Ask Dr Mel: Behavioural therapy and twitching eyelids

Every week we bring you expert advice from Woman's Weekly's health expert Dr Melanie Wynne-Jones, a GP from Stockport with 26 years' experience. This week she answers questions on having a dry mouth and vaginal contraception.

Q. My GP has suggested online cognitive behavioural therapy (CBT) instead of a therapist - will it be as effective?


A. CBT is a practical treatment for anxiety and low mood, as it helps us to understand and change our thoughts (cognition) and reactions (behaviour). CBT helps you to consider other explanations for, and reactions to, upsetting situations, and is particularly helpful if you don't want to focus too deeply on past events. For example, if someone looks at us, we may feel silently criticised, when it's quite possible the other person is admiring what we're wearing, or hasn't really noticed us at all!

Although more therapists are being trained, NHS waiting lists are still long, so some Primary Health Care Trusts are offering CBT online, through libraries, for example. Recent UK research has found that recovery rates after eight months were around 50 per cent higher in people with depression who were treated with online CBT, instead of going on a waiting list.

You may find that a real therapist motivates you better, provides more personalised feedback or uncovers issues that might be better treated in other ways. But if online CBT is available free, and your GP thinks that it could help, I believe it's certainly worth a try.

Q. My eyelid often twitches repeatedly. It's really annoying, but should I be worried?

A. Repeated muscle twitches or involuntary movements like this are called tics; they usually occur in the face or shoulders, and may even affect the voice, producing an audible noise. They're often preceded by discomfort or odd sensations in the muscle, and can get worse if you're feeling stressed or tired, but disappear during sleep.

A single tic, which doesn't happen very often, is probably just one of those things, and you may find that you can learn to ignore or partially suppress it. However, it could be related to increased muscle tension around the eyes, so I suggest you have an eye test if you haven't had one recently.

But see your GP if it keeps happening, especially if other muscles are twitching, too. Very occasionally, tics can be due to conditions that affect the muscles or the nerves that control them, especially in children (for example, Tourette syndrome). Drugs that regulate nerve impulses, such as clonidine, risperidone or even botox can be used to control severe tics, but I think it's unlikely that you'll need any treatment.

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