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Category Archives: depression

Why is Happiness Fleeting?

At the weekend, I was listening to James Rhodes’s brilliant new album, ‘Fire on all sides’ – what a masterpiece. To say he has talent is the understatement of the decade.  Almost at the same time, I saw his recent BBC Breakfast interview, which you can watch below, where he discusses happiness and what it means to pursue feeling happy.

Rhodes makes some interesting observations about the state of happiness, but this one statement in particular resonates:  ‘We are not meant to be happy all the time’.  Actually, his thoughts fit like a glove with major schools of spiritual wellbeing, ancient myths and archetypal psychology: Heraclitus to Graves, to Bly and Samuels, to name a few.

The Pursuit of Happiness

Rhodes says more on the pursuit of happiness; his view is that we are not meant to be happy all the time and that the pursuit of happiness at all costs is causing us pain. Wise words indeed.

Ancient wisdom tells us that ‘happiness is a fleeting state, not an arrival at a destination’. What, then, if we think about it in different terms ? How about ‘happiness comes and goes’, just like the tides?

At best, happiness is a fleeting emotion: a sensation to be enjoyed while it is here, however short the visit.  Sadness, happiness’ ugly twin, has the same fleeting visiting pattern. When sadness visits, we have to endure despite wanting rid of it. Jung aptly named sadness  ‘nigredo’, or dark night of the soul. Sadness is a fleeting emotion, too; just like other feelings, it will pass.

More often, sadness teaches – it enables us to grow spiritually and emotionally. How would we appreciate or even know happiness if sadness didn’t exist? If happiness were the permanent condition, or even much wrestled for a sense of balance, where would meaning be found? How would the green shoots of personal growth burst forth?

Carl Jung quote happiness and sadness balance

Jung famously wrote that ‘the word “happy” would lose its meaning if it were not balanced by sadness’. What do you think?

Understanding Sadness in Relation to Happiness

A permanent state of bliss could be likened to the Sisyphus myth (where Sisyphus must roll a stone up a hill, only for it to roll back down again every time he succeeds). It would be meaningless and eventually boring. Could too much happiness be no more than an ecstatic death sentence? It takes a bit of thought to consider sadness from this standpoint.

Self-help books certainly do have their rightful place, but the pursuit of happiness per se is both illogical and a fallacy. Depression, too, at times is a necessary position, and it has a purpose. We can’t always be happy, just as we can’t be continually sad. James Rhodes is making a wise observation that happiness and sadness are part of a continuum. They can be normalized as part of the experience of living.

Severe or prolonged depression is a different matter. It is not normal sadness at all. These symptoms are not part of normal sadness:

  • To really want to kill yourself
  • To not have the energy to wash or wear clean clothes
  • To want to scratch, burn or harm yourself
  • To not be able to think clearly
  • To not be able to make simple decisions

These depression symptoms need expert psychological or psychiatric help. These symptoms are not a progression of normal sadness, but a sign that help is needed.

However, if your sad feelings are fleeting, and part of a normal life with its ups and downs, rather than clinical depression, it’s important to put them in perspective, and Rhodes’ words can help with that process.

Written by Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk).

 

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How the Media Should Report Mental Health Stories

Writing a story or report with pen on paper - man's hands on top of desk and writing materials

Think before you publish that story or documentary.

On Monday, the Virgin Money Giving Mind Media Awards celebrated the most supportive and accurate mental health reporting in the British media, including documentaries, radio shows, digital content and newspaper reporting.

Mind, one of the UK’s best known mental health charities, knows how important it is to report sensitively on any mental health news story or feature, because ignorant or distressing content can lead to genuine distress for mental health sufferers and their families.

So, what does responsible media content look like, and how are mental health organisations ensuring fewer damaging reports slip through the net? These are the key factors to consider.

Think Before You Write

There are many misused terms still used by reporters and editors for widely misunderstood conditions – words like ‘psychotic’, ‘bipolar’ and ‘schizophrenic’ are often used inaccurately. Furthermore, casual words like ‘crazy’, ‘mad’, ‘breakdown’ and ‘bonkers’ can also be used to generate headlines or clickbait. By sensationalising these stories, the media is reducing sufferers to stereotypes.

Good mental health content is inquisitive without being intrusive: it respects the emotional impact that comes with telling your story to a journalist or producer. It works with, not against, interviewees, and involves a high level of research to avoid offending or stigmatising anyone involved in the story. When reporting on a failure of care by health professionals, it demands answers for those affected, as was the case in Mind Media Awards winner Catherine Jones’ investigation for Channel 5 News.

Any content that could be triggering for readers, listeners or viewers is best ended with contact details for relevant organisations, such as the Samaritans. This has now become standard on episodes of television soaps, where hotline numbers or websites are displayed at the end of the episode credits. Online and print content is catching up, but there is still work to be done.

The new Mental Health Media Charter, created by campaigner Natasha Devon, calls on all parts of the media to commit to creating stigma-free mental health content. Signatories so far include the Metro, Grazia, Tes and Heat magazine. I can’t wait to see who else signs the charter and makes a stand against irresponsible journalism.

Private no public right of way sign demonstrating privacy and boundaries in driveway

We all have a right to privacy, especially when grieving, but this can sadly be overlooked by intrusive journalists.

Reporting Suicide

When reporting suicide, or suicide attempts, the media should be particularly careful not to share graphic details which may encourage other suicidal people to imitate the methods mentioned. The charity Samaritans has issued useful guidelines for anyone reporting on suicide.

Friends and family members can often be hounded by the media in the wake of a loved one’s suicide, via incessant phone calls, ‘doorstepping’ (turning up at someone’s home to get an interview), or trawling social media profiles for signs of intent. This is deeply distressing and does not help with the grieving process.

When someone close to you commits suicide, you may fear you could have done more to help them, and you search for warning signs that could have been missed days, weeks or months earlier. However, people with mental health problems and suicidal thoughts don’t necessarily look depressed; they can develop coping mechanisms and present as upbeat and untroubled. CALM (Campaign Against Living Miserably), a mental health charity which aims to reduce male suicide, reminds us that ‘sometimes there are no warning signs because the person wants to keep their personal crisis private, and so will work hard at hiding their thoughts and feelings’.

The media needs to recognise there is no single pattern of suicidal thought or behaviour, nor is there a single ‘depressed’ or ‘suicidal’ stock image to be used alongside these articles (such as the dreaded stereotypical ‘head clutcher’, where a person sits with their head in their hands).

Crime Stories

Mental illness is often wrongly attributed as the sole cause for a horrendous crime, leading to media speculation that everyone with that diagnosis is a threat to society. One prime example is the Germanwings pilot, Andreas Lubitz, who deliberately crashed a plane in March 2015, killing everyone on board. Stories quickly appeared, speculating that, because the pilot had been treated for depression, depressed pilots posed a threat to their passengers. Mind quickly countered such arguments with a statement.

Unfortunately, the damaging stories in the UK and beyond were still read by millions of people. The World Psychiatry Journal published findings in October 2015 that ‘the plane crash did have a measurable impact on public attitudes towards persons with mental disorder’.

In reality, serious crime happens for a multitude of reasons: some environmental and societal, some caused by reactions to life events. Stastically, someone with a mental illness is more likely to be a victim of violence than a perpetrator. With one in four of us experiencing mental illness during our lifetime, imagine how many people you come into contact with every week who successfully manage a mental health issue. You shouldn’t fear these people. Being a pilot, or taking on a similarly intense job, involves regular medical checks, and we should trust that mental health can be responsibly managed, just like any other health condition, by patients, their therapists and health professionals.

Those diagnosed with schizophrenia can also be media targets. Every year, we see headlines around the world sensationalising the rare times when a schizophrenic patient becomes violent. This reportage doesn’t communicate how rare these incidents are, how much brilliant care there is for schizophrenia patients, and how many people with the diagnosis aren’t violent at all. Cal Strode, from the Mental Health Foundation, has blogged about this misrepresentation for the Huffington Post. The perceived threats suggested by certain parts of the media are both damaging and disrespectful.  

Weights on a bar at the gym and in a pile in the foreground

Society’s attitudes towards gender, body image ideals and identity can weigh you down.

Body Image and Identity

Writer and activist Juno Dawson spoke at the Mind Media Awards about the need for the media to respect transgender issues when reporting on them. She cited the statistic (from the National Centre for Transgender Equality) that 40% of those who identify as transgender will attempt suicide.

High-profile transgender icons, such as Caitlin Jenner and Kellie Maloney, are helping to break the stigma, but the transgender community and the wider LGBTQI+ community is still not given the same respect when it comes to mental health media coverage. For example, it’s important to use the pronouns that the person identifies with (this could be he, she or they/them), and to use the correct terminology when conducting interviews or producing content.

Beyond transgender issues, body image can become too much of a fixation for tabloids and websites, who incessantly report on celebrity weight loss, dieting and weight gain. Media figures who speak out about eating disorders have often seen their bodies scrutinised by reporters, on top of the self-stigmatisation that comes with their condition. Magazines not only publish intrusive images, but also the weight, dress size and BMI of celebrities, and the ‘good’ or ‘bad’ foods they eat, reinforcing fears of weight gain.

Some health professionals also believe that trends like ‘clean eating’, often celebrated by the media, can fuel an ENDOS (Eating Disorder Not Otherwise Specified), by excluding multiple food groups and developing a restricted diet with inflexible self-imposed rules. Dr. Max Pemberton is just one of those speaking out. When clean eating gurus are praised by magazines and websites, their food ethos becomes both normalised and amplified.

Events like the Mind Media Awards remind us that progress is being made to destigmatise mental illness in our newspapers, magazines and other media. However, it would be refreshing if all media outlets used emotional intelligence, tact and sensitivity when creating content about mental health.

Written by guest contributor and mental health campaigner Polly Allen, for Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk).

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Coping with Christmas After the Death of a Loved One

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Coping with Christmas after the death of a loved one is always very painful.  Pain is often made worse because everybody else appears to be happy at this time  of year.

While Christmas will be painful, there are a few things that can make the process a little easier.

It is important to recognise that sadness will come and go throughout the festive period. This is inevitable, grieving is the price we pay for love. You can and will get through it.

These practical steps for coping with Christmas after bereavement may help.

1) Plan for Christmas day: get out pen and paper or the iPad, and jot down things you might like to do if you were not feeling quite as sad

List simple things. Maybe you always wanted to drink Bucks Fizz in bed, but never could because your partner was teetotal, or perhaps you always wanted to walk in the country on Christmas morning rather than go to church. Now is the time to please yourself – don’t feel guilty, just do it.

In making new memories and new habits, you are building a future for yourself in small but tangible ways. And don’t forget to include the quiet time between Christmas and New Year, which many people can find difficult. Think about what you’ve always wanted to use that time for.

2) Anticipate the parts of the actual day when you are likely to feel worse

Once you can recognise where the major deep pits lie, you will be able to draw up a plan to be doing other activities at those especially vulnerable times. If you recognise that your dip in mood occurs after lunch, why not go for a walk, have a sleep or try and master a hobby?

Don’t be afraid to rip up the rule book to get through Christmas. Just because you’ve always done things a certain way, doesn’t mean they have to remain that way forever. If a particular tradition or ritual feels too upsetting to revive this year, attempt a new one. Swap the Queen’s Speech for a card game, or the post-lunch walk for a Boxing Day morning walk instead.

3) Create a ritual that honours the past but sows the seeds of hope for the future

Perhaps that might be to gather winter foliage from the country to make a seasonal wreath and then laying it at your partners resting place.  Afterwards, why not meet up with a son, daughter or grandchild to do something different together? Have some mulled wine, treat them to a meal, watch them ice skate, have a flutter on the horses.

It is not important what the activity is – the importance is found in developing new rituals. Why not create a ritual you can carry out and extend every year forward?

4) Buy yourself a present

Wrap it nicely and pamper yourself, whatever the budget. Don’t pick something practical with little personal meaning, such as a new iron.

Choose something you have always wanted but never dared to buy. If you can’t afford to be extravagant, buy something that works towards your dream – a Theatre Token, to help save for a theatre trip, or a pair of walking boots, to prepare for an exotic walking holiday at some point in the future. Open your present on Christmas Day, and immerse yourself in it.

5) Make an emergency ration pack

An emergency ration pack is a small parcel made up of items that will lift your spirit even in your darkest moments. The idea is that you take time to select items that comfort or cheer you. When sadness hits, you won’t feel like seeking out things that raise your mood, so be prepared, and have the ration pack ready before you need it.

A typical ration pack might include chocolate, bath oils, a favourite DVD, a magazine, notebook, a novel and a painting set. The items don’t have to be expensive or wildly exciting, but they keep you occupied in difficult times.

6) Accept invitations

You may not want to go out, and that’s fine, but try and be gracious. Accept the odd invitation, as it will help you realise that life goes on. When you’re struggling, set a time limit: tell yourself you’ll go to Christmas drinks for an hour, and then see how you feel. Could you stay half an hour longer? Don’t forget to enlist friends and family to help, too.

Socialising does not mean you have stopped grieving or have forgotten your partner.  It does mean that you are courageously choosing to walk on for yourself while honouring your past life.

7) Count your blessings

Remember, you are lucky to be here: you have your health, and the ability to choose to move forward. You are able to feel your pain, but this in itself means you will also feel joy again. Many are not so lucky.

You may find it helpful to talk to other people who have recently lost a loved one. Track down a support group near you, or consult bereavement charities, to find a network of like-minded people who may be further along in their journey with grief, and can remind you of the happier times to come.

8) Be kind to yourself: use mindfulness

Don’t be harsh on yourself when you feel sad. Feelings of sadness will pass. Feeling broken and like life has ended is part of the grieving process. Allow yourself to experience your emotions without dulling them with excessive alcohol or drug use.

If you are unable to take any of these steps and are thinking that you can’t go on, it is essential that you seek help.  Counselling or psychotherapy may help you to adjust to your situation. It may also allow you to recognise that, despite your current feelings of sadness, you do have the chance of a positive future ahead of you.

If things become too much before you have arranged psychotherapy, dial 111 (for NHS help in a non-emergency), 999 (in an emergency) or talk to the Samaritans, night or day, including over the Christmas period, on 116 123.

Written by Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk). 

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Five Easy Tips to Help Relieve Depression

 

Dark purple and blue grey clouds with light filtering through to symbolise how to relieve depression

Start to relieve the dark cloud of depression.

When depression strikes, everything feels overwhelming, whether you experience symptoms for the first time or as part of a larger pattern. How can you start to relieve mild to moderate depression? Put these five tips into action.

1) Get Active

Even if it is just a 10-minute walk around the block, build it up to 20 minutes over the next few days. As NHS Choices says, exercise can be beneficial for those with mild to moderate depression.

Exercise shouldn’t replace talking therapy or medication, but can be used alongside those strategies to nurture your mind and body and possibly relieve depression symptoms. Gentle exercise could include walking the dog, doing a Pilates or yoga session, or (in the case of bad weather) trying an exercise DVD at home with a friend.

2) Connect with Nature in Your Own Way

This might mean stroking an animal, which can trigger the brain chemical oxytocin (lowering stress) and dopamine, or spending time by the sea, where the sea air helps produce endorphins, the feel-good hormones. Fortunately, nowhere in the UK is more than 70 miles from the sea.

Being outside in the fresh air and an open space can make a world of difference to your stress levels, as National Geographic proves. In the UK, we’re lucky to have brilliant landscapes right on our doorstep – yes, even those of us living in towns and cities; 47% of London is green space.

Furthermore, according to a government report in 2016, half of the people in England live no more than 300 metres from a green space. Let’s not take it for granted. If you choose to explore this green space with your own pet, or you join a pets-as-therapy scheme, a dog sitting or dog walking initiative, you could reap the benefits of animal therapy as well as being in nature.

3) Eat a Bright Salad or Soup for Lunch

Pack it full of tomatoes, red peppers, sweetcorn, and so on. These foods are visually stimulating and good for you, too. Unsaturated fat and foods rich in Omega 3 oils can also support your mood, as Blurt explains.

Keep an eye on your sugar intake, as high quantities can exacerbate depression, especially when post-eating sugar crashes hit. You may want to seek out foods with a low GI (Glycaemic Index), which can reduce slumps caused by sugary or refined carb foods: low GI choices include sweet potato, nuts, eggs, cheese, kidney beans, oatmeal, yoghurt, and most fruits.

4) Spend Just 10 Minutes on an Absorbing Low-Cost Hobby

Your hobby might be maintaining your garden, doing Sudoku puzzles, or sketching. A 2011 study in the Journal of Health Psychology found that gardening can improve your mood and lower your stress levels more effectively than reading. However, if reading is more your thing, by all means crack open a book to try and relieve depression: for less of a challenge, pick a shorter read, like a novella, or revisit an old favourite. Do remember that depression can affect your concentration and ability to process information: if you’re a puzzle fan, you might need to move to the ‘easy’ or ‘moderate’ Sudoku puzzles, instead of the ‘hard’ option.

Be aware that your usual hobbies might fall by the wayside when depression hits, and you feel unfulfilled or lose interest in them altogether. This is a symptom of depression, called anhedonia. If you’re affected by anhedonia, try a new or less challenging hobby, and don’t put any pressure on yourself to enjoy or maintain it. So, don’t sign up for a year’s worth of French lessons in one go – instead, opt for a taster course or download a free app.

5) Say “Hi” to a Neighbour or Colleague and Add a Smile

It will probably be reciprocated and could help to lift your low mood. Perhaps you could try smiling at a stranger on the commute to work; what’s the worst that could happen?

Low-level contact and interaction doesn’t have to involve excruciating small talk or a long lunch together. Science has found that the act of smiling at others makes us feel more positive, too; it releases neuropeptides, plus serotonin, dopamine and endorphins. This powerful combination feels calming and relaxing.

Putting Tips to Help Relieve Depression into Practice

Remember these are very small but powerful techniques to help relieve depression, and each tip will make a difference.

When we are depressed, even small things can feel like climbing Mount Everest. If you set your goals too high, it is easy to fail and harder to start again. Make goals small and achievable and you can build on these as you feel better.  The most important thing is that you make your goal small enough to achieve.

These techniques can easily be combined with your current depression treatment, such as CBT (Cognitive Behavioural Therapy).

Important: If you experience suicidal thoughts or an urge to harm yourself, it is important that you speak to your doctor or mental health provider quickly. Contact your GP or community mental health team during working hours and ask for an emergency appointment. Outside of working hours, call 111, contact the Samaritans on 116 123, or call 999.

Written by Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk).

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Links Between Unemployment and Poor Emotional Health

Desk with empty calendar and chairs suggesting unemployment and emptiness in blank space

Unemployment and mental health: when you’ve got no work on the calendar, it can affect your mood and wellbeing.

Unemployment and living in situations of social adversity are among the main mental disorder contributory factors. This is according to new research led by Jorge Cervilla of the University of Granada Department of Psychiatry, which found being a woman is the other strongest trigger influence on subjects with a genetic predisposition to mental disorder.

A pilot study has been completed by the researchers – which include representatives of the University Hospital, the Andalusian School of Public Health and the Mental Health Program of the Andalusian Health Service – with the full study to look at 4,500 households in Andalusia.

It was found that 20 per cent of the population present a mental disorder at one time or another in their lives, with the most common of these including depression and anxiety disorders.

What do these findings mean for mental health?

Mr Cervilla said the findings “will be of great use in helping identify people at greater risk of suffering the onset of a mental disorder or of having a relapse”.

Chartered Psychologist Micheal Gallagher adds:

“This research takes place in the context of an official unemployment rate of 27 per ent in Spain, compared to just under 8 per cent for the UK. The nature and direction of the relationships between unemployment, social adversity and mental health have been matters of intense debate whenever unemployment increases substantially.

Two studies by Butterworth and colleagues have helped to clarify such relationships. Analysis of two waves of data from a large community survey (in Australia) showed that current financial hardship was strongly and independently associated with depression, above the effects of other measures of socio-economic position and demographic characteristics. In contrast, the effect of prior financial difficulty was explained by baseline depression symptoms. There was some evidence that current hardship was more strongly associated with depression for those who were not classified as depressed at baseline than for those identified with depression at baseline. The contemporaneous association between hardship and depression suggests that addressing deprivation could moderate socio-economic inequalities in mental health.

“More recently, Butterworth et al. found that baseline mental health status was a significant predictor of overall time spent unemployed for both men and women. However, this overall effect masked gender differences. For women, but not men, baseline mental health was associated with risk of experiencing any subsequent unemployment, whereas for men – but not women – who experienced unemployment, mental health was associated with the duration of unemployment.

“The Spanish finding that being a woman increases the risk of mental health problems (in those with a genetic predisposition) may need to be analysed carefully: in my experience of various community mental services in Ireland and the North of England, women make up 60 per cent or more of referrals, but the Mental Health Foundation website provides an excellent summary of the factors – positive and negative – influencing women’s mental health. Because they are more likely to be carers, to deal with the family budget on a daily basis, and more likely to work in part-time and/or low paid jobs, economic recession may have a greater psychological impact on some women.

“The findings of the main study in Andalusia will be awaited with great interest by social psychologists, sociologists and mental health professionals who subscribe to a biopsychosocial model, but I hope that clinical psychologists will also consider the relevance of the findings for greater understanding of the experiences of many of their clients.”

Courtesy of the British Psychological Society.

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