Twenty remedies for Depression

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Depression is a very common form of mental distress.

  • 1 in 5 people will experience depression at some point during their life. (source)
  • 1 in 4 young people in the UK experience suicidal thoughts
  • Rates of depression and anxiety in teenagers have increased by 70% in the past 25 years. (source)

Debate rages around whether it is ‘just’ a chemical imbalance in the brain and can be cured with medication alone, or whether it is an extreme form of sadness which should be accepted as part of the human experience. Whatever it is, depression is a bleak and lonely landscape to inhabit. One explorer of such a landscape, who returned with some advice for keeping it at bay, was a 19th century cleric names Sydney Smith. I have always loved his clear, no-nonsense advice to a friend who was suffering from ‘low spirits’. My favourites are numbers 6, 8, 14 and 18. I’m not too sure about 2, 10 and 19. Which ones do you like?

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Sydney Smith

1. Live as well as you dare.
2. Go into the shower-bath with a small quantity of water at a temperature low enough to give you a slight sensation of cold.
3. Read amusing books.
4. Take short views of human life – not further than dinner or tea.
5. Be as busy as you can.
6. See as much as you can of those friends who like and respect you.
7. And of those acquaintances who amuse you.
8. Make no secret of low spirits to your friends, but talk of them freely – they are always worse for dignified concealment.
9. Attend to the effects tea and coffee produce upon you.
10. Don’t expect too much from human life – a sorry business at the best.
11. Compare your lot with that of other people.
12. Avoid poetry, dramatic representations (except comedy), music, serious novels, melancholy, sentimental people, everything likely to excite feeling or emotion, not ending in active benevolence.
13. Do good and endeavour to please everybody of every degree.
14th: Be as much as you can in the open air without fatigue.
15. Make the room where you commonly sit gay and pleasant.
16. Struggle little by little against idleness.
17. Don’t be too severe upon yourself, or underrate yourself, but do yourself justice.
18. Keep good blazing fires.

19th: Be firm and constant in the exercise of rational religion.
20th: Believe me, dear Lady Georgiana.

Grey: a picture book about Depression

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I just love this little book by local illustrator Hannah Broadway. Depression can be such a slippery thing to pin down and explain, and of course it is unique to everyone who experiences it. When I think of depression I tend to think of it as beige – a nothing colour. But grey works too don’t you think?

Read Grey here.

Mindfulness and the Art of Noticing

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One of the reasons that Bristol is so loved by so many is for its interesting graffiti. If you’ve been to Bristol Temple Meads train station recently, you may have noticed this piece of graffiti.*

It is so easy to go around with our eyes and ears half closed to the world around us – and I say that as someone well acquainted with mindlessness. The practice of Mindfulness is one that has been around for a long time and now seems to be everywhere –perhaps for good reason.

It’s a form of meditation, and is rooted in the Buddhist tradition. I first discovered it when I visited Plum village, a very special community near Bordeaux, founded by a Vietnamese monk called Thich Nhat Hahn. He is known as ‘Thay’ which means teacher, and people come from all over the world to hear him speak.

Put simply, Mindfulness is about paying attention: to the present moment, to the world around us and to our thoughts and feelings. It can be tempting to place all our attention onto the past or the future, so much so that we lose sight of what is in front of us. A great deal of mindfulness is about tracking or following the breath as we breathe in and out. As we do this the mind will wander. As soon we notice this, we return our attention to our breathing. It’s not about stopping or restricting our thoughts, but letting them pass by, acknowledging them without judgement, and returning to the present moment.

Very often we experience thoughts, feelings or emotions that we label ‘bad’ and that must be stopped or suppressed, and the act of fighting these emotions only makes them stronger. What if we just accepted these thoughts, without judgement, in the knowledge that they would soon pass? In Mindfulness the mind is likened to a blue sky. Sometimes this sky is obscured by clouds of thoughts, but underneath, the calm blue sky of the mind remains.

The way that we think and the thoughts themselves can cause so much stress. In Mindfulness we learnt to stand back from our thoughts and see them as mental events. They don’t define us. It’s a bit like the difference between being caught in a thunderstorm, and watching a thunderstorm through a window, from the safety of your house.

Mindfulness is simple, but needs practicing regularly – just 10 minutes a day may make a real difference to how you experience your ‘inner chatter’. Try not to get annoyed with yourself if your mind wanders. My own mind sometimes leaps around different thoughts like a circus monkey on a trapeze. It can be frustrating, but don’t give up! Why not have a go now?

Set an alarm on your phone to go off in 5 minutes.

Sit comfortable (you want to be in a comfortable position, but not so relaxed that you fall asleep) with your eyes closed.

Direct your attention to your breathing and just notice it… you don’t have to do anything else.

When thoughts, feelings, physical sensations or external sounds occur, simply accept them. Let them come and go without judging or getting involved with them.

When you notice that your attention has drifted off and is becoming caught up in thoughts or feelings, simply bring your attention back to your breathing.

You may get annoyed that you keep getting distracted, but try not to judge yourself or anything that is happening. It’s natural for thoughts to arise, and for your attention to follow them – that’s what our brains do.

No matter how many times this happens, just keep bringing your attention back to your breathing. Keep going until the alarm goes off.

The Headspace website and app is a good way to get going.

http://www.headspace.com

*It says: NOTICE. Thankyou for noticing this notice. Your noticing it has been noted.

Prince Harry on the death of his mother

Prince Harry recently spoke about the impact that the death of his mother had on him when he was 12 years old. In conversation with footballer Rio Ferdinand he said that he had avoided talking about her death for the first 28 years of his life, but when he had been able to talk about it, it had helped him a great deal.

“it’s okay to suffer, but as long as you talk about it. It’s not a weakness. Weakness is having a problem and not recognising it and not solving that problem.”

Harry was at a barbeque at Kensington Palace in aid of the charity Heads Together, and went on to say that “anyone can suffer from mental health problems, whether you’re a member of the Royal Family, whether you’re a soldier, whether you’re a sports star, whether you’re a team sport, individual sport, whether you’re a white van driver, whether you’re a mother, father, a child, it doesn’t really matter.”

This is such a brilliant message, and helps to challenge the stigma that surrounds mental health. The tragedy is that mental health issues can strike so randomly, regardless of a person’s wealth, or social standing, or how many friends they have, or how good life is in general. If and when we do encounter problems of the mind, we must try and remember that it isn’t a sign of weakness.

Of course ‘talking about it’ doesn’t solve serious problems overnight (if only it were that simple), but being able to open up about what is going on inside your head can go a long way to beginning the healing process. It’s also important to remember that grief is messy and a deeply individual process. There is no timetable to it. We all work on different time scales and it may be that, like Harry, it takes a while to get to a place where it feels okay to talk.

Heads Together

Young Minds

Muffling the Anxiety Gremlin

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Recently I wrote a bit about anxiety – where it comes from and some of the symptoms. Many people find it reassuring to know that it’s not necessarily as random as it might appear, and that in many ways it’s the body’s way of trying to help us.

There are lots of ways to ease the symptoms of anxiety.

Identify your thoughts…

When anxiety gets the better of us it can feel like there is an incomprehensible tangle of thoughts, feelings and physical symptoms. It can be really helpful to try and pin these down. What goes on in your head when you feel anxious? Are there any phrases or words that you often hear? What happens to you physically? What are you feeling? Emotions are not necessarily black and white – you might experience a great deal of fear, but also some anger and sadness. Try and identify as much of what is going on as possible. It might help to keep a diary to jot ideas down as you notice them. Anxiety can seem to arrive at any time, but sometimes there are triggers that we don’t see at first. Keeping a diary can help to identify these triggers.

…..and challenge them.

There are certain styles of thinking that can be very unhealthy. You might identify a thinking pattern along the lines of

“if I say something in class I might get it wrong, everyone will think I’m stupid, they will all hate me, I’ll never have any friends, I’ll die alone”

This way of thinking would make anyone feel anxious! Thinking along these lines is also known as catastrophising. If we can identify unhealthy ways of thinking that are making us feel bad, we can challenge them.

  • What is the evidence in favour of this thought?
  • What is the evidence against?
  • What would my best friend/ mum/ other wise or sensible person, real or fictional (Dumbledore?) say?

Get into the habit of seeing your thoughts for what they are (very often negative, irrational, unhealthy, unbalanced) and challenging them with your inner Dumbledore. More on Negative Automatic Thoughts here.

Reach out.

It can be very difficult to ask for help. We worry that we will be burdening others, or worrying them, or boring them. But sometimes just saying those anxious thoughts out loud really does diminish them. Most people want to help, so don’t be afraid to lean on others!

Seek talking therapy.

I know, I would say that. But it can help enormously to have an objective perspective on your worldview, someone who isn’t a close friend or family. Ironically, it can be easier to speak to someone who is stranger. On that note, consider calling the Samaritans if those around you seem too close to confide in. They really are completely anonymous, confidential and available all day and night.

Use a grounding technique.

When it feels like the contents of your head have taken over and are governing your mood and behaviour, it can help to ground yourself in the here-and-now. One simple technique is to look around you and find:

5 things that you can see

4 things you can feel

3 things you can hear

2 things you can smell

and 1 good thing about yourself.

Remember what works for you.

We all have things that help when times are tough. In the heat of the moment it can be hard to remember what these are. Doing little things that make you feel good can ease symptoms of anxiety.

7/11 breathing.

Breathing out for longer than you breath in helps the physical symptoms of anxiety by increasing carbon dioxide in the blood and lowering blood pressure. It’s the reason why a paper bag is traditionally used for a panic attack.

  • Breath in through the nose for 7 counts
  • Breath out through the mouth for 11 counts.

Other relaxation techniques including Mindfulness.

In mindfulness the mind is likened to a blue sky, across which clouds of thought are constantly passing. Mindfulness is about paying attention to these thoughts, not struggling to deny them, but acknowledging them and letting them pass along. In mindfulness practice we observe our thoughts in a curious and detached way, knowing that all thoughts and feelings are transitory and do not last. Headspace is an excellent app for your phone that can be used to guide you through mindfulness meditations.

Use your senses to self soothe.

You will be calming your body’s alert system, the amygdala, and reactivating the pre-frontal cortex enabling you to think rationally again.

  • Look at a picture of a place you love, or a piece of art, or an old photo
  • Watch your favourite film or telly programme
  • Take a photo of something beautiful
  • Listen to your favourite music
  • Find some meditation music on youtube
  • Make yourself your favourite meal or drink (avoiding alcohol and caffeine if possible)
  • Run yourself a bubble bath
  • Wrap up in a blanket

Be self compassionate.

It might sound fluffy but being kind to yourself can be an effective tool in the battle with the anxiety gremlin. It might feel unnatural or difficult at first, but keep an eye on your self talk and monitor for critical thoughts. When you notice them, gently challenge talk to yourself in the same way that you would talk to a good friend.

 

Lizard, Squirrel, Monkey: why do we get anxious?

urlAs a counsellor something that I see again and again is anxiety. It is very common: along with depression it is one of the most frequently googled mental health issues. Research suggests that anxiety is growing in young people and is more common in women than it is in men. We can speculate over the factors in this increase, but lets focus first on what we mean by anxiety.

What is it? 

People often describe anxiety as a feeling of fear that comes out of the blue. Uncomfortable feelings can be easier to live with if there is a reason for them, so the seemingly irrational nature of anxiety makes it especially difficult. The founder of Cognitive Behaviour Therapy (CBT) Arron Beck, described anxiety as being a fixation with danger, and that it is the way our brains process information that is faulty. Anxiety can take many forms: it is sometimes described as Generalised Anxiety Disorder (GAD), social anxiety, Obsessive Compulsive Disorder (OCD), Post Traumatic Stress Disorder (PTSD) and trauma.

 Where does it come from?

Anxiety can feel very random and leaves us feeling out of control, but there are some explanations for its origin.

Our brains are very complex, but can roughly be divided into three parts. The oldest part of the brain is the Brain Stem and Cerebellum and is sometimes nicknamed the lizard or reptilian brain. This is responsible for our basic urges – to seek food, a mate and to watch for danger. It was once very useful when we spent our time hunting and killing prey, and being hunted. Today the threat of danger is more abstract: we might worry about how to pay the mortgage, why someone hasn’t texted back, or what will happen if we fail our exams, but the lizard part of our brain can’t tell the difference and gets us ready to fight, flight or freeze as if the danger is physical.

This leaves us physically ready to act, with a raised heartbeat, increased breathing, an excess of cortisol and adrenaline, but we cannot run away from problems that are in our heads.

The second layer of our brains is the Limbic system or ‘Squirrel brain’. This is responsible for our feelings and emotions, it helps us bond with others and form relationships. It is what makes us social rather than animals governed by primitive urges.

The most sophisticated part of the brain is the Neo Cortex or the Monkey brain. This is our logical thinking brain. It helps us to reason, speculate, fantasise, and think abstract thoughts.

All three parts of the brain are very different, and the theory goes that it is the clash between the three that contributes to modern anxiety.

How do I know if I have it?

There is certainly a role for anxiety, worry and stress in our lives. They may be uncomfortable but they can help us get things done. However when anxiety gets out of control it can get in the way of our plans, stop us from doing the things we want to do, and make our lives miserable. Anxiety is not just something that happens in our heads. It’s true that we may notice ourselves thinking differently, but we also see signs of it in the body, and we may also see our behaviour changing. Some of the symptoms include:

Physical signs:

  • Increase in muscle tension
  • Increased heart rate, heart palpitations, chest pain
  • Shortness of breath
  • Blushing
  •  Dry mouth
  • Decrease in appetite
  • Sweating
  • Diarrhoea and/ or vomiting
  • Headaches, dizziness
  • Shaking/ tremors

Psychological signs:

  • Worrying excessively about past or future events
  • Mind racing or blank
  • Feeling on edge or nervous for no reason
  • Feeling stuck in negative thought patterns
  • Unable to concentrate or focus
  • Repetitive thinking
  • Negative thoughts about self, others or the world in general
  • Feeling irritable or bad tempered
  • Feeling low or sad
  • Behavioural signs:
  • Avoiding situations that increase anxiety
  • Actions that are repetitive and compulsive
  • Over eating or drinking
  • Self harming
  • Insomnia (trouble sleeping)
  • Safety behaviours

For some people, knowing that their experience of anxiety is not completely random, and that it is the body’s way of helping us, can be a useful first step to getting better. For others, further tools and strategies are needed to get to grips with the anxiety gremlin. We will look at these in the next instalment….