Transgender Issues and Depression

Over the last 19 years as a psychiatrist I have made referrals to specialist centres for young people who present with depression with suicidal thinking and transgender identity.

In the last five years there has been an increase in the number of these types of cases referred by doctors to the Tavistock and Portman Clinic in London , where young people have to wait for over one year before they are seen.

Depression and Eating Disorders

I have been thinking about the relationship between depression and eating disorders for over a year. There is a range of eating disorders, although today I will consider Anorexia Nervosa. In the UK the NICE Guidance 2017 on the subject of treatment of depression in eating disorders has confirmed that there is a need for further research in this field.

Impact Study

Just over one year ago the Impact Study was published following a collection of data from multiple Child and Adolescent Mental Health Services in the United Kingdom. Essentially it was a landmark study looking at whether or not we are effective enough in treating depression in young people.

Cognitive Behaviour Therapy and Brief Psychoanalytic Psychotherapy were shown to be as effective as a Brief Psychosocial intervention and support. Most of the work was delivered in 28 weeks but data was collected up to 86 weeks.

Alfred is back after two years

In the last two years I moved job from West Sussex to Wiltshire, where I am specialising in Eating Disorders and more complex cases of depression, which often have child protection issues.

In the last two years we completed and depression audit, thought about the family is its of the impact study and thought more creatively about research that will focus more on the benefits of exercise and diet and the pursuit of personal goals comparison to medication.

Exam Stress

I should have written this blog over one months ago, but it got held up. Well at least it is in time for next year! Exams are like football matches in the sense that there is always a young person engaged in an exam or a big match somewhere. Many students in the world have to deal the stress of exams and the expectations they place on themselves, the pressure for parents, teachers and their sense of society's expectations on them.


In 2015 prior to May there were many promises in the media of support for mental health services in the UK. In the last year there had been wishes for parity of funding and staffing resources to emerge between physical and mental health. The previous Coalition Government had even enabled the publication of Future in Mind (see attachment) in which one can begin to see how better mental health service for children and young people can be realized.

Where are all the therapists?

In the UK Child and Adolescent Mental Health Services (CAMHS) have to try to offer comprehensive treatments for young people with understaffed teams. This will mean that many depressed teenagers awaiting therapy will be waiting for months to be seen for basic cognitive behaviour therapy for depression. Therefore one would think that there needs to be a development of good online resources that young people can access. It is a good practice to learn how to make links between how we are feeling, what we are doing and what we are thinking.


Easter is a time of year when many Christians in the world celebrate the Resurrection of Jesus Christ. Over two billion people in the world have a Christian faith. In the last few weeks we have learned about the persecution of Christians to death in the Middle East and Kenya. Our faith can be a resource in the fight against depression. The life of Christ has illuminated all history and he can walk with us all the days of our lives. I am a Christian and by daily practice and observance of faith I draw closer in understanding of the life of Christ.


Today I was thinking again about the importance of exercise in staying well. We all have a responsibility to look after our body and mind.

When we take exercise the blood flow to our brain increases. Therefore the blood flow can deliver more oxygen to our brain cells/ nerve cells which help then work better.

Depression in the context of exploitation

There are many cases of depression in which we see a young teenage girl who has suffered emotional, physical and sexual abuse. This could happen to boys, young adults and people with learning disabilities and the elderly. The most vulnerable people in our society are at risk from sexual exploitation. Although these people may experience severe depression, how can we treat them effectively if they are still in danger and their lives are at risk?