What’s Wrong With “Evidence Based” Depression Treatments?

With all our medical advances, why is it that the incidence of depression and anxiety is skyrocketing. The World Health Organization says that depression is the most disabling disease in the Western World today, yet all mental healthcare specialists seem to talk about is “evidence based” treatments such as counseling and anti depressants. Whilst these strategies have been shown to be helpful for some people, if this was really cutting edge advice, why aren’t we seeing the incidence of depression declining or at the very least plateauing. This in no way seeks to imply that medication and psychological counseling don’t have their place in treating depression, just that we are not exploring all the variables

Having interviewed thousands of people who have battled with depression, I am convinced that there are some serious issues with the “evidence based” approach to treating depression. These can be summarized as follows:

1. The “evidence” is where the money is
Unfortunately clinical trials are very expensive to run so private funding will only be directed towards those areas where “investors” can see a return on investment. In the world of depression treatments, this means that the vast majority of funds are directed towards medication and psychological counseling interventions. This means that important lifestyle strategies such as exercise, emotional support,nutrition, relaxation, and fulfilling work are relatively ignored. Ironically these less discussed strategies can be much less costly to implement.

2. When you’re holding a hammer everything looks like a nail
The vast majority of depression treatment studies are undertaken by doctors or psychologists. Whilst there is nothing wrong with this per se, most of these studies are evaluating areas where they have expertise (which makes sense). This means that the comparisons are often looking in isolation at one drug verses another (or a placebo) or one psychological intervention verses another. Quite often meaningful advancements in areas can come from someone outside the established “paradigms”. I love the story of the little boy who came across rescue workers who had been struggling for 3 hours with sophisticated hydraulic equipment trying to dislodge a truck which had been tightly wedged under an overhead bridge. After being encouraged to leave the site he quietly said “Why don’t you let down the tyres?”.

3. We are not just DNA
As human beings our bodies and minds are intricately linked. Depression treatments that focus purely on a “biological illness” are seriously limited. Much of the despair that exists in the western world today can be linked to loneliness, family breakdowns, excessive and unfulfilled work, and financial crises. Saying that depression is caused by low levels of serotonin is like saying teen pregnancies are caused by a sperm fertilizing an egg – yes, but…. Depression treatments that fail to reconnect us with our passions and purpose are ultimately going to be short lived solutions.

What are the right depression treatments?
To find out what works best in managing or overcoming depression, we must ask the people who are living with depression what works best for them. In 2007 I asked just that, and their answers were (in order) exercise, support of family and friends, psychological counseling, fulfilling work, relaxation/meditation, nutrition and medication.
Coincidentally, the Black Dog Institute (BDI) -one of the pre-eminent mood disorder units in the world – also undertook a study directly asking those with depression what helped them most. Although there were some differences in the studies, lifestyle strategies were also shown to be extremely important. One of the authors of the published study, Professor Gordon Parker, who has been practicing psychiatry for over 30 years, has now started advising General Practitioners and their patients to exercise regularly to aid recovery.

If Professor Parker, who has published over 600 clinical papers and book chapters regarding mood disorders, can learn something from these results, perhaps we all can.

Dental Insurance. The NHS in Dental Shambles

It’s truly shambolic say many dentists referring to the recent overhaul of the NHS dental service. The situation has become so bad that dentists are leaving the NHS in droves. Seven out of ten dentists have either quit the NHS or have signed their new NHS contract temporarily and “under dispute”. This means that come July this year they have the right to refuse NHS patients and switch entirely to private practice.

The hullabaloo is all about the new NHS contract which many dentists allege has been rushed out and forced upon them without proper consultation. A survey in the Daily Mail found that almost one third of dentists were still negotiating deals with their health authorities just three days before the deadline. The final rush has led to resentment, anxiety and confusion amongst dentists over what is in effect a complex packages of changes.

As far as the patient is concerned, the new contract greatly simplifies charges. Instead of some 400 different dental charges, there are now just three standard charges. Patients will be charged £15.50 for each check-up, £42.40 for fillings irrespective of the number of fillings and £189 for more complicated work such as crowns and bridges. Each of these charges pay for a complete course of treatment, irrespective of how long it takes and no matter how many teeth have to be treated.

But dentists believe that these three price bands will persuade many patients to delay treatment leading to an explosion of tooth decay. Says Dr Anthony Halperin from the Patients’ Association, “I’m concerned that many patients will wait until they need multiple treatments to try to get value for money. If that does happen, it is likely we will see a significant rise in tooth decay”.

This unprecedented exodus of dentists from the NHS means that up to 16 million patients could be left without state dental care. And there’s no guarantee that if you do decide to go private, you’ll find a dentist who’ll treat you. There are reports that dentists are becoming very choosey about who they’ll treat. It seems possible that some dentists will only accept patients who are well off or who have dental insurance.

So how do get insured? Well, without doubt, the Internet is going to be the place to find the best deals. Try searching under “dental insurance” and you’ll find lots of options. Of course, many dentists will leave details of one or two insurance schemes in their waiting room but dentists aren’t insurance experts and are not in a position to provide expert insurance advice.

Insurance companies are now widely promoting dental insurance but they’ll only sell their own products. We believe the best option is to find a specialised dental insurance broker. These brokers will essentially find you the best option from a wide array of dental insurance and dental capitalisation schemes. There is a third option – cash plans – but these tend to include a wide range of medical treatments with dental treatment being one small part of the insurance cover.

Dental Insurance

The problem for the patient is the wide range and complexity of the policies available. Almost every insurance policy is different with its own set of pros and cons. The broker’s job is to assess your needs and come up with suitable policies within your budget.

A typical policy helps to set the picture for what’s available. A policy with Western Provident pays the first 25% of each dental treatment but you claim up to £250 per year towards routine treatment such as check-ups, fillings and visits to the hygienist. Emergency dental treatment is often very expensive so you’re covered up to £1,000 per year with the maximum claim for accidental dental injury set at £250 per treatment. The cost? If you’re between18 and 49 the premium is £12.48. For those aged between 50 and 69 it’s £15.90 per month.

Capitalisation Schemes

A capitalisation scheme invariably works out the most expensive but it’s the option favoured by many dentists. Before you take out a capitalisation policy, your dentist carries out an assessment of your dental health and places you in one of five or so, treatment groups. The group you’re in then sets the cost of your scheme. The worse your dental condition, the more you pay.

For example, a capitalisation scheme from Denplan costs between £9 and £30 per month.

Cash Plans

The last alternative is a composite health cash plan. These plans cover you for a wide range of health treatments from dentistry to eye treatment, hospital treatment, physiotherapy, chiropody even allergy testing. Each treatment has a maximum claim value but they tend to be a bit on the mean side. In our view, you’re much better off with a dental insurance policy or a capitalisation scheme.

You pays your money and takes your choice!

How to Raise a Child With Autism

Being a parent to an autistic child is not easy. Autism often prevents the kid from being able to communicate very well. It is an illness that requires a lot of attention, and worse children with this disorder are often ostracized by society.

It is definitely going to be a tough road ahead, but mind you, a lot of parents have already learned with the illness effectively and raise fabulous children. Here are some tips:

Come up with a routine. Autistic children thrive well in environments where routines are being followed. This is because they do not have a lot of capacity to immediately follow some changes.

It is best if you can follow a certain schedule all throughout the day. Moreover, routines should also be the goals of the kid’s therapist and even the school. It is also not enough that it is only you who stick to the plan. Those people who are involved in raising the child should also follow.

Consider getting a guardian for the child. It is not all the time that you can be there for your child. You may have to go to work or travel. In cases where you will not be physically present, appoint a guardian for the child. States have different laws when it comes to guardianship, so read them first. Needless to say pick someone you can really trust and can show genuine concern and love for the kid.

Engage them all the time. Autistic children often find themselves withdrawn. They do not talk too much or mingle with other people. Nevertheless, how else would you know more about your kid if you allow them to do that?

Parents should learn to engage their autistic kid constantly. You should play with him, help him in his activities, watch movies and television shows with him, or just talk to him. You do not have to wait for a reply. As mentioned, you simply want to develop routines. Once he is already feels comfortable, he soon starts to warm up on you and be more responsive.

Learn as much as you can about the disorder. These days you will find all sorts of myths and misconceptions about autism. Hence, you need to have access to the right information. Plenty of organizations can already provide them for you. You can now download references, books, and journals. You can also talk to therapists and autism experts who may be working in health care facilities.

Make use of subliminal messages. Affirmations are good not only for the parents but also for the autistic child. Parents can use these positive words to empower and encourage them to never give up. They can boost their confidence, especially on their ability to take care of a special kid.

The kid, on the other hand, can listen to subliminal messages, particularly those that have very interesting sounds or images. They can be very relaxing for the child, which can reduce tantrums and other aggressive behaviors. They can also help the kid to be more positive and happier.

Getting Rid of Cancer in Early Stages

Cancer is different and more potent than other diseases. Though the effects of brain stroke and heart attacks can be more severe and immediate but Cancer has its own set of aspects. It may be present in the body since a long time and detected only at a later stage which makes it difficult to contain and treat it. There are no exact causes of this disease but there are several risk factors and even if you refrain from those, there is no surety that it won’t hit you. This is why it is considered as one of the most deadly diseases. If we have to define it, it is a group of diseases in which there is abnormal growth of cells that are not needed in the body.

It is detected by finding out where it is located and what is the extent of it. All of this is found out in diagnostic tests. Some of the common diagnostic tests are as follows –

• Imaging Tests

These tests take the images of the inside of the body. They are done to find out the extent and see if the treatment is working. Different forms of energy like x-rays, sound waves, radioactive particles etc are sent to your body. The energy patterns are changed to make an image. They are used in early stages and screening tests. Images which come out from these tests are used to track the changes during the treatment course.

• Ultrasound

This procedure is used to check the tumors in the body which are not detected in X-ray. There is no need of special preparation and is a quick procedure. The images created are known as sonograms. These waves bounce off organs and tissues and create echoes. Ultrasound is exceptional to create pictures of some soft tissue diseases. On an average, it is completed in 15-20 minutes.

• Endoscopy

It is a minimally invasive diagnostic test which is done with the help of an endoscope. It is a thin and slender instrument with hollow tubes that is inserted to look inside the body. They have a small video camera on top which puts pictures on the computer screen. It is either put in the mouth, anus or urethra. They are used to find cancer in people with no symptoms or to find cancer early.

• Bone Scan

This type of test scans the presence of cancer in the bones. It may either have started in the bones or may have spread from different parts. Bone test also helps in determining how well the treatment is working for the cancer. In this procedure, a very small amount of radioactive substance is used which is injected in the vein. Areas which absorb very less tracer are susceptible to this disease.

• Mammography

It is a particular type which is done to test for breast cancer in women. The image that is produced is known as mammogram. Tumors that cannot be felt by hands are shown by these images. The whole procedure takes around 10 to 15 minutes. It can be done wither with the help of digital mammography or 3-D breast imaging.

Below explained are the different treatment options –

1. Chemotherapy

It is the treatment method in which drugs are used to destroy cancer cells. It stops the affected cells from growing and making new cells. As the speed with which the cells are destroyed is very fast, there is damage to the nearby normal cells too. There are different ways to use this treatment –

• It is used as the only treatment in some diseases like leukemia and lymphoma.

• It is used before the surgery called as neoadjuvant chemotherapy and after the surgery is known as adjuvant chemotherapy.

• In case of metastatic cancer that has spread to other parts of the body and recurrent if the cancer comes back after the treatment.

Chemotherapy is given for a specific period of time. It is given in cycles and usually it lasts for 6 months or a year. There are different ways to impart this treatment method. Some of them are Intravenous, oral, injected, topical etc.

2. Surgery

It is an operation to remove tumor from the body. It is one of the most used and oldest forms of treatment. It can also be used for different purpose like diagnosing cancer, location of cancer and the extent to which it has spread. It can be used alone or in conjunction with other techniques like chemotherapy and radiation therapy.

In some cases, a surgeon is not able to remove the whole tumor as it may cause damage to the body. In these cases, debulking is done. As much of the tumor is removed from the body and the remaining tumor is removed with the help of other methods.

3. Radiation Therapy

Cancer cells are destroyed with the help of high energy x rays and other particles. The main aim of this treatment is to slow the growth of cancer cells and kill them without harming the nearby healthy tissue. More than half the people suffering from cancer receive radiation therapy at least once.

There are two ways of providing it. One is by external beam radiation in which radiation is delivered from outside the machine. It can treat large areas of the body too. Other method is internal radiation therapy.