Category Archives: Depression And Anxiety Articles

Fifteen Types of Depression.

facts about depression

types of depression

On average, and all else being equal, the more traumatic a person’s childhood, the more likely it is that s/he will experience depression at some point in his/her life.

I list below sixteen different categories of depression. A person can fit into more than one category at any one time.


1) AGITATED DEPRESSION – with this type of depression the person suffering from it is constantly restless, intensely worried and deeply anxious/fearful (I suffered this type of depression and was often incapable of even staying seated).

2) RETARDED DEPRESSION – this type of depression causes the person suffering from it to very significantly slow down both mentally and physically (this is technically referred to as PSYCHOMOTOR RETARDATION). There will also be great difficulty in concentrating. In its most extreme manifestation, the afflicted individual cannot move, speak or eat  which carries with it the risk that s/he will starve to death. This state of complete inactivity is sometimes referred to as CATATONIA.

3) PSYCHOTIC DEPRESSION – with this type of depression the individual may lose touch with reality and may suffer from delusions (outlandish false beliefs) or hallucinations (seeing or hearing things which are not there). It can be treated with anti-psychotic medication.

4) NEUROTIC DEPRESSION – (this term is now falling into disuse and is being replaced with the term ‘mild depression). It is a less severe form of depression than psychotic depression (see above) and the person’s mood may fluctuate from day to day and also during the day (often, for example, feeling bad in the morning but improving in the evening). The person suffering from it may have symptoms of irritability and disrupted sleep (finding it hard to go to sleep and frequently waking during the night; however, with this type of depression there does not tend to be early morning waking which is a hallmark of other types).

5) ORGANIC DEPRESSION – this type of depression has a physical cause and can manifest itself as a result of side effects of medication. For example, the British comedian Paul Merton suffered a serious depression, for which he needed to be hospitalized, as a complication of taking anti-malaria tablets.

6) DYSTHYMIA – this is a relatively mild but persistent type of depression. Its main symptoms are low self-esteem and difficulties in making decisions. It often responds better to psychotherapy than to treatment with drugs.

7) BRIEF RECURRENT DEPRESSION – this term is relatively new and refers to serious depression which comes and goes but tends only to last for a few days at a time.

8) MASKED DEPRESSION – this is also sometimes referred to as ‘smiling depression’. Whilst the individual who has this type of depression will report that they DO NOT feel depressed, they will, nevertheless, have some of the symptoms of depression. Indeed, the symptoms will often respond well to anti-depressant medication.

9) BIPOLAR DISORDER – this used to be referred to as ‘manic-depression’. With this disorder, the person vascillates between feelings of elation and periods of despair. During their highs (the ‘manic’ phase) there will be a reduced need for sleep, excessively high energy levels often leading to frenzied activity, racing thoughts and a ‘flight of ideas’, reduced need to eat and possible delusions (eg believing they are the reincarnation of a Roman Emperor, are next in line to the throne or have special, superhuman powers) and hallucinations.

Often, too, judgment will be extremely impaired leading to, for example, massive gambling losses, vast overspending or investing huge amounts of money in doomed business ventures. Also, the individual suffering from such mania is likely to feel ‘invincible’ and that s/he ‘can achieve anything.’  However, these periods burn themselves out and are replaced by depression which may be so severe the sufferer considers or attempts suicide.

The depression may be made worse due to the lack of judgment s/he experienced during the manic phase and the self-destructiveness this may have involved (eg s/he may have taken on enormous and unrepayable debts).

10) SEASONAL AFFECTIVE DISORDER (S. A. D.) – this is a form of depression which only strikes in the winter months due to the lowered amount of sunlight during this period. Symptoms can include an increased need for sleep and carbohydrate cravings.

11) UNIPOLAR DEPRESSION – this is, by a very long way, far more common than bipolar depression – only low mood is experienced ; there are no highs/manic episodes.

12) REACTIVE DEPRESSION – sometimes called ‘endogenous depression’. This type of depression occurs as a reaction to a stressful event, such as being made redundant ;  it is normally relatively short-lived and often responds well to counselling or family support.

13) RECURRENT DEPRESSION – any period of depression which is not the first one the person has experienced is called ‘recurrent depression.’

14) CHRONIC DEPRESSION – the word ‘chronic’ means long lasting (some people misuse the word when what they actually mean is ‘severe’). Doctors refer to a depression as being ‘chronic’ if it has gone on for at least two years.

15) TREATMENT RESISTANT DEPRESSION – this refers to a depression which does not improve with anti-depressant drugs. This was the type of depression I had/have. In such cases, if the depression is very severe and life-threatening (due to self-neglect or high suicide risk) electro-convulsive shock therapy (ECT)may be used as as  a last resort. I myself had to undergo ECT on a number of occasions over the years (although, unfortunately, this had no positive effect whatsoever in my own case ; however, for some it can be life saving).

David Hosier BSc Hons ; MSc ; PGDE(FAHE).

Metacognitive Therapy for Anxiety and Depression.

metacognitive therapy


Metacognitive therapy (MCT) was developed by Dr Adrian Wells and Dr Gerald Matthews in the early 1990s.  It shares elements in common with, but is distinct from, cognitive-behavioral therapy (CBT).

The main difference is that whilst CBT concentrates upon the negative CONTENT of a person’s thoughts and strives to alter that content, MCT, in contrast, focuses not on the contents of a person’s thoughts but rather on the WAY IN WHICH THE PERSON THINKS – it aims to help the person experience their negative thoughts in a new and accepting way which can greatly reduce the emotional distress that they had previously been causing.

Although MCT was first devised in order to treat anxiety, it is now used to treat a wide range of psychiatric conditions; these include :

– Generalized Anxiety Disorder (GAD)

– Social Phobia

– Post Traumatic Stress Disorder (PTSD)

Research into the effectiveness of MCT for the above conditions has so far yielded promising results.

metacognitive therapy


Essentially, metacognitions are THOUGHTS ABOUT OUR THOUGHTS. This might sound a little odd at first, so I will illustrate what is meant by the definition with the assistance of an example :

Suppose a person started to suffer clinical depression – at first, his/her thoughts (or ruminations, as they are referred to by psychiatrists) may be quite specific ; for example, worries about being made redundant at work, the breakdown of an important relationship, ruinous debt etc…etc…

As time goes on, however, the worries can become more abstract, and the individual can start worrying about the fact s/he is always worrying. This is also referred to as meta-worrying. Similarly, s/he might begin to feel depressed about always being depressed,

It is very easy to get tied up with this type of thinking, and many do. Essentially, it adds another layer of worry or depression that is clearly superfluous and serves no purpose other than to further lower mood and further torment the hapless individual.

Metacognitions such as those illustrated above frequently become OBSESSIVE and OUT OF CONTROL, dominating our mental state and making it extremely hard to think about anything else – thoughts circle around and around our tortured and exhausted minds in a futile, painful and incessant manner.

Indeed, one of the main behaviors that exacerbates depression and anxiety is OVER-THINKING ABOUT, AND OVER-ANALYZING, THE PARTICULAR PREDICAMENT IN WHICH WE FIND OURSELVES SO CRUELLY PLACED (I know this from my own experience, as I was particularly badly afflicted by obsessional anxieties and over-analysis). Dr Wells refers to getting ‘stuck in our thoughts’ in such a way as Cognitive Attentional Syndrome.

MCT works by helping people, as I stated in the first paragraph, change the way in which they think, and subsequently how they experience their negative thoughts, rather than trying to change the content of their thoughts. One of the aims is to help them accept their thoughts much more without those thoughts triggering psychological distress; and, also, to help them realize they do not need constantly to engage in an exhausting mental fight with their thoughts.

Research has so far shown MCT to be highly effective at treating a range of conditions. Another promising finding is that the therapy can achieve very significant positive effects in as little as 8 weeks.


MCT – Institute (click here).

David Hosier BSc Hons; MSc; PGDE(FAHE).


Human Stress : Why We Should Envy Gazelles

anxiety and the amydala

The human stress/fear response evolved millions of years ago in our ancestors to allow them to survive – it is commonly known as the ‘fight or flight’ response. If we saw a tiger, it was necessary to feel fear as this fear motivated us to freeze and then to run away when it was safe to do so. Modern day humans have inherited this mechanism.

One of the areas of the brain that becomes highly active when we experience fear, and gives rise to the fight/flight response, is called the AMYGDALLA. This area of the brain is also stimulated in other animals, such as gazelles, when they perceive danger.


Let’s imagine that a group (I don’t know the collective term for them – herd?) of gazelles is calmly grazing when they become aware that a tiger is preparing to launch a ferocious and potentially lethal attack. What is their response?

Well, what happens on a physiological level is that the sighting of the tiger instantaneously triggers intense activity in their brains’ amygdallas and their ‘fight/flight’ response is triggered. This causes them to experience feelings of panic and terror which in turn leads them to flee the tiger as fast as they are able (which, given they are gazelles. is very fast indeed – they don’t hang around!

Once the danger has passed, however, the activity in their amygdallae quickly returns to normal and, therefore, they are able to return to calmly grazing.

The gazelle, then, is easily able to ‘switch on’ their amygdalla, but, just as easily, ‘switch it off’ again when its activity is no longer required.

Sadly, we poor humans are not nearly as good at doing this. Because we have language, which allows us to carry out internal monologues, we also have imagination and are able to dwell on the past and contemplate the future; because of this, we are able to constantly torment ourselves with worries, regrets, concerns, fears and so on. In this way, especially if we suffer from anxiety, we can find ourselves constantly feeling we are trapped in the ‘fight or flight’ response – our amygdallas become permanently over-stimulated, even though we do not wish them to be and it is not in our survival interests that they are; indeed, being is such a state of permanent anxiety and fear imperils our survival (eg we might smoke and drink more, or, in extreme circumstances, attempt suicide).


It is now well established by scientific research that mindfulness and meditation are extremely effective at treating anxiety (and many other conditions) and can significantly and permanently reduce the general level of activity in the amygdalla, which, in turn, allows us to live our daily lives, gazelle-like, in a far calmer state of mind. I will look at the exciting research being conducted in relation to mindfulness and meditation in my next post.

In the meantime, a hypnotherapy MP3 download to help manage anxiety (entitled : ‘Quiet Mind’) is available by clicking here, although this is not free of charge.

Best wishes, David Hosier BSc Hons; MSc; PGDE(FAHE).

The Dysfunctional Family’s Scapegoat.


In this article I will examine the phenomenon of becoming the dysfunctional family’s scapegoat.

Personal Experience

I went to live with my father and obsessively religious step-mother when I was thirteen, having been thrown out of the house by my disturbed and highly unstable mother.

She and my father already had her own biological son living with them. She treated her own son, essentially, as a demi-god, whist viewing me as the devil incarnate – even at that age, (given I had the capacity to carry out elementary mental reasoning and was not intellectually retarded) I did not believe in god, and, consistent with this, refused to attend church with the other members of the household who regarded twice weekly attendance as their pious duty.

Indeed, and I write these words in all seriousness, it is even possible that my step-mother believed I was possessed by some kind of diabolical spirit – after all, soon after I went to live with her and my father, during a trivial argument in the kitchen, she began to shout at me in what she believed to be ‘tongues’. And, when I was a bit older, if one particular friend had been round to see me and she returned to the house later, she would say she knew he’d been round as she could ‘sense evil’ (actually, he was a very nice person). You couldn’t make it up.

In dysfunctional families, viewing one child as being able to do no wrong, and the other as being able to do nothing OTHER THAN wrong, is not an uncommon scenario. The latter, of course, becomes the family ‘scapegoat.’

family scapegoat

Whilst I have grown up with a profound inferiority complex, my step-brother has grown up, I think it is fair to say, puffed up with an impregnable sense of self-love, self-belief and self-pride; expecting others to admire him is his default position. Expecting others to despise me is mine. (And, in this regard, I’m seldom disappointed). This outcome, of course, would not be entirely unpredictable to anybody with an IQ above about 70.

Sadly, it invariably tends to be the most vulnerable and sensitive child who becomes the dysfunctional family’s scapegoat. It is also not uncommon that the child fulfilling the role of scapegoat has a characteristic, or characteristics, which a parent shares but represses, projecting his/her self-disapproval onto the scapegoat.

Denigration And Demonization

The family’s scapegoat will be blamed for the family’s deep rooted problems. Anger, disapproval and criticism will be directed at him/her, leading him/her to develop feelings of great shame, to lose all confidence and self-belief, and, in all probability, to experience self-loathing, depression and anxiety. And to expect everyone else to hate him/her too.

The motivation of the rest of the dysfunctional family, both consciously and unconsciously, for denigrating and demonizing the scapegoat is that it enables them to convince themselves that they are good and right. By telling relatives and friends that all the family’s woes derive from him/her they are also able to maintain a public image of blamelessness.

In this way, the family’s scapegoat finds him/herself not only rejected by his/her own immediate family, but, possibly, by those outside it too. S/he becomes utterly isolated and unsupported.

Also, by blaming the family’s scapegoat for the family’s difficulties, they not only evade their own responsibility but are also relieved, in their own minds, of any responsibility to support or help the scapegoat, who, because of the position in the family s/he has been allocated, and its myriad ramifications, will inevitably be suffering severe psychological distress.

Family Denial

Because the scapegoat is blamed for the family’s problems, the rest of its members are able to stay in DENIAL in relation to their own contributions to this sorry state of affairs; they will tend to reinforce one another’s false beliefs that whenever something goes wrong it is the fault of the family’s scapegoat – in this way, a symbiotic relationship develops between them : they all protect each other from feeling guilty and from shouldering their rightful portion of responsibility, drawing the strength of their fallacious convictions from being in a mutually reinforcing majority.

If the scapegoat is brazen enough to protest that not everything is his/her fault, these views are dismissed with scorn and derision – in this way, s/he is denied the opportunity to express them, allowing the other family members to conveniently side-step any searching questions being put to them which might otherwise produce deep discomfort.

If the scapegoat becomes too insistent about expressing his/her point of view, the rest of the family may cut him/her off from it entirely, thus totally isolating him/her.


Often, the rest of the family’s own guilt may be so profound that facing up to it would be psychologically overwhelming; in such a case there will be a powerful unconscious drive to maintain the illusion that everything is really the fault of the scapegoat – maintaining the illusion allows them to deflect blame which, more accurately, should be directed towards themselves.

It is likely, then, that they will not be fully aware that their projection of their own feelings of guilt onto the scapegoat is, in essence, a psychological defense mechanism necessary to allow them to maintain a positive image of themselves. Their views that they are in the right and the scapegoat is in the wrong become a necessary delusion.


Eventually, the scapegoat will come to INTERNALIZE (i.e. believe to be true) his/her family’s scathing view of him/her, and, therefore, his/her view of him/herself as a bad and unworthy person is in distinct danger of becoming a self-fulfilling prophecy. S/he is likely to develop feelings of intense psychological distress, perform well below his/her best academically and, later, vocationally, encounter serious problems with social interaction, and become hostile, aggressive and resentful towards both his/her family and those outside of it. This plays into the hands of the other family members, of course, as it facilitates their desire to continue projecting their own guilt onto the scapegoat.

As the scapegoat goes through life, s/he is likely, due to the powerful conditioning s/he has been subjected to as a child, to see him/herself as not merely unlovable, but, even, as unlikeable – unfit to be part of ‘decent’ society. Believing him/herself to be a terrible person, s/he may not even make any attempt to develop close, let alone intimate, relationships. After all, in his/her own mind, rejection would be ‘inevitable’, serving only to confirm and reinforce his/her wretched self-view.


David Hosier BSc Hons; MSc; PGDE(FAHE).

Treatment for Trauma Related Nightmares

how to help someone with PTSD nightmares

About 1 in 20 people suffer from nightmares. However, amongst those who are suffering from post traumatic stress disorder (PTSD), research indicates that this increases to approximately 70% – 95%. Those with PTSD may well also suffer from related psychological problems including intrusive memories, flashbacks and panic disorder.

Often, the content of the nightmare in those who suffer from PTSD will relate closely to the original trauma – resulting in a partial reliving of the experience/experiences. However, this is not always the case.

People who suffer from trauma related nightmares are more likely to have accompanying body movements (eg thrashing about – yes, that really does happen, as I can vouch for personally; it’s not just in the movies!) during their frightening dreams than those who have nightmares which are non-trauma related.

how to help someone with PTSD nightmares


The standard treatment for PTSD itself often improves nightmares. However, there is also a specific therapy available known as IMAGERY REHEARSAL THERAPY. This form of therapy involves the individual, under the guidance of the therapist, rehearsing content of the nightmare WHEN AWAKE repeatedly and changing the ending of the nightmare to make it less frightening.

More research needs to be conducted on the effectiveness of drugs at reducing nightmares, but, to-date, the most promising drug for this treatment is called PRAZOSIN.

Also, cognitive behavioural therapy (CBT) and Eye Movement Desensitization and Reprocessing Therapy (EMDR) have been shown in studies to be effective.

Some therapists claim to be able to help individuals who suffer from nightmares to turn these nightmares into what are known as LUCID DREAMS ( a lucid dream is a dream in which a person is aware s/he is dreaming and can exercise control over what happens in the dream. It is a genuine phenomenon; I know this because I have had about half-a-dozen such dreams in my life-time). However, more research needs to be conducted into this subject.

Finally, hypnotherapy and self-hypnosis can be used to reduce and improve nightmares by helping with changing the dream content (see above) and helping the person transform the nightmare into a lucid dream (see above). More on this can be found in the paper : ‘Hypnotherapy for Sleep Disorders‘ (Beng-Yeong Ng).



Disclaimer : Always seek medical advice before taking medication to treat nightmares.

BSc Hons; MSc; PGDE(FAHE).

Childhood Trauma Leading to Anhedonia (Inability to Experience Pleasure).


There is an established relationship between having experienced trauma as a child and suffering from anhedonia (the inability to experience feelings of pleasure) as an adult.

Anhedonia drains the color from life, rather like seeing a film in high resolution color suddenly fade into a grainy, blurred, black and white. One feels just intense emptiness and a complete blunting of positive emotional response. It can affect all areas of life including :

– social interaction

– career satisfaction

– food

– sex

– music

– sports

– previous hobbies and interests

– previously close and/or intimate relationships


Many who suffer anhedonia will have every aspect of their lives affected, whereas others may be affected in some areas but not in others.

In connection with research into the link between childhood trauma and anhedonia, Frewen et al have introduced the concept of ‘negative affective interference’. Essentially, this refers to the idea that in, in response to positive events, those suffering anhedonia are not only unable to feel any pleasure but the positive event may actually lead to them feeling worse. For example, when witnessing a beautiful sunset from the balcony of a luxury hotel in an idyllic setting, not only will those with anhedonia experience no joy, but experience an increase in negative affect (mood) such as intensified feelings of anxiety, guilt or shame. It is this increase in negative feelings in response to positive events which is referred to as ‘negative affect interference’.

Frewen et al’s study also showed that different types of childhood trauma led to different kinds of negative affective interference in response to positive events. For example, those who suffered emotional abuse as a child were more likely to experience increases in anxiety, whereas those who had suffered childhood sexual abuse were more likely to experience feelings of shame.


The above findings suggest that therapeutic interventions for those suffering from anhedonia should not only focus on increasing positive affect but also on strategies for regulating negative affect in response to positive events.

David Hosier BSc Hons; MSc; PGDE(FAHE).

Why Is Emotional Abuse So Harmful?

effects of emotional abuse

What Does Research Into Emotional Abuse Tell Us?

Research shows that emotional abuse is just as damaging as physical or sexual abuse (although it is only relatively recently that this has been acknowledged). In this article, I want to look at some of the reasons that its effects can be so devastating.

Emotional abuse not only negatively affects the child at the time it is going on (by lowering his/her self-esteem and causing him/her to live in a constant state of uncertainty and fear, for example), but, if there is no therapeutic intervention, leads to a deeply unhappy adulthood as well.

When a person has grown up in an environment which is emotionally abusive, his/her adult experiences will be viewed through the negative filter which was laid down during his/her childhood. This, in turn, is likely to lead to maladaptive (unhelpful) behaviours in adult life which may well jeopordise his/her career prospects, relationships and physical health, for example.


If as a child, you lived in an emotionally unstable environment, as I did with my mother until I was thirteen (when I was made to leave to go and live with my father and step-mother) you may, as I did, have felt that you were robbed of security and value.

As children, we desperately needed consistency and the knowledge that we were unconditionally accepted and valued by those who were supposed to deeply care for us. But, because an emotionally unstable environment is one which is devoid of consistency, children brought up in such a home never learn what to expect (their parent’/carers’ behaviour can wildly fluctuate in unpredictable ways) they are never able to feel the environment is under control – they never know what might happen next or what lies ahead; there is constant uncertainty and fear about how they will be treated. Anything seems possible. There exists in such children a permanent state of nervous anticipation, if not outright terror.

If there seem to be no boundaries on the parents’/carers’ behaviour, fear is the result. There is never a sense of safety. There is never a sense of securiy. The child can never relax. At any moment, unprovoked, can come verbal or physical violence. There develops a never ending sense of dread, there is always the question of how far the abuse might go. There is never a truly safe moment.


I will end this article with a short list and summary of some of the possible main damaging effects of emotional abuse. They are:

– a necessity to be in a state of constant hypervigilence; this will often lead to acute sensitivity and easily triggered hostility (attack, in this case, being a form of defense)

– if, as children, we are constantly told we are in the wrong, this can lead to procrastination, indecision and inaction (we become constantly concerned anything we try will turn to disaster)

– if we are constantly provoked, we may start reacting with outbursts of rage

– being constantly treated in an unfair way can lead us to become obsessed with getting justice

– the constant psychological strain can lead to a state of emotional exhaustion – this can easily result in apathy and depression (including losing motivation and an inability to derive any pleasure from activities or social interactions)

– being perpetually criticized can lead to feelings of insecurity, shame and guilt



David Hosier BSc Hons; MSc; PGDE(FAHE).

Deep Brain Stimulation – A Cutting-Edge Treatment for Depression

treatment for depression

depression and deep brain stimulation

In some people, severe clinical depression does not respond to established forms of treatment such as psychotherapy, behavioural therapy, drug treatment or electrconvulsive therapy (ECT). Such a depressive state is medically referred to as TREATMENT RESISTANT DEPRESSION (TRD).

However, there is new hope for people with TRD due to the discovery of a new, cutting -edge treatment known as DEEP BRAIN STIMULATION (DBS).

DBS is still in the relatively early stages of being researched and evaluated for efficacy but some initial studies have provided extremely promising results. At present, it is expensive and not very easy to access, but this state of affairs could, of course, change in the future.


DBS treatment involves an electrode being inserted deep within the brain ; once inserted, it sends out small pulses of current which help specific brain regions involved in contributing to symptoms of depression regain normal functioning.


Research into the effectiveness of DBS is ongoing and is trying to ascertain the specific brain regions where electrodes should be inserted in order to produce the maximum possible benefit to the patient. This is quite a complex area of study due to the fact that several areas of the brain are involved in giving rise to symptoms of depression. Different adversely affected brain regions correspond to different symptoms (such as intense and pervasive sadness, weight fluctuations, low self-esteem, sleep problems and anhedonia – anhedonia means an ‘inability to experience feelings of pleasure’ and is one of the hall-marks of clinical depression).

Another complication is that the different regions of the brain which give rise to the different symptoms of depression are all INTERCONNNECTED so that a change in functioning of one region has knock-on effects in relation to the other brain regions to which it is connected. The main brain regions which have been focused on so far are :

– the ventral striatum

– the nucleus accumbens

– the medial forebrain bundle


One study showed that six months after DBS treatment patients were able to recover psychologically from negative events in their lives significantly better than they were able to prior to treatment.

Another study showed that six months after treatment patients’ symptoms of depression had significantly improved.

A third study has given particularly exciting results – the region of the brain that was targeted in the study was the medial forebrain bundle, and, out of the 7 people who received the DBS treatment in the study, 6 experienced a RAPID and very significant alleviation of their depressive symptoms.

I hope you have found this post interesting.

Best wishes, David Hosier BSc Hons; MSc; PGDE(FAHE).


Childhood Trauma and Major Depressive Disorder.

link between childhood trauma and depression

childhood trauma and major depressive disorder

Studies overwhelmingly show a strong link between childhood trauma and the development of major depressive disorder in later life (in fact, nearly every study into this link has shown that the two are correlated to a statistically significant degree). However, it continues to be treated most often as primarily a disorder caused by faulty brain chemistry and there is, because of this, likely to be an over-emphasis on treating the condition with drugs (mainly anti-depressants).

It has been argued that drug companies have promoted the idea that depression is caused by neurochemical abnormalities in order to keep their vast profits flowing in. However, anti-depressant medication is not without its risks and undesirable side-effects. Furthermore, studies are increasingly revealing that these drugs work little better than placebos.

Studies on the effects of ACEs (adverse childhood experiences) on the individual are now suggesting that childhood trauma may well be the greatest cause of later depression. Indeed, research has shown that people who have suffered four or more ACEs are about 5 times more likely to experience depressive disorder in later life. Additonally, they are about 12 times more likely to commit suicide, 7 times more likely to become alcoholics and 10 times more likely to inject drugs.

It is therefore extremely important to recognize the effects of childhood trauma and to treat those effects appropriately even if the psychological disorder develops decades after the actual experiences of the trauma.


Some of the most important features of the disorder are as follows:


– low mood

– a marked increase or decrease in appetite

– loss of interest or pleasure

– insomnia or increased need to sleep

– low energy levels/fatigue

– marked reduction in psychomotor activity

– difficulties with concentration/memory

low self-esteem

suicidal ideation/attempts

Depressive disorder can also be split into different sub-groups. Two major subgroups are :

1) ENDOGENOUS DEPRESSION – depression thought to be caused by internal factors such as brain chemistry and genetic inheritance

2) EXOGENOUS DEPRESSION – depression thought to be caused by external factors such as trauma, relationship breakdown etc

(it should be noted that there is some dispute about how valid the above distinction is and I myself feel a split into these 2 categories is something of an over-simplification – this will be discussed in later posts.)

ENDOGENOUS depression is thought to account for about 30-40% of all depressive disorders diagnosed and if a person suffers from this treatment with anti-depressant drugs may be appropriate.

In the case of EXOGENOUS depression, however, it is clearly important to focus on the outside events which have caused it and to tailor therapeutic interventions appropriately.


Not only does depression commonly occur as part of PTSD, but PTSD symptoms can mimic many of the symptoms of depression. From these observations it is now being suggested amongst many researchers that those diagnosed with depression may well be PRIMARILY SUFFERING FROM PTSD, which clearly makes sense in terms of the link between childhood trauma and the condition which is, at present, being diagnosed as primarily depression.

Therefore, if what is currently being diagnosed as depression would more accurately be diagnosed as PTSD, there is clearly a strong argument in favour of reviewing how current ‘depressive disorders’ are being treated by the medical profession. This will be examined further in later posts.

I hope you have found this post of interest. Please leave a comment if you wish.

Best wishes, David Hosier BSc Hons, MSc; PGDE(FAHE).

DISCLAIMER : Do not make decisions about treatment of depression without seeking the appropriate professional advice.



Overcoming Social Anxiety : The ‘Acting As If’ Technique.


Social Anxiety And The ‘Acting As If’ Technique

I have already examined in detail in other posts how our traumatic childhoods can adversely affect our social confidence. However, there are techniques which can rectify this and, in this post, I want to concentrate on a technique related to cognitive-behavioural therapy (CBT) which I shall call the ‘Acting As If Technique’.


Many people assume that confidence is something that you either have or you don’t ; however, this is not actually the case. It is not a case of either being born confident or not. Also, feelings of confidence are not fixed. A person may be confident in some areas of life (eg about a hobby, their work or the ability to play a sport or musical instrument etc, but not confident in others). So it is not a question of being a confident person or not. Rather, it is a question of which areas of life you are confident in already, and which areas of life you have the potential to be confident.

Feeling a lack of social confidence does not set a person apart, nor does it make them in any way inadequate or inferior. Indeed, many people who we think of confident may well, beneath the veneer, be consumed by inner doubt. Even the most confident person’s confidence can take a severe knock by, for example, being rejected by someone they are in a relationship with or suffer a run of bad luck and misfortune.


In social situations, if we see others around us behaving very confidently, it is worth reminding ourselves that this is quite possibly not a true reflection of how they feel inside – they may simply have learned to hide their inner anxieties.

However, because some people are very good at putting on a confident social mask, others tend to take them at face value and assume that they are as confident as they appear.

Perhaps one of the most powerful strategies for overcoming social anxiety is to take a leaf out of these people’s book and, in social situations, start to ‘act as if’ we are confident. We can ask ourselves how a confident person would enter a room, how they would move, how they would behave, how they would use body language and meet others’ gazes etc, and then act in a similar manner ourselves. Doing this has a very powerful effect – acting confidently actually leads us to feel confident. It also causes others to respond to us differently which instills further feelings of confidence and initiates a virtuous circle of feeling and behaving.

The ‘acting as if’ technique can be made even more effective if, as well as acting in a confident manner, we train ourselves to start thinking confidently in social situations as well. We can practice positive self-talk and give ourselves positive messages like ‘there’s no reason these people should dislike me’ or ‘these people don’t represent a threat to me’ etc.

By employing such strategies as the ‘acting as if’ technique, success builds upon success and results can begin to show surprisingly quickly. 


David Hosier BSc Hons; MSc; PGDE(FAHE).