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Mental Health Awareness Week

Mental Health Awareness Week aims to address the fact that approximately one in ten people in the UK will, at some point in their life, experience depression. Mental Health Awareness Week aims to  increase consciousness of and reduce the stigma surrounding mental health.

We are all waking up to the fact that mental health needs to be discussed openly. If you know someone who is struggling you may feel unable or unequipped to help or offer your support, causing feelings of powerlessness, frustration, confusion and anxiety. Helping someone to recognise symptoms and seek professional help involves trust, patience and understanding.

Depression isn’t the same for everyone and varies from person to person.

Indicators can include

  • Becoming withdrawn
  • Preferring to spend time alone
  • Making excuses to not see friends
  • Showing less interest in things that have previously been a source of joy
  • Problems with concentration and focus
  • Increased irritability
  • Reduced sex drive
  • Increase in anger or short temper
  • Changes in sleeping habit

The list isn’t exhaustive and everyone can have bad days or a low period in their life. Depression isn’t feeling fed up or a bit down; depression is more than this and can carry on for weeks or months.

In Mental Health Awareness Week, encouraging a friend to visit their GP is a good place to start, if they don’t have a regular GP who they feel that they can talk to, a recommended and trusted therapist is another option worth seeking out.

Therapy is a process, it offers a safe space to talk, helps with understanding where problems come from and with developing strategies and tools for feeling better. Change doesn’t happen overnight and your support may be needed during the process. Therapy isn’t a quick fix, but it does work.

Learning More

It’s worthwhile reading official NHS advice and MIND is a brilliant resource, both for those wanting to help and those suffering with depression.

Being there

This is the main thing you can do. Ask how you can help; there will be times when gentle encouragement to talk is needed and times when your friend needs solitude. You may need to remind them to take care of themselves, to eat well, exercise and get enough sleep.

Depression is very real and not something that someone can ‘snap out of’, in the same way you wouldn’t tell someone who has a broken ankle to go for a run.

The simplest way to help someone with mental health issues

It’s important not to pressure someone suffering from depression or make them feel inadequate. Ask them how they’re feeling, listen with empathy and encourage them to seek professional help, but understand that someone suffering from depression may not want to do this or even be able to.

Psychotherapy is a resource for helping those suffering from depression, so seek help if you or someone you know needs it.

 

Procrastination is good

Procrastination is good

Therapy is full of cycles, be they cycles of progress or the less helpful type.

One of the less helpful type is that stress hormones suppress the growth of new brain cells. The more stress we suffer, as well as expected anxiety or depression risk,the less brain development, the less brain development, the less adaptability….. and the more stress.

See what I mean…..?    Cycles.

 

In mice, if they are brought up in a solitary non-stimulating environment (not their natural setting) neurogenesis – the birth of new brain cells – does not occur.

If you put that mouse in a social setting with plenty of stimulus, it does.

I have seen in clients with depression that trying to get them to engage with their support network can be a challenge; this is the settled science that proves that that is an important step.

So let’s look at other ways that cycles of difficulty our clients face can be re-framed with the help of a little psychology.

Take procrastination.

The title of this piece, procrastination is good might seem the opposite of what our parents and teachers tell us.

Now let’s look at this not from the perspective of putting off the washing up for an hour while you watch X factor, but from that wider more insidious perspective of procrastination without time limits.

I find many clients get stuck here, often by that fear of not being good enough and that without time limits that shock the system into doing the task, they can get stuck in a never-ending loop that is hard for them to break out of.

But the plus side of procrastination is that is linked to creativity, not productivity but creativity.

Now don’t tell my students this – but starting early and finishing late is a sweet spot for procrastinators. It’s simple, and once again psychology proves it –

If you wait until the last minute to do something, you don’t get any new ideas, not enough time for creative thinking. If you finish too quickly, again original thought is lost.

By starting early and finishing late, you get the maximum opportunity for original thought and creativity.

Give yourself time to be creative…

Procrastinate just enough…

…find your perfect level.

Anxious thoughts

Anxious thoughts can be a problem when self-reflection gets out of hand and becomes negative rumination.

As a health professional I accept that the Mental Health Foundation place this issue as a cause of anxiety and depression.

In 2013 the University of Liverpool published a study that  said that rumination (a word for constant repetitive thinking or dwelling that comes from the action in cows of chewing the cud) far from being a player in the most common mental health issues, is the largest predictor.

So what does this mean for us? It means that when we dwell on things, not only do our thoughts tend to spiral downwards but that can lead us to poor mental health.

This will come as no surprise to therapists, but the extent may. Most therapists see the link between persistent negative thought and self-blame and anxiety and depression, but as a causative factor?

It also means that psychological issues can lead to problems at a mental health level. Replaying thoughts over and over again makes us sad and anxious.

There is also evidence that rumination is at play in OCD and eating disorders, in fact anywhere our negative thoughts are stuck on repeat, we find the potential for problems.

So… what can we do about it?

Well firstly, we can learn to relax. Relaxation is often the key in early therapy to opening up the space into which the client can grow and change can be made.

Think about the amount of time that anxious thoughts or worried thoughts take up, or as some say, the amount of space they rent in your head. With all that time and energy freed up, what would you be able to do?

After that, we can look at the sense of threat that generally underpins anxiety, often being able to identify that threat can help us move forward to explore it and perhaps re-frame it or find ways to cope with it.

Please don’t think that anxious thoughts, constant thought repetition or rumination are something that you have to ‘put up with’ or suffer. If you need help to overcome these patterns, then please reach out to a professional.

 

 

Tinnitus relief

Tinnitus relief is a subject close to my heart and one that I am passionate about.

This week I have been invited to present and advise again at the Bolton Tinnitus Support Group which is a truly wonderful organisation. They help tinnitus sufferers to cope with the symptoms and the difficulties that often come along with the diagnosis.

It will be no surprise that people with tinnitus can get anxious and depressed, but it may be a surprise to know that these three issues can be chicken and egg. One thing is certain though, that tinnitus is a subjective issue which is sensitive to mood.

It’s similar to pain in that way, a subjective perception which is worse at some times and less so at others. Often when the person is distracted or absorbed (what psychology calls ‘flow state’) then the symptoms are less noticeable.

In therapy we can access states of relaxation which we call ‘resource states’. When someone is relaxed, they can’t be anxious at the same time so accessing such a state of relaxed being is an early aim of tinnitus relief.

After that, then ‘anchoring’ the resource state can allow the person to bring on that feeling of relaxation when needed by triggering a subconscious memory of it. In times of stress, this is an empowering tool for the client.

It’s often about learning to manage the symptoms and that has behavioural elements of environment and thought as well as wider elements of meaning and perception.

All of these layers of the onion, we can work on peeling in the therapy room, working towards finding your peace.

The feeling of being worn down by the tinnitus is something I also often hear and this is what can lead to low mood. Again, in therapy relief can be gained by re-framing and building emotional resilience.

If you want to discuss further then, please contact me from my website Talking-Cure

Money worries

Money worries and financial insecurity are another often hidden issue. There can be links to self-esteem and the need to be very careful about how money is spent.

While this is a different situation to someone who may have heavy debts or spend too much, it is still an issue. I see in clients that often anxiety can stretch to include worrying about security or even begin there. Constant checking, planning and looking to the future.

The fear of losing a job.

Many people see money as security but it can also be many other things.

Money can be a reward, a replacement for love, a punishment, a tool to inflict pain, the list goes on….

It’s also important to realise that how we feel in relation to money can have nothing to do with how much we have in the bank. Some very wealthy people can concern themselves with money, money, money.

Decisions about money can also cause anxiety, and therefore add to it. It can be a battleground in the mind that is constant, which is the right way to go? Can I spend on this treat?

Sometimes the opposite, ‘I deserve it’ and then regret buying it afterwards.

Viktor Frankl saw the will to money as a basic form of the will to power, caused by an existential vacuum.

We live in a society that sees shopping as a form of therapy, but is it…?

Often money worries as a source of anxiety and depression go unspoken. Sufferers don’t tell partners, parents, GPs and the worry is turned inward which increases the sense of isolation and stress.

All I suggest is that we don’t discount money from the discussion about anxious thinking and suffering.

The ‘if I win the lottery’ fantasy keeps clients deeply rooted in the future, ignoring the mindfulness of today.

In therapy, we can look at what money means to you, and then start to look at what the threat is that is driving the anxiety. Re-framing is very important, challenging the rigid black and white thinking.

Most importantly, let’s not let money worries become money anxiety…

 

Gambling addiction Bolton

Gambling addiction Bolton people will be sad to know, now affects a quarter of the young male population. This is the finding of a study from the University of Bristol into men aged eighteen to twenty-four.

There was a higher likelihood of problems in those with depression or addictions to drugs or alcohol.

High  levels of being exposed to gambling in this generation (which is the first to have grown up with internet gambling) are thought to have led to the issue.

Unlike smoking or addiction to other substances, gambling addiction is more likely to cause mental health issues. There is also, worryingly a link to depression and anxiety.

A Royal College of Psychiatrists spokesperson has called for GPs to be aware of gambling addiction as a possibility in patients presenting with addiction problems and low mood.

So do I see clients with this problem? Yes, and are they mainly young men, again yes.

Whilst it’s a little early to call for a gambling addiction Bolton specific survey, if Bristol has this problem… Then so does much of the rest of the country.

Using hypnotherapy and psychotherapy the compulsion to gamble can be treated as can other addictions like online addiction. Internet addiction can also be linked to gambling addiction because we gamble more and more online.

Of the clients I see, there is a mixed bag of online and high street betting but smartphones have led to much easier access and therefore to almost 24 hour exposure in some cases.

There are also self-esteem and anxiety issues alongside gambling. Sometimes the need to ‘win back’ the money and the failure to do so directly affect the person’s self-image.

So , let’s be aware of the possibility of this issue in friends, family and loved ones. It’s another of those issues that can be viewed as shameful and hidden.

There is no need to hide it, let’s deal with it and improve our lives.

Future Anxiety

Future Anxiety – do you live in the future?

I do. Sometimes. We all do, sometimes.

I used to live there much more, with all of the things I would have as well as all the places I would visit, the houses I would live in. There was a big long list in my head. 

I was very ambitious; I still am truth be told, but I had a slowly dawning realisation that I was almost solely focused on the future.

What I would do there? What things would I have there? 

The more plans I made and goals I set, I realised that my overall feeling was future anxiety:

This is future anxiety – ‘Today, this hour, this minute, is not good enough. I have none of the things I want and am working towards, therefore I’m not happy. Also I won’t be happy until I achieve a long (and possibly never ending) list of ‘wants’

You can see that I was blind to everything that I already have.

Can we be happy with what we already have?

Making a conscious effort in addition to realise just how beautiful life already is, bringing awareness to the ‘little things’ helped me become happier.

Five Minutes to Happiness” (Maxwell Maltz) was first published in 1962. A book written to help us learn the art of being happy.

Since then, many pages have been written about how we can be happier.  

The main gist is focusing on the good stuff, appreciating that which you have and being grateful for it. 

Making a list of just five things you’re grateful for may seem an odd way to help future anxiety. It’s not about what’s on the list, don’t judge yourself. It could be chocolate ice-cream, it could also be knowing that you’re family is fit and well. 

Just come up with five things

A nice meal maybe – it might’ve been a great salad or an enormous burger- remember not to judge.

No rain today.

Walking through the park first thing this morning perhaps.

Meeting a friend, for a particularly great cup of coffee.

Your health – even if you have a bad cold, perhaps you can be grateful that it’s not worse!

In addition, studies have shown that after making a nightly list for just one week happiness grows.

By doing this small, simple exercise you are retraining your brain to notice the good things, the positives. 

You start to look out for them as well as register them when they happen. 

Then you can enjoy and appreciate them all over again when you add them to your list. 

Caffeine panic

Caffeine panic – about 10 years ago now I cut caffeine from my diet.

Apart from a three day headache there seemed little effect at the time but I did it because I believed it would make things calmer in the long run, and on reflection, it did.

Although I can’t remember the hour or the day things felt different, they do.

It’s conspicuous by its absence caffeine.

Most people ingest a couple of hundred milligrams of this stimulant each day. The jury is out on what are the best levels, but as with many things, I think it depends on the individual.

For the anxious, it can make things a lot worse, and the anxious individual’s sensitivity is heightened.

This happens because caffeine mimics panic symptoms, it can make you jittery, nervous, filled with dread, irritable and restless. Caffeine can actually induce panic attacks.

Caffeine panic – It was this feeling of empty uneasiness and restlessness that I wondered about, and what had been causing it.

That’s the feeling that years later I no longer carry around with me.

Some symptoms of a Panic Attack include sweating, fast or irregular heartbeat, difficulty breathing, digestive issues. Also, it can bring on a feeling of dread, unreality, pins and needles, even chest pain. (APA, 2014)

Guess what? Caffeine can cause fast or irregular heartbeat, diarrhoea, racing thoughts, fast breathing, nausea, sweating… you get the picture, I’m sure.

Caffeine stimulates the central nervous system, the most commonly used psychoactive drug in the world. This is why we pay so much for it in Starbucks. It makes you alert, keeps you awake.

It can be natural or synthetic and is found in some unlikely foods and drinks, so if you are worried about caffeine panic and are anxious, then perhaps look at your consumption of chocolate, coffee, cola, tea and medicines and start to see where it is (Lucozade anyone?).

Are you struggling with anxiety, panic or stress levels?

Maybe have a look at whether that pick-me-up little helper is actually a part of the issue

 

Perfectionism or excellence

Perfectionism or excellence, that is the question….

Perfectionism or excellence is a choice.

While perfectionism can drive you towards fantastic achievements. Perfectionism can help to provide you with the motivation to keep going until you attain your goal:
Giving the perfect presentation
Doing the perfect job
Baking the perfect birthday cake
Perfectionism can really help you sustain the energy levels you need to reach your own personal challenge.

But pressure and anxiety all build when you try to be the perfect person.

Perfectionism is within you and therefore under your control.
Striving for perfectionism within yourself can lead to anxiety as you try to live up to your own expectations or how you perceive others’ expectations of you.
You will always be not quite there, not quite good enough, simply because the perfect person doesn’t exist.

Cakes, jobs and presentations are all measurable, people aren’t.

People make mistakes
People have imperfections

It’s part of what makes us human. Mistakes help us to learn.

Perfectionism, pressure, anxiety can take an enormous toll on you and your life in general.

You fear success because of the fear of maintaining success.
Fearing mistakes can be due to the fear of losing respect from others as well as yourself.
Fear of failure can mean that you never set yourself goals. Or setting goals so high as to be unattainable.
Being constantly aware and reminding yourself of your weaknesses, imperfections and failures.

Be Excellent Instead Of Perfect
Improving yourself can be an enjoyable journey.
Being great at something is an enormous achievement.
Take yourself (and life) a little less seriously, forgive yourself, be gentle with yourself.

Set small, achievable goals.
Reward yourself.
Be aware of the influence of social programming – social media, TV programmes, magazine articles.
Making the effort to change is an achievement in itself.
Just by being born, you literally won the race!

Therapy Ethics

 Therapy Ethics is a wide subject.

In the last post from my presentation at the NCHP conference we were talking about memory. Memory is not some ethereal concept, but is made up of specific neurons in the brain.

I work with a particularly scientific client, and  this principle opens up the idea that she is not stuck with a memory for life.

Memories change, re-frame.

Memory is malleable.

This introduces a sense of possibility and with unhelpful memories.

If things haven’t gone the way the client hoped, you’re often dealing with their attachment to how ‘it should have been’ .

Breaking the attachment to the memory (because it may not be entirely accurate) attaches the problem to the memory and not the client.

I’m not blind to the juxtaposition here with the person centred concept of self-actualisation and that the client is the expert in their problem.

I believe both these principles entirely but as with all things sometimes a perspective doesn’t work, and we need more creative solutions.

It’s strange to me too, that in therapy the idea of intervention against natural process is such a minefield

There is this idea that any sense of change in the client that they didn’t initiate themselves is somehow unethical. We do however change everything around us all the time.

We make different types of plants and foods by modification. .

It’s a complex ethical issue, and we will all have our standpoints. Putting male cells into a female body however is a different story when you’re doing it in the context of a bone marrow transplant to save someone’s life from cancer.

There always consequences to acting and there are always consequences to not doing anything.

All I am suggesting here is let’s not be hypocritical. Therapy Ethics is a lens.

Therapy Ethics are important when clients come to us as therapists to change, for us to help them change.

We work in an idiographic way of course, but change is nevertheless the brief. People will always be self-organising, adjusting to minimise discomfort but there are times when that isn’t enough on its own.

In Western medicine, we celebrate advancements and ways of changing things. One day we will beat cancer.

Will anybody be saying that we should have left that process to nature?

All I am suggesting is that we fit the methodology to the client.