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Can Cbt Help ‘Biological’ Depression?

We can all feel low and poorly motivated from time to time.  But for as many as 30% during our lives, our low mood and lack of motivation just won’t shift.  Often, despite our best efforts, and the efforts of those who care for us, our low moods exhaust our ability to cope.  We have become depressed.
mental health
The question for mental health practitioners is how best to help someone who has become depressed?  One treatment strategy, the medical approach, involves prescribing an antidepressant.  These work on the neurotransmitters in the brain cells to improve our mood.  The other strategy is to use a proven psychological approach like counselling or cognitive behavioural therapy (CBT).

On the face of it looks confusing for the patient.  Is my depression a biological illness, or a psychological problem?  The reality is that depression is best seen as both biological and psychological.  Just two sides of the same coin.

It is certainly true that for some patients, their depression falls more towards the biological, and for others their depression falls more toward the psychological.  One theory suggests that the more a person excretes catecholamines in their urine, the more the depression has a biological component.

For talking therapists like myself, the interesting question is, are the interventions I use effective for people with these biological markers of depression?  In a recent study by Oei in the journal Behavioural and Cognitive Psychotherapy, patients with high levels of catecholamine’s and low levels of catecholamine’s  were each given a course of CBT.  Although the high catecholamine’s group had a higher score of depression severity at the start of therapy, both groups showed the same rate of improvement overall.

What does this mean?  Well in short it suggests that CBT is an effective treatment for depression, even for people showing evidence of a high ‘biological’ component.  This will bring some comfort for those people who are depressed and don’t want to take medication.  CBT also holds the advantage that you learn the skills to stay well which, if practiced, will help keep you well for the long term.  Unfortunately with medical approaches, the depression can sometimes return once the medication is stopped.

My own view is that antidepressants and talking therapies like CBT both have a role to play in the treatment of depression and often work extremely well together.  But if you really don’t want to take tablets, CBT or counselling really is an effective option for many people.

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If The Gay Scene Is The Answer, What Is The Question?

This weekend hundreds of thousands of gay men from around the country and abroad are descending on Manchester to celebrate gay Pride.  These showcase events celebrate the diversity of gay culture, and offer an opportunity for men of all ages to stand together – out and proud.  But such festivals of gay culture hide some very disturbing truths.
gay parade
First, for many gay men, there is only one thing worse than coming out as gay … and that is finding out what the gay scene is like.  In my experience, young gay men’s expectations of the gay scene is of a community of like minded men through which they can find love and fulfilment.  The reality is often lots of shagging but very little by way of community, and even less of fulfilment.  Indeed for many gay men, they find the gay scene predatory, sleazy and demeaning.  What’s going on?

I guess the first thing to clear away is the psychological baggage some gay men bring to the gay scene.  Let’s face it; accepting that you are gay is tough.  Ever since you were a kid you picked up social messages that being gay was wrong or weird or antisocial.  Sometimes those messages were literally hammered home in the form of physical attack.  Sometimes in the street, and sadly, sometimes from brothers and fathers too.

So gay men bring a stock of self hatred to the gay scene.  Of course we see what we expect to find.  Our eyes seek out the stereotypes we were led to believe existed and our mind gravitates on them, often with aversion.  This is a process psychologist’s call projective identification.  We see those aspects we dislike in ourselves in other people, and then hate them for it.  Another name for it is internalised homophobia.

Many of my gay clients struggle with this internalised homophobia.  They go onto the gay scene, unaware and unprepared for what it has to offer, then recoil in dismay at what they find.  If we can clear our minds of such notions, what is really there in the gay scene?

Well I think a lot of what happens on the gay scene reflects not on gay men, but on the fact gay men are men.

Let me explain.  In girls, they develop into social creatures interested in faces and emotions from the day they are born.  Girls brains are not marinaded in testosterone.  Boys’ brains are, and this king of the male hormones kills off much of the social brain in boys.  Baby boys are less interested in faces and connecting and more interested in action and adventure.

As boys develop into young men testosterone again begins to shape their brains and they start to become interested not only in sex, but pecking order.  It’s just as important to boys and young men to know where they stand in the pecking order of life as it is for girls to connect and make friends.

Inhibited by a brain not wired for ‘community’, and testosterone fuelling the brain with action and sex, young gay men are thrust into a testosterone rich environment which prises, above all else, sexual beauty and the pecking order it creates.  As men’s brains are also driven by the automatic need to seek out beauty, the young and the gorgeous rise to the top, and everybody else falls in behind – which of course, is virtually everybody.

It wasn’t always like this.  In the 80’s and 90’s gay men had a cause to fight.  With regressive laws like the infamous Section 28, which banned the ‘promotion’ of homosexuality, and the AIDS pandemic killing young gay men by the thousand, there was much to get angry about.  Gay men petitioned, protested and confronted the establishment to end their oppressive law making and provide the services to help gay men die with dignity.

Things are different now.  With antidiscrimination legislation protecting gay men’s working, and let’s face it, shopping rights, we now live in a different era.  With civil partnerships, gay men can now pay taxes on an equal footing with their straight counterparts.  The pressure now is to normalise and assimilate gay men to a straight moral order.

So this leads me to ask a different question.  If the gay scene is to be more than simply establishing a pecking order based on youth and beauty, and the opportunity for young men to feed their testosterone driven sexual appetites, what does it need to be?

Well in my work with gay men, I see the social isolation, alienation, and drink and alcohol problems fueled by the commercial gay scene.  The gay scene might be in full on party mode, but the male brain isn’t making the connections it needs to sustain and nurture lives, old and young.  Gay men need community, not more drinking opportunities, and I see very little by way of community action bringing it about.

The commercial gay scene may be an answer to one question … but perhaps it’s not the right question to be asking.

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Want To Lose Weight? Laser Your Gut !

We all know blokes are prone to putting on the pounds around our guts.  We know its not good for our health but mores the point we don’t like it, our partners don’t like it, and now there appears to be a way of getting rid of it that is painless, quick and doesn’t involve diets or exercise – sound too good to be true?  Read on …
fat reduction
Lasers have been used in a wide range of medical procedures for years.  Rodrigo Neira, a plastic surgeon, noticed in 2001, that if he shone a laser at a culture of fat cells, the laser emulsified the tissue.  He reported his findings to the second South American Congress on Plastic and reconstructive surgery.

Later he showed that shining the laser onto fat tissue made fat tissue easier to remove by liposuction.  These findings were reported in the Aesthetic Surgery Journal (Vol. 22, p. 451).

The next step was to see if lasered fat cells would cause a loss of weight without liposuction.  The results were promising and reported in the journal Lasers in Surgery and Medicine (Vol. 41, p. 799).  The average lasered person lost 3.51 inches of girth.

The lasers seem to cause holes to form in the fat cell membranes. This allows the fat into the intercellular spaces.  It is then claimed that this fat is then harmlessly cleared by the body.

Although this technology is still relatively new and unproven by medical standards, it is now available.  It is not cheap though, a 20 minute laser consultation costs approximately £250 … but the provider Harley Fit claim you can loose up to seven inches in one treatment.

From my perspective, I am convinced the lasers do emulsify the fat which then passes through the body naturally.  The problem is that it may not destroy the fat cells themselves.

Fat cells work like a ratchet system; our bodies can produce new ones, but not destroy old ones.  This system will suffer from the Achilles heel of all fat reduction systems; it will trick the body into believing it is in starvation mode, and the fat may just pile back on.

If the results justify the hype, this truly is a remarkable breakthrough.  To hold on to your gains though, you are will still have to address your eating and exercising habits.

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