Depression

Often patients can have a great deal of value from on-line CBT. It is recommended by the National Institute of Clinical Excellence for mild to moderate depression.

I would recommend www.llttf.com which is a reputable website and can be very valuable. An Australian website, also for online CBT is www.moodgym.anu.edu.au. This has some good assessments of personality traits and ways of thinking which are amenable to change. It is well worth looking at.

I often recommend mental health information leaflets from The Royal College of Psychiatrists' website (www.rcpsych.ac.uk) and for more general support for depression, Depression Alliance (www.depressionalliance.org).

My recommendations for cognitive therapy based pamphlets and books are to be found by www.octc.co.uk and go onto the section for resources. The little booklets are a few pounds each and can be very helpful indeed.

To Read

For more substantive books on cognitive therapy I recommend Mind Over Moodby Christine Padesky and Dennis Greenberger:
www.amazon.co.uk/Mind-Over-Mood-Change-Changing/dp/0898621283

I also recommend The Feeling Good Handbook which is for both anxiety, low self-esteem and depressive symptoms by David D Burns:
www.amazon.co.uk/Feeling-Handbook-Plume-David-Burns/dp/0452281326

Severe or Difficult to Treat Depression

ECT

This unfashionable treatment is the gold standard for severe depression and although it has been known to cause memory impairment in some people. It can be lifesaving as it can be more effective than standard treatments. There is some suspicion that the beneficial effects do not last. It is certainly a treatment I would hope my psychiatrist would consider if I was seriously or suicidally depressed. It is possible to arrange it both on an inpatient at the Priory Hospital Roehampton or as an outpatient. ECT is usually given in specialised treatment centres. We use the treatment centre at Springfield Hospital in south London and it is probably the closest clinic. It is an NHS facility which takes private patients. It can be undertaken on an outpatient basis. I also use the Queen Mary’s Hospital Sidcup where there is a new unit recently set up.

Ketamine

This exciting treatment has been shown to be beneficial for some of my patients. I use the clinic in Oxford under Dr Rupert McShane. There is a handout from this clinic available online. Patients would need to monitor their mood using an online tool "True Colours". Patients have three injections of very small amounts of ketamine and there is often immediate improvement in mood. If this is shown to be the case then oral ketamine can be provided via the clinic in Oxford. It is surprisingly inexpensive.

Transcranial Magnetic Stimulation

This treatment is a non-invasive approach which uses strong magnets to alter neurotransmitters systems in the brain. It requires frequent attendance at the clinic in order to have the magnetic sessions.

It is thought to be helpful in the treatment of depression. It is somewhat expensive, given the amount of time that is required over two or three weeks for this treatment. I arrange it either via clinics in London or at the Queen Mary’s Hospital Sidcup.