Posts Tagged ‘depression’

Social media paints an unrealistic portrait of life. It’s full of pictures of people with perfect make-up who spend the whole lives drinking champagne and flossing in front of the Effiel Tower. Many of us do get the chance to do these things, of course, but most of the time we’re going to work, cleaning the kitchen or just passed out exhausted on the sofa.

The problem is that being bombarded with these images is bad for our mental health.

So, this September, Worfolk Anxiety is launching a campaign called 30 Days of Normal Life. We’re encouraging everyone to post boring pictures of their life with the hashtag #ThisIsNormalLife.

Won’t you join us in a month of making the internet a lot more dull and a little less depressing?

Below, I’ve collated a bunch of my blog posts on mental health into a list of interesting stuff to read. It’s all been published here or over on the Worfolk Anxiety blog.

Does social media damage your mental health?

In May, Royal Society for Public Health (RSPH) and Young Health Movement published a report on the impact of social media on mental health. The TL;DR is that yes, social media can be harmful. But it also has its uses, so when used in moderation, like most things in life, can be a useful tool.

Things you should know about antidepressants

This is a pretty old article now, and if I wrote it today I would probably say way more. But it highlights a few key things to think about when deciding to go down the antidepressant route or not, and more widely, what opinion you hold of them.

Things to do when you’re well, according to people with anxiety

Mental hygiene is the things you regularly do to keep yourself mentally healthy. Just like we have a daily routine for physical hygiene and dental hygiene, there are things we can do to keep our mental health on the right track. But what actually helps? We asked people who live with anxiety.

Things to tell yourself when you’re not well, according to people with anxiety

In last week’s blog post, we looked at some good things to do when you are feeling well. But what about when you are having a rough patch and can’t find the energy to do anything? What should you tell yourself?

Will suicide nets stop jumpers at the Golden Gate Bridge?

When it comes to stopping people throwing themselves off the bridge, the question is, can a one-time intervention really save lives? Turns out the answer is yes.

We don’t need more money for mental health

You regularly hear politicians talking about how the NHS needs more money for mental health. In today’s post, I want to challenge this idea and offer a very different explanation and very different solution.

What would a mental health workout look like?

If you want to improve your physical fitness, you might work out. Maybe you would eat a high protein breakfast, hit the gym, do a warm-up followed by some intervals and then take a warm bath to recover afterwards. But what about mental wellness? What would a training session look like? What specifically would you do?

Mark Manson came to fame because of his blogging and has since gone on to publish some bestselling books, including The Subtle Art of Not Giving a Fuck.

His writing style shines through his book, too. It’s engaging and entertaining. You laugh at points. You identify with all of the material. It keeps you interested.

This made me think about longevity, though. Manson’s style is entertaining partly because of all the pop culture references. But a few times, it did cross my mind that in ten years time, nobody would know what he was on about. The truth is, my memory of _Everybody Loves Raymond_ is already fading.

His storytelling is compelling. I was with him on the edge of that cliff. I felt the same feelings.

He makes some good points, too. Life is about giving a fuck about the right things, and not caring about the rest. Nobody who is happy needs to stand int front of a mirror saying positive affirmations. But I think the reason you do that is that you’re not happy. And given how often our emotions are driven by our behaviour, I don’t write it off as a useless tactic.

Given all of that great delivery, though, I am wondering how much I take away from the book. He threw so many great ideas at me that I struggled to take it all in. And, which a not very conclusive conclusion, I was a little confused by the end. I’m a simple man: I need the take-home message spelling out for me. And maybe that was the title. But I would have liked a clearer finish.

This book is an entertaining and enjoyable exploration of Manson’s philosophy. Whether it helps you, I’m not sure. But you are unlikely to feel it was time wasted.

Sane New World: Taming the Mind is a book by Ruby Wax. Wax is a well-known comedian but what you might not know is that she is also a trained therapist with a masters degree in mindfulness-based cognitive therapy.

This book is all about how to use mindfulness to solve mental health difficulties, narrated through her own struggles with depression. Her own anecdotes really add some sparkle to the book and there is a lot for anyone with depression to identify with in here and think “yes, me too!”. It’s also funny, as you would expect from a big-name comedian.

She also knows her stuff. Her round-up of what parts of the brain do what, and her round-up of the evidence for mindfulness-based therapies have both proved excellent starting points for research.

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.

The Happiness Trap is a self-help book based on ACT (acceptance and commitment therapy).

It starts with a simple but profound message. Humans are not happy to be default. They are not designed to be happy. Happiness is not required to continue the species along. So if you’re not happy with your life, that might just make you completely normal.

It puts aside things like cognitive therapy, point out that we have a lot less control over our thoughts and feelings than we would like to think. Instead it focuses on accepting negative thoughts and feelings (indeed, it claims all feelings are just feelings, rather than good and bad ones).

The techniques it teaches including connecting with the world around you and accessing the observing self. Which is a fancy way of saying mindfulness, being in the moment rather than over-thinking life.

It gives you exercises to do, and tells you off if you do not do them! I stopped reading the book for maybe two months because it said I could not continue until I had done one the exercises and I did not want to go back and do it. When I did, it turned out it was really easy. As are almost all of the exercises – they are designed for busy people. This is kind of stupid really, how can I be too busy to look after my health? But I also suspect many of us all into this trap.

The end of the book is a little more strange. It has a section about how ACT is not a religion. I know that. But stating it puts up a red flag against the book’s version of ACT (Scientology isn’t a cult remember…).

Then it talks about connecting with your values, the things you think are genuinely important in life and pursuing those. This is a good thing to do, but not something I expected in a book about managing my feelings and anxieties.

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.

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?