Readers mental health concerns answered by resident GP Dr Zak

Thank you to the two readers who wrote in about their mental health concerns. As always, my advice is given in good faith, in line with current guidelines and treatment. However, it cannot act as a substitute for consulting your own doctor.

Question - My mood is up and down, sometimes I’m happy, a lot of the time I’m down. How do I know I’ve not got bipolar, and not just depression – Kerry, 23

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Answer – For anyone suffering depression, this may be punctuated by periods of feeling optimistic. This is normal. Indeed, for those with sub-threshold symptoms, you are unhappy for a prolonged period, such that you fit the criteria of being sad more than you are happy.

True bipolar affective disorder is less common than depression and is marked by vast swings in mood from the depths of despair through to episodes of mania.

In mania, you may be so elated you feel like you are invincible. Grand plans are often made. You may behave much more confidently than normal, engaging in risky behaviour including sexual promiscuity, spend money you do not have and feel like you do not need sleep.

The phases of mania and depression can be that drastic that they switch within a very short space of time.

Depression can be difficult to treat, and requires patience from both the individual suffering and those who are helping them. Within it there will be points of happiness, hopefulness and positivity. The hope is that treatment will make you feel happier more often than you feel sad.

However, bipolar affective disorder may not respond to traditional treatments for depression. If you recognise the symptoms of bipolar in yourself, it is worth raising these concerns.

Question – I have anxiety and have been prescribed an antidepressant. My GP advised me to cut back on my alcohol, but I find it helps me to relax. Rob – 45

Answer – While sometimes acceptable in moderation, it must be remembered that alcohol is a depressant.

Alcohol competes with antidepressants for the same receptors in the brain, hence your medication may not work as well, if at all.

Aside from the physical and mental health aspects, using alcohol to relax would be seen as a maladaptive coping mechanism.

There are many other ways of relaxing and reducing levels of anxiety that are not only good for the body, yet can also be pleasurable.

Walking, picking up a hobby, or joining a support group will give you much greater rewards and a sense of empowerment.

While it would be a very unpopular suggestion that you should banish alcohol completely, it should not be relied on to keep you calm.