February

CBT IN THE CITY

February 2013

contents. A message from Guest Dawn, Book reviews

Diabetes & Emotions Mindfulness

ness can make a difference with blood sugar levels Have you adjusted to the news of being Diabetic?

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Check out our new services in you local area

February

• Website: www.cbtinthecity.com • Join Our Facebook Groups: CBT in the City - CBT in the City for Schools - Mindfulness and the City • Follow us on Twitter: CBTDaily  -  SchoolsCBT  -  MindfulnessCB

CBT London and the Home Counties

Our head office is based in Harley Street, London, while we also hold London CBT Clinics

at the Healix Wellbeing Centre in Southgate, North

London. Highbury and Islington Brixton, Dulwich,

Camberwell and Walthamstowe. In the home counties we

have CBT Therapists available on the network in Berkshire, Buckinghamshire, Essex,

Norwich, St Albans in Hertfordshire, Kent , Surrey and Sussex. For more information, book an appointment or enrol in a Group CBT Programs you will need to contact us, register online or telephone 0207 467 1508 Message From Dawn @ Making Mental Health Positive The book is an easy read and has lots of useful suggestions on thinking styles and how this contributes to low mood, having been an anxiety and depression sufferer, I have found the techniques to be useful and easy to understand.

I do like the way the book is structured and it is user friendly, having used CBT before it has given me some useful reminders on the the tools we have to control our thought processes. A very good read and check out our raffle in February for the Making Mental Health Positive campaign

February

2 CBT in the City Ltd Registered company in UK:6709268. CBT in the City is a registered Trademark copyright 2010 and all work produced and published is the property of CBT in the City Ltd. Any reproduction is prohibited 2012

Amazon.co.uk: Nemo "frenchyuk"'s review of Managing Depression with CBT For Dummies I already owned the "CBT for Dummies" book and love it so was quite excited about this new book coming out. And it did not disappoint. Having suffered from depression and received CBT sessions in the past this book is a great reminder of the tools and techniques I've learned and it is easy to pick up

February

This review is from: Managing Depression with CBT For Dummies (For Dummies (Lifestyles Paperback)) (Paperback) The book is a new exciting edition to the dummies range offering some needed advice to those who are managing their depression from a Cognitive Behavioural Therapeutic viewpoint. The authors offer a range of ideas from the 1st 2nd and 3rd wave CBT approaches and I think they blend it quite well in an easy to read style that the dummies range is famous for. Much is offered to overcome the problem but here the authors help with strategies to help with the day to day management of depression It has a chapter on how to develop intelligence about emotions which is essential to know when dealing with the mind-field of emotions and when knowledge is gained then the individual has power to make the changes. The writing style is good clear and inviting the reader to engage on a journey of self discovery. The beauty of the style is that the depressed person with reduced attention span can dip in and out the book and glen a gem or 2 in helping them that day A good read and provides a menu of tips and challenges to understand and for the depressed individual it is a bible to recovery and if not recovery then a of management of the day to day challenges that depression brings

for a specific question/issue without having to read the whole thing in one go. Whenever I have a little wobble I just go to the book and manage to "sort myself out" which is really empowering and testiment to the whole CBT ethos. Of couse the book doesn't replace one on one CBT sessions but as either a companion to one to one CBT sessions or just as a "home read" book I think it's really valuable. Anyone thinking/hoping it'll be a quick miracle cure will be disappointed as it's not how CBT work, but anyone willing to give it a go and put in the work should see some benefit. I've already recommended it to some friends who it may help.

Diabetes and Emotions This section features Psychology based articles written by Dr Jen Nash, a Clinical Psychologist and Charlotte Summers, a Mindfulness-based diabetes researcher.For anyone with diabetes, experiencing negative emotions such as anger, frustration, hopelessness, fear, guilt and shame is very common.

According to NICE (NICE, 2005) when a person is first diagnosed with diabetes, they will often go through similar psychological stages as that of bereavement: disbelief, denial, anger and depression. We look at how these emotions can affect your life and diabetes management: AngerAnxietyGuiltDepressionDiabetes burnoutHigher HbA1c levels have been found to be associated with physical symptoms including hyperglycemic score, mood including levels of displeasure, depression, tension and fatigue and with worse general well-being. The relative association varied between 1.02 and 1.36 for each percentage difference in HbA1c. The relation between HbA1c and some mood states have been found to be modified by neuroticism a patient who is less inclined to complain was associated with worse glyceamic control. [45]

February

Mindfulness training has been shown to address depression, stress, anxiety, chronic pain all of which have been implemented with better glycaemia control, diabetes management and greater reported quality of life: Mindfulness and hypoglycaemiaMindfulness' effect on blood glucose levels and blood pressureMindfulness and sleepMindfulness and back painMore likely to suffer from depression According to the NHS people with diabetes are twice as likely to suffer with depression. Evidence presented by the National Diabetes Support Team indicate that 'recovery from depression is associated with reductions in HbA1c levels of between 0.5% and 1% suggesting that treating depression can not only improve quality of life but could also significantly reduce the risk of complications.' Some stressors may emerge after many weeks, months or years following diagnosis. Alternatively, there may be difficulties that arise upon initial diabetes diagnosis and continue without being resolved. These may include: Coping with your diabetes diagnosisUnderstanding your relationship with food and why you overeatCommunicating openly and effectively with healthcare professionalsHow to deal with compulsive behavioursManaging low moods and depressionHow to increase your motivationSex, diabetes and relationshipsNeedle phobia and overcoming itFear of long term complicationsDealing with denialAnxiety with hypoglycemiaTackling lifestyle changesA NHS Confederation briefing paper has highlighted the importance of integrating the treatment of physical and mental healthcare and acknowledges the increased prevalence of mental health needs amongst people with physical health conditions. The paper also accepts that treatment of the mental health needs has a positive impact on physical wellbeing (NHS Confederation, 2009). Explore Diabetes and EmotionsMindfulness and Hypoglycemia Hypoglycaemia is a concern for people with diabetes and often causes heightened anxiety due to the unpredictable nature of when a hypo may occur. February

Hypoglycaemic episodes are less common for a person with type 2 diabetes but could arise as a result of dietary decisions. Hypoglycaemia is considered to occur when blood sugar levels fall below 4mmol/L. Hyperglycaemia, which is when blood glucose levels are higher than 10 mmol/L, tends to be a greater problem for people with type 2 diabetes, attributed to more long term complications associated with diabetes, particularly cardiovascular problems such as high blood pressure, heart disease and stroke. Improving blood glucose control with mindfulness Mindfulness has been shown to increase glycemic control and subsequently reduce the chances of having hypoglycaemic, hyperglycaemic episodes, leading to a reduction of the mental distress associated with diabetes management. Study 1: Reduction of HbA1c and blood pressure A team of researchers lead by Dr Rosenweig, conducted a study where participants completed a mindfulness course for 8 weeks along with keeping a diary of the exercise and diet regimes. At a one month follow up point, HbA1c levels and blood pressure were significantly reduced, in the mindfulness participants, over the participants who had not completed the Mindfulness course. It is blood pressure that in diabetics has been linked to additional complications such as heart attacks, hypertension and stroke. Though body weight did not change over the course of the research, the participants reported that emotionally they felt less anxiety and depression meaning they subsequently were in a better frame of mind to self manage their diabetes. [37] Study 2: Reduction of HbA1c Another study compared a course of Acceptance and Commitment Therapy (ACT) which included teaching participants about acceptance and mindfulness techniques with a standard diabetes education day. When comparing patients who had only attended the education session, at a 3 month follow up period those diabetics in the ACT reported they used the coping strategies learned on the course and reported better diabetes self-care.The diabetics in the ACT condition were more likely than those in the education alone group to have their glycated haemoglobin (HbA1c) levels in their target range.It was concluded that the changes in HbA1c levels were as a result of changes in acceptance coping, mindfulness and improved self care instigated by the ACT course. Explore Mindfulness February

February

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February

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