I offer psychotherapy, counselling, and psychoeducation sessions for individuals and their families affected by mental health issues associated with cognitive impairments stemming from neurodevelopmental, neurodegenerative, psychiatric, and psychological disorders.

According to the DSM-5-TR, addiction is now classified as a severe form of substance use disorder (SUD), characterised by a chronic, relapsing pattern where an individual meets 6 or more of the 11 diagnostic criteria, including loss of control, continued use despite negative consequences, and significant changes in brain reward systems. Drug misuse represents a milder form of SUD (meeting 2-3 diagnostic criteria) where substances are used in ways that cause harm or differently than prescribed, but without the severe compulsive patterns seen in addiction. The key distinction lies in severity and control: whilst misuse may be situational or periodic, addiction involves persistent inability to control substance use despite serious consequences, accompanied by significant behavioural changes and neurological alterations. The DSM-5-TR has moved away from using terms like "abuse" and "dependence," instead adopting a spectrum approach where substance use disorders are classified as mild, moderate, or severe based on the number of criteria met.

Alzheimer's disease is a specific neurodevelopmental disorder and the most common cause of dementia, characterised by progressive memory loss and cognitive decline that interferes with daily functioning, where memory impairment is positioned as the core symptom requiring a decline in memory and learning plus at least one other cognitive domain. Other types of dementia include vascular dementia (caused by reduced blood flow to the brain), Lewy body dementia (characterised by protein deposits affecting brain cell communication), frontotemporal dementia (affecting personality, behaviour, and language skills), and mixed dementia (combination of multiple types). The key distinction lies in the affected brain regions and presenting symptoms: whilst Alzheimer's typically begins with memory problems affecting the memory centres of the brain, vascular dementia often starts with planning and organisational issues, Lewy body dementia presents with visual hallucinations and movement problems, and frontotemporal dementia primarily affects personality and language. All types of dementia are progressive conditions that damage the brain, but they differ in their underlying causes, progression patterns, and initial symptoms, with Alzheimer's accounting for 60-80% of all dementia cases.

Anxiety is characterised by excessive worry and apprehensive expectations occurring more days than not for at least 6 months, accompanied by physical symptoms such as restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbance. Depression, or Major Depressive Disorder (MDD), is distinct from anxiety, though they frequently co-occur with approximately 60% of individuals experiencing symptoms of both conditions. Whilst anxiety focuses on anticipation of future concerns with muscle tension and avoidance behaviours, depression typically involves persistent feelings of sadness, loss of interest, and changes in sleep, appetite, and energy levels. The key distinction lies in their temporal focus and primary symptoms: anxiety is future-oriented with excessive worry as its core feature, whilst depression is often present-focused with depressed mood and anhedonia as central symptoms, though both conditions can be effectively treated with similar approaches including psychotherapy and medication.

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition characterised by persistent challenges in social communication and interaction across multiple contexts, along with restricted, repetitive patterns of behaviour, interests, or activities that must be present in early development. According to the DSM-5-TR, ASD symptoms must cause clinically significant impairment in social, occupational, or other important areas of functioning, with deficits ranging from social-emotional reciprocity issues to difficulties with nonverbal communication and developing/maintaining relationships. The condition exists on a spectrum, with varying levels of severity and support needs, and may be accompanied by intellectual impairment, language impairment, or other comorbid conditions. Whilst previously separated into distinct diagnoses (like Asperger's syndrome), the DSM-5-TR now conceptualises autism as a single spectrum disorder with different levels of support needs, recognising that symptoms can manifest differently across individuals and may not be fully apparent until social demands exceed limited capacities.

Bipolar disorder is a complex brain condition characterised by extreme fluctuations in mood, energy, and ability to function, where individuals experience periods of mania (extreme highs) and depression (extreme lows). According to the DSM-5-TR, there are three main types: Bipolar I (requiring at least one manic episode lasting a week or more), Bipolar II (involving hypomanic episodes and major depressive episodes), and Cyclothymic disorder (featuring brief episodes of hypomania and depression). A manic episode is characterised by elevated or irritable mood, inflated self-esteem, decreased need for sleep, racing thoughts, and increased goal-directed activity, whilst depressive episodes involve persistent sadness, loss of interest, changes in appetite or sleep, and potentially suicidal thoughts. The condition affects up to 2.5% of the population and often requires careful differential diagnosis to distinguish it from other psychiatric conditions, particularly when evaluating whether mood episodes are superimposed on or better explained by other psychiatric disorders.

Borderline Personality Disorder (BPD) is a complex mental health condition characterised by a pervasive pattern of instability in interpersonal relationships, self-image, and affects, along with marked impulsivity beginning by early adulthood. According to the DSM-5-TR, diagnosis requires at least five symptoms from a set of criteria including fear of abandonment, unstable relationships, identity disturbance, impulsive behaviours, recurrent suicidal behaviour or self-harm, emotional instability, chronic feelings of emptiness, inappropriate anger, and stress-related paranoid thoughts. The condition affects approximately 1.4% of the adult population, with brain structure differences, genetic predisposition, and environmental factors such as childhood trauma potentially contributing to its development. Whilst historically viewed as challenging to treat, evidence-based treatments like Dialectical Behaviour Therapy (DBT) and Cognitive Behavioural Therapy (CBT) have shown significant effectiveness in helping individuals manage symptoms and improve their quality of life.

Based on the DSM-5-TR, children's sleep disorders are classified as sleep-wake disorders, with insomnia being particularly common, where symptoms may manifest uniquely in children such as difficulty initiating sleep without caregiver intervention. Sleep difficulties in children often present as bedtime resistance, frequent night wakings, and early morning awakenings, which must occur at least three times per week for at least three months to meet diagnostic criteria. Non-rapid eye movement (NREM) sleep arousal disorders are especially prevalent in children, with sleepwalking affecting between 6.9-29.2% of children and sleep terrors being particularly common in very young children (affecting about 37% at 18 months of age and 20% at 30 months). Sleep issues in children can significantly impact their daytime functioning, including behavioural problems, academic performance, and emotional regulation, requiring careful assessment to distinguish between normal developmental variations and clinically significant sleep disorders.

Dyscalculia is a specific learning disorder that affects approximately 3-7% of the population, characterised by persistent difficulties in processing numbers, learning arithmetic facts, performing accurate calculations, and mathematical reasoning that significantly impacts daily functioning. According to the DSM-5-TR, symptoms must persist for at least six months despite intervention, with mathematical skills substantially below those expected for the individual's age, causing significant interference with academic performance, occupational activities, or daily living. The condition often co-occurs with other disorders, including ADHD, dyslexia, and anxiety, with individuals frequently experiencing emotional difficulties when faced with mathematical tasks. Whilst there is no single cause identified, research suggests that dyscalculia involves differences in brain development affecting areas responsible for number processing, with evidence indicating genetic factors may play a role, though the condition is treatable through specialised interventions, particularly when identified early.

Dysgraphia is recognised in the DSM-5 as a specific learning disorder with impairment in written expression, characterised by persistent difficulties in the acquisition and use of writing skills, particularly in handwriting, spelling, and written expression. According to diagnostic criteria, symptoms must persist for at least six months despite intervention, with writing skills substantially below those expected for the individual's age, causing significant interference with academic performance or daily activities. The condition manifests in three main types: linguistic dysgraphia (affecting spelling and word retrieval), motor dysgraphia (involving fine motor skills and muscle control), and spatial dysgraphia (affecting spatial awareness in writing). Whilst affecting approximately 5-20% of the population, dysgraphia often co-occurs with other neurodevelopmental disorders such as ADHD, dyslexia, or developmental coordination disorder, and requires comprehensive evaluation by specialists including psychologists and occupational therapists for proper diagnosis and intervention.

Dyslexia is recognised in the DSM-5-TR as a specific learning disorder with impairment in reading, characterised by persistent difficulties with accurate and/or fluent word recognition, poor decoding abilities, and spelling problems. The condition is neurobiological in origin, affecting approximately 5-17% of the population, with difficulties typically resulting from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities. According to diagnostic criteria, symptoms must persist for at least six months despite intervention, with reading skills substantially below those expected for the individual's age, causing significant interference with academic performance or daily activities. The condition can manifest in two primary forms: difficulties with decoding (classic dyslexia) and difficulties with comprehension (reading comprehension impairment), with each type requiring different treatment approaches and potentially co-occurring with other disorders such as ADHD or language impairments.

Healthy child development is characterized by predictable patterns of physical, cognitive, social, and emotional growth that occur in a sequential manner across distinct developmental stages. According to established developmental frameworks, children should achieve specific milestones within expected age ranges, including motor skills, language acquisition, social interaction abilities, and emotional regulation capacities. The DSM-5-TR emphasizes that healthy development involves the successful mastery of age-appropriate tasks while maintaining flexibility in adaptation to environmental demands, with development occurring within the context of family, cultural, and social systems. Importantly, while there is a typical range for reaching developmental milestones, individual variation is normal, and development should be assessed holistically, considering multiple domains of functioning and the child's unique environmental and biological factors.

Hoarding Disorder is a distinct mental health condition characterised by persistent difficulty discarding or parting with possessions, regardless of their actual value, due to a perceived need to save items and distress associated with discarding them. According to the DSM-5-TR, the condition results in the accumulation of possessions that congest and clutter active living areas, substantially compromising their intended use, and causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. The disorder affects approximately 2.6% of the population, with higher rates among people over 60 years old and those with other psychiatric diagnoses, particularly anxiety and depression. Hoarding typically begins during adolescence and gradually worsens with age, causing significant issues by the mid-30s, with symptoms often triggered by stressful or traumatic events, and requires careful differential diagnosis to distinguish it from other conditions such as OCD or autism spectrum disorder.

Major Depressive Disorder (MDD) is a serious mood disorder characterised by persistent feelings of sadness, hopelessness, and loss of interest in activities, affecting approximately 20.6% of adults during their lifetime. According to the DSM-5-TR, diagnosis requires at least five symptoms, including depressed mood or anhedonia, plus additional symptoms such as changes in sleep, appetite, energy, concentration, feelings of worthlessness, or suicidal thoughts, persisting for at least two weeks and causing significant functional impairment. Most lifetime MDD cases are classified as moderate (39.7%) or severe (49.5%), with the condition being more prevalent in women than men and often accompanied by other psychiatric disorders, particularly anxiety and substance use disorders. The condition requires careful differential diagnosis to rule out bipolar disorder, substance-induced depression, or medical conditions, and whilst approximately 70% of individuals receive some form of treatment, MDD remains one of the leading causes of disability worldwide.

Mental well-being encompasses multiple dimensions, with self-esteem and confidence being key components that reflect one's overall psychological health and ability to cope with life's challenges. Burnout, whilst not classified as a distinct mental disorder in the DSM-5-TR, is characterised by three main dimensions: emotional exhaustion, depersonalisation (or cynicism), and reduced personal accomplishment, typically resulting from chronic occupational stress. Self-esteem and confidence can be significantly impacted by burnout, with research showing that prolonged stress and burnout can lead to decreased personal accomplishment, increased anxiety and depression, and deteriorating mental well-being. The condition can manifest through physical and psychological symptoms, including exhaustion, reduced performance, negative attitudes, and loss of interest, potentially leading to more serious mental health issues if left unaddressed.

Mild Cognitive Impairment (MCI), now termed as mild neurocognitive disorder in DSM-5-TR, is a condition characterised by cognitive decline that goes beyond normal age-related changes but is not severe enough to significantly interfere with daily activities. The condition typically appears in adults 65 or older and can present in two main forms: amnestic MCI (primarily affecting memory) and non-amnestic MCI (affecting other cognitive domains such as language, visuospatial skills, or executive function). According to research, approximately 50% of people diagnosed with MCI progress to develop Alzheimer's disease within five years, though some cases may remain stable or even improve. Early detection is crucial as it provides opportunities for intervention, with risk factors including age, family history, and cardiovascular disease, whilst diagnosis requires comprehensive clinical assessment including neuroimaging, blood tests, and neuropsychological testing.

Obsessive-Compulsive Disorder (OCD) is a complex neuropsychiatric condition characterised by recurrent, intrusive thoughts, urges, or images (obsessions) and repetitive behaviours or mental acts (compulsions) that the individual feels driven to perform in response to the obsessions. According to the DSM-5-TR, symptoms must persist for at least one hour per day, cause significant distress or functional impairment, and not be attributable to other medical conditions or mental disorders. OCD affects approximately 2-3% of the global population, making it twice as common as schizophrenia, with higher prevalence among women in adulthood though it more commonly affects boys during childhood. The condition typically requires comprehensive treatment, with the most effective approaches being Cognitive Behavioural Therapy (particularly Exposure and Response Prevention) and/or medication (specifically serotonin reuptake inhibitors), with about 70% of patients benefitting from these first-line treatments.

Opioid Use Disorder (OUD) is a chronic condition characterised by compulsive, long-term self-administration of opioids for nonmedical purposes, affecting over 16 million people worldwide and over 2.1 million in the United States. According to the DSM-5-TR, diagnosis requires at least two of eleven specific criteria occurring within a 12-month period, including taking opioids in larger amounts than intended, unsuccessful attempts to decrease use, spending excessive time obtaining or using opioids, and experiencing withdrawal symptoms. The severity is determined by the number of criteria met: mild (2-3 criteria), moderate (4-5 criteria), or severe (6 or more criteria), with physical dependence developing rapidly due to changes in mu-opioid receptors. Treatment typically involves a comprehensive approach combining medication-assisted treatment (such as methadone) with ongoing counselling and support, which has been shown to reduce mortality by 50% and decrease drug-related crimes whilst improving social interactions.

Parenting is a complex, dynamic, and bi-directional process involving the activities, interactions, and responsibilities of providing care, love, and guidance to children from birth through adulthood. According to research, effective parenting encompasses three critical attributes: process (ongoing development and adaptation), purposive activity (deliberate actions for child-rearing), and interactions (relationships between parent and child) that promote the child's growth, development, and health. The process requires parents to develop and utilise appropriate knowledge and skills for creating, rearing, and educating children, whilst considering their cognition, emotions, attitudes, and values. Parenting serves as the primary method for child socialisation, aiming to foster children's independent decision-making, interpersonal skills, and self-regulation, ultimately promoting their development into self-actualised, productive adults.

Parkinson's disease is a progressive neurodegenerative disorder characterised by the loss of dopamine-producing neurons in the substantia nigra region of the brain, leading to both motor and non-motor symptoms. The primary motor symptoms include involuntary tremors (particularly at rest), bradykinesia (slow movement), muscle rigidity, and postural instability, whilst non-motor symptoms encompass depression, anxiety, sleep disorders, cognitive impairment, and loss of smell. The condition typically develops gradually after age 50, affecting slightly more men than women, with symptoms becoming apparent only after 60-80% of substantia nigra neurons have been lost or impaired. Whilst there is currently no cure, treatment options include medication (primarily dopamine replacement therapy), physiotherapy, occupational therapy, and in some cases brain surgery, with most people maintaining a normal or near-normal life expectancy despite the progressive nature of the disease.

Postnatal depression (PPD) is a complex mental health condition that affects approximately 10-15% of new mothers, occurring within four weeks after childbirth and characterised by persistent feelings of sadness, loss of interest in activities, and difficulties bonding with the baby. According to the DSM-5-TR, symptoms must include either depressed mood or loss of interest in daily activities, plus four associated symptoms such as appetite disturbance, sleep problems, psychomotor changes, fatigue, feelings of worthlessness, poor concentration, or suicidal thoughts. The condition differs from the temporary "baby blues" (which affects up to 75% of new mothers and resolves within 10 days postpartum) and can persist for months if untreated, potentially impacting maternal-infant attachment and child development. Treatment options include antidepressant medication, psychological interventions such as Cognitive Behavioural Therapy (CBT), and psychosocial support, with evidence showing that early intervention leads to better outcomes for both mother and child.

Prolonged Grief Disorder (PGD) is a trauma and stressor-related disorder characterised by intense yearning or longing for the deceased person and persistent preoccupation with thoughts or memories of the deceased, occurring daily for at least one month. According to the DSM-5-TR, diagnosis requires the death to have occurred at least 12 months ago for adults (six months for children and adolescents), with the individual experiencing at least three additional symptoms such as identity disruption, marked disbelief about the death, avoidance of reminders, intense emotional pain, or difficulty reintegrating into life. The condition affects approximately 7-10% of bereaved adults and 5-10% of bereaved children and adolescents, with higher risk among older adults, carers, and those with a history of depression or bipolar disorder. Whilst normal grief typically lessens over time, PGD involves persistent, disabling symptoms that significantly interfere with daily functioning, often requiring specialised treatment such as Cognitive Behavioural Therapy.

Psychological interventions for survivors of abuse and violence require trauma-informed, survivor-centred approaches that address both immediate trauma symptoms and longer-term mental health impacts. According to research, effective treatments include Cognitive Behavioural Therapy (CBT), Trauma-Focused CBT, and integrative therapies that help survivors process trauma, develop coping strategies, and address negative cognitions whilst considering the broader context of gender inequality and social stigma. For survivors of intimate partner violence and sexual abuse, psychological interventions must be tailored to address specific trauma responses including PTSD, depression, and anxiety, whilst ensuring safety and providing support for practical needs. Treatment effectiveness has been demonstrated through various modalities including individual and group therapy, with evidence showing that psychological interventions can significantly reduce PTSD symptoms, depression, and help survivors rebuild their sense of safety and self-efficacy.

Psychological trauma from maltreatment in children and adolescents is characterised by persistent patterns of emotional, cognitive, and behavioural difficulties that can significantly impact development and functioning across multiple domains. Research indicates that maltreated youth often experience post-traumatic stress disorder (PTSD), depression, anxiety, attachment disorders, and social difficulties, with these problems frequently persisting into adulthood and potentially leading to increased risks of substance abuse, self-harm, and revictimisation. The trauma can cause significant changes in brain structure and function, particularly in areas responsible for threat processing, emotion regulation, and executive control, which may persist even in the absence of overt psychopathology. Treatment approaches must be trauma-informed and developmentally appropriate, considering that traumatic experiences during childhood and adolescence can affect cognitive development, academic performance, emotional regulation, and social relationships, with evidence showing that early intervention and consistent support can improve outcomes.

Psychosis is a serious mental condition characterised by a disconnection from reality, primarily manifesting through hallucinations (false sensory experiences), delusions (fixed false beliefs), and disorganised thinking or speech. According to the DSM-5-TR, diagnosis requires the presence of at least two symptoms from a set that includes delusions, hallucinations, disorganised speech, grossly disorganised or catatonic behaviour, and negative symptoms, with at least one being either delusions, hallucinations, or disorganised speech. Treatment typically involves antipsychotic medications combined with coordinated specialty care, including psychotherapy, family support, and case management, with early intervention being crucial for better outcomes. The condition can occur as part of various disorders, including schizophrenia, schizoaffective disorder, brief psychotic disorder, or as a result of medical conditions or substance use.

Schizophrenia is a complex neuropsychiatric disorder characterised by a combination of positive symptoms (hallucinations, delusions, disorganised speech), negative symptoms (diminished emotional expression, avolition), and cognitive impairments that significantly impact daily functioning. According to the DSM-5-TR, diagnosis requires at least two of these symptoms to be present for a significant portion of time during a one-month period, with some signs of the disorder persisting for at least six months, and other medical conditions or substance use being ruled out. Treatment typically involves a combination of antipsychotic medications (either typical or atypical) to manage symptoms by altering levels of dopamine and serotonin, alongside psychosocial interventions such as Cognitive Behavioural Therapy (CBT), social skills training, and family intervention. Whilst there is no cure, early intervention and consistent treatment can significantly improve outcomes, with many individuals able to manage their symptoms effectively through a combination of medication and therapy, though most will need to continue treatment long-term.

Suicidal ideation in young children manifests as both passive thoughts (such as "I wish I was dead" or "I wish I had never been born") and active thoughts (such as expressing intent to harm oneself), with research showing that children as young as age 4-6 can understand the concept of death's permanence. According to studies, the prevalence of suicidal ideation in children under 12 is higher than previously believed, affecting approximately 7.9% of boys and 6.4% of girls, with rates being higher when children are interviewed directly rather than through parent reports. Mental health concerns, particularly ADHD and depression, along with trauma experiences and family-related problems are significant risk factors, with research indicating that children who attempt suicide are six times more likely to attempt again in adolescence. The presence of suicidal thoughts in young children requires immediate clinical attention and intervention, as studies show that most children who died by suicide had previously expressed suicidal statements, making early detection and treatment crucial for prevention.

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Transgender youth are individuals whose gender identity differs from their sex assigned at birth, with research showing that children can develop a sense of their gender identity as early as age 2-3 years. Studies indicate that approximately 1.4% of youth ages 13-17 identify as transgender, with transgender individuals being younger on average than the general population. These youth face disproportionate mental health challenges, with research showing higher rates of depression, anxiety, and suicidality compared to their cisgender peers, particularly when they lack family support or access to gender-affirming care. Evidence demonstrates that early access to gender-affirming care and support significantly improves mental health outcomes, with studies showing lower odds of depression and suicidality among youth who receive appropriate medical interventions and support.