What we can help with

Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder (ADD/ADHD) 

People with ADHD and ADD present with deficit of attention and/or hyperactivity/impulsivity since childhood, though they might be only diagnosed as adults.

Some ADHD symptoms include struggling with attention to details; failing to complete schoolwork or duties in the workplace; difficulty in organising and planning activities; being fidgety, restless, or hyperactive; talking too much; being impatient; being impulsive. This condition can cause problems with impulse control, emotional regulation, anger management, substance misuse, eating problems, sleep problems, and can impact on education, work, daily activities, relationship and quality of life.

With appropriate medical and psychotherapy treatment, people with ADHD can improve considerably and achieve their real potential. ADHD or ADD are present in about 4-5% of the adult population. 

When to consider an ADD/ADHD assessment

If you experience the symptoms above, it would be helpful to explore an ADHD/ADD assessment.

What is Addiction?

An individual suffers from an addiction when they become physically or psychologically dependent on a substance or a particular activity despite negative consequences on their life. Some of the symptoms of addiction include excess use, inability to manage everyday life without the substance or activity, mood swings, irritability, lying, change in performance and others. There are different types of addiction listed below:

Substance misuse – repetitive use of a substance in a way that is damaging for an individual and can lead to dependence in a substance. Dependence involves developing a tolerance for the substance over time and going through withdrawal symptoms without it. Examples of substances that are often misused include:

• Alcohol
• Cannabis
• Cocaine
• Heroin
• Methamphetamines
• Club drugs
• Ecstasy
• GHB
• Ketamine
• LSD
• PCP
• Nicotine

Behavioural addictions – Behaviours can also become addictive. Similar to substances, behaviours become addictive when used excessively to help the person cope with difficult thoughts and feelings. Examples of addictive behaviours include compulsive shopping, gambling, pornography, internet, eating and others.

Treatment for Addiction

If you decide to see a psychologist for your addiction, they will take some time to understand the origins of your difficulties and will help you develop alternative strategies for managing your life and building resilience.

The most effective treatments for addictions are motivational interviewing Cognitive Behavioral Therapy. All the psychologists at Life Element Medical Center are trained to deliver CBT and motivational interviewing for addictions. In some instances, we might require you to also have an assessment with our Psychiatrist to consider medication that might help you manage the physiological elements of your addiction.

What is anxiety?

Anxiety is a very common human emotion which comes from an experience that one is in a dangerous situation. In this sense anxiety has evolutionary value as it is an important emotion that alerts to danger and threat in the environment. When individuals suffer from anxiety their experience of fear becomes overgeneralised as they begin to experience that in reality are not threatening to them as posing a significant threat.

If you suffer from an anxiety disorder you might find yourself unable to stop worrying and being in a state of heightened stress most of the time. This can become an all-consuming experience taking over your life.

There are various types of anxiety as listed below:

Generalized Anxiety Disorder (GAD) – If you suffer from GAD you are likely to feel anxious about most things and in most situations rather than have a specific focus for your worries. This could have an effect on your concentration, sleep and appetite and is likely to be an obstacle to being able to live your life as you would like.

Panic Disorder – If you suffer from panic disorder you might find yourself experiencing intense panic and this could be in relation to specific situations or more generalised. Over time people who suffer from panic attacks become anxious about experiencing another panic attack so the focus of anxiety becomes the anticipation of anxiety. Panic disorder often involves physical symptoms of anxiety such as palpitations, dizziness, sweating and others.

Other forms of anxiety include health anxiety, phobias, and Obsessive Compulsive Disorder. 

Treatment for anxiety

In the long term the most effective treatments for anxiety are psychological and the approaches with the best evidence are acceptance and commitment therapy (ACT), cognitive behavioural therapy (CBT), mindfulness based cognitive therapy (MBCT). The emphasis on these treatments is on the individual’s thinking and how this influences their experiences of anxiety, behaviours that might maintain anxiety and the acquisition of new skills including mindfulness.

The psychologists at Life Element Medical Center are highly trained in therapies for the treatment of anxiety and will recommend the most suitable approach for you depending on their assessment of your difficulties.

AUTISM SPECTRUM DISORDERS (ASD), including Asperger’s Syndrome, is a type of neurodevelopmental disorders. It is a lifelong diagnosis. With the right kind of support, people with ASD often lead successful and fulfilling lives. However, there are particular areas of their lives where they experience genuine barriers:

• Managing social situations and social interactions;
• Communicating with other people, and;
• Developing and maintaining social relationships.

Additionally, people with ASD may find it hard to cope with changes and rely on extraordinarily strict routines to manage their lives. Some have very intense interests in certain areas, and dedicate most of their energy and time in pursuing these interests. Sensory sensitivities (e.g. sensitivity to light, sounds, textures) are also frequently reported amongst people with ASD.

When to consider an Autism Diagnostic Assessment?

If you experience the aforementioned symptoms, it would be helpful to explore an Autism Diagnostic Assessment and see if a diagnosis of ASD is a useful way of understanding your difficulties.

What is bipolar disorder?

Bipolar disorder, previously known as manic depression, is a condition that can affect your mood, making it swing from one extreme to another. If you are suffering from bipolar disorder you will have episodes of depression during which you feel low and lethargic alternating with episodes of mania during which you feel high and overactive. Symptoms of bipolar disorder depend on which mood you experience at the time. Unlike mood swings, in bipolar disorder each mood can last for several weeks with some people not often experiencing a ‘normal’ or ordinary mood.

Symptoms of depressed phase:

• Sadness
• Uncontrollable crying
• Anxiety
• Loss of interest or enjoyment in activities
• Withdrawal from family and friends
• Excessive guilt
• Suicidal thoughts and urges

Symptoms of manic phase:

• Increased energy
• Unusual talkativeness
• Racing thoughts
• Little need for sleep
• Inflated self esteem
• Spending sprees

There are two different types of bipolar disorder, bipolar I and bipolar II. The main difference between them is that a person with Bipolar I has manic episodes, while someone with Bipolar II has hypomanic episodes. The main difference between mania and hypomania is one of severity.

Treatment for bipolar disorder

Medication is an important aspect of the treatment of bipolar disorder. This is prescribed to prevent episodes of mania, hypomania and depression and also to treat symptoms of these episodes when they occur. If you need to be assessed for bipolar disorder, the first step would be to see our psychiatrist for an assessment.

Psychological therapy is also an important part of the treatment of bipolar disorder. Cognitive Behavioural Therapy (CBT) can help a person cope with bipolar symptoms and learn to recognise when a mood shift is about to occur. CBT can also help someone with bipolar disorder stick to a treatment plan to reduce the chances of relapse.

Binge Eating Disorder

What is binge eating disorder?

Binge eating disorder is when an individual regularly eats more food than most other people would in a similar time period and in similar circumstances and feeling that one’s eating is out of control during a binge.
Binge eating episodes include three of the following:

• Eating extremely fast
• Eating beyond feeling full
• Eating a lot when not hungry
• Eating in secret to hide the amount that is being eaten
• Feeling terrible after a binge

In order to meet the diagnosis for the disorder, the person needs to binge eat at least once a week for three months.

Unlike other eating disorders such as bulimia, binge eating disorder doesn’t involve engaging in compensatory behaviours such as purging or use of laxatives or over-exercising.

Treatment for binge eating disorder

Effective psychological therapies for binge eating disorder are cognitive behavioral therapy (CBT) and modified dialectical behavioural therapy (DBT). All the psychologists at Life Element Medical Clinic are trained in CBT and DBT and can offer you the most appropriate intervention following an assessment of your difficulties.

What is body dysmorphic disorder?

Body dysmorphic disorder is an anxiety disorder that causes the person to have a distorted view of how they look and to spend a lot of time worrying about their appearance. This could be focused on any aspect of their face or body. Having BDD does not mean that the person is vain or self obsessed.

Symptoms of BDD include:

• Constantly comparing one’s looks to other people’s
• Spending a lot of time in front of the mirror or at other times avoiding mirrors altogether
• Spending a lot of time concealing what is seen to be a defect
• Becoming distressed by a particular area of their body (or commonly their face)
• Feeling anxious when around other people and avoiding social situations
• Being overly worried about asking for help out of fear that they will be seen to be vain or self obsessed
• Seeking medical treatment for the perceived defect such as cosmetic surgery
• Excessive diet and exercise

Although BDD is not the same as OCD, there are some similarities for instance in the repetition of compulsive behaviours. BDD can also lead depression, self-harm, and suicidal thoughts.

Treatment for BDD

Different therapeutic approaches may be utilised in the treatment of BDD such as Acceptance and Commitment Therapy, Cognitive Analytic Therapy, and most commonly, Cognitive Behavioral Therapy (CBT). All the psychologists at The Chelsea Psychology Clinic are able to work with BDD. In some instances, if BDD symptoms are particularly severe a medication review by a Psychiatrist might be helpful.

What is borderline personality disorder?

Borderline personality disorder (BPD) is a developmental disorder that is characterised by intense emotional dysregulation, impulsivity and unstable interpersonal relationships. Unfortunately, BPD can often be misdiagnosed. Some people with BPD are given the diagnosis of bipolar disorder when in BPD the mood changes are much more rapid as mood can fluctuate significantly often within the same day.

To be diagnosed with BPD the person must experience at least five of the following symptoms:

• Fear of abandonment
• Unstable or changing relationships
• Unstable self image; struggles with identity or sense of self
• Impulsive self-destructive behaviours (excessive spending, unsafe sex, substance misuse, binge eating and others)
• Suicidal behaviour or self-injury
• Mood instability with varied mood swings
• Feelings of emptiness
• Difficulties with anger, including frequent loss of temper or physical fights
• Stress related paranoia or dissociation

If you are worried that you are suffering from BPD, it is important that you have a specialist assessment to verify or exclude the diagnosis. There is often co-morbidity between BPD and other disorders such as depression, anxiety, substance misuse or eating disorders.

Treatment for BPD

BPD can be a serious condition and many people with the condition are at risk of attempting suicide at some point in their life. However, the outlook for BPD is positive over time, and specialist psychological therapy and medical treatment can be helpful.

There are several specialist psychological therapies that can be effective for treating BPD. Those are Dialectical Behaviour Therapy (DBT, Mentalization Based Treatment (MBT), and Schema Therapy (ST).

What are psychosexual issues?

Psychosexual issues are sexual problems that are psychological in origin rather than physiological. They may arise as a result of stress, anxiety, nervousness, worry, fear, depression, trauma and other causes. Sexual problems can vary in severity and intensity, some can be minor and temporary whereas others have been around for a long time. Examples of psychosexual issues are:

• Loss of sexual desire
• Painful intercourse
• Difficulties with orgasm
• Arousal disorders
• Erectile dysfunction
• Premature or delayed ejaculation
• General breakdown in a couple’s sexual relationship

Treatment for psychosexual issues

Psychological therapy can help you understand the origins of psychosexual difficulties. Often therapy is likely to focus on the underlying causes than the sexual difficulties themselves though some guidance is also offered about strategies for managing some of the difficulties you might be struggling with. We are likely to meet you first for an initial assessment and spend some time developing a psychological formulation of your difficulties. An appropriate treatment plan will be formulated then. Sometimes we may subsequently refer you to another specialist for assessment if this is deemed appropriate.

What is depression?

We all go through spells of feeling down but if you are feeling depressed you are likely to be feeling persistently sad for weeks or months, rather than just a few days. Depression is a serious mental health condition, not a sign of weakness or something the individual can just ‘snap out of’. Depression can affect people in different ways and cause a variety of symptoms. Here is a list of some of the symptoms of depression:

• Continuous low mood or sadness
• Feeling hopeless or helpless
• Feeling tearful
• Feeling guilt-ridden
• Feeling irritable and intolerant of other people
• Having no motivation or interest in things
• Feeling indecisive
• Not getting enjoyment out of life
• Feeling anxious or worried
• Having suicidal thoughts or thoughts of harming yourself
• Lack of energy or interest in sex
• Change in appetite
• Disturbed sleep (sleeping too much or sleeping too little)

This is not an exhaustive list as there are different levels of severity of depression (mild, moderate and severe) as well as different types of depression such as seasonal affective disorder, bipolar disorder, post-natal depression and others.

If you think you are suffering from depression, contact your GP to discuss your symptoms.

Treatment for depression

A combination of anti-depressant medication and psychological therapy has been shown to be most effective for the treatment of depression. Cognitive-behavioural therapy, acceptance and commitment therapy and mindfulness-based cognitive therapy are the most effective therapeutic approaches for the treatment of depression. If you are interested in exploring the underlying causes of your depressive symptoms, cognitive analytic therapy could also be helpful.

What is an eating disorder?

Eating disorders are characterised by an abnormal attitude to food that causes someone to change their eating habits and behaviour. An individual with an eating disorder tends to focus on their weight excessively, leading them to make unhealthy choices, over-exercise or use other behaviours such as purging to control their weight. Eating disorders often have a very damaging effect on an individual’s health.

There are different types of eating disorders with the most common being:

Anorexia nervosa – When a person tries to keep their weight as low as possible, often by excessively restricting their eating and/or excessive exercise

Bulimia – When a person goes through periods of binge eating and is then deliberately sick or uses laxatives to control their weight

Binge eating disorder – When a person eats large amounts of food in a short time

Some people might be diagnosed with an eating disorder that has a mixed presentation of these symptoms which is referred to as EDNOS, eating disorder not otherwise specified.

The most common symptoms of an eating disorder are:

• Negative perception of your own body
• Constant weighing yourself
• Dissatisfaction with body parts
• Food restriction
• Compulsive exercise
• Need for perfection
• Purging
• Fear of being fat
• Excess eating

Treatment for eating disorders

If you are suffering from an eating disorder, depending on its type and severity, you might require a multi-disciplinary approach to treatment. 

What is Generalised anxiety disorder (GAD)?

Whilst anxiety is a normal human emotion and also a feature of a range of psychological disorders, when someone suffers from GAD they can experience anxiety around a wide range of aspects of their daily lives in a way that is debilitating. People who suffer from GAD feel anxious most days and often struggle to remember the last time they felt calm or relaxed. As soon as one anxious thought dissipates, another thought might appear and take hold for a completely different issue. There both psychological and physical symptoms of GAD and these are:

• Restlessness
• Feeling constantly ‘on edge’
• Difficulty concentrating
• Sense of dread
• Fast, irregular heartbeat
• Difficulties sleeping
• Headaches
• Excessive sweating
• Shortness of breath
• Dizziness
• Irritability

This is not an exhaustive list as anxiety can manifest itself in many ways. The most characteristic feature of GAD is the experience of endless and persistent worries that can feel overwhelming.

Treatment for GAD

In the first instance it might be helpful to have an assessment with a psychologist to consider what therapeutic approach might be helpful with your difficulties. The most effective forms of therapy for GAD are cognitive behavioural therapy, acceptance and commitment therapy, and mindfulness based cognitive therapy. 

If psychological therapy hasn’t been effective some medication can be prescribed on a short term or long term basis.

Grief reaction is a term used to describe the sense of loss felt when a loved one passes away. The sense of loss might come with a range of different emotions such as sadness, anger, anxiety and guilt. Although this is a normal process that everyone goes through sometimes grief can be an overwhelming experience or bring up particularly unmanageable feelings depending on the nature of the relationship to the person that passed away resulting in ‘complicated bereavement’. This can then cause difficulties such as the individual becoming withdrawn, angry or even experiencing symptoms of depression.

What are the symptoms of bereavement?

• Intense sorrow and pain at the thought of your loved one
• Focus on little else but your loved one’s death
• Extreme focus on reminders of the loved one or avoidance of reminders
• Difficulties accepting the death
• Numbness and/or detachment
• Feeling that life has no purpose
• Irritability or agitation
• Lack of trust in others
• Inability to enjoy life or think back on positive experiences with your loved one

If these symptoms don’t improve over time it might be helpful to seek therapy. Some of the signs that your bereavement might be more complicated and requiring treatment would be:

• Having trouble carrying out normal routines or activities
• Withdrawal from social activities
• Depression
• Thoughts of guilt or self-blame
• Persistent belief that you did something wrong or could have prevented the death
• Loss of sense of purpose in life
• Feeling that life isn’t worth living without your loved one
• Wish that you had died along with your loved one

Treatment for bereavement

Therapy for bereavement can be helpful in understanding your loss and how it has impacted you and your life. There are different types of therapy that are beneficial when struggling with bereavement such cognitive behavioural therapy (CBT), cognitive analytic therapy (CAT) and acceptance and commitment therapy (ACT).

What is health anxiety?

Health anxiety is a psychological disorder that results in the individual worrying excessively about their health and fearing that they have a serious physical illness, often when there is no reason to think this. This excessive worry about one’s health can cause great distress and affect everyday life. Some people with health anxiety have a medical condition about which they worry excessively whilst others might have medically unexplained symptoms. Others may just be persistently worried about their future health.

Some of the symptoms of health anxiety are:

• A constellation of unexplained physical symptoms and frequent visits to the GP to check if these symptoms represent an undiagnosed medical condition
• Fear of getting sick or experiencing symptoms of illness in the absence of current symptoms
• Residual fear about the possible reoccurrence of a disease or illness
• Fear about catastrophic outcomes that might occur if one were to contract an illness
• Fear of heightened vulnerability or susceptibility to disease or illness
• Engaging in a range of behaviours such as consulting multiple doctors, undergoing diagnostic procedures, researching possible explanations of symptoms, engaging in frequent hand washing and other safety behaviours

Treatment for health anxiety

Once a physical cause for your current symptoms has been excluded your GP, a psychiatrist or psychologist in liaison with your GP could give you the diagnosis of health anxiety. The most effective treatment approach for health anxiety is cognitive behavioral therapy (CBT). 

What is obsessive-compulsive disorder (OCD)?

Obsessive-compulsive disorder is a common disorder in which the individual suffers from obsessive thoughts and subsequently engages in compulsive activity to manage these thoughts.

An obsession is defined as an unwanted thought, image or urge that repeatedly enters the person’s mind, causing feelings of anxiety, disgust or unease.

A compulsion is a repetitive behaviour (which could also be mental) that someone feels they need to carry out to relieve the unpleasant feelings brought on by the obsessive thought.

OCD symptoms can vary in terms of their severity. For some people these thoughts and compulsive behaviours can take up to an hour of their day whereas for others it can take over their life.

Symptoms of OCD

• Obsessions – where an unwanted thought, image or urge repeatedly enters your mind
• Anxiety – the obsession provokes intense anxiety and distress
• Compulsion – repetitive behaviours or mental acts are performed to bring about relief to the distress or anxiety
• Temporary relief – the compulsive behaviour only brings about temporary relief but the anxiety and obsession soon return

OCD manifests itself in different ways but some common obsessions are fear of deliberately harming yourself or others, fear of contamination by disease or infection, a need for symmetry and orderliness. The compulsive behaviours people engage in can also vary from counting, seeking reassurance repetitively, repeating words silently, extensively overthinking, thinking ‘neutralising thoughts’, cleaning and hand washing, checking and other behaviours.

Treatment for OCD

The most effective treatment for OCD involves graded exposure and response prevention, a therapy which focuses on experiencing the obsessive thoughts without trying to ‘neutralise’ them with compulsive behaviour. On some occasions if OCD is particularly severe it might be helpful to have a consultation with our psychiatrist to consider medication options that might assist in the management of your symptoms. 

Anorexia nervosa is a serious mental health condition. It’s an eating disorder where an individual keeps their weight as low as possible to the detriment of their physical health. Individuals suffering from anorexia do this by restricting their food intake, making themselves vomit and through excessive exercising.

The main underlying fear is about body shape and becoming fat which can often be a consequence of the person having a distorted image of themselves and a belief that they are fat even when they are not. Anorexia mostly affects girls and women though more recently it has started to be also common in boys and men.

Individuals with anorexia often hide their behaviour from loved ones. Common symptoms of anorexia include:

• Missing meals, eating very little or avoiding certain types of food
• Obsessively counting calories in food
• Leaving the table immediately after eating in order to vomit
• Taking laxatives and appetite suppressants
• Physical problems such as feeling lightheaded or dizzy, hair loss or dry skin
• Repeated weighing and checking one’s body in the mirror

Individuals suffering from anorexia might also suffer from a range of other emotional difficulties such as anxiety, depression and self-harm.

Treatment for anorexia

Treatment for anorexia involves psychiatric management, cognitive behavioral therapy, and Cognitive Analytic Therapy (CAT). Due to the complexity of the disorder it is often recommended that treatment needs to be multi-disciplinary attending to the individual’s mental, emotional and physical well-being.

What is panic disorder? 

Panic disorder (PD) is an anxiety disorder which causes someone to experience recurrent and unexpected attacks of anxiety. Panic attacks cause a reaction of intense fear – otherwise known as fight-or-flight – and are usually disproportionate to the actual danger presented.

Panic disorder signs and symptoms 

Panic attacks are a central symptom of panic disorder (and perhaps the most recognisable one), but they’re not the only one. There are a wide range of other behavioural, psychological and physiological symptoms associated with this type of anxiety disorder.

Physiological:

• Palpitations
• Sweating
• Trembling or shaking
• Feelings of choking
• Chest pain or discomfort
• Nausea or abdominal distress
• Feeling dizzy, light-headed or faint
• Chills or heat sensations
• Numbness or tingling sensations
• Depersonalisation (feeling “out of body”)

Behavioural:

• Avoiding situations
• Avoiding any physical activity that may trigger a feeling similar to a panic attack
• Placing oneself close to exits within a room
• Being accompanied to places by a family member or friend in anticipation of a panic attack

Psychological:

• Worrying about future panic attacks
• Fear of having a heart attack
• Fear of dying
• Feelings of losing control

How does panic disorder develop? 

Panic disorder usually develops following a major, stressful life event, such as losing a loved one or a serious illness. It’s also been shown to hold a genetic basis which means you’re more likely to develop it if a family member also has the disorder.

Therapies for panic disorder 

Cognitive Behavioural Therapy (CBT) 

Cognitive Behavioural Therapy (CBT) centres around the belief that our thoughts, beliefs, and attitudes are all connected, and impact the way we feel and how we respond to situations. CBT will help you learn to recognise and challenge negative thoughts so that you can replace them with healthier ways of thinking.

Cognitive Analytic Therapy (CAT)

Although CBT is likely to be the first type of therapy you’re offered, you might also benefit from Cognitive Analytic Therapy (CAT) which looks to explore any problematic ways of thinking, feeling, and behaving. Your therapist will work with you to understand the origins of your anxiety and how your current coping strategies might be making it worse.

Mindfulness-Based Cognitive Therapy (MBCT) 

Mindfulness-Based Cognitive Therapy (MBCT) combines elements of CBT with mindfulness techniques to teach you how to observe your thoughts, feelings, and bodily sensations in the present moment. Whilst CBT aims to change anxious thoughts, MBCT focuses on ‘decentering’ – becoming aware of all incoming thoughts and feelings and simply accepting them.

Panic disorder myths 

“Panic attacks are the only symptom of panic disorder”

Whilst panic attacks are central to the disorder, they’re not the only symptom. If you have panic disorder, you will also likely be experiencing other accompanying symptoms such as persistent worry and anxiety.

“Panic attacks can be avoided”

Some people wrongly believe that if they avoid a triggering situation, they can avoid the panic attack. Unfortunately, this isn’t usually true. Due to the unexpected nature of panic attacks, there may not be any specific stimuli that causes them. And avoiding a situation is likely to increase fear which can end up exacerbating symptoms.

“Individuals with panic disorder have to take medicine for the rest of their life”

For some people, medication can help reduce the severity of their panic attacks and anxiety but this treatment is unlikely to last over a prolonged period of time.

“Panic attacks do serious harm to your body”

Panic attacks can be a terrifying experiencing – particularly the first time they happen. But their symptoms are usually not life-threatening and will gradually subside.

“Panic attacks only occur when awake”

Panic attacks tend to happen when someone is awake. However, they can also be triggered whilst someone is sleeping. When this happens, it’s known as a ‘nocturnal panic attack’. These attacks can sometimes contribute to sleep disorders.

What is personality disorder?

If you are suffering from a personality disorder you are likely to differ significantly from an average person in terms of how you think, feel or relate to other people. Personality disorders typically emerge in adolescence and continue into adulthood. There are different types of personality disorder that present with different sets of symptoms. The different types of personality disorder have been grouped into three clusters, cluster A, B and C. Some of the common symptoms are listed below:

Cluster A

• Difficulty relating to others, often there is a lack of wish to form relationships
• Odd and eccentric behaviours

The types of personality disorder that fall under cluster A are paranoid, schizoid and schizotypal.

Cluster B

• Difficulty relating to others but often there is a wish to form close relationships
• Dramatic, emotional and unpredictable behaviours

The types of personality disorder that fall under cluster B are borderline, antisocial, histrionic and narcissistic.

Cluster C

• Difficulty relating to others, often there is a wish to form close relationships
• Anxious and fearful thinking and behaviour

The types of personality disorder that fall under cluster C are avoidant, dependent and obsessive-compulsive (the latter being a different diagnosis to obsessive-compulsive disorder).

Treatment for personality disorders

Treatment for personality disorders is mainly in the form of psychological therapyDialectical Behavioural Therapy (DBT) and mentalisation based treatment (MBT) have been shown to be effective for the treatment of borderline personality disorder (BPD). Schema Therapy (ST) and Cognitive Analytic Therapy (CAT) have a wider applicability and can be effective approaches for the treatment of a range of different types of personality disorder.

What is a phobia?

A phobia is a debilitating fear of an object, place, situation or animal. Phobias are more intense than fear and involve an unrealistic perception of danger about a situation or object. If a phobia becomes severe a person might organise their life around avoiding the situation or object that causes them anxiety. There are different types of phobia, simple phobias and complex phobias.

Some examples of simple phobias are:

• Animal phobias – such as rodents, dogs, spiders, birds and others
• Bodily phobias – such as blood, vomit or injections
• Environmental phobias – such as heights, deep water and germs
• Sexual phobias – such as performance anxiety or fear of sexually transmitted diseases
• Situational phobias – such as flying or going to the doctor

Some examples of complex phobias are:

Agoraphobia – fear of open spaces, crowded places, traveling or public transport

Social phobia – fear of social situations

Treatment for phobias

Phobias can be treated through psychological therapy with cognitive behavioral therapy (CBT) and mindfulness based approaches being the most commonly used for effective outcomes.

What is post-partum depression?

Post-partum depression is a type of depression that parents can experience after having a baby. It is a common problem mostly affecting mothers although it can also affect partners. If you think you are suffering from post-partum depression it is important to seek help as soon as possible as the symptoms could have a significant impact on you and your baby. With the appropriate treatment most women make a full recovery from post-partum depression.

Symptoms of post-partum depression are listed here:

• Persistent feeling of sadness or low mood
• Loss of interest in the world around you and no longer enjoying things
• Lack of energy and feeling tired all the time
• Feeling that you are unable to look after your baby
• Problems concentrating and making decisions
• Loss of appetite or increased appetite
• Feelings of guilt, hopelessness and self-blame
• Difficulty bonding with your baby with a feeling of indifference and no sense of enjoyment in his or her company
• Frightening thoughts such as wishing to hurt your baby, these can be very scary and disturbing but they are rarely acted upon
• Thinking about self-harm and suicide

Treatment for post-partum depression

Psychological treatments are mostly recommended for post-partum depression though if your symptoms of depression are severe it might also be helpful to consider anti-depressant medication. The most helpful approaches for post-partum depression are cognitive behavioral therapy (CBT) and cognitive analytic therapy (CAT).

What is Post Traumatic Stress Disorder?

It’s normal after a distressing event to have trouble sleeping or to have difficulties adjusting back to day-to-day life, but if these symptoms last over a month, you might be suffering from Post-Traumatic Stress Disorder (PTSD).

PTSD is a type of anxiety disorder triggered by very difficult, frightening and upsetting events. Although often associated with war veterans, PTSD can develop following any event (or series of events) that has been very overwhelming – such as a sexual assault, an accident, a natural disaster etc.

PTSD can involve reliving the traumatic event through nightmares and flashbacks.

PTSD can affect anyone, including people who have had indirect exposure to a distressing event or repeated exposure to graphic details of trauma.

If you’re suffering from PTSD, you might be avoiding situations or people that remind you of what happened, or you might have heightened reactions to loud or unexpected noises or movements.

The disorder can be mild, moderate or severe. These categories are defined according to how much your symptoms are influencing your day-to-day life, rather than a judgement on the event itself.

Sometimes, PTSD will be described under the following categories:

• Delayed-onset PTSD – if symptoms occur more than 6 months after the distressing event.
• Complex PTSD – if you experienced trauma at an early age or it lasted for a long time.
• Birth trauma – occurs after a traumatic childbirth experience
• Signs and symptoms of PTSD 
• Physiological Symptoms
• Sweating
• Pain
• Nausea
• Trembling
• Psychological Symptoms
• Vivid flashbacks
• Intrusive thoughts or images
• Irritability
• Nightmares
• Difficulty feeling emotions
• Hypervigilance
• Hyperacusis (reduced tolerance to noise)
• Persistent fear, anger, guilt or shame
• Difficulty with concentration
• Behavioural Symptoms
• Avoiding places that remind you of the event
• Diminished interest in participation of activities and social gatherings
• Reckless or destructive behaviour
• Difficulty falling and/or remaining asleep

Therapies that we offer for PTSD:

Cognitive Behavioural Therapy (CBT)

CBT can help you become aware of your negative thought patterns and recognise how they might be contributing to your anxiety. Your therapist will work with you to identify negative thought patterns, safely and gradually expose you to situations that trigger your anxiety, and also teach you how to manage challenging situations more effectively. CBT is a short-term therapy and will usually last anywhere from 8 – 16 sessions.

Eye Movement Desensitisation and Reprocessing (EMDR)

EMDR is an evidence-based approach that instead of talking, relies on the patient’s own rapid, rhythmic movements. EMDR uses eye movements to help you process the feelings and memories associated with the trauma. Treatment can be fairly short-term for a specific trauma e.g. 8-16 sessions, or continue over a longer period of time for C-PTSD.

To find out more about which approach to therapy might be best for you, contact us here or call 020 3930 1437 for a free phone consultation.

How PTSD develops 

PTSD can develop following a traumatic or distressing event – or after a prolonged traumatic experience (sometimes referred to as Complex-PTSD). 

There are certain factors that can make you more likely to develop PTSD. For example, if you’ve experience depression or anxiety in the past or if you haven’t received the right support following the event. Also, having a parent with mental health issues can also increase your chances of developing PTSD.

It’s still not clear why some people develop PTSD and others don’t. However, recent research points to a biological predisposition – with the development of PTSD being a type of survival mechanism, caused by high adrenaline levels and physical and hormonal changes that happen in the brain.

What is self-harm?

Self-harm is when someone intentionally causes harm to their body as a way of managing overwhelming emotions and distress. Sometimes when people self-harm this can be linked to suicidal feelings but mostly self-harm tends to have other functions for the person such as self-punishment, communication of unbearable distress and a way of decreasing emotional arousal by focusing on physical pain.

Some forms of self-harm are listed below:

• Cutting or severely scratching your skin
• Burning or scalding yourself
• Hitting yourself or banging your head
• Punching things or throwing your body against walls and hard objects
• Sticking objects into your skin
• Intentionally preventing wounds from healing
• Taking overdoses with tablets or toxic chemicals

There are many underlying reasons for which people self-harm. Self-harm is also often linked to anxiety, depression and past trauma. Whilst in the moment self-harm might feel like an effective strategy, the relief that comes from it doesn’t last very long. Self-harm is strongly related to suicide with over half of people who die of suicide having a prior history of self-harm. If are currently engaging in self harming behaviours, it might be useful to confide in your GP about your emotional difficulties and consider what forms of help might be available to you.

Treatment for self-harm

The main treatment for self-harm is talking therapy with cognitive behavioural therapy (CBT) and dialectical behaviour therapy (DBT) being the most effective therapeutic approaches for this difficulty. The way therapy tends to target self-harm is by teaching the person new effective coping strategies for managing their feelings so that self-harm no longer feels like the only option.

Underlying psychological issues that might make someone vulnerable to adopting self-harm as a coping strategy might subsequently be further explored using other therapeutic approaches such as schema therapy or cognitive analytic therapy.

What is a sleep disorder?

Sleep disorders are condition which negatively impact the quality of your sleep, and they tend to be caused by either emotional or physical problems (sometimes both).

Insomnia is the most common type of sleep disorder, and whilst it can sometimes be caused by physical ailments, it typically persists due to an underlying psychological issue.

The overriding symptom of insomnia is the inability to sleep well – for a period of one month or more. This might mean difficulty falling asleep, but can also manifest as the inability to stay asleep (waking multiple times throughout the night) or waking up very early and being unable to fall asleep again.

Most of us will encounter difficulties sleeping at some point in our lives, and it usually happens following a temporary period of stress. However, most people find their sleeping patterns finally settle down again when life returns to normal. If sleeping problems persist, it might lead to a long-term sleeping disorder.

The good news is that sleep disorders can be treated and managed effectively using a combination of medication, mindfulness – and therapy.

Some common sleep disorders are:

• Hypersomnolence disorder – excessive sleepiness and difficulty waking up (even when getting sufficient sleep).
• Narcolepsy – excessive daytime sleepiness and “sleep attacks” usually occurring several times a week.
• Hyperventilation – exhaling more than you inhale.
• Parasomnia – experiencing abnormal events whilst sleeping.
• Restless leg syndrome – frequent awakenings and difficulty falling asleep due to pain, relieved by moving the leg.
• Signs you have a sleep disorder 
• Not everyone experiences sleep disorders in the same way or to the same degree. Although not all of the following will apply to you, some of the most common symptoms are listed below.
• Physiological Symptoms
• Difficulty concentrating
• Aches and pains in the body
• Dry eyes
• Appetite changes
• Psychological Symptoms
• Feeling overwhelmed
• Experiencing exhaustion throughout the day
• Increased irritability
• Depression
• Anxiety
• Behavioural Symptoms
• Struggling to fall asleep at night
• Frequent awakenings throughout the night
• Waking up extremely early in the morning
• Therapy for sleep disorders – treating sleep disorders 

Cognitive Behavioural Therapy (CBT)

Cognitive Behavioural Therapy (CBT) centres around the belief that our thoughts and beliefs about the world impact the way we feel, and respond to situations. CBT will help you recognise and challenge negative thoughts which might be exacerbating your symptoms so you can replace them with healthier ways of thinking.

Mindfulness Based Cognitive Therapy (MCBT)

Mindfulness-Based Cognitive Therapy (MCBT) can be carried out in one-on-sessions or in a group setting. Mindfulness is the practice of being present – learning to simply observe thoughts without attaching meaning to them. This type of therapy combines mindfulness techniques with CBT, teaching you how to observe your thoughts with the goal of creating new, more effective ways of thinking.

What is social anxiety?

Social anxiety (or social phobia) is one of the most common anxiety disorders. It is persistent and overwhelming fear of social situations which can lead the individual to feel unable to manage even everyday activities such as speaking on the phone or interacting with others in a shop. Whilst anxiety about social situations can be at times normal, someone with social anxiety will worry more excessively and feel far more overwhelmed at the thought of a social situation. Sometimes those worries can take a concrete form such as doing something that is humiliating or embarrassing, blushing, sweating or appearing inadequate in some way.

Social anxiety can be described as a complex phobia and can be a condition that is debilitating for the person and limiting of their life. Some of the symptoms of social anxiety are described below:

• Dread of everyday activities such as meetings, talking in groups, speaking on the phone, shopping
• Low self esteem
• Fear of being criticised
• Avoiding eye contact
• Misuse of drugs or alcohol to manage social anxiety

Treatment for social anxiety

Psychological therapy can be very effective both in helping you understand the origins of your social anxiety and in helping you overcome it. Certain forms of therapy such as cognitive behavioural therapy and cognitive analytic therapy can be especially beneficial for social anxiety. In some instances, people can also benefit from medication to help them manage anxiety symptoms.

What is stress?

Stress is our response to situations in our life that we experience as worthy of anxiety. Many aspects of life can cause stress such as financial concerns, work pressures or relationships. When a person is stressed this can interfere with their ability to manage their life and responsibilities which in turn can cause further difficulties and further stress.

From a physiological perspective, stress is your body’s way of responding to any demand or threat. When you experience a sense of threat your body releases stress hormones which rouse the body for emergency action. This is known as ‘fight or flight’ response and it is your body’s way of protecting you from dangerous situations. Stress becomes too overwhelming as a result the body not being able to distinguish between daily stressors and life threatening events. Many health problems can be exacerbated by stress.

Some of the common symptoms of stress are:

• Memory problems
• Inability to concentrate
• Anxious or racing thoughts
• Constant worry
• Irritability or short temper
• Feeling overwhelmed
• Moodiness
• Aches and pains
• Chest pains
• Procrastination or neglecting responsibilities
• Nervous habits (e.g. nail biting, pacing)

Treatment for stress/stress management

Everyone is different in terms of their ability to manage stress. Cognitive behavioural therapy can be very effective in helping you develop more effective stress management strategies including relaxation techniques. Prior to receiving treatment for stress you will have a psychological assessment to help understand the current causes of stress in your life and what factors might be implicated in your difficulties. This will involve developing a psychological formulation that explores your stress responses and aims to break negative cycles that maintain stress.

Substance misuse – repetitive use of a substance in a way that is damaging for an individual and can lead to dependence in a substance. Dependence involves developing a tolerance for the substance over time and going through withdrawal symptoms without it. Examples of substances that are often misused include:

• Alcohol
• Cannabis
• Cocaine
• Heroin
• Methamphetamines
• Club drugs
• Ecstacy
• GHB
• Ketamine
• LSD
• PCP
• Nicotine

The most effective treatment for substance misuse are motivational interviewing and cognitive behavioural therapy (CBT). All the psychologists at The Chelsea Psychology Clinic are trained to deliver CBT and motivational interviewing for substance misuse. For more information, please see our more detailed page on addictions.