Morning Depression

Morning depression is also known as ‘diurnal variation of depressive symptoms’ or ‘diurnal mood variation’.

Symptoms of morning depression

People with morning depression often have severe symptoms in the morning, such as feelings of deep sadness and gloom, and trouble waking up, getting out of bed and a profound lack of energy.  However, they feel better as the day goes on.

waking up tired

Morning depression is not a separate diagnosis but your doctor or therapist may ask you about sleep patterns and mood changes throughout your day:

  • Are your symptoms generally worse in the morning or in the evening?
  • Do you have trouble getting out of bed or getting started in the morning?
  • Do your moods change dramatically during the day?
  • Do you have trouble concentrating more than usual?
  • Do you find pleasure in the activities that you usually enjoy?
  • Have your daily routines changed recently?
  • What, if anything, improves your mood?

Possible causes of morning depression

Low blood sugar levels (hypoglycaemia)

There is a direct link between mood and blood sugar balance. While you sleep, your blood sugar levels progressively drop. The reason for this is that you haven’t eaten anything in the past few hours. Many people don’t eat before they sleep, so all those hours add up.

Poor nutrition

This relates significantly to low blood sugar levels. People tend to eat so much processed sugar that it causes a major drop in blood sugar levels, which leads to depression and anxiety. When foods of this kind are eaten at night before one sleeps, the negative effect of hypoglycaemia is increased. The conclusion is to eat healthy.

Bad sleep

If your sleep is not stable and you wake up in the middle of the night several times or have difficulty letting go of your scattered thoughts, it is definitely going to influence how depressed you are when waking up.  Bad sleep can cause  morning depression, grumpiness, anger, stress and anxiety.

“Waking up is coming back from a world of dreams under comfortable sheets to a world of reality – many times, a reality that you do not want to be in, a reality that you don’t enjoy”.

The depression involved in waking up in the morning may occur because you are not happy about your life in certain areas.

Therefore, opening your eyes and coming back to reality is difficult because all of the things you are not happy about are popping up rapidly all at once!


Treatments for morning depression

Here are some of the treatments that can help ease morning depression.



Unlike other symptoms of depression, morning depression doesn’t respond well to selective serotonin reuptake inhibitors (SSRIs). SSRIs are commonly prescribed antidepressants that can help ease symptoms of major depression.

However, serotonin–norepinephrine reuptake inhibitors (SNRIs) may be helpful for people with morning depression.

Talk therapy

Talk therapies — such as counselling and psychotherapy — can also treat morning depression. Medication and talk therapy are especially effective when combined. These therapies can help you address any issues that may contribute to your depression and may be making your symptoms worse.  Issues might include conflicts in a romantic relationship, problems in the workplace, or negative thought patterns.

Light therapy


Light therapy, also known as bright light therapy or phototherapy, can also help treat people with morning depression. With this type of therapy, you sit or work near a light therapy box. The box emits bright light that mimics natural outdoor light.

The exposure to light is believed to affect brain chemicals linked to mood. Although generally recognized as a treatment for seasonal affective disorder, some people with morning depression may find this approach helpful.

There are also things that you can do yourself to help reduce your symptoms of morning depression:

  • Try going to bed and waking up at the same time every day
  • Eat meals at regular times and make sure that you eat breakfast
  • Refrain from taking long naps
  • Create an environment that promotes sleep, such as a dark, silent, cool room
  • Avoid substances that can prevent a good night’s sleep, such as caffeine, alcohol, and tobacco
  • Exercise more often, but avoid strenuous exercise for at least 4 hours before bedtime
  • Start your day with doing something that makes you feel good and have a good stretch when you wake up

Taking these steps can help stabilize your circadian rhythm so that your body makes the correct hormones at the right time. And that should help improve your mood and other symptoms.

You can also try using self-dialogue:

“I feel very overwhelmed right now because I have just woken up and all of the things that I fear are emerging right away, all at once. I realize that it can be scary and a bit stressful, but all is well. I can take care of everything. I’m on top of things and later on I will feel much better. However, I will not get better if I surrender to my excuses and ignore life. I should just face it and trust myself that I’m going to manage everything the right way. All is well.”





Students and Mental Health!

It’s often described as the best time of one’s life, but for many students the reality is very different.


Mental health problems are as common among students as they are in the general population.

But it’s not just students who have a diagnosed mental health condition that can benefit from counselling.  A lot of the difficulties that students face are caused by normal life issues such as family or relationship problems, financial problems, self-esteem, anxiety about their studies, problems with alcohol or drugs, sexuality and generally being away from home for possibly the first time in their lives.

Where to get help

It’s normal to feel down, anxious or stressed from time to time, but if these feelings affect your daily activities, including your studies, or don’t go away after a couple of weeks, you may need to seek help.

Signs of depression and anxiety include:

  • feeling low
  • feeling more anxious or agitated than usual
  • losing interest in life
  • losing motivation

Some people also:

  • put on or lose weight
  • stop caring about the way they look or about keeping clean
  • do too much work
  • stop attending lectures
  • become withdrawn
  • have sleep problems

Drugs, drink and mental health in students

This may be the first time that you have experimented with alcohol or drugs and you may start to self-medicate on these substances  If you’re feeling low or stressed, you may be tempted to drink more alcohol or relax by smoking cannabis.

Consider how this may make you feel in the longer term though, as your mood could slip, making you feel a lot worse.

Some cannabis users can have unpleasant experiences, including confusion, hallucinations, anxiety and paranoia.

Any underlying mental disorder could be worsened by drug and alcohol use.


Where to go for help

Talk to someone

The first thing to do is to talk to someone. This could be a friend or relative to begin with and this may bring some immediate relief. If your studies are being affected then it may be a good idea to talk to your tutor as well so that they understand how you are feeling and may be able to offer some advice.

You may decide that you need more support and then it is advisable to talk to a professional.

University counselling services

Many colleges and most universities have a free and confidential in-house counselling service you can access, with professionally qualified counsellors and psychotherapists.

You can usually find out what they offer and how to make an appointment in the counselling service section of your university’s website. This free service in universities is available to both undergraduates and postgraduates.

Other help

As well as counselling or therapy, you may also be entitled to “reasonable adjustments” such as extra time in exams, extensions on coursework, and specialist mental health mentor support.

Student-led services

Many student unions also offer student-led services. Although the students involved aren’t qualified counsellors, you may prefer to talk about problems, such as stress and depression, with another student.


When to see your GP

For more serious or longer-lasting mental health symptoms, see your GP, as you may need prescribed treatment or referral to a specialist.

If you have or develop a mental health condition that requires treatment, it’s important to arrange continuity of care between your college doctor and your family GP.

A mental health adviser can support this communication. Your condition may worsen if moving between university and home results in a gap in treatment.

Therapy and counselling

Counselling offers an opportunity to explore the underlying issues of your unhappiness or any worries you have in a safe environment, including helping you develop ways of coping.


The thing to remember is that you are not alone. Many students suffer from some form of mental illness during their time at university. There is so much pressure on young people to achieve good results that sometimes the fact that they are living away from home for the first time gets missed. This may be first time that you have had to cook for yourself, wash your clothes, go food shopping, take responsibility for bills etc. You have to make new friends and fit in with a whole new way of life. For some this freedom is amazing and they thrive in this new environment but most students will suffer some degree of anxiety and others will suffer from a more debilitating mental illness. Universities are more aware of this and there is now more provision to help with difficulties.

Please ask for help if you need it – do not suffer in silence.


Self Esteem

In today’s world we may feel pressurised to achieve our best; to look a certain way; to own certain material things; to be in a relationship; to have a high-powered job; to have a great social life; to have lots of friends etc etc. When we don’t achieve these then our self-esteem can plummet.

Our self-esteem is how we value and perceive ourselves and when we fail to meet the expectation that society puts on us then we may suffer from low self-esteem.

Do any of these sound familiar:

  • you may feel that you hate or dislike yourself
  • you may feel worthless or not good enough
  • are you unable to make decisions or assert yourself
  • do you feel that no one likes you?
  • do you blame yourself for things that aren’t your fault?
  • Do you feel guilty if you spend time or money on yourself?
  • You are unable to recognise your strengths
  • You feel that you are undeserving of happiness
  • You are low in confidence


We all have times when we lack confidence and don’t feel good about ourselves.

But when low self-esteem becomes a long-term problem, it can have a harmful effect on our mental health and our lives.

Self-esteem is the opinion we have of ourselves. When we have healthy self-esteem, we tend to feel positive about ourselves and about life in general. It makes us able to deal with life’s ups and downs better.

When our self-esteem is low, we tend to see ourselves, and our life in a more negative and critical light. We also feel less able to take on the challenges life throws at us.


What can cause low self-esteem?

Low self-esteem often begins in childhood. Teachers, friends, siblings, parents, and even the media give us lots of messages – both positive and negative.

You may have found it difficult to live up to other people’s expectations of you, or to your own expectations.

Stress and difficult life events, such as serious illness, bereavement, break up of parent’s relationship, experiences at school etc can have a negative effect on self-esteem. Personality can also play a part. Some of us are simply more prone to negative thinking, while others set impossibly high standards for themselves.


How does low self-esteem affect us?

 The problem with thinking we’re no good is that we start to behave as if it’s true. Low self-esteem can change our behaviour so that we start behave in ways to confirm that we are ‘no good’.

If you have low self-esteem or confidence, you may hide yourself away from social situations, stop trying new things and avoid things you find challenging. This may help in the short term as you can feel a lot safer but in the long term, this avoidance will reinforce your fears. You will then find that the only way to cope is to avoid doing things that are challenging.

Living with low self-esteem can harm your mental health, leading to problems such as depression and anxiety. You may also develop unhelpful habits, such as smoking, drinking excessively, taking drugs etc, as a way of coping.


How can you improve your self-esteem?


 Firstly, you need to identify and challenge the negative beliefs that you have about yourself. You could start by writing down all the negatives and then writing evidence that disproves these.

For example: You may feel that you are too stupid to apply for a certain job or that no-one likes you. You could ask yourself when you first started to think these thoughts. Then you can write down evidence that challenges these beliefs. For example: “I have certain qualifications” or “people find me easy to talk to”. You could also write down good things that other people say about you. Keep adding to this list and keep looking at it.

Recognise things that you are good at: We are all good at something, Try to recognize what you are good at and try to do them as often as possible. This will also boost your mood. Focus on your positives and celebrate your successes.

Build positive relationships: Spend more time with people that you have good relationships with. Avoid people that make you feel less good about yourself. Talking to loved ones about how you feel can help you to reassess how you view yourself. Ask them what they like about you – it’s likely that they see you differently to how you see yourself.

Be kind to yourself: Be gentle and compassionate to yourself. Try to think what you would say to a friend if they were in a similar situation. Write a list of what you like about yourself. You could include aspects of your personality, your appearance and what you like doing. If you’re finding it difficult, ask a friend or loved one to help you.


Learn to be assertive and start saying no!

 Being assertive is about respecting other people’s opinions and needs, and expecting the same from them.

When you don’t like yourself, it’s easy to assume others won’t like you either. You may find you go out of your way to help others as you feel it’s the only way they’ll like you. It can make you feel even worse if this help isn’t reciprocated. A good deed is great but over stretching yourself to please others can leave you with less energy to focus on yourself and can affect your mental health.

People with low self-esteem often feel they always have to say yes to other people, even when they don’t really want to. The risk is that you become overburdened, resentful, angry and depressed.

Take a breath before automatically agreeing to do something you don’t want to and try saying “no”.

Set boundaries around how much you do for other people.

 Take control of your own decisions

 At first you might find it difficult to break these habits but making small changes to be more assertive can feel liberating and gets easier the more you do it.


Challenge yourself!

We all feel nervous or afraid to do things at times. People with healthy self-esteem don’t let these feelings stop them from trying new things or taking on challenges.

Find something you like doing and do more of it.

You could take up a hobby, join a class or volunteer your time for something you feel passionate about.

At times it can be hard to find the motivation to set goals for yourself, especially when you don’t feel confident or worry about what other people may think, but it doesn’t have to be something big.

Making small goals such as trying a recipe or learning the days of the week in a new language can help you to feel more positive about yourself.

And try to remind yourself you don’t have to be perfect at it to enjoy yourself.

 If things are getting too much, then you may need some extra support. Counselling aims to give you a safe, confidential space to talk about your thoughts and feelings.


Bristol Central Counselling is Expanding!

I am very pleased to announce that I am increasing the availability of counselling sessions due to increased demand.

I will now have sessions available on Tuesday evenings from 6pm to 9pm and also on Friday afternoons from 2pm to 6pm.  This is in additions to the Friday evenings that I am currently working.

Please contact me if you would like to book a session.

Thank you for all the support I have received from family and friends and the inspiration I have received from some amazing clients.

I feel so blessed to be building a career and doing something that brings me such pleasure and satisfaction.  It is never too late to follow your dreams!



New Year’s Resolutions

A New Year = A New You?


We are now a week into 2017 and how many of us made New Year Resolutions that we are struggling to keep? A New Year’s resolution is a promise we make for the New Year and the goal is to improve our lives in the year ahead. Resolutions take many forms but are usually to change a bad habit such as smoking, excessive drinking or eating junk food, or to develop a positive habit such as exercising more, volunteering for a worthwhile cause or looking after ourselves more.

As the clock strikes midnight on 31st December we make decisions to improve our lives in the year ahead but how did this custom originate?

The tradition started in 153 B.C. January is named after a mythical god of early Rome, Janus. Janus had two faces, which allowed him to look back on the past and forward to the future. On 31st December, the Romans imagined Janus looking backward to the old year and forward to the New Year. The Romans made resolutions for the New Year and forgave enemies for troubles in the past. They also believed that Janus would forgive them for their wrongdoings during the previous year. The Romans would give gifts and make promises, believing that Janus would see this and bless them in the year ahead. And thus the New Year’s Resolution was born!


Above are some of the most common New Year resolutions but why do we have such a hard time keeping to them?

One theory is that we try to do too much. So perhaps set a goal that is challenging, but manageable. If you try to do much you are more likely to fail and this can drain your confidence. So, build on small victories and achievements and take one thing at a time.

Whatever goals you do tackle, try to monitor your progress. If your resolution is to lose weight, check your weight regularly (but not obsessively). If it’s to save money, write down where you’ve spent your money. Monitoring those few, challenging goals you set is more likely to improve your success. Sometimes, just the act of recording everything you eat or spend can cause you to eat or spend less even if you don’t consciously change anything else.

Many resolutions include overcoming bad habits, such as smoking or too much alcohol consumption. These could be tough because they are easy to rely on when stressed out. But, again, take things a day at a time and think about joining support groups and encourage friends to join you in your resolution. This could really help if you want to get more exercise or lose weight. It’s more fun to go to the gym or exercise classes with a friend.


If you have made some New Year’s Resolutions, here are some tips to help you succeed:

  1. Focus on one resolution rather than several, and set realistic, specific goals. Losing weight is not a specific goal. Losing 10 pounds in 90 days is.
  1. Don’t wait till New Year’s Eve to make resolutions. Make it a year long process, every day;
  1. Take small steps. Many people quit because the goal is too big requiring too much effort and action all at once;
  1. Celebrate your success between milestones. Don’t wait the goal to be finally completed;
  1. Focus your thinking on new behaviors and thought patterns. You have to create new neural pathways in your brain to change habits;
  1. Focus on the present. What’s the one thing you can do today, right now, towards your goal?
  1. Be mindful. Become physically, emotionally and mentally aware of your inner state as each external event happens, moment-by-moment, rather than living in the past or future.
  1. And finally, don’t take yourself so seriously. Have fun and laugh at yourself when you slip, but don’t let the slip hold you back from working at your goal.


Relationships – Part Three!

Sex and Relationships

Sex and intimacy are very important in most relationships but all couples go through phases where they don’t have the time, energy or inclination for sex. There may also be other reasons why couples experience problems in their sex life and this can leave them feeling very alone and helpless. For the majority of couples the problems may be linked to other challenges and difficulties such as feeling stressed and having a lot on their mind. Having sex or being intimate may not be a priority at this time but if the stress is resolved then it is likely that a satisfactory sexual relationship will be resumed. However, if a sexual problem is more severe or complex, it can have a stronger and longer-term effect on your sexuality and relationship. Couples may be reluctant to seek help due to shame, fear and embarrassment and may suffer in silence for months or even years.


What causes sex problems? 

Problems in a sexual relationship are usually the result of a combination of factors:

Physical factors:

Disabilities and illnesses such as diabetes, heart disease, alcoholism and drug abuse can contribute to sexual dysfunction.

Major surgery, pregnancy and the menopause are also more likely to have a negative impact on sexual relationships.

Psychological :

Anxiety, depression and other mental health issues can have a negative impact on sexual responses.


Unresolved grief, betrayal, unhappiness in a relationship, and low self-esteem effect how a person feels and they maybe unable to fully participate during sexual intimacy.


A change in circumstances or living in a stressful situation such as moving to a new home, having a baby, change or loss of employment or financial problems, can contribute to sexual difficulties

Common female sex problems

Pain during sex

This can be very common particularly in women who are going through or have gone through the menopause. There are also medical conditions that can contribute to pain such as endometriosis, ovarian cysts, scar tissue from surgery or sexually transmitted diseases.

Another condition is known as vaginismus characterized by an involuntary spasm of the muscles surrounding the entrance of the vagina. This may stem from a long term sexual phobia or a previous trauma such as sexual abuse or childbirth. It may also be linked to relationship problems or a fear of getting pregnant.

Orgasmic Disorder

It is estimated that about one in four women will have problems reaching an orgasm at some stage in their life and some may have never experienced orgasm.   This may not be necessary for a satisfactory sexual relationship but it can be a source of unhappiness for many couples. The reasons may be related to medical problems including hormonal imbalances or medication. Some women may have a fear of sex and losing control while others may be unhappy in their relationship in general.

Loss of desire 

Women often experience of loss of desire at certain periods in their life such as pregnancy, after having given birth, times of stress, menopause and while this is quite normal and desire is likely to return, for some women this is a persistent problem.  This can be caused by a variety of different factors including: physical illness, relationship problems, hormone disorders, depression, excessive tiredness, traumatic sexual experiences and drug and alcohol abuse. Lack of sex drive is also linked to a reduction in a woman’s natural testosterone levels. 

 There is also a condition known as ‘sexual anorexia’, which is a complete lack of desire for sex. Like the eating disorder this is psychologically linked and counseling is essential to help suffers perceive sexual intimacy to be natural and healthy rather than bad and shameful.

Common Male Sex Problems

 Ejaculation problems 

Ejaculation problems are very common and men will typically experience one of three types of disorder:

Premature ejaculation:

This is when a man ejaculates too quickly during sexual intercourse. The average time of ejaculation is considered five minutes so regularly ejaculating before or within one minute of penetration is regarded as premature.

Retarded/delayed ejaculation:

This is when a man is unable to ejaculate during sex or ejaculation is significantly delayed.

Retrograde ejaculation:

This is the least common and is when the sperm travels backwards and enters the bladder instead of passing through the urethra and head of the penis. Orgasm is still experienced but there will be no, or little semen.

These may all be linked to psychological and/or physical factors including stress and previous sexual trauma or medical conditions such as diabetes.

Erectile Dysfunction:

This is also known as impotence, and refers to the inability to get and maintain an erection that is satisfactory for sexual intercourse. This is quite common and is linked to hormonal problems and the narrowing of blood vessels inside of the penis due to high blood pressure. Stress, anxiety and mental health issues are further causes of erectile dysfunction, along with sexual boredom and constant worrying about pleasing a partner. Unfortunately, for many men, even when the initial cause of an erection problem has passed, the anxiety of repeated failure may block future erections.

When is the right time to seek help for sex problems? 

Talking about sex problems can be difficult and embarrassing for many, and as a result some people may suffer in silence.

Sex and sexual intimacy is an important part of bonding between two people in a relationship and without it a couple can become disconnected.

Some of the signs that sex problems are affecting your relationship include:

  • Sex causes disappointment.
  • Sex is the cause of rows.
  • One or both partners are feeling dissatisfied or stuck in a rut.
  • Couples start drifting apart and losing touch.
  • One or both partners feels taken for granted or neglected.


The first step is to contact your GP to establish the cause(s) of the problem and to identify is there is a medical reason, which can be treated by medication. Sex therapy may be the next course of action.


Sex Therapy can help you if you’re experiencing difficulties in your love life and can help you to improve physical intimacy.

Sex therapists are specially trained to help you identify any issues that are effecting your sexual relationship and can give practical advice and suggestions to help you. Although it can seem embarrassing to talk about such personal things with a stranger they are trained to put you at ease and enable you to explore your relationship together.

Whether you are single, married, in a relationship, gay, lesbian or straight, Sex Therapy can help you to improve your sex life and to overcome many specific sexual dysfunctions.

Relationship – Part Two!

Conflict Resolution in Healthy Relationships


There is conflict in all relationships – verbal disagreements and arguments. People disagree and that isn’t necessarily a bad thing. In fact, everyone has the right to a different opinion from their partner.

In a healthy relationship communication is key. When you communicate effectively, you understand your partner better and make your relationship stronger.

If your conflict is based on which film to see or who should do the dishes etc then some of the tips below may be useful:

  • Set Boundaries: Everyone deserves to be treated with respect — even during an argument.  Make sure that you both understand that name-calling and insults are not acceptable. It is possible to argue without reverting to verbal abuse.
  • Find out the real issue: Typically, arguments happen when one partner’s wants are not being met. Try to get to the heart of the matter. If your partner seems needy, maybe they are just feeling insecure and need your encouragement. If, for example, you’re angry that your partner isn’t taking out the bins, maybe you’re really upset because you feel like you do all the work around the house. Learn to talk about the real issue so you can avoid constant fighting.
  • Agree to disagree: If you and your partner can’t resolve an issue, sometimes it’s best to drop it. You can’t agree on everything. Focus on what matters. If the issue is too important to just drop then maybe you can set aside some time to talk about it.
  • Compromise when possible: Easy to say but hard to do, compromising is a major part of conflict resolution and any successful relationship. Find a middle ground that can allow both of you to feel satisfied with the outcome. Remember that you are both different people with different expectations.
  • Consider everything: Is this issue really important? Does it change how the two of you feel about each other? Are you compromising your beliefs or morals? If yes, it’s important that you really stress your position. If not, maybe this is a time for compromise. Also, consider your partner’s arguments. Why are they upset? What does the issue look like from their point of view? Is it unusual for your partner to get this upset? Does your partner usually compromise? Are you being inconsiderate?

Relationship conflict occurs when expectations aren’t being met. Everyone enters into a relationship with certain expectations which are based on past experiences, childhood, or how you think things should be.

But no two people think the same, no matter how much they have in common.

Instead of seeing conflict as a threat to a relationship, what if we see it as an opportunity for the relationship to grow and mature?

This requires understanding that conflict will inevitably occur in any close relationship.