Posts Tagged ‘mental health’

Over at Anxiety Leeds we have some brand new promo material for the group. Not only do we have some updated flyers but we also have some brand new glossy A3 posters as well. If anyone wants some for their work, school, community centre, etc, get in touch and I can have some sent!

Reasons to Stay Alive is a book by Matt Haig about depression. He talks about his own breakdown in his twenties and how he survived it.

It’s a short read. Not only is it a short book but Haig keeps the chapters very short too. He mixes up the content. Sometimes he talks about his personal story, sometimes offers a list up and sometimes presents it as a discussion across time with his younger self.

I did not learn anything, but I did identity with a lot of the content. As such, I think for someone coming into contact with depression and anxiety for the first time, it would be a valuable read.

My mindfulness book has recommended that I do one thing a day and really concentrate on it. I decided to do my walk home. I usually listen to an audiobook on the walk to and from work, so I decided to skip one of those and ‘be mindful’. Evening made the most sense as there was more light.

Here is what I noticed:

Not thinking about things is really difficult

Like super-difficult. My mind has no off switch. It wants to think about things. They are loads of things to think about. It doesn’t even need to search for things: there are already a bunch of topics rolling around in there that need some CPU time. How is one supposed to banish it all? I suppose that is the exercise.

The world is really noisy

Cars, planes, trains, alarms. They all make loads of noise. And when you are not allowed to think about anything, you think about that. It occurs to me that train tracks properly run alongside rivers because rivers have the flattest and most consistent ascent. However, that means the one potential haven of peace and quiet in cities often has trains running alongside it. The mode of transport I passed most frequently was the canal boat: all of which were silent.

I miss my thinking time

My mind jumps from topic to topic, but I actually enjoy most of the thoughts. My walk is good imagination time. I don’t really want to experience the world. It’s Leeds. It’s cold, dark and full of ugly buildings.

I don’t feel like I usually miss anything

According to the books, people experience this great awakening about how much of life they have been missing out on. I did not experience any of that. I probably did notice things more, but nothing that was interesting or memorable. It was just the regular world that is always there.

Jon Ronson is a journalist who writes books the same way Louis Theroux makes documentaries. He goes and interviews odd people and pokes them gently but persistently until interesting stories fall out.

In his book The Psychopath Test: A Journey Through the Madness Industry he looks at what psychopathy is, how it is diagnosed (there is a checklist), what can be done about it (very little) and where you might find psychopaths. The answer to the last question is apparently prisons and CEOs.

He starts off by narcissistically whining about his own problems and anxieties. I find this annoying at first as he sounds too similar to myself for comfort, but gradually come round to it as the book goes on. He is very much a character in the story. Given a preference, I think I would opt-out of that, but it doesn’t ruin the book.

If you ever worry that you are a psychopath, then good news, that probably means you are not one. Psychopaths typically do not suffer from anxiety. However, if you want to double check, you could use the PCL-R, a checklist developed by Robert Hare.

Ronson also provides advice for psychopaths looking to avoid the media spotlight – be as boring as possible because then no journalist will want to write about you. Statically, that should be useful to just under 1% of my visitors…

Recently we were discussing antidepressants at the mental health charity I run and I thought it would be worth sharing a few points that came out of the discussion.

Antidepressants are approved by NICE

There is often a lot of scepticism around antidepressants. Irving Kirsch has a whole book about it. However, not only have the drugs been shown to work in clinical trials (I’m not sure how much faith I put in this since All Trials) they are also approved by the National Institute of Clinical Excellence. They are not immune from bias of course, but they generally don’t mess around because the NHS has a limited budget and it’s their job to make sure it is spent on stuff that works.

Antidepressants are trial and error

There are a number of different drugs on the market, some of which do different things and at different doses. These affect people in different ways. That means that what helps some people might not help others, and what gives some people side effects will be fine for others.

It also means that your prescription is trial and error. There is a good chance the first one you get prescribed will not work, either because it is the wrong drug or because you need a different dose.

That means if the first thing you try does not work, try not to get disheartened.

A side effect of antidepressants is suicide

April is suicide month sadly. More people kill themselves in April than any other month. The working theory is that the improved weather conditions provide people suffering from depression to go out and doing something. Unfortunately, this something is sometimes taking their own life.

If true, this would also explain why one of the side effects of antidepressants is suicide. Luckily the limited data available on it suggests that if you inform patients to expect these feelings and be aware of them you mitigate the risk.

Long life the termination of Jeremy Clarkson. His actions, forcing the BBC to cancel the remaining episodes of Top Gear, have bumped Louis Theroux’s new documentaries into a prime slot on Sunday evenings. Though given Theroux has a history of speaking to violent, bigoted people, maybe we can expect “When Louis Met Clarkson” to be hitting our screens soon.

Theroux’s new two parter, entitled “By Reason of Insanity”, saw him visit the Ohio State psychiatric hospital to interview people who have been found not guilty by reason of insanity, or in some cases, not fit to stand trial.

It was no wonder this was the first time they have agreed to let cameras in in 50 years. The hospital looks great. Far from the questionable standards Norah Vincent encountered in Voluntary Madness, the building is clean and new, and the facilities look reasonable. Not quite up to the standards of Norwegian prisons, but still pretty good. Of course, it is a treatment centre, not a prison, but it was still heartwarming to see good facilities and good staff to help these people.

Indeed even after conditional release there is still a lot of support. One man who had recently been released was staying at a hotel and received daily drug deliveries to ensure that he stayed on track.

As Chris Bennion points out, we know the format by now. Theroux wandering around wide-eyed and looking innocent, slowly poking people with a stick until they spill their stories. However, it’s a format that works, so why not? The documentaries are both moving and revealing, bringing attention to some of the most sensitive topics in our society.

Someone recommended the book Potatoes Not Prozac by Kathleen DesMaisons saying that it had really helped them. It describes itself as a food programme to help with depression, though what it actually turns out to be about is a guide for people who are “sugar sensitive”.

Sugar sensitivity is something that Dr MesMaisons has made up. Or discovered if you were being generous. There is nothing on Wikipedia about it. There is a stub article about sugar addiction, a topic still under research before we have any real understanding of it. However the book justifies its existence using the following phrase.

“a solution too important to wait for the approval of scientific authorities”

From there it turns to a classic self-help book that is big on claims and small on scientific references. The text is regularly interlaced with quotes from people telling the reader how good the programme is and how it has changed their lives. As long as you follow the programme to the letter of course.

It’s the classic heartwarming story – an underdog doctor without the backing of the scientific community dares to go it alone because she has seen it work for hundreds of people. She has developed a simple programme that offers quick results without pharmaceutical. It’s all our dreams come true. In fact, it’s so simple that 9 of the 256 pages can be devoted to a copy and paste of an internet chat in which people on the programme describe how they felt before and after it.

Helpfully there are also lots of references to the Radiant Recovery programme that MesMaisons runs, including which of the products you might want to buy. But who am I to say that George’s Shake® isn’t as delicious as claimed? Maybe it is. With sugar sensitivity being linked to alcoholism, there are also some references to Alcoholics Anonymous. Another programme that can boast of having no evidence of efficacy.

The programme starts by encouraging you to eat breakfast and have some protein in it. One of the example meals is a sausage. Of co,urse eating processed meat every day will literally take years off your life (the scientific authorities have had time to approve that), but if it improves your quality of life, that is a trade off you might feel is worth making.

There is probably some good stuff in here. Eating sensible meals three times a day in some kind of routine is going to provide your life some structure and normality. The rest remains an unknown though. Perhaps it will eventually be scientifically proven. However, as it is I cannot see the evidence nor it is packaged in a way that I can describe any other way than yet another cultish self-help book.

After writing her book Self-Made Man, Norah Vincent found herself struggling psychologically. So she checked herself into a psychiatric hospital, whereupon she got her next idea for a book. The result is “Voluntary Madness: My Year Lost and Found in the Loony Bin”.

In the book she checks herself into three different hospitals – a downtown public one named Meriwether, a private Catholic facility named St Luke’s, and an alternative therapy centre named Mobius.

She has no problems getting in. As she says, you can only look back and see the mental health problem. This is exactly the feature Daniel Kahneman talks about in Thinking, Fast and Slow. Staff at psychiatric hospital (or indeed anyone, but you would expect these people to be able to) cannot tell the difference between the sane and in the insane. Not that there is necessarily a line between the two.

The results are rather predictable. Meriwether is a cold, clinical hellhole, St Luke’s is tolerable and Mobius comes off the best.

How much we can draw from this, I am not sure. Firstly, you have to look at clinical outcomes and Norah being a sample of one is merely an anecdote about her experience rather than data to draw any conclusions from. Secondly, Mobius only take a select band of mental health issues, and so it is difficult to compare them like-for-like.

It is difficult to compare the financial costs of them because they are all in the United States, where prices are warped by the insurance system where there is little incentive to keep costs down. However, the fact that her insurance company pulled the plug because she was allowed out for runs and not drugged up to the eyeballs speak quite poorly of the US system. It would be interesting to read a similar book looking at British hospitals to compare the differences.

There are some no-brainers that we should take away from the book. Not providing health meals, or a gym, is just stupid. There is loads of clinical evidence to suggest a healthy physical lifestyle helps with mental health too, so these things should probably be the first things you put in.

Providing fresh air, using drugs sensibly, treating people like human beings, giving them a clean bathroom and some proper therapy would all probably be helpful too. However, it would be naive to think that there are not complex social reasons why these are not always provided.

In some ways, mental health could be the most exciting area of healthcare to work in. I suggest this because a lot of the ideas mentioned above are both a) easily to implement and b) would probably improve clinical outcomes.

Improving outcomes for cancer for example is really difficult. We need to find a whole new treatment, lab test it and role it out. Cancer Research UK spends nearly half a billion pounds a year on this. In comparison, to improve some mental health outcomes, you need to buy a treadmill. They’re £150 on eBay.

Of course that is a massive over-simplification and if it really was that easy you would hope that we would have done it by now. Nevertheless, it feels like we have room to make some positive changes in mental health that are easier than with physical health. Hopefully, with increased funding and research focusing on these areas, those changes will come.

I, like many people, was saddened to hear about the apparent suicide of Robin Williams. Loved by many for his work as an actor in Aladdin, Jumanji, Dead Poets Society, Good Morning Vietnam, Patch Adams, Flubber and above all here in the UK – Mrs. Doubtfire. This is to list just a few of the films he has starred in and to say nothing of his stand-up career.

Williams death has, at least briefly, shed a light on mental health issues in the wider public consciousness. I think this is a good thing. The more light we can bring to it, the better.

However, this only has value if we can capitalise on this attention and use it to make a positive difference for society. Which is why I am going to shamelessly use this opportunity to ask you to donate to Anxiety Leeds. You only get these opportunities every so often, and my pride is definitely less important than working to prevent more people who are struggling with mental health issues trying to take their own life.

At Anxiety Leeds we run a monthly peer-support group. To be most effective, we need to move to fortnightly. We have the volunteers ready, but currently we lack the funds to do this. Can you help us?

I was recently passed an article by The Priory Group entitled “Anxiety – are you taking it serious?”

It talks about how common anxiety is and how people do not take it seriously. It then shows twenty photos of people holding up signs with messages such as “don’t be such a drama queen” and “it must be horrible being you!”.

Powerful stuff. But is it accurate? Because if it isn’t, we could be unnecessarily worrying people from being open about their issues.

It is easy to pick out a couple of anecdotes that reflect badly on a certain situation. Doing so proves nothing more than that you are entirely qualified to become a journalist for the Huffington Post. However, if you want to make an important point, I think you need to back it up with some actual statistics. How many people were surveyed? What percentage of people report a negative experience?

The reason I ask is that I do not believe the percentage would be high. I have usually found the experience of being open about anxiety a positive one. So have many people. Indeed an overwhelming majority of people who attend Anxiety Leeds have. Of course I am working of anecdotal evidence as well, but the least we can say is that do not know either way whether most people have a positive or negative experience.

How about the control group?

Further, I would argue that you need to factor in a control group.

Yes, some people might make negative comments about anxiety. However, people make negative comments about a variety of conditions. Have you tried having flu as a man? Nobody has any sympathy for you. “Oh, man flu again, poor you.” It’s horrible. I have never experienced anything like that regarding anxiety.

Okay, but why is it important?

Selecting anecdotes without publishing evidence to back it up is harmful because you cannot substantiate the claims you making. Which means they might not be true. But people might believe them anyway.

This is primarily harmful to people suffering from anxiety. Mental health is the new gay and we need people to come out about it. Publishing articles that suggest that anyone who does will be subject to ridicule and abuse will only encourage people to keep their problems suppressed.

This is bad for them and bad for society. If we want to encourage people to be open about mental health difficulties they are facing, we need to reassure them coming out is a good move.