Conditions Seen by Dr Davies

Depression can affect up to 16% of adults at some time. Many of us use the term “depressed” as an everyday word to mean sad or fed up. Clinical depression is different to this. People with clinical depression have become down in their mood or spirits most or all of the time. They experience other symptoms, including inability to enjoy things, tiredness, problems with appetite and sleep, low confidence as well as reduced motivation and ability to concentrate. At its worst, affected people may become hopeless, feel suicidal or become unable to function.

Sometimes other conditions can look like depression. These include physical illnesses such as thyroid disease, drug and alcohol misuse or other psychiatric disorders. It is important to have the correct diagnosis. Psychiatrists can help to ensure this, and guide towards the right treatment. Anti-depressants can be an effective treatment for depression, particularly when more severe. Anti-depressants are not addictive in the way that sleeping tablets can be. A Psychiatrist can also advise on things you can do to help yourself in your recovery, or advise on effective forms of psychological treatment.

All of us at some time have felt anxious. For example before a job interview, important exam or perhaps before making a speech. A “phobia” is when a person repeatedly experiences anxiety in response to a specific situation or object – for example heights, flying or spiders. With “panic disorder”, people get sudden bouts of anxiety which do not seem to be provoked by any particular situation. People are well in between the episodes of panic. With “generalised anxiety disorder” people experience some level of anxiety all the time. Sometimes, these conditions overlap. Also, anxiety can be a feature of other disorders such as depression, post-traumatic stress disorder, or due to alcohol or drugs use. A psychiatrist can help determine an accurate diagnosis, and advise on effective medical and psychological treatment as well as suggest things that you can do to help yourself.

At some time in our lives, as many as 40% of us will be exposed to a highly traumatic experience, such as a serious transport accident, a serious assault, or a natural or human-made disaster. It is normal to experience strong emotions after something like this, and to dwell on what happened for a while. Not everyone who has been in a Traumatic incident will go on to develop Post Traumatic Stress Disorder (PTSD).  About 7% of people will develop post-traumatic stress disorder at some time in their lives. Features of PTSD include re-experiencing the traumatic event (such as through bad dreams, recurring distressing thoughts or vivid imagery such as flashbacks). Other symptoms include avoiding situations or activities that resemble or remind the person of the incident, feeling irritable or constantly on edge, feeling generally more vulnerable and cutting oneself off from people we were close to. Many people with post-traumatic stress disorder experience other conditions such as depression or substance misuse. Sometimes, it is difficult for health professionsls to recognise that post-traumatic stress disorder is present, because the person hides their feelings, will not discuss the distressing incident, or because they mask their feelings with alcohol or drugs. A Psychiatrist can help to establish what conditions are present and advise on effective treatment as well as things that the person and those close to them can do to help. Dr Davies worked for many years in a General Hospital and has seen many people with PTSD relating to serious accidents, burns and assaults.

Obsessive Compulsive Disorder can present as repeated thoughts, images actions or impulses, for example about cleaning, washing or counting. In Body Dysmorphic Disorder, a person is preoccupied with an aspect of their appearance which others do not see as a cause for concern. Although these conditions might sound very different, both can arise due to a problem with levels of a chemical known as serotonin in parts of the brain. Other conditions seen with this pattern of disorder include hair pulling and binge eating/bulimia. Often these conditions are helped by boosting the chemical serotonin in this part of the brain with antidepressant medication at higher doses than are used for treating depressin. Psychological treatments are also effective. A Psychiatrist can help to confirm the diagnosis, recommend effective psychological or medical treatment as well as things a person can do to help themselves.

Excessive consumption of alcohol may develop for many reasons. Often there will be a family history of this. It can develop in response to traumatic events, physical or mental illnesses or life stresses. Many people will hide or deny the problem. People with a drink problem often have one or more other mental or physical illnesses, and it is important to ensure that these are not missed. A Psychiatrist can help establish the diagnosis and ensure that a person receives effective psychological and physical treatment. Sometimes advice, self-help or attending a group may be what is needed. Sometimes more intensive out-patient physical or psychological treatment is required. Sometimes a spell of treatment as an in-patient or in a rehabilitation unit is needed. Again, a careful psychiatric assessment can help to predict what type of treatment a person will need.

There are a numerous  possible features of this, broadly classified into problems with (i) social communication skills and (ii)  restricted and repetitive behaviour. But different people are affected in different ways, and there is a range of severities of the condition. Some people regard Asperger’s syndrome and PDA as dstinct types of ASD. Recently it has been realised that the condition is more prevalent than was previously thought and up to 1% of the population may be on the spectrum of having this condition. Many more people will have some features of the condition at a lesser level. Around a 100 different genes have been identified as playing a role, and this helps explain why it can look so different and why there are varrying levels of severity.  Also it can explain why conditions such as dyslexia or  ADHD are sometimes also present and of course why it can run in families. Many people with the condition emphasise that they have skills and abilities that are different, rather than a disease or disorder. Obtaining a reliable diagnosis may help the person with ASD to understand better how to get on with others or make best use of their skills in the workplace.  Sometimes a diagnosis is needed to obtain help with studies or work, or help people close to the person better to understand that they are not being difficult or anti-social. Dr Daves uses a standardised semi-structured interview developed by the Royal College of Psychiatrists, and this is suitable for use i most cases,  in adults who do not have a learning disability.  Please note that this requires a longer consultation, different charges apply, and you should check if  your insurer will cover this (request a neurodevelopmental assessment).

ADHD  in adults – see the dedicated ADHD page for information

Many of us experience some kind of stress when we have a tight deadline or competing demands on our time, or between our roles. The feeling of stress should resolve when the situation is dealt with. Some people experience continuing problems when the source of the stress does not go away. For example, continuous excessive demands in work, being bullied or having health or family worries. Stress itself is not a psychiatric disorder, but being in a stressful situation for a prolonged period can lead to psychiatric disorders such as depression. Burn-Out is a particular form of stress, and is characterised by exhaustion, loss of motivation, feelings of ineffectiveness, and may entail disillusionment and loss of empathy. A Psychiatrist can help a person or their employers to identify the source of stress, whether there is another psychiatric diagnosis present, and what to do about it.