CBT in the City Newsletter 30 April 2013

April 2013

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A message from Susie, Information

Multiple Sclerosis

CBT can make a

Have you adjusted to the news of being with MS? difference on the speed of depreciation on the myelin sheath

February

CBT London and the Home Counties Our head office is based in at the

Harley Street, London, while we also hold London CBT Clinics

Healix Wellbeing Centre

London. Highbury and Islington

in Southgate, North

Brixton

, Dulwich,

Camberwell and Walthamstowe. In the home counties we have CBT Therapists available on Norwich,

the network in Berkshire, Buckinghamshire, Essex,

St Albans in Hertfordshire

, Kent , Surrey and Sussex. For more

information, book an appointment or enrol in a Group CBT Programs you will need to contact us, register

online or telephone

0207 467 1508

Message From Susie @ CBT in the City

The clinic now offers clients the ability to control how many sessions they want and when to have them by paying on the website. This facility is easy to use and all you need to do is pay for the number of sessions you wish to use. It all major credit cards and once payment is received then all the rest I take care of and ensure an accepts appointment sent with in 24 hours. Also the clinic specialists offer therapy via, telephone and video online to fit into busy schedule and child care arrangements, so help can literally be at hand at any time and any where! your Remember we are here to help with not just mental health issues but physical health as well

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What is multiple sclerosis?

Multiple sclerosis or MS is a disease that affects the brain and spinal cord resulting in loss of muscle control, vision, balance, and sensation (such as numbness). It is the commonest disabling neurological disease in young adults, and affects about 100,000 people in the UK. With MS, the nerves of the brain and spinal cord are damaged by one's own immune system. The condition is therefore called an autoimmune disease.

Auto-immune diseases are those whereby the body's immune system, which normally targets and destroys substances foreign to the body, such as bacteria and viruses, mistakenly attacks normal tissues.

In MS, the immune system attacks the brain and spinal cord, the two components of the central nervous system. Other auto-immune diseases include systemic lupus erythematosus and rheumatoid arthritis.

The central nervous system is made up of nerves that act as the body's messenger system. Each nerve is covered by a fatty substance called myelin, which insulates the nerves and helps in the transmission of nerve impulses, or messages, between the brain and other parts of the body. These messages control muscle movements involved in movements such as walking and vision.

MS gets its name from the build-up of scar tissue (sclerosis) in the brain and/or spinal cord. The scar tissue or plaques form when the protective and insulating myelin covering the nerves is destroyed, a process called demyelination. Without the myelin, electrical signals transmitted throughout the brain and spinal cord are disrupted or halted. The brain then becomes unable to send and to receive messages properly. It is this breakdown of communication that causes the symptoms of MS.

Although the nerves can regain myelin, this process is not fast enough to outpace the deterioration that occurs in MS. The types of symptoms, severity of symptoms, and the course of MS vary widely, partly due to the location of the scar tissue and the extent of demyelination.

MS is two to three times as common in females as in males and it is unusual for it to occur before adolescence. A person has an increased risk of developing the disease from the teenage years to age 50 with the risk gradually declining thereafter.

What causes MS?

No one is sure what causes the body's immune system to go awry. Some scientists believe that it is a combination of genetics and something in the environment to which the person was exposed to early in life.

What are the symptoms?

Symptoms vary from person to person and can change over time in the same person. The most common early symptoms include:

Muscle weakness Numbness and tingling Decreased co-ordination Blurred, hazy or double vision Eye pain February

How is MS diagnosed?

Making the diagnosis of MS isn't easy because the symptoms are vague and often fleeting. If your GP suspects that you may have MS, he or she will refer you to a neurologist for further investigations.

These include:

Magnetic resonance imaging (MRI) of the brain and spinal cord can show areas of demyelination (lesions) Evoked potentials are measurements of electrical activity from the brain and nerves. This is a painless procedure, and if demyelination has occurred, this test can demonstrate that the transmission of messages along the nerves is slower than normal.

A lumbar puncture (or spinal tap) involves inserting a needle into the lumbar spine under local anaesthetic to draw off a small amount of the cerebrospinal fluid that surrounds the brain and spinal cord. Testing the fluid may show antibodies that show the immune system in the central nervous system has been overactive. It is not performed routinely but is reserved for cases where the diagnosis is not entirely clear.

There are other tests that a neurologist may perform, mainly to exclude other conditions that may mimic MS.

How is MS treated?

There are a variety of medicines available that can reduce the frequency and severity of MS symptoms in some people with MS. Some drugs can also slow the progression of certain types of MS.

There are also a variety of medicines available that can:

Shorten attacks of MS (acute worsening of symptoms) Relieve the symptoms of MS (such as pain, urinary problems and muscle stiffness)

February

A to Z of MS

Cognitive behavioural therapy or CBT is a form of psychotherapy that is commonly used in the treatment of conditions such as anxiety and depression. It is based on the belief that how we think about a situation influences how we act, and our actions subsequently influence how we think and feel. It encourages the adoption of new thinking and behavioural techniques.

Research into CBT

A number of studies have assessed the effectiveness of CBT as a treatment for MS-related symptoms. One study, measuring the impact of a telephone-administered cognitive behavioural therapy programme compared with an emotional support programme, found that CBT led to significantly greater decreases in disability, fatigue levels, and depression. A more recent trial assessed the effectiveness of CBT as a treatment for multiple sclerosis fatigue compared with a relaxation training programme. While both programmes were deemed to be clinically effective treatments for fatigue in MS, CBT proved to be the more effective of the two.

How CBT is administered

A cognitive behavioural therapy programme can be delivered in a number of ways and might be group-based, computer-based or telephone administered. It usually consists of a programme of once weekly hour long sessions. It is available on the NHS, though availability varies across the UK. If you feel that CBT may be of benefit to you, or you would like further information about CBT, you should consult your GP.

References

Mohr DC, et al.

Reduction in disability in a randomized controlled trial of telephone administered cognitive behavioural therapy.

Health Psychology 2007;26(5):554-563. abstract

van Kessel K, et al.

A randomized controlled trial of cognitive behaviour therapy for multiple sclerosis fatigue.

Psychosomatic Medicine 2008; 70(2):205-213

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