You feel like a better version of yourself when you’re in a healthy, mature relationship. That doesn’t mean your partner completes you, but they do complement your life in just the right way.

What are some other signs that you’re in the right relationship? Below, marriage experts share seven key differences between a healthy relationship and a toxic one.

1. You’re free to pursue your hobbies and maintain friendships.

Nothing about your core identity should change drastically because of your new relationship status. A mature partner will recognize that pursuing outside interests is necessary and a healthy way to get some air from the relationship, said Kari Carroll, a couples therapist base in the US.

“When a partner is too attached to allow you to enjoy something on your own, it can lead to sacrificing one’s own identity to appease the relationship,” she said. “If your partner has fears about you doing things on your own, it could turn into the self-fulfilling prophecy. In other words, you may ultimately seek even more space and leave.”

2. You don’t act differently when you’re around them.

Do you act noticeably different when you’re alone with your friends and family versus when your new boo tags along? In a healthy relationship, your demeanor, personality and general interactions are pretty much the same regardless of who’s there, said Marie Land, a renowned psychologist.

“If you act differently when your partner is in the room, it’s a bad sign,” she told The Huffington Post. “You shouldn’t feel the need to adjust your behavior based on your partner’s presence.”

3. Power is relatively equal.

In a healthy relationship, power and household responsibilities are pretty much evenly distributed, said Amy Kipp, a couples and family therapist based in San Antonio, California. You can count on your partner to respect your work obligations and to help clean up before mystery odors begin emanating from your apartment. It’s all part of the deal.

“Both partners should have equal decision making power in every part of the relationship,” she said. “Toxic relationships often involve one partner that is highly dominant or two partners that engage in attempts to ‘grab’ power from the other.”

4. You can follow your dreams.

Your dreams and goals for the future don’t have to perfectly align, but your partner should support your big life plans. She may give you a slight side-eye when you mention opening an artisan cheese shop one day, but ultimately, you know she’d support you, Carroll said.

“Compromise should always come into effect. If your partner consistently shoots down your dreams as unrealistic or not convenient, you may not feel like you are fully supported or understood,” she said. “Over time, this can lead to giving up on one’s dreams and the relationship feeling less like a partnership.”

A shared life is complicated enough without throwing dashed dreams into the mix. To sidestep this issue, Carroll recommends talking about your plans for the future early and often.

5. Your differences are celebrated.

 

You grew up in the city, but she’s a country girl at heart. You are a meat and potatoes kind of guy, but she’s strictly vegan. Your differences in outlooks, beliefs and interests probably drew you to each other initially ― and they should stay interesting with time.

“In toxic relationships, couples become enmeshed with each other and differences are often seen as threats to the relationship,” she said. “In healthy relationships, differences in interest or opinion are not only tolerated, but celebrated.”

Obviously, substantial differences in values can be a problem, but otherwise, “the things that make people unique help to keep the relationship interesting,” Kipp said.

6. You can leave your cellphone unattended.

In a healthy relationship, you should feel comfortable leaving your phone unguarded around the house. Why? You can trust that your partner won’t go rifling through your texts and even if she did, she wouldn’t find anything worrisome, Land said.

“Everyone is entitled to their privacy but you should not feel like it’s a big deal to have your computer open or phone around,” she said. “There should be trust between the two of you.”

 7. You can tell your partner when they hurt you.

Don’t be worried if you argue with your partner; conflict is natural and a sign that you’re open to communication, Carroll said. But you should be worried if you feel uncomfortable opening up about why you’re upset, Carroll said.

“Talking about it leads to partners feeling valued and heard,” she said. “If you don’t feel comfortable discussing a misunderstanding, it can lead to compounding resentment and distance. Learning to discuss conflict is uncomfortable but ultimately rewarding.”

Words by Brittany Wong.

Unique ID: NHS_GP_LAYCOCK ST_GP CONSULT 94 Caption: The consultation room. A doctor writing patient notes, and a woman seated with him.  Restrictions:  Copyright: ©

The General Practitioner Health Service (NHS GP Health) and Efficacy are delighted to launch their joint service for the new national England-wide NHS GPH . Efficacy and the NHS Practitioner Health Programme (NHS PHP) have worked together for 6 years in the Greater London area to treat NHS dentists, hospital doctors and GPs requiring psychological therapies and are now extending their partnership to encompass all NHS GPH England-wide referrals.

GPs who are unable to access confidential care through mainstream NHS routes due to the nature of their role and/or health condition will be able to access a range of options for clients that follows NICE guidance for evidence-based treatments.

The multi-channel care reflects the best in mental health provision and recognizes the need to provide choice to its GP Clients. This includes remote delivery of therapies as well as face to face appointments. The remote models have been designed with GPs in mind understanding that they require consistently high quality therapy delivered by accredited senior therapists together with anonymity and schedule flexibility.  Clients will be offered the chance to receive therapy over the telephone, skype and with a therapist-supported programme with the gold standard SilverCloud software platform.

“Our experience of GPs suffering with mental health problems is that being treated in a confidential service is important to manage their access to therapy and engagement in a much-needed treatment” explains Lee Grant, Clinical Director at Efficacy Ltd. “we are honoured to work with such a critical group of people and look forward to supporting these clients back to health, and back to work.”

“Our England-wide service is extremely important in understanding the human side to GPs by recognizing that sometimes they do become unwell” says Lucy Warner, CEO of PHP. “Providing our GP clients, a high-quality range of treatment options, both remote and face-to-face reflects modern clinical practice in mental health and supports our goal of delivering accessible and confidential services”

The NHS GPH service is a self-referral service only and can offer support to any GP or GP trainee who is registered on the National Performers List in England or who is looking to return to clinical practice after a period of absence and has mental health or addiction concerns.

For more information, please contact Shamira Graham, on 0207 9297911 or 07932 909369 or shamiragraham@efficacy.org.uk.

 

Prof Colin Ellard was walking past the rows of new-build towers that dominate the west of central Toronto when he had a sudden realisation. “I was struck by how dark, sombre and sad these new urban canyons made me feel,” he says.

Ellard, a cognitive neuroscientist at the University of Waterloo in Canada who studies the impact of places on the brain and body, wanted to know why he felt like that – and if others felt the same.

His curiosity ultimately led him to conduct a series of virtual reality experiments in which he asked people to wear specialised headsets and stroll through a variety of urban environments created to test their responses. The findings, he says, proved he was not alone. Being surrounded by tall buildings produces a “substantial” negative impact on mood.

If proven, Ellard’s theory adds weight to existing studies finding a negative effect of high-rises on the mental health of city residents. With both government policy and the potential for greater profits driving high-density construction in cities around the world, this raises an important question for the development industry.

London skyline

 

Dwellers have a 40% increased risk of depression and double the rate of schizophrenia, according to the Centre for Urban Design and Mental Health. Ellard’s idea is that the moment to moment bad feelings he observed in the virtual reality environment can affect everyday interactions in the real world and people’s experience of living in cities. “When people are in these very dense environments that produce oppressiveness and increase negative emotion, it seems logical that those things will spin off into the ways we understand other people and the way we treat them,” he says. “Those are the variables that are most likely to show relationships with [increased incidence of] psychiatric illness.”

This may seem a big leap but Ellard is the latest in a long line of researchers to see a link between high-rises and poor mental health. Nicholas Boys Smith, founder of built environment social enterprise Create Streets, analysed academic studies on high-rise living for his 2016 report on the design of cities. According to Boys Smith, the balance of evidence shows residents of high-rise blocks tend to suffer from more stress, mental health difficulties and neurosis, with child development particularly affected. “High-rise can work, but it’s much harder,” he says.

 

These concerns also come up against the commercial reality in high value areas such as London, where there are more than 400 towers in the development pipeline (pdf). David Birkbeck, chief executive of housing consultant Design for Homes, says inflated land prices mean developers have little option but to go upwards to make their investment back. “Once they’ve outbid everyone for a site, height is their only way to recover the price paid,” he says.

The question is how to build densely without these negative repercussions. “The villain isn’t density itself, it’s insensitive design,” says Layla McCay, director of the Centre for Urban Design and Mental Health. “It’s about how you design in things that are protective to people’s mental health – green spaces and opportunities for social interaction.”

Words by Joey Gardiner

 

In a bid to shake off the stigma around mental health, Marks and Spencer is planning to launch mental health ‘cafes’ where shoppers can talk about issues that are affecting them.

The Frazzled Cafe project will allow customers to offload their stresses in 11 stores across the country, with more locations to be added in the coming months. Taking place after hours at M&S cafes, the fortnightly sessions will be led by volunteer therapists, and will provide an anonymous and non-judgemental environment for people to chat.

The-Death-Cafe-011

The branches taking part include three in the London, as well as Nottingham, Leeds and Newcastle.  The retailer’s new initiative is in partnership with author, comedian and mental health awareness campaigner Ruby Wax.

Wax has written several books on the topic of mindfulness, having suffered episodes of depression for most of her life. “We live in a time where to have a life crammed to the hilt is considered a success story,” the comedian commented.

“But with all this pressure, so many of us have nowhere to go to meet and talk about it.”

Words by the Evening Standard

Anxiety is one of the most common mental health disorders worldwide. Because of this you probably know at least one person who struggles with their anxiety, but have you considered how debilitating is actually is for them? There are many types of anxiety conditions from social anxiety to post-traumatic stress disorder. Around 12 to 18 percent of people are affected by an anxiety condition at any given time. There must be a fairly large proportion of couples where at least one partner struggles – And that’s completely normal.

The different types of an anxiety disorder include general anxiety disorder, social anxiety, panic disorder, phobias, obsessive-compulsive disorder, post-traumatic stress disorder, separation anxiety disorder, agoraphobia and more. Anxiety can be a challenge in any relationship, however there is no reason to let it spoil things between you and your partner – It can bring two people much, much closer. A lot of people find themselves wanting to help their partner but not knowing what to do. Here are some tips to help you support your partner.

First, learn about their anxiety. Find out what it means for them, how it starts and develops, what helps and what doesn’t. There are many good resources online to learn, but your partner may not be able to access these because the anxiety gets in the way. Don’t try to lecture your partner, but use the knowledge to help. The NHS has very good information on anxiety disorders that you can find following this link.

Couples link

Remember, it is nothing personal. Some people with anxiety prefer to be left alone while they recover from an attack, or to remain focused. This is not because they don’t love you or that you aren’t calming enough; it is just the way in which they prefer to cope. It is their battle and whichever way they feel most comfortable overcoming it, let them do it – That in itself is showing support. Those with anxiety may also respond in an angry tone, be resentful or feel guilty towards their spouses. Do not let this bring you down, it is the condition that is causing your partner to behave this way. Always bear that in mind.

Encourage treatment. If your partner does not yet receive treatment for their anxiety, gently suggest that you can help make arrangements – After all, you want to help them. Offer your support during the appointment so it is less daunting. If left untreated anxiety disorders can get worse. There are lots of online resources, videos, books and more if your partner does not yet feel confident enough to sit face to face with someone. Calm breathing is one of the simplest and easiest ways to calm an anxiety attack.

Don’t criticise what they do. If you don’t know what it is like to experience an anxiety disorder (or even if you do), do not tell your partner off for getting anxious over situations which may seem silly to you. Also, don’t criticise their way of coping with anxiety. Don’t offer advice or alternatives, if it works for them, leave them to it. Instead, support them through it and praise them when they manage to cope well.

You will NOT ‘cure’ your partner of their anxiety. A lot of the time, some partners go into a relationship assuming they can instantly cure their spouse of their mental health disorder. Just as you cannot ‘cure’ someone with diabetes, just by making them happy; it is also not possible to cure your partner of anxiety by loving them lots (although it does help).

Don’t assume what your partner needs or wants during anxious periods, listen instead. Although you may only be trying to help, you do not want your partner to feel small and incapable by offering help constantly.

Be there, but do not isolate yourself. Many people with anxiety disorders prefer to have a small circle of friends. Because of this they will not be as social as you may like. It is okay to spend nights in together if that is what you prefer however do not become isolated from your friends/family. Ensure you get out and socialise to maintain a healthy mind yourself.

Communication is key when in a relationship with somebody experiencing an anxiety disorder. An understanding of when they feel particularly low or are having a good day will not come instantly. Encourage communication to recognise the signs.

Being with somebody with anxiety is not a burden in any way. Neither of you are victims and if you chose to be with a person experiencing an anxiety disorder, life won’t be too much different. However it may require a little more patience, care and a better understanding of one another – Which will only bring you closer together.

Words by Samantha Glass

Depression and anxiety are both mental health conditions, however, the causes, signs and symptoms can occur in different ways. Depression is more than just feeling unhappy for a couple of days. However the illness affects people in different ways and can cause a wide variety of symptoms – from mild to severe. Depression and anxiety sometimes appear together and can even be treated with similar techniques.

Stephen Buckley, a Professional said: “Different mental health problems share many of the same potential causes, including depression and anxiety disorders.

“The reasons for experiencing a mental health problem vary from person to person, and there won’t always be a clear or known reason, but some people experience mental health problems due to stressful or traumatic life events (e.g. losing your job, money worries, bereavement, experiencing abuse or violence, physical illness). Depression and anxiety can also both be caused by other mental health problems. People experiencing anxiety may find that their worries persist for a long period of time, that they are overwhelming, or that they are feeling anxious about everyday activities such as going to work or meeting friends. In some cases, anxiety can even stop you being able to do things like hold down a job or maintain close relationships.”

Anxiety-depression-headlines

“Depression affects everyone differently, but there are some common symptoms, including feeling low-spirited, restless, irritable, seeing no point in the future, feeling numb and disconnected from other people, gaining no pleasure from things usually enjoyed and losing interest in sex.” He said severe depression can be ‘debilitating and even life-threatening’ as it can cause suicidal thoughts.

Stephen added: “There are treatments that help with both depression and anxiety, such as talking therapy/CBT – so the positive news is that while depression and anxiety can occur together, they can usually also be treated together. If you or someone you know may be experiencing either or both anxiety and depression, it is important to speak to someone, such as your GP or friend or family member, as soon as possible so you are not alone in dealing with it and can get the right help and support. We know mental health can be a difficult thing to talk about, especially with a GP or practice nurse, someone you might hardly know.”

New figures reveal the impact of stigma faced by those of us with a mental health problem. Results from the biggest UK wide survey into the impact of mental health stigma showed that almost two fifths – 38 per cent – of respondents had been negatively treated as a result of their mental health problem – potentially affecting millions nationwide. The independent public poll was carried out across a sample of 2,000 adults living with a range of mental health problems. Sue Baker, Director of Time to Change, said: “These figures show the devastating impact that mental health stigma continues to have on potentially millions of lives.

“We know that progress is being made in improving attitudes and reducing discrimination in some key areas of life but too many of us are still being made to feel isolated, ashamed and worthless by other people’s reactions, resulting in the loss of what means the most – our friends, our families, our jobs. The good news is that being open about mental health, and ready to listen, can make a positive difference and potentially change lives. Time to Talk Day is a great reason for everyone to get involved and become part of our movement to change how we all think and act about mental health.”

 

Words by Olivia Lerche