What can CBT help with?
We all experience low mood and it is a normal part of life. However, when it is persistent and interferes significantly with your life you may be suffering from depression. Along with a persistent low mood you may notice changes in sleep, appetite and not being able to enjoy the things you would normally enjoy or once valued. The ability to focus on a task can become difficult and energy levels can reduce. Often people report feeling hopeless and can be self critical or feel shameful. If you notice any of these symptoms you may benefit from CBT which can be effective for both those who are not taking medication and for those who may have been prescribed anti-depressants.
Self-esteem can be defined as the value we place on ourselves. When people suffer from low self-esteem or low self-confidence it can recognised with critical thoughts about ourselves, such as feeling worthless, a failure, not good enough or not loveable. We all use these words to describe ourselves at times, but with low self-esteem these feelings begin to take over, often affecting relationships, work and can become dominant in many areas of life. Low self-esteem is very common and CBT can be effective at building a more healthy sense of self by exploring the effect of it in the here and now as well as how and when it develops.
Perfectionism involves trying to achieve high standards. This can promote success and most of us can say that striving for high standards has helped us to achieve our goals. However, clinical perfectionism is when we relentlessly strive for standards that are unrealistically high, and our self worth is dependent on achieving these standards. The negative consequences of this can be working to exhaustion, feelings of low self worth and a breakdown in relationships. Yet despite these consequences, the high standards are still relentlessly sought after. CBT can be highly effective at treating clinical perfectionism.
Panic disorder is where panic attacks are repeatedly experienced, and their occurrence is also feared which may lead to ways of trying to avoid situations that may lead to a panic attacks. During a panic attack the symptoms of anxiety can be feared to be something dangerous, such as a heart attack or suffocation. Panic disorder can significantly affect one's life and CBT is effective by challenging the thoughts and behaviours involved in maintaining the disorder.
People suffering from health anxiety experience a preoccupation with being seriously ill. They may interpret normal bodily sensations or symptoms as being a sign of something serious, for example cancer or a tumour. This may lead to looking up symptoms on the internet, frequently visiting the GP or A&E, wanting to have medical tests often and avoiding situations that make the anxiety worse. Steps taken to relieve their health worries and concerns often keep the anxiety going in the long term. The health worries can become overwhelming and significantly impact one’s life. CBT for health anxiety can be effective by targeting health anxiety management.
Social anxiety is a fear of being judged negatively in social situations. There is often a worry about how one comes across to others, with a fear that we are boring or will say the wrong thing. There can be a preoccupation with how we appear to others, such as worrying about sweating, shaking, blushing or stuttering. Many people also suffer from social anxiety when having to perform or give presentations. In order to manage social anxiety, people often avoid these situations altogether or use unhelpful strategies. CBT can be highly effective for social anxiety.
Generalised Anxiety Disorder
Generalised Anxiety Disorder (GAD) is when there is worry and anxiety about many different things, and a difficulty coping with uncertain situations. Often a worry will spiral out into many different worries about things that have not come to pass yet. There are worries about future events and a fear of not being able to cope. CBT aims to identify the role of worry itself in maintaining anxiety, and involves a combination of challenging thoughts and behaviours as well as developing skills to manage worry.
Post-Traumatic Stress Disorder (PTSD) can develop after experiencing or witnessing a traumatic incident. Experiencing stress after such an event is normal and expected. If the symptoms continue after several weeks then you may benefit from CBT. Symptoms include having flashbacks where it can feel like you are re-experiencing the event and nightmares. You may notice feeling more irritable and more easily startled. To manage the anxiety people often avoid situations that remind them of the trauma. CBT can help by processing the trauma in order to reduce the symptoms and distress.
Post-Traumatic Stress Disorder
Obsessive Compulsive Disorder
People with obsessive compulsive disorder (OCD) have a fear of something terrible happening, which leads to significant anxiety and distress. A lot of people, but not all, feel a sense of responsibility for preventing this from happening. Compulsions develop as a way of trying to reduce the anxiety, or control the distressing thoughts. These can include cleaning, checking or mental compulsions such as counting or repeating things. CBT can help to make positive changes in the way we think and behave in order to treat the symptoms of OCD.
Many people are not completely satisfied with their body image. Body dysmorphic disorder (BDD) is about an intense preoccupation with a specific body image problem. This can lead to a lot of time being spent checking in the mirror, trying to hide the area of concern or comparing the way you look with others. In BDD the bodily concern is usually very slight and not in line with how the person sees the concern as a major flaw. Depression and anxiety are often associated and feelings of shame, which can interfere with day to day functioning and relationships. CBT can be effective at treating the negative body image.
Body Dysmorphic Disorder
A phobia is a fear of a situation or object that leads to avoidance of anything that can trigger the fear or anxiety surrounding the phobia. Sometimes even the thought or image of the fear is enough to induce significant anxiety. Adrenaline plays an important part, and the body learns to associate the feared object/situation as being a life or death situation, hence the production of adrenaline, which further aggravates the anxiety. The key to maintaining a fear is avoidance, and CBT can be effectively used to gradually expose someone to the feared situation, whilst looking at the thought and behavioural processes that play a part in maintaining the fear.
Chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME) is where excessive exhaustion significantly affects quality of life and daily functions. Often sleep is un-refreshing and people may have muscular pain. There can be problems with concentrating on tasks and when these symptoms persist for several months CFS is a likely diagnosis if other medical causes cannot be found. CBT is one of the main treatments, looking at activity levels and sleep, as well as management of stress and low mood.
Tinnitus is hearing sounds that are not from an external source and can be heard in different forms, such as a buzzing or hissing sounds. CBT is not a treatment specifically for tinnitus reduction, but has been shown to be effective in helping to reduce the tinnitus related distress and to help tolerance of noise so it becomes less noticeable, which can help improve quality of life.