Problems Treated

Most of us are likely to be affected by emotional problems at some stage in our lives, and this is more likely to occur at times when the stress of life is increased by major life.

Feeling down or anxious will affect our day to day existence, influencing our thoughts and behaviours, how we relate to others, and our work performance. Some emotional difficulties may have commenced recently, but others may have been with us since childhood. These may range from difficulties which cause minor inconvenience, through to difficulties that affect our daily living. A fear of bungee jumping may not greatly impact on our lives, but a fear of leaving our own home most certainly will.

What is depression?

Everyone notices changes in their mood from day to day, or even hour to hour. All of us talk about being “a bit depressed” from time to time, but clearly we do not need to seek treatment every time we say this. So, when is depression a problem which may need professional help? There is no exact dividing line between everyday depression and what people sometimes call ‘clinical depression’. It is a matter of degree. When depression is more severe, more long-lasting, and more widespread in its effects, then we start to say this may be a clinical depression which needs help. People who have this more severe kind of depression usually have other symptoms besides the obvious one of feeling depressed. These are described below:

Common symptoms of depression

The following is a list of the common symptoms of people who are depressed. Not everyone will have all of these, and not everyone will follow exactly the same pattern.

Depressed mood. Feeling low, sad, fed-up, or bleak, numb and empty.

Losing interest, enjoyment and motivation. Nothing seems like fun, everything feels like a chore. Life seems grey, boring and pointless.

Self-criticism and guilt. Feeling that you are bad, useless, inadequate or worthless.

Increased irritability and anger.

Seeing the most negative interpretation of everything that happens. Thinking that nothing will work out right, seeing everything through dark glasses.

Hopelessness, Thinking that not only is everything bleak and pointless, but it will always be like this. It may seem like there’s no point in even trying to make things better because the future contains nothing but further misery and loss.

Feeling anxious, worried or tense, often without knowing why.

Loss of energy.  Feeling tired all the time.

Reduced activity.  In some cases this may reach a point where people just lie in bed or sit in a chair all day without moving.

Finding it hard to be with people. Withdrawing from social activities.

Being excessively restless, agitated and fidgety; or the opposite extreme, doing everything much more slowly than usual.

Difficulty in concentrating, often to the point where it is difficult to follow a TV programme or a conversation.

Memory difficulties. For example forgetting where you have put something down, or not being able to remember someone’s name. There are often more specific memory changes as well, such as finding it much easier to remember anything bad that has happened to you than anything good.

Changes in sleep pattern.  Most often difficulty in getting off to sleep, disturbed sleep, or waking up early and not being able to get back to sleep. Sometimes, however, people may sleep more than usual, perhaps as a way of escaping from feeling bad.

Changes in appetite and weight. Most often a loss of appetite and weight, but sometimes people may 'comfort eat’, resulting in weight gain.

Loss of interest in sex.

Thoughts of death. These may range from thinking it would not be so bad to be killed accidently, to actively making plans for suicide.

While the above are common symptoms of depression, remember that everyone's depression is different and different people experience different combinations of the above listed symptoms.

Problems treated

Panic attacks
What is a panic attack?

A panic attack has three important feature

1. It is accompanied by intense fear and anxiety
2. It usually comes on fairly suddenly
3. The most intense feelings last a relatively brief time (although it may seem like a very long time when you are in the middle of an attack, and it may leave you feeling uncomfortable for some time after the peak has passed).

Panic is usually accompanied by a sense that something awful is about to happen. You may think that you will die, or go mad, lose control, or make a complete fool of yourself, or something else. There are many different fears. Panic often appears to come “out of the blue”, the panic attack is completely unexpected and does not appear to be triggered by anything. Other times, people can recognise particular situations which are likely to trigger an attack.

Panic attacks are very common, but they are not a sign of serious mental illness. We know that as many as one in ten of the general public may have at least one panic attack in their life time (that’s just around half a million people in Ireland!). Many people have panic attacks for a while, but then the panics go away. For others, they may cause problems for a long time. A lot of people presenting for treatment report that they no longer have panic attacks, but they live in fear of having another one. Unfortunately, perhaps because of the prejudices about psychological problems which still exist, many people wait years before they tell anyone or seek professional help, and some people never seek help at all. which is unfortunate, given that the success rate in treating panic disorder using CBT is over 90%.

The symptoms of panic
Panic affects your body, your thoughts and your actions. Below are some of the most common symptoms.

What happens to your body in panic
During an attack, people usually have very unpleasant bodily sensations. You will probably have noticed certain sensations in your own attacks. Some of the common ones are:

You heart beating very fast, skipping beats or having ‘palpitations’
Breathing very fast (sometimes called overbreathing or hyperventilation).
Feeling short of breath, as if you cannot get enough air.
Chest pains, headaches, or pains in other parts of your body.
Tightness in your throat, choking sensations
Feeling as if you have to go to the toilet
Feeling sick
Feeling faint, dizzy or unsteady on your feet
Numbness or tingling, especially in the fingers, toes or lips
Trembling or shaking
Sweating or hot flushes
Feelings of unreality, as if you are not really there, or as if you are separated from everything around you

These are the commonest sensations, but one of the confusing things about panic is that it can cause a very wide range of sensations. Even though your own symptoms may not be on this particular list, you still may be having panic attacks.

Your thoughts/fears in panic
Some of the common fears that people report when having a panic attack:

I am going to have a heart attack
I will collapse or faint
I will not be able to breathe, I will suffocate
I will lose control of my bladder and / or bowels
I will choke
I will be sick
I am going to lose all control, go ‘crazy’, get taken to a mental hospital
I am going to make a complete fool of myself in front of everyone
My panic will never end
In the middle of a panic attack these thoughts are very frightening.

Your action or behaviour in panic
When something as frightening as a panic attack happens, you will obviously do something to try and prevent the harm that seems to threaten you. Most commonly, people believe that they will be safer if they leave the situation they are in, escape as soon as possible to what seems a safer place. For many, this means going home or finding someone with whom they feel safe.

Panic disorder is routinely treated effectively at this clinic. CBT is the gold standard in the treatment of panic disorder.