Long- term health conditions have a severe impact on all aspects of a person’s life: physical and emotional well-being, work, sex, family life and roles. Adjusting to a long-term health condition can understandably be difficult given the changes aforementioned. Therefore, it is unsurprising that there is high co-morbidity between long-term health conditions and depression and anxiety. Almost a third of people who have suffered a heart attack experience clinical symptoms of depression. People with diabetes are two to three times more likely to experience depression than the general population. Over half the people with chronic obstructive pulmonary disease experience clinically significant symptoms of depression and anxiety. Between 30% and 45% of people experiencing chronic pain have clinical symptoms of depression and are also more likely to suffer from health anxiety. And, depression, post-stroke has been estimated at 61%.
There is overwhelming evidence to suggest higher prevalence of depression and anxiety in long-term health conditions, however access to appropriate psychological intervention is poor within this population. This is concerning given that psychological intervention can improve health benefits, in addition to psychological benefits: Reduced hospital admissions, improved medical compliance, physical symptom reduction, increased life-span, and improved quality of life (in terms of physical, emotional and social functioning).
Evidence from several studies suggests that Acceptance and Commitment Therapy (ACT) is an effective intervention and treatment for chronic pain and long term health conditions.
Acceptance and Commitment Therapy (ACT):
ACT is a mindfulness-based behavioural therapy. Proponents of ACT do not emphasise symptom reduction but encourage acceptance of what is out of your personal control, and a commitment to actions that will maximise your potential to lead a rich, fulfilling life. The therapy focuses on values, forgiveness, acceptance, compassion, and being at one with oneself, which in turn leads to symptom reduction.
The National Institute of Health Care and Excellence recommend the following psychological therapies for the highest success rate in treating depression and anxiety as a cause or consequence of long-term health conditions.
Cognitive Behavioural Therapy (CBT):
Cognitive behavioural therapy focuses on the relationship between thoughts, feelings, behaviours and physiological sensations. The cognitive facet assumes that the meaning one gives to an event is important and if you can change the interpretation or perception you can change the feeling (affect) associated with it. The behavioural facet assumes changing what you do is often a powerful way of changing other things in your life, which can improve affect and reduce depressive symptoms.
Interpersonal Psychotherapy (IPT):
Interpersonal psychotherapy focuses on the relationship between depressive symptoms and interpersonal problems. The premise is that depression can be understood as a response to difficulties within our interpersonal context. And in turn depression can affect the quality of our relationships. IPT predominantly works on improving the quality of these relationships and reducing depressive symptoms. IPT has a core focal area dedicated to transitions, which is a major issue in long-term health conditions.
Behavioural activation is a brief psychosocial approach that aims to alleviate depression by focusing directly on behaviour change. The therapy aims to increase activation systematically so that you can have more pleasurable and/or rewarding experiences and improve any problems that you might have in your life.
Behavioural Couples Therapy:
Behavioural couples therapy is recommended for people who have a regular partner and where the relationship may contribute to the development and maintenance of depression, of where involving the partner would have a therapeutic benefit.
An anti-depressant is recommended for people who have moderate to severe depression. The combination of an anti-depressant and one of the psychological therapies mentioned above is deemed the most effective intervention according to research trials. This treatment is also recommended by NICE guidelines, for the treatment of moderate to severe depression.
Elite Psychology comprises of an expert team, specialising in the range of best private evidence-based therapies for anxiety and depression associated with long-term health conditions. Our highly qualified associates are accredited in all of the most successful therapies, complimented by psychiatrists who can prescribe anti-depressants on private prescriptions. We can assess you and provide the most efficacious therapy tailored to your difficulties. We know the importance of being understood, and endeavour to deliver the highest standard of psychological interventions to meet your needs.
Call us on 020 3815 7935 for further information or to book an assessment. Alternatively you can complete the online contact form.