Feeling low?

Have you been feeling low of late? It is often difficult to know at what point to ask for help when you have been feeling low. Depression is a term used by people when they are feeling low or having a bad period but at what stage does this become what doctors would call depression.

Depression is diagnosed based on the following criteria:
- persistent sadness or low mood;and/or
- loss of interests or pleasure
- fatigue or low energy
at least one of these, most days, most of the time for at least 2 weeks

symptoms should be present for a month or more and every symptom should be present for most of every day.

Does this ring any bells?

If it does there a number of things you can start to look at to try to help - things that doctors refer to as lifestyle measures.

Alcohol - although this can sometimes numb your feelings and make you feel better at the time, alcohol actually acts as a depressant and will worsen feelings of low mood. For this reason if you are feeling low alcohol is best either avoided altogether or consumed in very modest amounts

Exercise - the positive effects of cardiovascular exercise on health are widely recognised, but few people appreciate that it actually has a very positive effect people's mental health. Exercise releases endorphins which are the body's natural "feel good" hormones and can help to combat stress, anxiety and depression. Some form of exercise that gets you out of breath and gets your heart rate up for more than 30 minutes at least 3 times a week is recommended

Diet - eat healthily and make sure that you don't skip meals. Also look to reduce caffeine intake in things like tea, coffee, chocolate and some energy or carbonated drinks. These all tend to give you temporary increases in energy but then leave you feeling more tired afterwards.

There are also a number of helpful web resources available to you. A really good online resource is http://moodgym.anu.edu.au/ this is based on cognitive behavioural therapy and goes through some of the things a counsellor would begin to cover if you were to see them. It is free and something I regularly recommend to my patients. Another really good resource is the self help pamphlet developed by Northumberland, Tyne and Wear NHS trust. Again this follows a very CBT approach which is a common sense and pragmatic way of looking at the thought processes around depression.

I have also put together a list of the books that I find useful for patients and these are found at the bottom of the blog.

As you can see there is much you can do to help yourself, but if you are suffering from the symptoms listed above it is really sensible to seek attention from your GP. Although very nerve racking, they will be very understanding and hopefully help you navigate through the path to recovery.

Hypertension

So why do doctors worry so much about people having raised blood pressure? The main reason is that Hypertension (persistently raised blood pressure) increases the risk of people having a heart attack or stroke. Both of these events are disasters for all involved and prevention is definitely better than treatment once they have occurred. I as a GP know that if I lower 100 people's blood pressure for a 10 year period I stand to stop 5 people having a heart attack or stroke. When these are people I have known for years and whose families I also often know, this makes me even keener to do all that I can.

What is hypertension? A really good patient information leaflet is found at http://www.patient.co.uk/health/High-Blood-Pressure-(Hypertension).htm this tells you all you need to know about what the readings your doctor gets means and gives you a lot of useful advice.

If you are found to have high blood pressure, the most important thing to do is to look carefully at your lifestyle and see if there is room for improvement. A lot of the time it comes down to a stark choice between addressing unhealthy lifestyle choices or taking increasing amounts of medication. Yes you can continue to smoke, not exercise and eat rubbish-but this will mean you will end up on a number of different pills as a consequence. As blood pressure tends to increase with age, this can mean you end up taking more and more medication. When looking at lifestyle modification, make sure you are realistic about what you can maintain in the long term. It is important to make changes which you can sustain on an ongoing basis as temporary measures will only have a temporary effect on your blood pressure.

A last quick word of warning, if you monitor your own blood pressure at home you have to add 10mmHg to the readings for them to be equivalent to those you have done at the doctors. This is commonly forgotten and can lead to suboptimal blood pressure treatment.

So this is GP Oracle

So this our first blog..... We are completely new to this so hope our initial ramblings make sense. We are a company specialising in IT solutions for the NHS. In particular we aim to improve communication between general practice surgeries and their patients. Our system allows surgeries to alter all the mediums they use to communicate with their patients from one place: hence website, practice leaflet, patient display boards and practice intranet only need editing in one place and the information changes in all places.

Our content is continually being added to by users and health charities which has created a lively online community dedicated to highlighting useful health related information. Through our involvement with our other ventures we also have a lot of content which aims to encourage cost effective use of medications.

We are aiming with this blog to highlight useful health information and encourage healthy living!