Tag Archives: depression

Psychological Treatment for Anorexia Nervosa: A Comprehensive Guide

Psychological treatment for anorexia nervosa: a comprehensive guide. Anorexia nervosa is a severe mental illness that demands thorough treatment, with a particular focus on psychological intervention. In this article, we explore the critical role of psychological treatment in the recovery process for individuals battling anorexia, with an emphasis on Melbourne psychologists and therapists specializing in eating disorders.

Overcoming Treatment Barriers

Regrettably, many individuals with eating disorders, including anorexia, face obstacles in accessing appropriate treatment consistent with clinical guidelines. These barriers may stem from an individual’s reluctance to seek help, limited screening, and the scarcity of suitable treatment options.

Assessment for Anorexia Nervosa: A Multifaceted Approach

Effective treatment begins with a comprehensive assessment. Clinical interviews are the gold standard for evaluating and diagnosing eating disorders. In this context, Melbourne psychologists play a pivotal role. The Eating Disorder Examination (EDE) serves as a valuable guide for assessment, while validated self-report questionnaires like the Eating Disorders Examination Questionnaire (EDE-Q) offer insights into recent eating disorder symptoms.

Given the potential impact of eating disorders on physical health, a medical assessment is also indispensable. The National Practice Standards for Eating Disorders (NEDC, 2018) and the Australia and New Zealand Academy for Eating Disorders (ANZAED) provide comprehensive guidelines for eating disorder assessment.

Psychological Treatment for Anorexia Nervosa: Melbourne’s Expertise

In the realm of psychological treatment, Melbourne is home to skilled therapists who specialize in eating disorders. Here’s what you need to know:

• Interdisciplinary Treatment: Effective anorexia treatment typically involves a multidisciplinary approach. It encompasses nutrition, medical care, and psychological therapy, often led by Melbourne therapists specializing in eating disorders.
• Specialized Therapist-Led Psychological Treatment: Long-term specialized therapist-led manualized psychological treatment is vital, with a focus on addressing cognitive and behavioral aspects of the disorder. Melbourne psychologists are equipped to provide expert guidance in this area.
• Family-Based Therapy for Young People: For adolescents, involving the family in the treatment process is particularly beneficial. Experienced Melbourne therapists actively facilitate family-based therapy to support young individuals.
• Hospitalization When Necessary: In severe cases where there’s a significant medical or psychological risk, hospitalization is considered. Melbourne therapists collaborate with medical professionals to ensure comprehensive care.

Keep in mind that individuals highly personalize their journey to recovery from anorexia. Psychological treatment, guided by Melbourne psychologists and therapists with expertise in eating disorders, is central to addressing the complex cognitive and behavioral aspects of the condition. With the right support, commitment, and access to Melbourne’s specialized therapists, individuals can conquer anorexia and regain control of their lives. If you or someone you know is struggling with anorexia in Melbourne, don’t hesitate to seek help. Early intervention can make all the difference in achieving a successful recovery.

Early Childhood Experiences – Shaping Worldviews

Schema Therapy is a 3rd wave iteration of Cognitive Behaviour Therapy. It aims to identify and address schemas, which are mental constructs or ways of conceptualizing the world. Maladaptive schemas are counterproductive to our wellbeing and can affect interpersonal and personal outcomes. Schema therapy suggests that particularly influential, and possibly traumatic, childhood/adolescent experiences cause these maladaptive schemas. These schemas are gradually reinforced over time as we interpret similar experiences as further support for this schema. Read on to learn how early childhood experiences can shape our worldview as adults.

There are five domains in which a maladaptive schema can fall, domain 1 is explored below:

Disconnection and Rejection

When a child’s need to feel safe, secure and nurtured is not met, it will likely lead to a schema in the domain of disconnection rejection.

There are 5 schemas in this domain, they are:

1. ABANDONMENT / INSTABILITY
2. MISTRUST / ABUSE 
3. EMOTIONAL DEPRIVATION 
4. DEFECTIVENESS / SHAME 
5. SOCIAL ISOLATION / ALIENATION

 

A child who develops a schema of abandonment/instability will begin to view later life experiences in this vein. Even if the experience is objectively benign, like someone canceling plans, they are likely to consider this further evidence that people will always abandon them or are unreliable. For this person and their relationships, it can make normal relationship occurrences a source of distress and conflict.

Schema Therapy employs various exercises, assessments, and techniques to tackle maladaptive schemas and the dysfunction they may cause. With the help of a schema therapy practitioner, people can learn to identify when they are acting out of maladaptive modes. Through the support and guidance of a psychologist, the person can learn to address their own needs that were not met during childhood. In turn, this will allow them to fully engage in relationships and other meaningful pursuits.

For more information on our schema therapy practitioners at The Three Seas Psychology, call us on 9809 1000.

 

References

Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner’s guide. Guilford Press.

 

The Physical Symptoms of Depression

It’s Not Just In Your Head – The Physical Symptoms of Depression

The emotional and cognitive symptoms of Depression co-occur with severe physical symptoms. Four of the nine diagnostic criteria for Depression are physical: changes in sleep, weight, psychomotor abilities and physical fatigue¹. Those with Depression can be three to four times more likely to experience comorbid psychomotor, musculoskeletal and inflammatory diseases1. Although the two predominant symptoms involve mood and cognition, physical symptoms can be easier to observe. Therefore, they may be more useful in noticing a depressive episode in yourself or someone else. Research suggests that depression is the result of a combination of biological, physiological and social factors. Recently more attention has been paid to the co-occurrence of physical and psychological symptoms of depression. It’s well known that the physical and psychological symptoms of depression exacerbate each other, for example, physical fatigue stop someone from engaging in activities that boost their mood. Recently research has linked the co-occurrence of the psychological and some of the physical symptoms of depression to dysregulation of neurotransmitters (serotonin and norephedrine) and inflammation in the body².

Sleep and Fatigue

A symptom of Depression is a change to regular sleep patterns experienced most days for more than two weeks. This can either be increased (Hypersomnia) or decreased (Insomnia) hours of sleep as well as difficulties breathing during sleep (Obstructive Sleep Apnoea)­³. It’s estimated that 75% of adults with depression also experience insomnia⁴. Notably, those with hypersomnia often don’t feel rested even after a long period of sleep. Another symptom of Depression is feeling fatigued or a loss of energy most days for at least two weeks. This is likely due to the dysregulation of serotonin and norephedrine, amongst other factors⁵. Many antidepressants assist in the release of serotonin and some additionally affect norephedrine. Serotonin is associated with calm, sleep and mood regulation whereas norepinephrine with attention and energy levels.

Weight

There are many reasons for weight changes including aging, hormones and lifestyle factors. For those with depression weight changes can occur for multiple reasons⁶. Firstly, changes in mood and stress that leads to depression can change dietary and exercise habits. People often eat excessive or unhealthy food in response to low mood or distress. Those with depression also lose motivation and interest in previously pleasurable activities, especially those with a delayed reward-like exercise. This combination paired with irregular sleep patterns often leads to fluctuations in weight. Everybody is different and depression manifests differently. Those with predispositions around disordered body image and food may start to lose weight, which is also highly correlated with depression. Unfortunately, some anti-depressants prescribed for depression can cause weight gain. Luckily there are many types of antidepressant treatments with differing side effects.

Psychomotor Agitation and Retardation

Another symptom of depression is psychomotor retardation or agitation. This involves changes in movement and speech: Speech typically becomes slower, with more pauses, lower volume and less expressivity; Gross body movement of the limbs, torso and head is slowed; Eye movement becomes more static and eye contact is less frequent; Posture tends to be more slumped⁷.

Pain

Those with depression are more likely to experience specific and general physical pain that has no other medical cause². They also tend to have a lower pain tolerance and threshold⁸. It’s theorised that this is due to dysregulation of neurotransmitters and/or because of increased inflammation. Research suggests that inflammation is a contributing factor to depression and its resulting fatigue and pain. Those with depression frequently report headaches, back and neck pain. Women with depression may experience more severe period pain as well.

Psychosomatic Manifestation of Symptoms

People with depression often identify their physical symptoms before their psychological ones. If someone goes to their doctor for physical symptoms it can be upsetting to hear it’s caused by a psychological issue9. People tend to interpret this as ‘all in their head’ and not real. For those with depression, who often experience unnecessary guilt and shame, this idea can reinforce feelings of unworthiness and hopelessness towards the possibility of recovery¹. Yet psychosomatic symptoms are real and can be just as severe as those that stem from diseases in the rest of the body². The public perception of psychosomatic symptoms stems from the same bias that made amputation and physical scarring easier to discuss than Shell Shock (PTSD) in World War 1 and 2. Psychosomatic symptoms are more common in cultures where mental health is a taboo10. It’s often theorised that when internal distress is not able to be expressed in healthy ways it is forced to present in physical problems. The research into psychosomatic symptoms is challenged because it can present itself in vastly different ways depending on the person.

In Summary

The symptoms of depression stretch far beyond the psychological. Often physical symptoms can be easier to spot at the beginning of a depressive episode. Despite public bias against psychosomatic symptoms, these are just as valid and significant in recovery from depression. For someone without a history of depression, I considered myself well informed about the symptoms and pain that it can cause. Writing this article has opened my eyes to the many ways in which it can affect a person’s life. My respect for anyone who works their way through this disorder has doubled.

If you or someone else needs help with their Depression or other mental health difficulties, please contact us at 9809 1000 or submit an online enquiry here.

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References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders : DSM-5. American Psychiatric Association.
Steffen, A., Nübel, J., Jacobi, F. et al. Mental and somatic comorbidity of depression: a comprehensive cross-sectional analysis of 202 diagnosis groups using German nationwide ambulatory claims data. BMC Psychiatry 20, 142 (2020). https://doi.org/10.1186/s12888-020-02546-8
Schimelpfening, N. (2019). Physical Effects of Depression. Verywell Mind. https://www.verywellmind.com/physical-effects-of-depression-1066890
Nutt, D., Wilson, S., & Paterson, L. (2008). Sleep disorders as core symptoms of depression. Dialogues in clinical neuroscience, 10(3), 329–336. https://doi.org/10.31887/DCNS.2008.10.3/dnutt
Newsom, R. (2020). Depression and Sleep. Sleep Foundation. https://www.sleepfoundation.org/mental-health/depression-and-sleep
McMillen, M. (2021, August 20). Does Depression Cause Weight Gain or Weight Loss? What’s the Depression/Weight Connection? WebMD. https://www.webmd.com/depression/features/depression-and-weight-connection
Buyukdura, J. S., McClintock, S. M., & Croarkin, P. E. (2011). Psychomotor retardation in depression: biological underpinnings, measurement, and treatment. Progress in neuro-psychopharmacology & biological psychiatry, 35(2), 395–409. https://doi.org/10.1016/j.pnpbp.2010.10.019
Schimelpfening, N. (2019). Physical Effects of Depression. Verywell Mind. https://www.verywellmind.com/physical-effects-of-depression-1066890
Zambito Marsala, S., Pistacchi, M., Tocco, P., Gioulis, M., Fabris, F., Brigo, F., & Tinazzi, M. (2015). Pain perception in major depressive disorder: A neurophysiological case–control study. Journal of the Neurological Sciences, 357(1-2), 19–21. https://doi.org/10.1016/j.jns.2015.06.051
O’Sullivan, S. (2017). When the Body Speaks | Psychology Today Australia. Www.psychologytoday.com. https://www.psychologytoday.com/au/articles/201701/when-the-body-speaks

 

Do I Need Counselling?

At Three Seas, we’re accustomed to hearing all variety of myths about counselling. From the mistaken belief that counselling is just about talking about feelings to the notion that therapists or psychologist become counsellors to deal with their own psychological issues, we’ve heard it all. One of the things that we hear most frequently, though, is the claim that therapy is for “crazy” people. Therapy is for everyone, and it can benefit even the most emotionally healthy among us. Thus if you’re contemplating whether you need counselling, the truth is that almost everyone can benefit. Still on the fence? Here are some telltale signs that it’s time to consider counselling.

Your Relationships Are All Troubled

If you have problems in all of your relationships, the common denominator is you. This doesn’t necessarily mean you’re causing the problems, but a history of troubled relationships suggests that you’re either choosing the wrong people, have poor relationships skills, or are consistently doing something that throws your relationships into turmoil. Without blame or judgment, we can help you discern what’s behind a long history of challenging relationships.

You’re Unhappy or Unfulfilled

It’s easy to blame the circumstances of your life for your dissatisfaction. But the truth is that people are able to remain happy even amid the most challenging circumstances—dire poverty, life-threatening health conditions, the death of a beloved family member. Counselling helps you cultivate the skills that make it possible to be happy. If you’re struggling with lack of fulfillment, feel shiftless and directionless, or are at a major crossroads in your career or relationship, therapy can help yo make the right decision.

You Keep Making the Same Mistakes

We all have habits we find hard to break, no matter how frequently we resolve to do better. Whether it’s spending too much money, eating too much food, procrastination, negative thinking, picking fights with family members, or something else, understanding your pattern is the key to upending it. We’ll help you understand why you keep making the same mistakes, then work with you to ensure the drama ends once and for all.

The Problem is With Everyone Else

It’s not easy to admit, but if you’re having problems with everyone you know, the problem is likely you. If you think your unhappiness can be blamed on your unaffectionate spouse, your nagging mother, and your cruel boss, you’ve got it backwards. Happiness comes from within, and people who don’t realize this face an uphill battle when it comes to finding happiness and fulfillment. We’ll help you figure out what the real problem is, so you can fix it and live the life you deserve—at long last.

You Struggle With Mental Illness

Mental illness is common, and is no different from physical ailments. It’s not your fault, not something you can will away, and certainly not something you can cause. But too many Australians are hesitant to seek the help they need for their mental health difficulties. If you suffer from obsessive-compulsive disorder, bipolar, depression, anxiety, or another mental health difficulty, let us show you a path to hope, healing, and recovery. Mental illness does not have to ruin your life, and you might not even need to take medication to get better.

You’re Overwhelmed

Let’s face it: life is hard. Endless responsibilities, unreasonable expectations from loved ones, and myriad other challenges can leave you feeling exhausted, burned out, and overwhelmed. If you feel hopeless about your ability to cope, we can renew your sense of hope. So much so that some times even the lights can have an impact on how you feel. The right skills can help you cope with even the most stressful life events, and by steadily cultivating these skills, you can even learn to manage with difficult people. You don’t have to be overwhelmed, but you do have to reach out for help if you want hope for a better tomorrow.

You Have Health Issues

People with health issues are often reluctant to seek therapy. After all, if the problem is with the body, then how can counselling the mind help? Not so fast. The mind and body are interrelated, and stress, anxiety can undermine your ability to cope with your health issues. Some research even suggests that unexplained symptoms, especially chronic pain, headaches, and gastrointestinal distress, may get better with therapy.

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