I am a consultant adult psychiatrist with extensive experience across medicine, therapy and counselling.
All of us, at some stage in our lives, suffer from emotional problems and their consequences. I recognise the distress mental health problems bring and offer an empathic, open-minded and flexible approach to my patients.
I hope not only to reduce distress and anxiety but to also resolve low mood while improving confidence and self-belief.
Depression can be caused by a number of factors, including persistent stress, anxiety, life events, poor self esteem and use of alcohol or drugs. Sometimes it runs in families.
Signs of depression include persistent low mood for weeks, lethargy or agitation, difficulties enjoying life, poor concentration, appetite changes, difficulties with sleep, feeling hopeless or bad about ourselves with suicidal thoughts.
Management includes antidepressant medication, CBT to identify and challenge unhelpful thinking, planning activities and mindfulness.
Learning new skills, especially if we do this with others or to help others, mindfulness and exercise have been shown to improve mood and focus as well as reduce stress and anxiety.
Exercise also reduces cravings for alcohol, improves sleep and gives a feel good factor. There are also numerous physical benefits. It helps prevent strokes, heart attacks, cancers, diabetes, high blood pressure and arthritis.
Mindfulness is about appreciating and enjoying the present moment. It can help not to worry about the future or be preoccupied with past problems.
Alcohol, substance misuse and addictions
Therapy needs to be considered if, for example, there are cravings or there is a need to prevent harm.
The reasons for misuse need to be considered. For example, alcohol is sometimes used to steady nerves. Underlying health issues such as depression, anxiety and ADHD may be relevant. Treatment needs to be focused on reducing harm and addressing dependency issues through, for example, CBT or a detox.
Psychological therapy and pharmacological support to prevent relapse are also important.
Posttraumatic stress disorder (PTSD)
This can follow a single traumatic event or after prolonged abuse. The overwhelming nature of distressing events can result in intense distress and the persistent reliving of events, such as in nightmares. If necessary, I hope to work closely with you to help you recognise and manage the risks to yourself and others from abuse.
Eye Movement Desenitzation and Reprocessing (EMDR), CBT, medication and psychotherapy have also been shown to help PTSD.
EMDR aims to process and store the trauma in a less emotionally charged way. I also use EMDR to address addictions, anxiety and other disorders.
Anxiety is a normal reaction and helps us to deal with threats. It can help us work hard and it can reduce risk taking. However, inappropriate excessive and persistent worrying can be disabling and interfere with day-to-day activities.
A genetic predisposition, childhood adversity and bullying can predispose. It is often precipitated by life events.
Seeking treatment early helps prevent secondary problems such as depression and unhelpful coping mechanisms, such as taking alcohol to excess to feel calm or comfort eating.
Anxiety can be a feature of other disorders such as obsessive-compulsive disorder, posttraumatic stress disorder, anorexia, hypochondriasis, attention deficit hyperactivity disorder and autism.
Anxiety can be reduced with treatment. A thorough assessment is required to establish the problem. Management needs to be tailored to the individual taking into account personal preferences, in the context of treatments that are most likely to have the greatest benefit.
Management includes the development of awareness and learning how to deal with the manifestations of anxiety through applied relaxation and breathing techniques, distraction, mindfulness, confidence building and CBT principles. Medication may also have a useful role.
Social anxiety disorder
This and depression are the most common mental health problem. It is characterised by worrying about what others think of us. A common anxiety is when speaking in public but it may occur in a very severe form and prevent a sufferer from leaving their home.
Panic attacks are a very severe form of anxiety when, out of the blue, overwhelming fear or distress appears. However, they can also occur when in an anxious situation such as prior to giving a talk or when travelling on the tube. It needs to be treated early so as to prevent the avoidance of situations.
Work related stress
I have a wide experience of managing work-related stress. This often results in underachievement and poor mental health. I hope to reduce anxiety, resolve low mood and improve self-belief. I use techniques to improve confidence, manage relationship difficulties and conflicts, explore and challenge fears and worries and improve mental well-being.
Attention deficit hyperactivity disorder (ADHD)
This condition manifests itself through difficulties in focusing. Sufferers may be high achieving due to their drive, energy and ability to think out of the box. However, inattention, difficulties relaxing, forgetfulness, poor organisational skills, relationship difficulties and secondary disorders including depression and substance misuse can cause problems. ADHD can become apparent in early adulthood with the move from a structured home and school environment to living independently.
I have developed my practice to diagnose and treat those with adult ADHD since working, 10 years ago, at a neurodevelopmental assessment center. I hope to improve focus through medication and psychological therapy and address any other issues arising from the disorder.
Autistic Spectrum Disorder (ASD)
Autistic traits are common and bring many strengths, including the ability to absorb and retain facts, the ability to concentrate well and tenacity in overcoming problems. Autism is associated with anxiety and other mental health problems. Diagnosis can often help self-awareness and self-acceptance. Recognising that we all have our foibles and health issues can help us to be kind to ourselves.
Anorexia nervosa occurs when weight loss is self-induced due to a fear of fatness. Self worth is often based on the ability to control weight and body shape.
Bulimia nervosa is a condition in which large amounts of food are taken followed by self-induced vomiting or purging due to a fear of fatness.
Management includes restoring nutritional health and normal eating habits, dealing with self-criticism, cognitive behaviour therapy, improving self-confidence and addressing anxiety, depression and relationship issues. Medication can also help.
Compulsive eating disorder is a similar condition in which large amounts of food are rapidly consumed often in secret. An assessment helps to determine the relative contributions of psychological problems and diet.
It can be a feature of depression, bipolar, anxiety, bulimia and attention deficit hyperactivity disorder, which may need treating in their own right.
I also have experience in managing psychoses, schizophrenia, bipolar disorder, dementia, phobias, and obsessive-compulsive disorder.