Counselling and Psychotherapy – Wimbledon Dr. Maura Abdelall CPsychol

What is Depression?

A person is affected by depression when they feel: sad for most of the time; they lose pleasure in life; their sleep and eating patterns become disrupted; and they withdraw from friends, family and the world. When a person experiences depression they tend to see themselves, others and the future in a negative light, with little hope of change. This can lead to feelings of anger or self-loathing. Thoughts held by the person are usually negative and involve ruminating mainly on the past, rather than the future. Depression can be hard to spot, because an individual may feel tired all the time and may attribute this to being “lazy”.

Furthermore a person may feel a burden on their friends and family, preferring not to say anything and instead withdraw more in themselves. Depression can last from a couple of days to many months, and can impact greatly on the person’s functioning, rendering them unable to look after themselves and to work. As a consequence problems begin to rise and grow and the person feels unable to tackle all the problems, leading to things spiralling out of control. This may lead to some people experiencing suicidal thoughts and of self-harm, which then start to be acted out into behaviours.

If you are experiencing suicidal thoughts or feel at risk to yourself or to others then contact your GP, visit your local A&E or call 999.


What is Anxiety?

Anxiety is a feeling of intense fear in the face of a real or imagined threat. In anxiety an individual may indeed worry about something bad happening, but will always tend to think the “worst” will happen. When affected by anxiety, a person can experience a variety of physical symptoms including: increased heart race; sweating; shortness of breath; and a dry mouth. This is because the person fears that something is about to occur to them or to someone they care about and the body is getting ready for a fight or flight response. Whilst in depression a person tends to engage in extensive rumination, with thoughts focusing mainly on the past, in anxiety a person tends to have thoughts that focus mainly on the future.

There are different types of anxiety that a person may experience:

Generalised Anxiety Disorder (GAD)
Generalised anxiety disorder involves an anxiety about a wide range of situations and issues, rather than something specific. Worries can include finances, children, work, health etc. When a person is affected by GAD they will worry about many things over and over, and feel that their minds are “out of control”. A common worry people report is their worry about worry, and the fear of “going mad”.

Panic
When a person experiences a panic attack they feel their heart beating fast, the breathe quickly, they may feel hot or cold, they start to feel dizzy, their sight can be affected. During these moments people usually think that they are going to faint, have a stroke or die. People will try to hold on to something to steady themselves, may sit down or flee the situation. Panic attacks can be triggered by a specific situation or for no apparent reason, which makes the person scared these will happen again.

Obsessive Compulsive Disorder (OCD)
OCD is an anxiety disorder characterised by constant obsessive thoughts which are neutralised by the individual to reduce the anxiety, by performing compulsive and repetitive behaviours. These behaviours can include cleaning, checking, tapping, washing, counting, which are carried out by the person to reduce the anxiety provoking thoughts. OCD is very time-consuming for the individual and can be alienating, and often can cause severe emotional and financial distress.

Specific Phobias
This is a fear of a specific object or activity which causes extreme anxiety to the individual. Some of the most common phobias include: enclosed spaces; height; spiders; needles; blood; flying; driving and many more. Whilst most of us are not affected by these in day to day life, because we can avoid them, it is only in certain situations that complications may arise. For example, a person may have a fear of an elevator, but may work in an office on the 40th floor. Additionally, a fear of enclosed spaces may prevent a person from taking the public transport to work, or from travelling abroad for holidays. In these instances the specific phobia can impact the person’s life significantly.

Health Anxiety
This is a specific anxiety centring on ill health and the fear of dying. A person is affected by this type of anxiety will fear that they, or their loved ones, will become severely ill or die. They will check their body for symptoms many times, at times unconsciously, and will interpret symptoms in a negative way (a head ache is interpreted as being a sign of a brain tumour). A person will also constantly seek reassurance from family and friends, and visit the doctors frequently to have checks ups. They will find it hard to accept that hospital results show negative results, and will often want the same test(s) carried out several times just to “be sure”; as they constantly fear that their illness has not been identified.

Social Anxiety
Involves an extreme anxiety about being in social situations. When affected by social anxiety an individual becomes very worried and fearful when in social situations. Activities such a public speaking, carrying out presentations, participating in a group are extremely anxiety provoking. In social anxiety the individual usually thinks that people are observing them and judging him/her negatively. As a consequence, the person feels anxious and may choose to withdraw from the situation or engage in certain behaviours aimed at reducing the anxiety. A person may go to extreme lengths to cover up their anxiety with a series of “safety behaviours”, such as rehearsing content of speech over and over, covering their hands, so that others do not see them shake, or avoid situations completely and make excuses for their absence.

Agoraphobia
This involves a fear of being out in public spaces. When affected by agoraphobia an individual is very anxious to leave the safety of home and can spend days, weeks and months at home. A person affected by this type of anxiety fears that when outside their home something bad will happen to them. In some cases this fear may be a result of some sort of accident that happened in the past and has made the person anxious to go out again.


What is Anger?

Anger is an emotion like anxiety, happiness, sadness etc. Anger can be present when a person feels violated, insulted, deceived or threatened in some way. Anger can be expressed both in a constructive or destructive manner. What this means is that a person can be angry at oneself or another, without the need to physically attack and inflict physical pain. Learning to be assertive is an important part of this process. Being assertive means expressing one’s views and opinions confidently without the need to be aggressive. Some individuals express their anger actively, through shouting, kicking and hitting out. Whereas others tend to keep their anger suppressed which then becomes displaced in other ways, for example by eating, drinking or smoking.


What is Stress?

Everyone has felt stressed at some point in life. Stress is experienced as feeling under too much mental or emotional pressure. Among the common signs of stress include: sleeping problems; sweating; loss of appetite; and difficulty concentrating. A person may also experience headaches, muscle tension or pain, or dizziness. Although stress at times can be a stimulant, a motivator to get one going, a constant high level of anxiety, worry, and of being frantic can take its toll on the individual’s physical, psychological and emotional health. Stress can impact the person in many ways, including: increasing distraction, short- temper, disorganisation and exhaustion. When one is stressed this can get in the way of conducting normal daily tasks, can increase distraction and cloud judgement. Stress is not an illness itself, but it can cause serious illness if it is not addressed.


What is Low Self- Esteem?

When a person has a low self-esteem they tend to hold a negative view about themselves, only focusing on their weaknesses or mistakes made. Low self-esteem means the person views themselves with very little worth and the self is not valued very much. A person with a low self-esteem will feel inadequate or inferior and that they are not entitled to the good things in life. Low self-esteem can be linked to issues such as weight, physical appearance and illness and many other factors. The importance of self-esteem lies in the fact that it concerns the way the person feels as a whole and their sense of personal value. Thus, it affects the way the person feels and acts in the world and the way they relate to everybody else. Low self-esteem can have a damaging effect on an individuals’ life and can prevent the person from making new relationships, going to work, engaging in new activities and much more.


Useful Self- Help Materials

You can find a variety of self-help modules on the following links:

http://www.cci.health.wa.gov.au/resources/consumers.cfm

https://web.ntw.nhs.uk/pic/selfhelp/


Useful Information. BPS and HCPC Logos

For more information on how I may be able to help you, or to arrange an initial appointment please call/text 07931229137 or What is Depression?


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