Fear is the emotional response to real or perceived imminent threat, where as anxiety is anticipation of future threat. An anxiety disorder is diagnosed if the person’s fear and anxiety become excessive or persistent and response is not appropriate for the situation, and causes significant personal distress, impairs function and reduces quality of life. Anxiety disorders can get worse if not treated. Effective treatments are available.
Some of the common anxiety disorders:
Generalised Anxiety Disorder (GAD)
Excessive and inappropriate worrying that is persistent (lasting more than a few months) and not restricted to particular circumstances.
Recurrent unexpected surges of severe anxiety (‘panic attacks’) reach a peak within minutes, with varying degrees of anticipatory anxiety between attacks. Panic attacks are discrete periods of intense fear or discomfort. Most patients develop a fear of having further panic attacks. The term unexpected refers to a panic attack for which there is no obvious cue or trigger at the time of occurrence.
Social phobia (Social Anxiety Disorder)
Marked, persistent and unreasonable fear of being observed or evaluated negatively by other people, in social or performance situations. Feared situations (such as speaking to unfamiliar people or eating in public) are either avoided or are endured with significant distress.
Post-traumatic stress disorder (PTSD)
Post-traumatic stress disorder is characterised by a history of exposure to trauma or serious injury or threats with a response of intense fear, helplessness or horror; with the later development of lasting disabling symptoms.
Obsessive-compulsive disorder (OCD)
Obsessive-compulsive disorder is characterised by the presence of obsessions and/or compulsions. Obsessions are recurrent and persistent thoughts, images or urges that are unwanted. Compulsions are repetitive behaviours or mental acts that an individual feels driven to perform in response to an obsession or according to rules.
Common obsessions relate to contamination, accidents, and religious or sexual matters. Common rituals include washing, checking, cleaning, counting and touching.
Symptoms are distressing, time-consuming and cause interference with social and occupational function.
No matter what the condition is, treatment is available. However, a thorough assessment for identifying the condition and developing a management plan depending on the severity of symptoms and functional ability are what is required.
Dr. Ghosh offers assessments and most up to date management plan as per the individual requirements.
Social anxiety disorder(Social Phobia)
Social phobia is characterised by a marked, persistent and unreasonable fear of being observed or evaluated negatively by other people, in social or performance situations, which is associated with physical and psychological anxiety symptoms. Feared situations (such as speaking to unfamiliar people or eating in public) are either avoided or are endured with significant distress.
Specific, simple or isolated phobia is characterised by excessive or unreasonable fear of (and restricted to) single people, animals, objects, or situations (for example, dentists, spiders, lifts, flying, seeing blood) which are either avoided or are endured with significant personal distress.
Please contact to have a discussion or to book an appointment or to send referrals:
M: 07533 567161
Fax: 01733 516014
There are two most common types:
Broadly symptoms are the presence of sad, empty or irritable mood …….
Types of Depressive disorder:
Major depressive Episode:
Depressive mood, lack of pleasure or interest, lack of energy, loss of appetite, weight loss, sleep disturbances, lack of concentration and recurrent thoughts of death causing distress and impairments in a range of settings.
If symptoms last for 2 weeks or more, a thorough assessment and treatment is required.
Depressive mood lasting for most of the day and for more days than not for at least 2 years could be an indication for this disorder.
Seasonal Affective Disorder (SAD) or Depressive Disorder with seasonal pattern:
Regularly recurring depressive episodes in the autumn and winter but disappearing in the spring and/or summer. At least two prior autumn/winter depressive episodes with no depressive episodes in other seasons in the last 2 years are the indication for seeking assessment by a Psychiatrist. Seasonal episodes outnumber non seasonal ones in person’s life time.
Post partum depression or Depressive episode with peripartum onset:
"Baby blues" after childbirth is not uncommon in new mothers which commonly include mood swings and crying spells but do not last long. Some new mothers experience a more severe, long-lasting form of depression known as postpartum depression. Depression can start prior to delivery and continue after delivery. A type of postpartum depression known as postpartum psychosis develops after childbirth which is rare but requires urgent assessment and treatment.
Depression after delivery does not let mothers enjoy their motherhoods and look after their babies as well as others children.
Depressive Disorder due to medical conditions:
There are many medical conditions where depression is very common. It is important that symptoms of depression are identified as soon as possible and appropriate treatment is offered. Depressed mood interferes with recovery process.
Depression is common mental health problem. 4-10% of people in England will experience depression in their lifetime.
Dr. Ghosh provides a thorough and timely assessment and an individualised treatment plan which is based on up to date evidence.
Bipolar Affective Disorder:
Common types of Bipolar Affective Disorder
Bipolar I disorder
At least one manic episode**
has to be present. However, Major depressive Episodes are common in Bipolar I disorder and may precede or follow manic episode.
Bipolar II disorder
At least one hypomanic episode***
and at least one major depressive episode have to be present. There has never been a manic episode.
For at least 2 years there have been numerous periods of hypomanic episodes and numerous periods of depressive symptoms that do not meet the criteria for Major depressive disorder.
A distinct period of abnormally and persistent elevated expansive or irritable mood, persistent activities or energy lasting for at least 1 week. Symptoms are present most of the day and nearly everyday. Symptoms are severe enough to cause marked impairment of functioning in different settings.
Same symptoms as observed in manic episode but lasting at least 4 consecutive days. Symptoms are not as severe as in a manic episode to cause marked functional impairments.
Bipolar Affective disorder is the fourth most-common mental health problem worldwide after depression, anxiety and schizophrenia.
Please contact Dr. Ghosh for assessment and treatment. Prompt assessment and early treatment is the key to success.
Some time during their life about 1 in 100 men and women will suffer an episode of schizophrenia. People from all walks of life and social backgrounds suffer from Schizophrenia. Schizophrenia affects the way a person acts, thinks, and sees the world. People with schizophrenia have an altered perception of reality, often a significant loss of contact with reality. Schizophrenia can be successfully managed. With the right treatment and support, a person with schizophrenia can lead a happy and fulfilling life.
There are many other psychotic conditions such as delusional disorder, schizophrenia, schizoaffective disorder, drug-induced psychosis.
It is therefore important to identify the signs and symptoms and to seek help without delay. Continuation of treatment is the key to success.
Please contact Dr. Ghosh for assessment and treatment. He is able to help.
Adult Attention Deficit Hyperactivity Disorder (ADHD)
A significant number of adults suffers from ADHD (2.5-4.3%) but may not have the diagnosis. Overall around two-thirds of children with ADHD continue to have impairing symptoms in adulthood. Many children with ADHD need to continue to take medication into their adulthood. ADHD in adults is associated with significant impairment in work, education, parenting, driving, financial management and partnership. Adults with untreated ADHD often use health and social care settings for problems such as smoking-related disorders, serious accidents, and alcohol and drug misuse. It is also said that that ADHD is the most important predictor of offences involving violence and substance misuse. Symptoms of men and women can vary.
A thorough assessment and appropriate treatment can bring significant change in individual’s life.
Dr. Ghosh has years of experience in diagnosing and managing ADHD. Please contact him.
Alcohol related problems
Drinking alcohol can become a problem for many people, sometimes even before they realise it has become a problem for them. Alcohol has significant impact on physical and mental health and all round wellbeing. It impacts a number of areas in life such as work, education, parenting, driving, financial management and partnership, to name a few.
The most important thing is to recognise if this is a problem and then to seek help. People with both mental health and alcohol problems will benefit by addressing their alcohol problem as this helps improving their mental and physical health in order to have a fulfilling life.
Dr. Ghosh is happy to provide advice. Do not suffer in silence. Please contact him.
The Psychiatric assessment will obtain an accurate account of the circumstances surrounding the onset of the pain, intensity of pain and if there is exceptional mental or physical stress just before the painful event as this may accompany the painful symptoms and contribute to their maintenance. It is known that sufferers, who are in distress from physical or psychiatric factors, tend to rate the intensity of their pain as higher than when they are not in that state.
One-third of sufferers have a psychiatric illness, the most common of which is depression. Anxiety disorder is also common. A number of other psychiatric problems are associated with chronic pain. Depression and anxiety predict a range of negative outcomes, including greater pain, disability, and longer time to get back to work. Anxiety and depression are associated with lower pain threshold and tolerance levels.
Management of existing psychiatric illnesses by a Psychiatrist may help in achieving better outcomes. An individual sufferer’s needs and preferences are taken into account before any treatment is offered.
Please read my article on Active magazine- April 2018
Please contact Dr. Ghosh for assessment and discussion about how to improve the outcome in order to have a good quality life.
Medical conditions with psychiatric problems
It is recognised that Psychiatric conditions can coexist with medical conditions and are responsible for increasing illness burden as well as delaying recovery. It makes the management more complex. Recognition of symptoms, thorough assessments and individualised management improve overall outcome a lot better.
Do not suffer in silence. Delay in seeking help may not improve outcome. Unfortunately, one size fits all measure does not work in these complex cases.
Dr. Ghosh is able to help with assessments and advise. Please contact him.
Complex psychiatric and behavioural problems
This is a very complex area of psychiatry where significant behavioural problems with or without psychiatric diagnosis need management. People with neuro-developmental problems (e.g. people with intellectual disability or autism etc.) tend to display behaviours which challenge. The impact of these behaviours is huge-both to the individual and carers. It is highly likely that a number of causes can give rise to such behaviours, therefore, they need an expert to untangle these complex problems in order to provide an individualised management plan.
Do not hesitate to contact Dr. Ghosh for assessment and management.
It is not unlikely that an individual can have both physical and mental health problems at the same time and the problems can be intertwined.
It is also not uncommon that a person suffers from symptoms of mental illnesses but has never fulfilled the existing diagnostic criteria when assessed in the past. It is also likely that a person suffers from more than one mental health problem but that has not been recognised. This can cause a huge burden on the individual and affect every sphere of their life.
Treatment of diagnosis does not help. These individuals rather need person specific treatment plan by taking their conditions, functional ability and wishes on board.
Please contact Dr. Ghosh who understands these problems and is keen to provide individualised treatment plan.
Referrals to be sent to:
1 North Street
T: 0330 202 0597
For all enquiries:
M: 07533 567161
Fax: 01733 516014
Kings Lynn Clinic
BMI The Sandringham Hospital
T: 01553 769770
F: 01553 767573
Please ask your GP for referral