Alfred Perera's blog

Exercise

Today I was thinking again about the importance of exercise in staying well. We all have a responsibility to look after our body and mind.

When we take exercise the blood flow to our brain increases. Therefore the blood flow can deliver more oxygen to our brain cells/ nerve cells which help then work better.

Depression in the context of exploitation

There are many cases of depression in which we see a young teenage girl who has suffered emotional, physical and sexual abuse. This could happen to boys, young adults and people with learning disabilities and the elderly. The most vulnerable people in our society are at risk from sexual exploitation. Although these people may experience severe depression, how can we treat them effectively if they are still in danger and their lives are at risk? 

Has depression almost made the main news this week?

This week we learned that Zayn Malik had left One Direction (famous boy band) with stress. We also discovered that Andreas Lubitz, a co-pilot who had died with 149 other people in the plane crash in the French Alps, had a past history of depression. We may never really know what exactly happened but how has depression affected the life course of these individuals? If they had been more able to talk about their feelings earlier or receive support around their key relationships then maybe their life paths would have changed.

Depression and Alcohol / Drug Misuse

Depression, low mood and sadness are feelings that most people have each day. However, 3% of all young people aged 13-25 years experience severe depression for most of the time. There are 2 million teenagers in the UK who have one or more parents who are addicted to alcohol. If your parents are depressed and/or using alcohol or drugs, then how will it affect you as a young person? You are not alone. Alateen is a part of Alcoholics Anonymous which offers help to young people with parents who have problems with drinking.

NICE Guidelines there 2005, 2013, 2015

In the UK the National Institute for Health and Care Excellence (NICE) had published guidelines in 2005 for the treatment of depression in young people. These guidelines were updated in 2013 and 2015. After an assessment, if a young person is diagnosed with depression they should be offered therapy. This would usually consist of Cognitive Behaviour Therapy (CBT), Family Therapy or Interpersonal Therapy (IPT). In practise, there is usually a delay of several months for most young people before they can access therapy.

Brain Derived Neurotropic Factor

The brain is even more than a veritable soup of chemicals mixed with a spaghetti junction of endless combinations of nerve connections. How do our nerves remain healthy? They need Brain Derived Neurotropic Factor (BDNF) to grow and maintain their function. However, in stressful situations there is a reduction in BDNF in key brain areas, especially the hippocampus.

The hippocampus of the rat has been studied by John O'Keefe who won the Nobel Prize for Medicine last year. We now know that this region of the brain possesses its own stem cells which can be made into new nerve cells.

The UK Government

In the UK, we are lucky that our government gives £717,000,000 a year for the funding of child and adolescent mental health services. However this is £50,000,000 less than in 2010 under the previous government. Even after seven years as a NHS Consultant, I cannot get severely depressed teenagers into therapeutic work promptly because we just do not have enough professionals working in CAMHS.

Our government will need to ensure that we can do more for young people's health, education, employment and life prospects to contribute to this Great Britain.

Depression in Teenage Pregnancy

In the UK, the National Institute of Clinical Excellence (NICE) produced Guideline CR192 to focus on the clinical management of antenatal and postnatal mental health.

The focus of this document is the wide range of mental illnesses such as depression, psychosis, anxiety, eating disorders, drug and alcohol use disorders.

2.9 in 100 girls in the UK between the ages of 15 and 19 years give birth which is high compared to other countries 0,9 per 100 in France, 1.1 per 100 in Germany and 0.4 per 100 in Japan. In the UK there are 48000 babies born each year to teenage mothers.

Depression Care Pathway

Happy New Year for 2015!

3% of all young people from the teenage years to young adulthood experience severe depression but only a quarter of individuals receive any kind of treatment. In my NHS practice in the UK I have been able to assess young people promptly when they have been referred in by their GP but there has been too much of a delay in enabling them to access cognitive behaviour therapy with one of our therapists.

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