Common Conditions

  • Depression

    Feeling sad or ‘fed-up’ is a normal reaction to experiences that are upsetting, stressful or difficult. Everyone occasionally feels low, but these feelings are usually fleeting and pass within a couple of days.

    If you are affected by depression, you are not ‘just’ sad or upset. You have an illness which means that intense feeling of persistent sadness, helplessness and hopelessness are accompanied by physical effects such as sleeplessness, a loss of energy, or physical aches and pains.

    Clinical depression can feel overwhelming not only for the sufferer but for those around them. It’s important to remember that somebody who is clinically depressed cannot simply will themselves to feel better or just “snap out of it.”  If they do not receive appropriate treatment their symptoms can continue for weeks, months, or years.

    Common symptoms of depression include tiredness and loss of energy, persistent sadness, loss of self-confidence and self-esteem, difficulty concentrating, not being able to enjoy things that are usually pleasurable or interesting, undue feelings of guilt or worthlessness, feelings of helplessness and hopelessness, sleeping problems – difficulties in getting off to sleep or waking up much earlier than usual, avoiding other people, sometimes even your close friends, finding it hard to function at work/college/school, loss of appetite, loss of sex drive and/ or sexual problems, physical aches and pains, self-harm, thinking about suicide and death.

    If you have experienced four or more of these symptoms, for most of the day nearly every day, for over two weeks, then you should seek help. Psychological therapy can enable to you better manage and improve your mood.

  • Stress

    The pressures of modern life can often lead you to feel stressed. While some levels of stress keep us motivated and driving towards our goals, stress levels that are too high or go on for too long can lead to significant physical and mental health issues.

    Problematic stress may lead you to feel very low or anxious. You may notice that you react more intensely to things and are more tearful, sensitive or irritable than normal. Stress may also lead you to withdraw from other and feel very alone with your struggles.

    You may find your thinking is affected by prolonged or intense levels of stress. You may find it harder to make decisions, get more easily confused, have difficulty concentrating, or notice that your memory is uncharacteristically poor.  If you are stressed, you may find yourself worrying about things constantly and going ‘over and over’ situations in your head. You may also feel great disappointment with yourself for not feeling able to effectively cope, and notice a loss in motivation, commitment and confidence.

    Unhealthy stress levels can also lead to marked changes in behaviour. Some common signs of stress include changes in your eating habits (eating more or less than usual), increased smoking, drinking or drug taking as a means of coping with your stress, changes in sleep patterns, and twitchy ‘nervous’ behaviours.

    Physically, your body may respond with headaches, muscle tension and pain, digestive problems, sweating, feeling dizzy, bowel or bladder problems, breathlessness, dry mouth and sexual difficulties.

    If you believe that you are experiencing problematic stress, please contact Altum.  Stress is a common reason why clients come to see us.  We are skilled at helping clients understand the causes of their stress and helping them to develop techniques and coping strategies to manage or reduce stress symptoms.

  • Anxiety

    Anxiety is a feeling of unease, such as worry or fear, which can be mild or severe. It is a normal, if unpleasant, part of life, and it can affect us all in different ways and at different times.  And while all of us experience healthy anxiety from time-to-time, some people find it difficult to control their worries, and experience more constant levels of anxiety that affect daily life.

    Our bodies are ‘biologically wired’ to experience anxiety in response to threat, and so when we are presented with a situation that we interpret as potentially dangerous, we can experience this in the ways we feel, think and behave.

    Some of the most common physical symptoms of anxiety are increased heart rate, hyperventilation (over breathing), dizziness, feeling sick, tightness in the chest, ‘butterflies’ in the stomach, headaches, problems sleeping, sweating, dry mouth and shaking.

    Common psychological symptoms of anxiety are thinking that you may lose control and/or go ‘mad’, thinking that you might die,  thinking that you may have a heart attack/be sick/faint/have a brain tumour, feeling that people are looking at you and observing your anxiety, feeling as though things are speeding up/slowing down,  feeling detached from your environment and the people in it, feeling like wanting to run away/escape from the situation, or feeling ‘on edge’ and alert to everything around you.

    Psychological treatment can help you to better understand, manage and reduce anxiety.

  • Trauma

    Trauma symptoms can occur when you experience a situation that is life threatening, or where there is a significant threat to your physical or psychological wellbeing.

    Many situations can trigger psychological trauma. Among these are:

    -Acts of violence such as an armed robbery, war or bombings

    -Natural disasters or manmade disasters such as fires, earthquake or floods

    -Interpersonal violence such as sexual assault or domestic violence

    -Child abuse

    -Suicide of a family member or friend

    -Involvement in a serious road traffic or workplace accident

    The following symptoms are normal and common reactions to abnormal (traumatic) events. If these symptoms persist for more than one month and significantly interfere with your day to day functioning, we recommend you seek psychological help:


    Excessive alertness (on the look-out for signs of danger), easily startled, fatigue/exhaustion, disturbed sleep, general aches and pains, stomach problems


    Intense fear,  numbness and detachment, depression, guilt, anger and irritability, anxiety and panic attacks

    Cognitive (Thoughts):

    Intrusive thoughts and memories of the event,  visual images of the event,  flashbacks, recurrent nightmares, poor concentration and memory, confusion


    Avoidance of places or activities that are reminders of the event, social withdrawal and isolation

    For some people, time and social support are great healers and these factors can enable people to recover from their traumatic experiences. For others, the normal effects of trauma (see below) can persist for a long period and significantly interfere with the activities of life. When this happens, people can develop Post-traumatic stress disorder (PTSD).

    Psychologists at Altum Health can provide trauma focused therapy for those people who become stuck in their recovery. In addition to Cognitive Behavioural Therapy (CBT), we have trauma specialists on our team who can provide Eye Movement Desensitisation Reprocessing Therapy (EMDR) for PTSD.

  • Eating Disorders

    Eating disorders and disordered eating patterns are serious problems that have become increasingly more common over the past 30 years. They are responsible for more loss of life than any other psychological problem.

    People struggling with eating disorders place excessive value on weight and body shape.  They tend to be highly critical of their bodies.  This ‘overevaluation’ and ‘critical-eye’ leads them to engage in a host of thoughts, feelings and often behaviours aimed at controlling their weight and shape.

    The most commonly known eating disorders are Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder. It is quite common for somebody to shift between more anorexic and more bulimic symptoms; indeed, many of our clients have had symptoms of both of these difficulties at different points in time.

    Below you will find some descriptions of Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder.  Please note that these are here to provide the common characteristics of these difficulties, and is by no means an exhaustive description of the psychological and physical effects of these problems. If you recognise yourself or somebody you love in the below descriptions, and want to read more about them, we recommend the Eating Disorder Association’s Webiste ( for a wealth of up-to-date information.

    Anorexia Nervosa (AN)

    People with AN restrict their food intake such that they reach a significantly low body weight. In addition to food restriction, people with AN are terrified of gaining weight or becoming fat. Although significantly low in weight, this intense fear drives them to act in persistent ways that interfere with weight gain. They do not experience their body weight or shape abnormally; despite the obviousness to those around them, they may also not recognise the severity and seriousness of their current low body weight.

    A proportion of people with AN also binge and/or purge their food through methods such as self-induced vomiting, the misuse of laxatives, diuretics or enemas.  For a more detailed description of bingeing and purging, please see the description below for Bulimia Nervosa.

    Bulimia Nervosa (BN)

    Those struggling with BN engage in recurrent episodes of binge eating.  Binges consist of eating large amounts of food, usually over a short period of time. During these episodes, many describe feeling that they cannot stop eating or control how much they are eating.

    Following these binges (although some of our clients do this following normal amounts of food, as well), those with BN purge their food in order to prevent weight gain.  Common methods of purging include self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting; and excessive exercise.

    Binge Eating Disorder (BED)

    Like those with BN, people with BED engage in recurrent episodes of binge eating. However, unlike those with BN, they do not try to compensate for their eating through purging.

    Binges tend to be consumed quickly and consist of large amounts of food. Bingeing is often done alone because of the embarrassment by how much one is eating.  Many people describe feeling disgusted, ashamed, depressed, or very guilty after bingeing.

    Other Problematic Eating

    As well as the more common difficulties of AN, BN and BED, there has been increased attention on variations of these difficulties. Most notably, the media has focused much on difficulties coined ‘orthorexia’  which describes an orthodox and rigid approach to eating that dominates one’s life and interferes with normal social functioning.  We have also seen an increase of eating disorders in men. While this often does take the form of AN, BN or BED, we also see a subgroup of men who are obsessively focused on musculature, body fat percentages, and overexercise.  These problems extend to difficulties we see in professional athletes struggling with eating disorders.

    These descriptions aside, what is most prevalent today is what we call ‘disordered eating’.  This term is meant to include the intense focus and obsession many women and men have today on their bodies and their diets.  Caused by a variety of factors, this unhealthy focus leads people to feel low, guilty, ashamed, and generally unhappy.

    If you feel that you may have a problem with your eating or self-image, please contact us so that we can help.

  • Obesity

    The terms ‘obesity’ and ‘overweight’ are medical terms used to describe abnormal or excessive levels of body fat.  And while being a little bit overweight is not likely to cause too many problems, there comes a point at which too much body fat can seriously affect your health and quality of life.

    There are many ways to measure weight and body fat, but a widely used measure of ‘overweight’ and ‘obesity’ comes from assessing Body Mass Index (BMI). This is essentially a ratio of your height in relation your weight (click here to access a BMI calculator).  A BMI of 18.5-24.9 is considered ‘normal’, while a BMI of 25-29.9 is considered ‘overweight’, and a BMI above 30 is considered ‘obese’.  While BMI is a very good general guide to assessing one’s body mass, this calculation does not take into account important weight contributing factors such as muscle mass and bone density. Certain populations (very athletic people, people from certain ethnic backgrounds) may fall into the ‘overweight’ or ‘underweight’ categories with regards to BMI, but be healthy.  It is unlikely that most people who fall into the ‘obese’ category would not be at considerable potential physical risk.

    Many serious medical complications have been linked to obesity. Day-to-day problems may include breathlessness, increased sweating, snoring, sleep/apnea problems, inability to cope with sudden physical activity, feeling very tired every day, as well as back and joint pains. Longer-term physical problems include Type 2 diabetes, high blood pressure, heart disease, high cholesterol and osteoarthritis.  Obesity is also linked to higher rates of certain cancers.

    Psychological and Social Difficulties

    Aside from the physical difficulties associated with obesity, these problems can result in significant social and psychological problems.  Many people erroneously think that individuals with obesity are greedy and/or lazy.  As a result, people who are obese often face prejudice or discrimination in the job market, at school, and in social situations. These situations can lead to feelings of rejection, shame, and depression. With society emphasizing physical appearance and often equating attractiveness with slimness, it is easy to see how obesity can lead to low self-esteem, poor self-image, low self-confidence, loneliness, relationship problems, sexual problems and depression. In some cases, obesity leads to decreased mobility which can result in an overall lower quality of life.


    The aim of obesity treatment is to reduce weight in order to improve quality of life.  It is generally agreed that doing this involves making changes to your diet and lifestyle habits.  In some cases, this may involve weight-loss surgery.  At Altum, we have experience helping people to overcome the barriers involved in changing what can often be a lifetime of unhealthy eating habits.  We aim to provide the psychological support necessary for you to make the changes necessary to reach your goals.  We are committed working closely with your dietician, GP, or other medical professionals to ensure you receive a comprehensive plan.

  • Body Image Difficulties

    Most of us spend some time in front of the mirror checking our appearance. How we feel about our appearance is part of our self-image, and it’s perfectly natural to take care of our bodies and be interested in the way we look.

    At some points in our lives, many of us will also experience some level of dissatisfaction with some aspect of the way we look. This can be especially true during adolescence when our bodies and appearance go through lots of changes. Although many of us feel dissatisfied with some aspect of our appearance, these worries usually don’t constantly occupy our thoughts or cause us to feel tormented.

    For some people, concerns about appearance become extreme and upsetting. Some people become so focused on imagined or minor imperfections in their looks that they can’t seem to stop checking or obsessing about their appearance. Being constantly preoccupied and upset about body imperfections or appearance flaws is called body dysmorphic disorder (BDD).

    Body Dysmorphic Disorder (BDD)

    BDD is a condition where people spend a lot of time worried about and concerned about their appearance.

    People with BDD might focus on what they think is a facial flaw, but they can also worry about other body parts, such as short legs, breast size, or body shape. Just as people with eating disorders obsess about their weight, those with BDD become obsessed over an aspect of their appearance. They may worry their hair is thin, their face is scarred, their eyes aren’t exactly the same size, their nose is too big, or their lips are too thin.

    BDD has been called “imagined ugliness” because the appearance issues the person is obsessing about usually are so small that others don’t even notice them. Or, if others do notice them, they consider them trivial. But for someone with BDD, the concerns feel very real, because the obsessive thoughts distort and magnify any tiny imperfection.  This obsession is very distressing for people with BDD and can cause great impact on day-to-day functioning.

    People with BDD tend to spend prolonged periods of time feeling trapped in front of the mirror. They may camouflage their perceived defect with clothing, make-up, hats or posture. They may avoid social situations, or even avoid getting out of the house as they fear their imagined or minor defect will attract undue attention.   Some people with BDD will consult a cosmetic surgeon to have the imagined or minor defect corrected. In some cases, distress can become so overwhelming that people consider suicide.

    If you are experiencing distressing preoccupations about some aspect of your appearance that interferes with your daily life and well-being, please contact us to make an appointment.

    Psychological therapy has been found to be a highly effective treatment for BDD, and our therapists at Altum are here to help.

    For more information about BDD, please see the Body Dysmorphic Disorder Foundation: