Stepping Up with a Helping Hand

In the last few years mental health difficulties are more openly talked about and acknowledged and it is becoming increasingly acceptable to seek help without the concerns of being stigmatized. Over the years I have seen large numbers of patients in General Practice who have struggled with depression and/or anxiety. It is not uncommon for the two mood states to be experienced together as an anxiety state may bring with it despondency, and conversely a depressed state of mind often involves an element of agitation. In my view, when a patient is very low and very anxious it is the combination of medication and talking therapies that is the key to getting people better in both the short and long term.

A severely depressed or anxious patient is not going to be able to engage with talking therapies until their brain biochemistry is stable. This often involves treatment with a Selective Serotonin Re-uptake Inhibitor (SSRI) to lift them out of the depression or take the edge off the anxiety before a real connection with a trusted professional can help.

Scoring systems such as the PHQ-9 and GAD-7 are good markers of the severity of a patient’s symptoms and a useful tool for proving to the patient after a few weeks of treatment how much better they are. Patients can really forget the sheer desperation of the past and it’s therapeutic to be able to demonstrate their improvement in mood and activity levels.

A couple of steps up the ladder with the correct biochemical support and then the work can start. CBT is very helpful in addressing the thinking that is leading to the change in emotions and consequential behavioural difficulties. This coupled with hypnotherapy which has numerous applications but can be used for changing habits, building self-esteem and future planning is very effective at getting my patients back on the right track. This is both rewarding for the patient and rewarding for me.

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