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Press Release Date: 18 January 2023 According to some reports, there has been increasing concern about the role of serotonin in moods and whether SSRI’s work as a treatment. The research which featured in Molecular Psychiatry reviewed 17 studies and found people with depression didn’t appear to have different levels of serotonin in their brains to those without.  This in turn questions the theory of how the drugs might work – by correcting a deficiency. We spoke to expert, Senior Psychiatrist Dr James Woolley at Schoen Clinic Chelsea in London to find out more about the research and whether it will have an impact on the use of SSRI’s in treating depression. Is depression a chemical imbalance? What could be the other biological factors predisposing for depression? It has long been thought that there are differences in some people’s levels of serotonin in the brain, and that in some cases this may predispose to depression.  This research has been one of the reasons given why medication which increases effective serotonin levels can help improve depressive symptoms.  These sorts of medications, commonly known as SSRIs are very widely prescribed within hospitals and GP surgeries alike, so if there is a suggestion they may not even work, then this is big news. The research was something of an oversimplification when the study was reported in the press concluding that, "antidepressants do not work", are little different from placebos, and, rather than improve depression, just "numb emotions".  As well as not being supported by a great deal of other scientific studies, without a more balanced discussion there was the risk of people suddenly stopping antidepressants which they had taken without difficulty, sometimes for a long time, leading to withdrawal symptoms and risking a return of their depression. More balanced reading of the evidence reveals that there is good evidence from large, well conducted studies clearly demonstrating that antidepressants are effective in treating people with new episodes of depression-and not just due to the placebo effect.  For example, 25% of people with depression taking part in a well-designed trial of antidepressants experienced a significant improvement, compared with about 10% of people taking placebos. The question of antidepressants either working, or not is at best not helpful and can be rather damaging.  In reality, some people find them very helpful, do not experience any significant side effects, take them for a while (often a few months), and then stop them again without any problems and remain well. How do SSRIs work? For those where SSRIs work well, they do not put extra serotonin into your system, but they allow the brain to more effectively use your existing serotonin levels.  Serotonin is a neurotransmitter which helps to pass electrical signals from one nerve cell to the next.  Is contained in a small balloon-like structure at the end of the nerve cell, and when required is released, travels along the gap from one nerve cell to the next, and then triggers a signal at the next one which then passes it on.  However, that is not the end of the story, as the serotonin when it has done its job, is then recirculated.  It is reabsorbed by the nerve cell which released it in the first place, packaged back up again into the balloon and is ready to be released once more.  SSRI antidepressants block this reabsorption process to a degree.  So, once the serotonin is released it lingers around for longer, exerting a greater effect and so it effectively seems as if there are high levels of serotonin before eventually getting reabsorbed.  One of the reasons why antidepressants are thought to take a while to have an overall impact on mood, is that the nerve cells do notice that there is not so much serotonin being reabsorbed and so readjust by starting to produce more than they would have ordinarily done in order to balance back the levels they are expecting again.  This process takes a while and does result in higher overall levels of serotonin eventually, but can take a few weeks to become noticeable. What else causes depression? Serotonin is clearly not the whole story, as a sizable proportion of people with depression do not improve significantly with antidepressants which boost serotonin levels.  Rather than therefore leading to a conclusion that "antidepressants do not work", a more meaningful question is to try and work out why some people improve and others do not.  This likely points to the issue that what we call "depression", can be quite a broad umbrella term encompassing lots of different people, varying situations, triggers, stresses and traumas which have led to a similar cluster of symptoms.  We end up calling the result depression, but underneath this there may be a wide range of causes and reasons - only some of which are linked to low serotonin levels.  However for those people at least, having access to effective medication which assists them by boosting serotonin levels is valuable. Most psychiatrists and GPs, when surveyed, will readily acknowledge that a chemical imbalance is only one possible cause of depression.  In fact in one study they ranked this in last place amongst thirteen broader biological, psychological and social factors. This confirmed that most clinicians understand the complexity of a much wider overall concept of depression than just an imbalance of a single chemical such as serotonin. What other neurochemicals may be involved? Even if we put to one side the range of social and psychological factors which can quite easily lead to depression, and confine our thinking to biochemical imbalance alone, we know that there are a wide range of neurochemicals involved in depression.  As well as serotonin others include histamine, melatonin, noradrenaline and dopamine to name a few.  In fact there are a range of antidepressants which work largely through these other mechanisms and have very little to do with serotonin at all. -ENDS- For interviews and further information, please contact our Press Office at ukmarketing@schoen-clinic.co.uk

Positive mental health is critical to overall well-being during pregnancy and after childbirth. It includes a wide range of emotional and psychological issues which may be experienced during and after pregnancy, such as stress, anxiety, depression, and mood disorders. The most common form of maternal mental health issue is postpartum depression, also known as PPD, which affects more than 1 in 10 new mothers. PPD is a condition which lasts longer than two weeks and can significantly impact the ability to function in day-to-day life as well as bonding with the newborn child, so early recognition is really important. Is PDD the same as baby blues? PPD and baby blues might share the postpartum phase, but they're distinct experiences. Baby blues are common, fleeting feelings of sadness, anxiety, or irritability that many new parents experience within the first two weeks after childbirth. These emotions often arise due to hormonal shifts, sleep deprivation, and the adjustment to parenthood. Symptoms include mood swings, weepiness, and trouble sleeping, yet they tend to fade on their own. In contrast, PDD involves more intense and persistent feelings of sadness, hopelessness, or emptiness that can interfere with daily life and bonding with the baby. These symptoms endure beyond the initial two weeks and might exacerbate over time if left untreated. Seeking help or treatment becomes crucial when these feelings persist for longer periods, impacting one's ability to function. Unlike baby blues, PDD often requires professional intervention, such as therapy or medication, to support the individual's mental health during this challenging postpartum period. Postpartum depression symptoms Postpartum depression (PDD) manifests differently for each individual, but certain symptoms are commonly observed, affecting mental, behavioral, and self-perception aspects: Mental symptoms: PDD often triggers overwhelming feelings of sadness, despair, or emptiness that persist beyond the initial weeks after childbirth. Some experience severe mood swings, irritability, or constant crying without a clear cause. Anxiety, excessive worry, or feeling disconnected from the baby are prevalent. Thoughts of harming oneself or the baby may also occur, though these are serious and require immediate attention. Everyday/behavioural symptoms: Individuals with PDD might struggle with sleep disturbances, either sleeping excessively or facing insomnia even when the baby is resting. Appetite changes, whether an increase or decrease in eating habits, are common. Difficulty concentrating or making decisions, along with a loss of interest in activities once enjoyed, can also be observed. Fatigue or a lack of energy, despite adequate rest, is pervasive. Changes in self-perception or baby perception: PDD often leads to negative thoughts about oneself as a parent, feeling incompetent or unworthy. Some may experience a lack of attachment or bonding with the baby, despite efforts to connect, fostering guilt or shame. It's essential to recognise that these symptoms might vary in intensity and duration for each person experiencing PDD, emphasising the importance of seeking professional help to address these challenges effectively. Not only is good mental health essential for overall wellness, but it can also impact the child’s mental and emotional wellbeing. For example,  studies have shown  that postpartum depression can negatively impact a child’s cognitive and social development if not treated promptly. What causes postpartum depression? We’re not exactly sure what causes PPD. It can happen to any woman after having a baby. Possible causes include hormonal changes, genetic predisposition, stress, lack of support, prior mental health issues, and the adjustment to new parenthood, all contributing to the complex onset of postpartum depression. Hormonal changes: After childbirth, hormonal fluctuations occur as estrogen and progesterone levels, which surged during pregnancy, swiftly return to baseline within the initial 24 hours. This sudden decline in hormone levels post-birth is associated with the onset of postpartum depression (PPD), potentially impacting mood regulation and contributing to its development. Genes: Genes, the body’s instructions for growth and function, can influence postpartum depression (PPD). When depression runs in the family—a family history of depression—there’s a higher likelihood of experiencing PPD due to inherited genetic predispositions passed from parents to children, making it more prevalent among those with familial depressive tendencies. Lifestyle changes: Sleep deprivation post-childbirth can exacerbate postpartum depression (PDD). Women struggling to achieve restful sleep often experience physical symptoms like body pain and exhaustion, intensifying the risk of PDD. Additionally, the loss of freedom and "me time" in the transition to parenthood can be challenging and contribute significantly to feelings of depression. Adjusting to this loss of personal time and independence might amplify the emotional strain and vulnerability to postpartum depression. Are some mothers more at risk of postpartum depression? There are many risk factors for postpartum depression, such as a history of mental health issues, lack of social support, unforeseen circumstances during pregnancy, and complications during childbirth. However, it can also appear without any obvious risk factors. Increased risk factors for postpartum depression include: Prior or during pregnancy depression Family history of depression Childhood abuse or adversity Challenging or traumatic childbirth Previous pregnancy/birth complications Limited support from family, friends, or partners Current or past experience of domestic violence Relationship issues, financial stress, or significant life stressors Being under 20 years old Difficulty breastfeeding Premature birth or a baby with special health needs Unplanned pregnancy Certain factors, from past experiences to current circumstances, may heighten the likelihood of postpartum depression. Can men have PPD? Recent studies reveal that postpartum depression affects nearly 1 in 10 fathers, a largely overlooked phenomenon. A comprehensive study  delved into this under-recognised issue, outlining factors influencing its manifestation in men. Similar to women, men experience comparable symptoms of postpartum depression. However, these signs might be less conspicuous, given men's tendency to mask their emotions. Remember, seeking help is crucial regardless of gender, and openness about these feelings can lead to effective support and treatment. Treatment for postpartum depression Fortunately, several effective treatments are available for PPD. The choice of treatment, considering symptom severity, personal preferences, and various factors, offers hope for recovery. Remember, never let worrying or shameful thoughts deter you from seeking the support and care you deserve during this challenging time. Some treatment options for PPD include: Psychotherapy One of the most effective treatments for PPD is psychotherapy, also known as talk therapy. A therapist can help to explore  feelings and concerns and provide tools to better cope with the challenges of parenting. Cognitive-behavioural therapy (CBT) is a particular type of psychotherapy that has been shown to be effective for PPD. Medication Antidepressants can also be helpful in treating PPD. Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant that is often prescribed for PPD. These drugs can take several weeks to start working and may cause side effects such as nausea, dizziness, and changes in sexual function. However, they have been  shown to be effective in improving mood and reducing symptoms of PPD. Self-care Engaging in self-care activities such as exercise, yoga, and meditation can also help alleviate symptoms of PPD. Women with PPD should aim to get enough sleep, eat a healthy diet, and make time for themselves. A supportive network of family and friends can also be beneficial during this time. Support groups Participating in a support group for women with PPD can help reduce feelings of isolation and provide a supportive environment for women to share their experiences. These groups can be found through healthcare providers, community centres, or online. Find help for postpartum depression in London It’s important to seek treatment for PPD as soon as possible, as symptoms can become more severe if left untreated. Women with PPD can talk to their healthcare provider about their options for treatment, who will work with them to find the best approach for their individual needs. At Schoen Clinic Chelsea we’re committed to providing highly specialised treatment for a range of mental health problems. We also offer a variety of helpful group therapies which may be beneficial to those experiencing PPD. If you’re experiencing depression or another mental health problem and need support, please feel free to get in touch with our team. Can you prevent postpartum depression? Supporting mental wellbeing during pregnancy involves various proactive steps, including maintaining a healthy lifestyle, nurturing a robust support network for open conversations, attending antenatal classes to connect with peers, and seeking guidance from healthcare professionals. However, despite these efforts, developing postpartum depression (PDD) isn't indicative of failure. PDD can arise irrespective of preventive measures. It's crucial not to perceive it as a personal shortcoming. Factors contributing to PDD are multifaceted and can't always be prevented, even with diligent preparation. Instead, view seeking help and support as a proactive step toward managing PDD should it occur. Prioritising mental health throughout pregnancy is commendable. Remember, seeking advice and guidance from specialists in the area, particularly if there's a history of depression or mental health issues, is a responsible approach. Acknowledging that PDD can occur despite efforts empowers individuals to focus on effective coping strategies and seek assistance without self-blame. References This page was reviewed by Dr James Woolley , Senior Consultant Psychiatrist at Schoen Clinic Chelsea on 4th May 2023. https://www.maternalmentalhealthalliance.org/about/perinatal-mental-health/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2724169/ https://www.cambridge.org/core/journals/psychological-medicine/article/inperson-1day-cognitive-behavioral-therapybased-workshops-for-postpartum-depression-a-randomized-controlled-trial/E729E7D8385D87779FED7548CA36E39C https://www.sciencedirect.com/science/article/abs/pii/S0165032713006939

Recent research by PWC has revealed mental health is a growing issue for employees in the UK with statistics revealing that a third of the UK’s workforce is compromised by issues like depression, anxiety or stress. The survey also found two in five employees said they had taken time off work or reduced their responsibilities due to their health. However, of those who had taken time off work for mental health reasons, 39% said they did not feel comfortable telling their employer about the issue. In addition to this nearly a quarter (23%), said they do not think their organisation takes employee wellbeing seriously. Interestingly, the data on mental health in the workplace is correlating to the increase in patients paying for private healthcare to avoid long NHS waiting times – a figure which has jumped almost 40% since before the pandemic, according to PHIN . Senior Consultant Psychiatrist at Schoen Clinic Chelsea , Dr James Woolley , explained he first began to see an increase in people coming to him with workplace-related mental health issues on a self-referral basis prior to the pandemic, but now seeing more of a partnership approach between the employer and employee when it comes to mental health. Discussing whether it is ultimately a manager’s role to manage productivity in a company, he said: “Any good manager will see the link between productivity and the mental health of the workforce, keeping an eye on that and putting reasonable accommodations in place.” He goes on to say that mental health in the workplace is measurable and the kinds of issues which have an impact on productivity are things like absenteeism and even presenteeism where people turn up for work despite how they are feeling, resulting in poorer productivity.  The rise of home working during the pandemic has also had a sizeable impact on people’s mental health, with RSPH polls (2021) showing 67% feel less connected to their colleagues and 56% find it harder to switch off. However, only about a third of people (34%) feel like they have been offered support with their mental health from their employer. With working from home set to continue for millions, recent data shows that NHS waiting lists across the UK are also listed as the highest ever on record, forcing many employees to take sick leave without access to vital treatment.  Reacting to the worrying rise in mental health disorders in the workplace, Schoen Clinic Chelsea offers bespoke workplace wellbeing support services to businesses, to keep employees productive and healthy. Offering leading mental health support, the benefits include reducing stress, anxiety and depression whilst boosting productivity and staff retention rates. Unlike most private healthcare providers, Schoen Clinic’s world-leading experts work together in highly specialised multidisciplinary teams to ensure patients get an advanced level of clinical input throughout their treatment journey. The hospital group say this model is based on clinical research and proven outcome excellence.  Whether work is causing the health issue or aggravating it, research shows over half of employees express higher expectations for mental health support from their employer than before the pandemic, highlighting the need for businesses to go beyond the legal ‘Duty of Care’. This is particularly true in a climate where almost 14% of all sickness absence days in the UK are attributed to mental health conditions. “The latest data from the Office for National Statistics forewarns of a mental health crisis likely to reverberate across the UK economy via the workforce,” says Chris Horlick, a senior advisor to Schoen Clinic UK Group and former Distribution Director for AXA Health, being responsible for all their corporate business. He also mentions how businesses must approach employee mental health with the same business metrics as company profits. Chris notes “Businesses must apply the same rigour to mental health investment as they do to any other investment. Investing in the mental health of the workforce will lead to increased productivity and increased profitability.” He spoke about the need to create robust mental health policies which value employees and ultimately strengthen the workforce, saying, “Using a preventative approach to mental health by partnering with a programme where individuals can gain quick access to clinicians, will be much more cost-effective than damage limitation tactics usually applied when a significant number of employees are already reducing working hours or taking further sick days due to anxiety or stress. A situation which could have been easily managed only a few months earlier through proactive mental health care.” The Schoen Clinic Group has an international reputation for clinical excellence and is widely regarded as a global leader in treating anxiety, mood and eating disorders. Dr James Woolley adds, “We understand that everyone who comes through our doors experiences mental health problems differently. That’s why our treatments are tailored to the needs of both our clients and their families and are always based on the latest clinical research.” He continues, “We use a mixture of one-to-one and group therapies via our day treatment programmes, which we’ve found helps to get people experiencing stress and burnout back on their feet faster.  “In turn, this can save businesses money in the long run with less sickness absence taken, along with better staff retention rates. We know that the right mental health support and a fast resolution of issues can lead to a happier, healthier and more productive workforce.” Are you a London-based employer keen to discuss co-creating a mental health pathway for your company? Email lpenn@schoen-clinic.co.uk today or call 07498 031036 . For more information about Schoen Clinic UK’s workplace wellbeing services, email lpenn@schoen-clinic.co.uk or call 07498 031036 .

Press Release Date: 10.07.23 YouTube's recent announcement regarding its new regulations to crack down on content related to eating disorders has raised concerns from a leading eating disorder specialist. Dr Tony Winston, Medical Director at Schoen Clinic UK Group, has welcomed the platform's efforts to adopt a more responsible attitude towards harmful content but has questioned the effectiveness of these measures and their impact. YouTube’s latest policy update around content related to eating disorders outlines plans to provide more guidance for at-risk users, while also restricting access to some eating disorder content for younger audiences. Videos promoting or glorifying eating disorders are already banned on the platform, but the new rules will see a clamp down on content which demonstrates eating disorder behaviours viewers could imitate. Speaking following the announcement, Dr Winston said: “It is welcome that YouTube is starting to take a more responsible attitude towards material which might encourage eating disorders. However, I am not sure how effective this will be.” Moreover, Dr Winston highlighted the vast array of informative videos available on YouTube focussing on recognising the signs, symptoms, treatment options and recovery from eating disorders. Created by qualified health experts, these videos play a vital role in raising awareness and encouraging individuals to seek professional help. “It would be illiberal and impractical to ban any videos which make reference to eating disorder behaviours and this would include important educational materials. However, deciding whether videos which refer to ‘imitable behaviours’ are glorifying or promoting these behaviours will not be easy.” One of the proposed measures is to restrict access to these videos to individuals over the age of 18, with users required to sign in to a verified account to watch. Dr Winston acknowledged this is a step in the right direction, but noted that individuals aged 18+ are not immune to their potential impact. Dr Winston's comments and YouTube’s new policy come in the wake of TikTok's ban last year on content promoting disordered eating symptoms, such as overexercising and short-term fasting, which the platform said are ‘under-recognized signs of a potential problem.’ About Dr Tony Winston Dr Winston is Medical Director at Schoen Clinic UK Group and a Consultant in Eating Disorders at Coventry and Warwickshire NHS Partnership Trust. He has more than 20 years’ experience treating young people with eating disorders. He qualified in medicine in 1987 and undertook postgraduate training in general medicine, psychiatry and psychotherapy. Dr Winston is an Honorary Associate Clinical Professor at the University of Warwick and has published extensively on various aspects of eating disorders. He currently leads a national working group on complex eating disorders at NHS England. For more information, please contact our Press Office at ukmarketing@schoen-clinic.co.uk

“The aftermath of the pandemic, cost of living crisis and longest NHS waiting lists in years, have all collided to create societal issues that are seriously impacting on male mental health.” says Dr Sarah Perkins, Clinical Psychologist at Schoen Clinic Chelsea . The HSE (Health and safety Executive) reveals that people struggling with anxiety, stress and/or depression took an average of 21.6 days off in 2020. Whilst it is a complex situation and not always clear cut, at times of economic hardship, for example when a cost-of-living crisis leads to money worries during periods of insecure employment, those who struggle with mental health can be vulnerable to varying degrees of psychological triggers. These pressures are having a significant impact on self-esteem and self-perception too and there is a pattern emerging. Studies show that men are generally more reluctant than women to see a doctor. E.g., a *study in the British Medical Journal showed that general primary care consultation rates were 32% lower in men than women. “While it’s clearly a gross generalisation to say women are more willing to talk about emotions and men tend to bottle them up, many studies have looked at how over long periods of time society has encouraged men to be 'strong' and not admit they’re struggling by talking openly to others. There can be a sense that we condition boys from a very young age to not express emotion, because to express emotion is to be 'weak' and that this is not seen as a desirable male characteristic,” says Dr Perkins. Dr Perkins continues: “Men appear to seek help for depression less often – not because they can deal with problems better but possibly because they are less used to knowing and recognising themselves the warning signs, which is why raising awareness is so important. If you don’t even know or recognise you have a condition, you’re less likely to seek help and will have less awareness that effective treatment is available. Generally, at Schoen Clinic Chelsea , we see that women with depression often ask for help sooner than men. Often the men we see have a higher risk as things seem that much worse by the time they seek help at a later stage. The burden of social expectations coupled with economic impact, can mean that men are often brought up to measure their self-worth and esteem by comparison to others, with the focus often on financial, career and status success. In economic circumstances which an individual can’t control, this can have a significant impact on self-perception, adding to a sense of helplessness; all of which can lead to increased depression rates,” concludes Dr Sarah Perkins, Clinical Psychologist at Schoen Clinic Chelsea . Works cited: (Wang Y, Hunt K, Nazareth I, et al. Do men consult less than women? An analysis of routinely collected UK general practice data. BMJ Open 2013;3:e003320. doi: 10.1136/bmjopen-2013-003320 For more information, please contact our Press Office at ukmarketing@schoen-clinic.co.uk

PRESS RELEASE: 29.01.24 The mental healthcare group today have announced the acquisition of Minster Grange Care Home in York from the Maria Mallaband Care Group (MMCG), as part of their ongoing expansion plans in the mental healthcare field. The home on Haxby Road in the Clifton area of York until recently provided residential and nursing care for both younger people and those living with dementia. However, it also shared its premises with specialist mental healthcare provider, Schoen Clinic, which has occupied the ground floor of the building since spring 2021. Significant investment by both providers has been made in refurbishing the building and accommodation at Minster Grange. Following discussions with Schoen Clinic UK Group, MMCG took the decision to close the elderly care service offering Schoen Clinic York the opportunity to expand their service within the home. Andy Davey, Managing Director of Schoen Clinic UK Group, says: “Our acquisition of Minster Grange demonstrates our ongoing commitment to growing our mental healthcare portfolio and inpatient bed capacity within our UK group. The demand for our services is rapidly growing and evolving, and our vision remains to help as many patients as possible access treatment for the highly specialised care we offer. We would like to extend our support to the MMCG York team and the residents of Minster Grange following the relocation of their valued service.” Schoen Clinic York will continue to offer inpatient services for adults with eating disorders, but also expand into complex neurological conditions requiring specialist mental health care. **Commissioning partners - we are delighted to invite commissioning opportunities or discussions relating to our current or forthcoming offering. Please reach out to Hospital Director, Chloe Baron direct at cbaron@schoen-clinic.co.uk   --ENDS-- For any press enquiries, please email our Press Office– ukmarketing@schoen-clinic.co.uk Notes to Editors:  About Maria Mallaband Care Group Maria Mallaband Care Group and sister company Countrywide Care are together one of the UK’s leading independent care home providers, with more than 80 homes across the UK. This family-run company offers a wide range of care and support including day care, respite care, palliative care, dementia nursing care, disability care, nursing care and residential care.  About Schoen Clinic UK Group The Schoen Clinic Group  was founded in 1985 and has since developed into Germany's fifth-largest privately-owned hospital group. It currently treats 300,000+ patients annually at 46 hospitals and clinics in Germany and the UK. The group also includes the leading online telemedicine clinic: MindDoc. Schoen Clinic entered the UK healthcare market in 2017 providing award-winning, expert-led healthcare super-specialising in certain areas of medicine – now mental health and eating disorders.

Research shows that September marks the start of SAD season, where 1 in 20 people in the UK suffer from Winter Depression, medically known as SAD or Seasonal Affective Disorder. Seasonal Affective Disorder is a form of depression that comes and goes in a pattern with seasonal change. Throughout the autumn/winter period, sufferers feel a change of mood, decreased energy or motivation, may sleep longer or lose focus. Research has recently found that women are affected more often than men and it usually begins during adulthood, with the risk increasing with age. Over a third of those aged 16 years+ suspect they may have SAD, suffering from low moods in autumn and winter and Londoners are significantly likelier than those anywhere else in the UK to have been diagnosed with SAD (over 11% of people in London) . Dr Sarah Perkins, a Clinical Psychologist specialising in anxiety and mood disorders at Schoen Clinic Chelsea , explains: “The symptoms of SAD usually peak in January and February. The main cause noted is the lack of sunlight which could prevent a part of the brain, the hypothalamus,  from functioning properly which consequently affects several issues, such as: The production of melatonin – a hormone that makes you feel sleepy.  Sufferers of SAD may produce higher levels. The production of serotonin – the hormone that affects your mood, appetite, and sleep; reduced serotonin is linked to feelings of depression. The body’s internal clock (circadian rhythm) – your body uses sunlight to time various functions such as when you wake up.  Lower light levels can disrupt your body clock leading to SAD symptoms. For some, SAD symptoms can come on during summer months and feel lighter during the wintertime, however, that’s quite rare”. The most common symptoms of SAD include: Persistent low mood Excessive sleep or sleeping longer than normal Decreased ability to focus or concentrate Loss of interest or pleasure in activities formerly enjoyed Irritability and anxiety Feelings of guilt and hopelessness Fatigue, or low energy level Decreased sex drive Increased appetite, especially for sugary foods and carbohydrates Physical issues, such as headaches Dr Perkins continues: “For many people, SAD can cause significant disruption to their work, home-life and relationships. Regular exercise and getting natural light can alleviate or lessen the symptoms. An early morning walk is highly recommended.” If you're suffering from Seasonal Affective Disorder (SAD), our experts at Schoen Clinic Chelsea can help. Call their friendly team on 0203 146 2300 or email them directly.

Talented 23-year-old Kipp Popert from Sevenoaks, Kent who last year soared to the top of world rankings for golfers with a disability, became the first winner of the G4D British Masters Tour, in May 2022. Kipp, who graduated from Birmingham University in 2020, has his sights firmly set on another world medal and is hopeful for golf to be officially recognised as a Paralympic sport. What makes his list of achievements all the more impressive is that he was born with spastic diplegia, a form of cerebral palsy that affects muscle control, reflex and coordination in his legs. Kipp is as humble as he is ambitious and keen to say how grateful he is to his sponsors, including Schoen Clinic for the support and encouragement they’ve given him in his career and also to the NHS. Although not a degenerative condition, his childhood diagnosis of cerebral palsy has meant Kipp had over ten surgeries to cut and lengthen the bilateral muscles in his legs and enable him to place his heels down fully; two of these took place before his 8th birthday. He describes how his parents, his mother a GP and father a urological surgeon at Guy’s and St Thomas’, first realised he was having difficulty walking. “I was born 10 weeks premature and it wasn’t until I was 3 that I began learning to walk. I was on the beach and they noticed only toe prints in the sand – not the whole foot imprint, that was when they realised, I was walking only on my toes and I couldn’t put my heel down fully.” Kipp who has three younger siblings, spent many childhood years learning pain management and wearing leg casts during the night to help with ankle inflection. Most of his surgeries and protracted recuperation took place during the school summer holidays, leaving him out of action for 4-6 months at a time. He endured his two biggest surgeries between the ages of 16 and 18 when he underwent foot reconstruction. Schoen Clinic are proud sponsors of Kipp Schoen Clinic UK’s Managing Director Andy Davey says “Kipp is an inspirational young man and a talented golfer. To win the G4D British Masters is an incredible achievement and we’re behind him all the way in the Porsche European Open. Good luck Kipp!” When asked about his aspirations Kipp says he’s always wanted to be a pro golfer. He describes how as a child, he used to watch golfing videos with his father and how he could hit a golf ball from the moment he could walk. He tried all sports as a child but always came back to golf. He describes his tough mental mindset as genetic, “both my parents worked extremely hard but were never pushy with me. When I didn’t get picked for sports teams at school, I saw that as a challenge.” Kipp’s aspirations increased after the tragic death of his cousin and good friend, rugby league player, Archie Bruce, in 2019, aged just 20. Kipp says: “I decided then that I wanted to achieve something, for him. I’m self-motivated and I aspire one day to represent my country in the Paralympics and turn full-time professional in able-bodied golf, it’s my ambition to bridge the gap between able-bodied and disability sport." The next G4D (Golf for the Disabled) Tour event will took place from 30th-31st May with G4D @ Porsche European Open at Green Eagle Golf Courses in Hamburg, Germany, with further events taking place in the Republic of Ireland, Northern Ireland, England, Spain and Dubai in 2022. Watch the highlights from G4D on YouTube now. Show your support for Kipp by following his journey on Instagram .

Depression can be such an isolating and lonely disorder to experience, but with more than 264 million people affected *  worldwide, it's a very common illness. With the right treatment, it is possible to recover from depression and our Specialists are here to help. 18 months after being discharged from treatment at Schoen Clinic Chelsea, Robin looks back on his journey and explains how Dr Woolley, along with the team at Chelsea, helped him to change his outlook for the better. I have a long history of recurrent depressive episodes, and over the last twenty years I have seen a variety of people to try and help me find coping strategies – and perhaps even solutions – for my struggles.  Over the years I've seen Psychiatrists, engaged in hours of talking therapy and have even endured electroconvulsive therapy – I found temporary relief but depression always found me again. I have Parkinson's Disease, which has a bearing on my mental health but, nevertheless, I needed to find a lasting way to cope with the severe moods which were impacting every part of my life, from my work to my homelife.  When I met Dr Woolley, I was very much in negative mindset where I'd virtually written off any hope for positive progress. I think it's fair to say that by this point I was very cynical when it came to doctors. Due to the number of doctors and therapists I'd seen and variety of methods I'd tried. I'd lost all confidence in new medications, or claims of a cure.  However, Dr Woolley didn't give me any outlandish promises, and made it clear that the hard work started now. He suggested that we try treatment sessions at Schoen Clinic Chelsea, where I join group therapy sessions and even yoga classes. Both of these ideas thoroughly pushed me out of my comfort zone – a man of my age practising yoga seemed absurd – but Dr Woolley's caring nature really made me believe he was on my side, and he persuaded me to give both activities a go. I can honestly say that I've had the best treatment of my life at the clinic.  Every single person who works at Schoen Clinic Chelsea has such a caring and patient attitude, and contributes to the non-judgemental atmosphere. The environment itself is very peaceful and friendly, and is a stark contrast to some of the other facilities I have visited over the years. The clinic isn't institutional – it's fresh and welcoming, with the staff to match.  Before I started at the clinic, during episodes of depression and anxiety, I would become very isolated with feelings of hopelessness and pointlessness. I would drop out of social contact, and marital life became very difficult for both me and my wife. In the past I had mostly not responded to one-on-one psychological therapy, and was despondent about antidepressants, having been on a number over the years. Dr Woolley put together an intensive group program, which was very helpful in reducing isolation, stigma and engendering a greater sense of optimism. The session sizes were small, which suited me very well. They enabled us to bounce ideas off other people, and discover that I’m not alone in my problems.   The sessions, combined with more intensive medication approaches, meant we managed to avoid an inpatient admission, which had been a feature of my previous history and I recovered sufficiently to resume my very active lifestyle.  It’s almost 18 months since I was discharged from treatment sessions at Schoen Clinic Chelsea and I still see Dr Woolley every six months to keep me ticking over. I don't think it's any exaggeration to say that Dr Woolley saved me at a time in my life where I was both desperate for, and despondent about, help. I now regularly see my grandchildren, and my wife and I are greatly looking forward to a trip to America to see my son get married.  Throughout this difficult journey with depression, my wife has been my rock and greatest comfort. The care I received at Schoen Clinic Chelsea, complemented by my wife’s support, has meant that I truly feel the happiest and most stable I have for many years, and I’ve got Dr Woolley and his team to thank. - Robin. Key facts about depression Depression is a common mental disorder. Globally, more than 264 million people of all ages suffer from depression. Depression doesn't always have a "good" reason. The chemicals responsible for mood control in the brain may be out of balance, leaving you depressed with seemingly no reason to be. Depression is a leading cause of disability worldwide and is a major contributor to the overall global burden of disease. Depression is more than just ordinary sadness. Anyone of any age can be affected by depression. More women are affected by depression than men. Depression can lead to suicide. There are effective psychological and pharmacological treatments for moderate and severe depression. If you or a loved one are struggling with an anxiety or mood disorder, contact our caring team at Schoen Clinic Chelsea today on 0203 146 2300 or email che-privateenquiries@schoen-clinic.co.uk . *At Robin's request, the images used in his story are of an actor and are for reference purposes only.  * GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. (2018). Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet. DOI.

Everyone deserves help when they need it. Emily began to notice her eating disorder developing in the lead up to her GCSE exams. It gradually got worse through the exam period and continued into her first year at sixth form college as a way for her to have a sense of control. When she realised how much her eating disorder had been limiting her, she decided to seek help and came to the Specialists at Schoen Clinic Chelsea to help her get into recovery and on track for the future. Emily shares her first-hand experience here. Hi everyone,  I was a little unsure of how to start this letter. I spent rather a long time thinking about how to begin, trying to make sure I wouldn’t say the wrong thing. But I came to the conclusion that the best option was simply to be honest. To be honest about why I came to Schoen Clinic Chelsea, to be honest about my experiences here, but also to be completely and utterly honest about how my life has changed in the past 2 years.  I joined Schoen Clinic Chelsea as an outpatient a little under two years ago.  When my treatment first began, the only thing I remember is feeling as if I didn’t deserve or need help. I kept telling myself that I was ‘fine’, and that by receiving help I was taking an opportunity away from someone else who truly deserved treatment. It was a toxic mindset, and if any of this sounds familiar, then I just want to emphasise to you, that you do deserve support. Mental illness does not discriminate. You deserve to live a life that doesn’t revolve around food. I never truly recognised how limiting having an eating disorder was, until I finally began to break away from it.                I’m not going to go into detail, but I began to struggle with my mental health just before by GCSEs began. Initially, my relationship with food was a way to deal with my anxiety and stress in the run-up to exams. I was a perfectionist, I felt the insatiable need to control every minuscule detail and ultimately, I couldn’t do that with the exams. I couldn’t control what was in the papers, but I could control my food. It carried on throughout the exam season, through the summer and into my next academic year when I began sixth form. Despite being overjoyed with the grades I had achieved in my GCSEs, my relationship with food spiralled until I ended up at the Schoen Clinic.  I didn’t want to receive help. Yes, there was that thought that other people were much sicker than me, but I was also terrified of what recovery would mean. I not only didn’t see the issue with how I was living my life, but I was completely desperate for it not to change. No matter how miserable my eating disorder made me, I felt that it had become a part of me – I thought it was my entire personality.  It is only now that I realise my eating disorder was not truly who I was. My eating disorder destroyed my self-confidence, it alienated me from my friendships and embedded a deep sense of guilt and shame within me. I was so desperate to keep that pretence of me being ‘fine’ at school that the moment I came home, I simply wasn’t a very nice person. Through starving myself I was unable to rationalise, I became aggressive, intolerant and someone who just didn’t want to carry on anymore. Everybody’s experiences leading up to, and during treatment is different. For me, it wasn’t just learning to perceive food in a different way, but I needed to confront my obsessive perfectionism and the overwhelming anxiety I suffered with. Through working with dieticians who helped dispel my incorrect beliefs surrounding food; also an occupational therapist where I learnt techniques using RODBT (Radically Open Dialectical Behaviour Therapy - it sounds a lot scarier than it really is!), I began to make steady progress. I also joined the ‘Good Enough Group’ at the clinic where I began to confront and challenge the perfectionist control methods that had become embedded into my daily routines. But I was frustrated that I wasn’t recovering as quickly as I had hoped. At that moment, I don’t think I quite realised that recovery wasn’t going to happen overnight. It isn’t a steady or an easy process. I had days, and still do have days, where I struggle.  I made a decision on my 17th Birthday that I couldn’t continue with the way I was going. This is by no means the same process as others go through, but I do believe that at some point you have to consciously fight to get better. With the immense support of my family and everyone at Schoen, I began to challenge myself more and more every day.  It does take time, you continually have to work at it, and you continually have to put the techniques and advice that you will receive into practice. But I promise you, it is 100% worth it. Before I joined Schoen Clinic, I was ready to not go back to school. I was prepared to throw away everything I had worked for. But I am so happy I didn’t. When you’re in that toxic mindset, recovery or even just enjoying food again seems impossible. It seems like a very long and very dark tunnel from which you never quite reach the end. But I am proof that there is a light at the end of the tunnel. I have been able to slowly but surely break free from the restrictions that food imposed on me and every little battle I fought, even when every now and then I would lose a battle, I knew I was making progress. I knew that each time I challenged myself, I was taking a step closer to finally feeling, and being liberated from the prison that my eating disorder was.  In one of my last sessions with my wonderful therapist, we spoke about some of the changes I had made in the last couple of years. Although a lot is different (most of it only possible because of the amazing work of those at Schoen Clinic) the most important change for me was that I had regained my smile.  As I write this, I am about to finish my final year at school. I am taking a gap year where I will go explore the world before I come back home to study International Relations at university. All those statements are things that two years ago I was ready to give up on, that I was sure I would no longer be able to achieve.  I urge you every day to fight for your recovery.  I know this little overview may just be words on a page. Whatever you’re thinking right now, whatever emotions are dominating you, I want you to know that I was sitting in an incredibly similar position not so long ago. And now, although I still have my bad days, I am happy and content. I never thought I would be able to reclaim my life in the way I have.  Just give it your best shot. Do everything you can to beat this. You might feel like you can’t, or maybe you don’t want to start the recovery process. But please try. It is the best decision I have ever made. And one that I choose to make again and again every single day. It really is worth it. Please make the decision to recover. With all the best of luck in the world.  Emily  If you or a loved one are struggling with an eating disorder, contact our caring team at Schoen Clinic Chelsea today on 0203 146 2300. Learn more about our highly specialised treatments for children and young people with eating disorders in London.