This is the third in a series of blog posts on last Wednesday's SIGN draft guideline seminar on "Non-pharmacological management of mild to moderate depression."  The first session of the day was on "Lifestyle and Alternative/Complementary Therapies 1".  Yesterday's blog discussed the first presenter, Ian Ross's talk on the value of exercise in depression.  The second presentation was by Cliff Sharp, a psychiatrist from NHS borders.  He reviewed St John's Wort & Dietary Supplements.  He talked about the possible value of folate in treating depression when used to supplement conventional antidepressants.  He concluded that current evidence was insufficient to determine whether folate boosts response for those on antidepressants only if their initial folate levels are low, or whether it boosts response for anyone taking antidepressants.  See an

“ Disagreements between scientists of good intention are merely truth in the making. ” - Andrews

The "Improving Access to Psychological Therapies" (IAPT) initiative is very ambitious and exciting.  It states its principal aim is to support English Primary Care Trusts in implementing "National Institute for Health and Clinical Excellence" (NICE) guidelines for people suffering from depression and anxiety disorders.  It comments "The Improving Access to Psychological Therapies (IAPT) programme began in 2008 and has transformed treatment of adult anxiety disorders and depression in England. Over 900,000 people now access IAPT services each year, and the 'five year forward view for mental health' committed to expanding services further, alongside improving quality."  

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The genius of Tulku Urgyen was that he could point out the nature of mind with precision and matter-of-factness of teaching a person how to thread a needle and could get an ordinary meditator like me to recognize that consciousness is intrinsically free of self ... I came to Tulku Urgyen yearning for the experience of self-transcendence, and in a few minutes he showed me I had no self to transcend ... Tulku Urgyen simply handed me the ability to cut through the illusion of the self directly, even in ordinary states of consciousness.  This instruction was, without question, the most important thing I have ever been explicitly taught by another human being.  It has given me a way to escape the usual tides of psychological suffering - fear, anger, shame - in an instant.

” - Sam Harris

In May 2013, the National Institute for Health and Clinical Excellence (NICE) published a new evidence-based clinical guideline on "Social anxiety disorder: recognition, assessment and treatment".  They state: "This clinical guideline offers evidence-based advice on the recognition, assessment and treatment of social anxiety disorder in children and young people (from school age to 17 years) and adults (aged 18 years and older).

“ The eye altering, alters all. ” - William Blake

Making a formal psychological diagnosis can be a mixed blessing. It has several potential advantages. If many of my symptoms can be accurately grouped under a specific psychological diagnosis, it may well help to understand what is happening, to clarify the likely time course of my symptoms, and to choose treatments that have the best chance of being effective. It's worth noting that often people suffer from more than one psychological disorder at the same time - this is called comorbidity and it is common.

Here are details and links for a couple of dozen January articles that I found interesting.