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Mental and Emotional Wellbeing | Test

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People suffer a variety of mental health problems such as burnout, depression and anxiety or somatic tension and pain.

In many cases, painful experiences in life’s formative years, including trauma, may serve as unconscious obstacles to recovery if not recognised and addressed (a careful judgement has to be made in each patient’s case as to whether facing such underlying issues at this time is appropriate and will support recovery or will increase vulnerability to relapse).

At Clinic Les Alpes we work with our patients to identify these issues and to develop plans for reducing their impact and to build their ‘recovery capital’, the collection of social and personal resources at your disposal to support your recovery.

Everyone will have experienced a degree of anxiety at some time, perhaps in the mild form of worry, apprehension or nervousness, while some will know what it is like to feel the kind of extreme anxiety known as panic.  We use the term “panic attack” to convey the particularly unpleasant sensations associated with an acute episode of intense anxiety that comes seemingly without warning.  From time to time people may also have experienced a sense of dread or doom, without always knowing why. For many, these emotional experiences are transitory.  For others they may become severe and persistent to the point where they may be described as chronic and attract the diagnosis of an Anxiety Disorder. This is when anxiety has become so debilitating it interferes with the normal course of life and treatment may be required.

Anxiety is not the same as fear, which is a normal response to a real, present threat and passes as the threat dissipates. Anxiety has an anticipatory quality to it which may be a mindset imprinted  by previous adverse, sometimes traumatic, experiences.  Viewed purely in terms of a current context, this state of mind can seem irrational. Severe anxiety is frequently accompanied by restlessness, insomnia, irritability, fatigue and fruitless rumination. People may also simultaneously experience physical discomfort in the form of tension that may bring with it muscle soreness and a variety of aches and pains.  Palms may sweat and hands shake.

Anxiety disorders tend to encompass Generalised Anxiety Disorder on the one hand and on the other anxiety that has a particular focus, such in the case of phobias (claustrophobia, mysophobia/germophobia, arachnophobia etc.), of which there are any number.  Some phobias can place significant limits on a person, Social Phobia being a case in point, as interaction with other people is integral to life. In the grip of severe anxiety some people will avoid human contact, partly out of a worry of what could happen that might be beyond their control. There is also Obsessive Compulsive Disorder, where obsessive, anxiety-based thoughts result in compulsively repetitive behaviour to relieve the anxiety, such as hand washing to avoid germs.

Anxiety disorders may coexist with and relate to, other psychological disorders such as depression, burn out or physical conditions; especially those that pose a significant threat to well-being, to personal capacity and even to life itself. Anxiety is also a characteristic feature of addiction. Many addictions originate in attempts to alleviate, escape or control anxiety in a process often referred to as self-medication. Paradoxically, all addictions tend to provoke anxiety, given the loss of control that generally defines them.  Furthermore, some addictive substances actually stimulate anxiety.

Treatment of anxiety will begin with a careful assessment of the anxiety suffered, including its form, severity, onset and history, as well as current circumstances, including any complicating or aggravating factors such as other illness or lifestyle.  Options, which are applied as appropriate, include, either singly or in combination: psychotherapy (particularly Cognitive Behavioural Therapy), medication, mindfulness, guided relaxation and mutual aid. Other complementary therapies such as equine assisted psychotherapy, massage and some forms of exercise may be also called upon.

Symptom relief may take time and as in all psychotherapy, personal commitment is required. Medication may play an important part in temporarily reducing levels of anxiety if it has come to interfere with normal function.  The good news is that alleviation of anxiety-related problems is achievable.

Everyone will feel down from time to time but for some people a low mood will weigh so heavily on them and persist well beyond a short period that ordinary day-to-day life can come to seem impossible. As this suggests, depression can range in degree from mild, through moderate to severe, at which point a clinical depression requiring treatment may be diagnosed.

Although such emotions can feature, depression is not the same as sadness or grief, especially if these are clearly an appropriate response to a life event such as bereavement. Major losses, however, can trigger a depression, as can illness, injury and other major stressors in life.

There are a number of symptoms which may in some combination signal a serious depression.  These include psychological, physical and social symptoms.  Not everyone will experience depression in exactly the same way.

Psychological

  • Persistently low mood
  • Feelings of hopelessness, helplessness and despair
  • Low self-esteem even to the point of self-loathing
  • Loss of motivation, desire or interest
  • Anxiety in the form of intense worry
  • Feelings of guilt
  • Difficulty making decisions and concentrating
  • Irritability and/or tearfulness
  • Suicidal thoughts and/or impulses

Social

  • Avoidance of social activities
  • Giving up hobbies and personal interests
  • Problems in family and other close relationships

Physical

  • Markedly slowed movement and speech
  • Loss of appetite or weight (or occasionally increases to these)
  • Constipation
  • Tension, aches and pains without apparent cause
  • Loss of energy and a sense of inertia
  • Disturbed sleep
  • Lowered sex drive
  • Changes to menstrual cycle

Some depressions may be understood as being linked to particular circumstances, as with Post-Natal Depression or Seasonal Affective Disorder. The condition may also be a feature of a Bipolar Disorder.

Depression often features in addictions and may be revealed as an underlying factor in the onset of an addiction, which may have begun partly through attempts to self-medicate or find behavioural ways to alleviate a persistently low mood.  Some substances, such as alcohol or benzodiazepines are depressant in nature, while others, such as cocaine, may induce a crash in mood as a rebound from the high they produce.  Behaviours like gambling may initiate a similar pattern.

Treatment for depression will naturally depend upon the severity of the condition.  In a case of mild depression, time will often see the symptoms fade. For depression in the mild to moderate range, exercise is increasingly recommended, though it is important to find a form that suits the individual and to avoid slipping into an obsessive approach. Group exercise can be helpful as it adds a social dimension, reducing any symptomatic tendency to isolate. Self-help groups can be similarly useful as can workbooks (either in print or online). Mindfulness has also been found to help in many cases.

For people unfortunate enough to suffer from moderate to severe depression, Cognitive Behavioural Therapy (CBT) or specialist counselling is a generally preferred option but prescribed medication in the form of anti-depressants may also be called for.  This so-called Combination Therapy is likely to be the most effective response to severe depression.  While CBT is the talking therapy most supported by evidence, some people may prefer to engage with an interpersonal or psychodynamic model.

Because so much negativity surrounds depression, given its very nature, it is easy to lose sight of the fact that with the right treatment and support, most people do recover from depression.