The National Institute for Health and Care Excellence (NICE) is in the process of updating its guidance for how to treat depression and is consulting on this document. NICE guidance is used by the NHS to inform treatment pathways and provide a common approach across the country for a range of conditions; in this case, depression. This update is the first review of this guidance for 12 years (NICE, 2021) for the treatment of depression, the key theme being an offer of a menu of treatments. Given depression is commonly diagnosed alongside anxiety; half to two-thirds of adults with anxiety disorders also live with depression (Lancet, 2021), the updating of this guidance is of significant importance to Anxiety UK and the anxiety disorders community.
Early 2021 saw around 1 in 5 (21%) adults aged 16 years and over in Great Britain experiencing some form of depression; going into the summer rates were still high at around one in six adults being affected by this condition (17%) (ONS, 2021). Currently, those seeking support for depression via their GP, are likely to have been offered the current first line treatment, which is psychiatric medication; specifically, antidepressants. Before we continue, it is important to say there is absolutely nothing wrong with taking medication to help with depression and/or anxiety; indeed, a lot of people rely on medication and it can play a vital role in the treatment and management of such conditions. Unfortunately, however, there is still a stigma around taking antidepressants; something that is often reported to us by people we help. However, just as you people take medication for physical health conditions, such as diabetes, epilepsy etc., medication can also be for some, a critical part of the treatment plan.
This said, not everyone feels comfortable taking medication. This can be for numerous different reasons. For example, some people feel that their anxiety-related depression is insufficiently severe to warrant taking it; others are uncomfortable with the possibility of encountering side effects. For some, the aforementioned stigma around taking antidepressants is what lays at the root of their decision not to pursue this particular treatment option. Reducing stigma is an important part of our work here at Anxiety UK, and on this note, we are pleased to see that the updated NICE guidelines also address stigma in calling for steps to be taken that reduce stigma for individuals seeking help for depression.
So, if you do decide not to take the medication, what other options are available? That’s where this update comes in. The guidance recommends that more of a discussion should be had about contributing factors, treatment options available and preferences for treatment. And that people are informed about treatment options and given choice as to what they want to put into action and which treatment pathway they choose to take. The additions to this treatment menu include group exercise, group therapy and individual talking therapy options; all things we very much welcome here at Anxiety UK. Indeed, we often discuss the benefit of exercise with our clients as regular exercise can be hugely effective in managing anxiety and depression. It doesn’t have to be challenging; even a quick walk in the brisk winter air can make a difference. Exercise clears stress hormones from your body that can build up when feeling anxious or low. It can also be quite a mindful activity, giving you something else to focus on or work towards when everything feels a bit too much. Have a look at our top tips, which include exercise, for dealing with anxiety in our YouTube video here: https://www.youtube.com/watch?v=ttHu_N-zAnQ&t=81s.
At the start of the pandemic, we launched a selection of online groups and courses, and group support has been really popular. So much so that we have gone from offering one anxiety support group a week to three anxiety support groups, an anxiety management course, an art for anxiety relief course and our popular calm club initiative which uses clinical hypnotherapy techniques in relaxation sessions. It can be quite therapeutic to share your thoughts and feelings with likeminded people whilst also learning new tips on how to manage anxiety. Knowing you aren’t alone in what you are going through and finding there are ways to overcome it, many say is incredibly comforting.
Our therapist-led anxiety management group is a 6 session course facilitated by an Anxiety UK Approved Therapist, designed to provide tools, tips and techniques in a supportive space. In the sessions, participants learn about anxiety and are taught anxiety management strategies based on the principles of Cognitive Behavioural Therapy (CBT), Compassion Focused Therapy (CFT) and Acceptance and Commitment Therapy (ACT). If you are interested in our anxiety management course, read more about it here: /get-help/anxiety-uk-courses-and-groups/.
Talking therapies can be very effective in the management of anxiety disorders; helping people to learn how to manage and overcome anxiety. We provide a range of therapy services include counselling, Cognitive Behavioural Therapy (CBT) as well as Compassion Focussed Therapy (CFT), Clinical Hypnotherapy and Eye Movement Desensitisation and Reprocessing (EMDR). We really believe in choice and have a long-track record in supporting our clients to choose the form of therapy they would like to access. To find out more about our therapy services, take a look at our website here: /get-help/access-therapy/. According to a review in 2019, people with mental health conditions who received their preferred treatment, had lower dropout rates and higher commitment to therapy than those who received their non-preferred treatment or who were not given a choice (Lancet, 2021). Providing a range of support options and giving people treatment choices, is something we have been doing since our organisation’s inception in 1970.
In summary, Anxiety UK very much supports the changes proposed by NICE; welcoming the introduction of a wider range of treatment options, the tackling of stigma associated with the condition which can often prevent people from getting the help they deserve, and the emphasis on client empowerment – putting people firmly and squarely in the driving seat when it comes to their care.
Lancet Anxiety disorders: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00359-7/fulltext
ONS Coronavirus and depression in adults, Great Britain: July to August 2021: https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/articles/coronavirusanddepressioninadultsgreatbritain/julytoaugust2021
NICE creates new menu of treatment options for those suffering from depression: https://www.nice.org.uk/news/nice-creates-new-menu-of-treatment-options-for-those-suffering-from-depression