Leaving Lockdown

With the UK Government’s decision to begin to move us out of lockdown, by easing some restrictions, there has been an outcry about the affects of lockdown on our mental health. I’d like to explore with you what this mean for us on a personal level.

I think it’s worth starting with some simple premises:

Our society pre-lockdown was not a mental health eutopia. People beforehand suffered with mental health issues, mental health and wellbeing were not taken seriously, stigma caused people to not seek help, and NHS services struggled with those who did reach out.

Work based Employee Assistance Programs, counselling and CBT are underfunded and people often get a set number of 6-12 sessions, which is often not long enough (I typically work with clients for around a year). Despite the fact that the biggest predictor of a good outcome in therapy being how well you get on with your therapist, most people accessing these services have no choice in who they see.

We know from research and anecdotal evidence that people experiencing the same event will have vastly differing feelings, memories and responses to those events. Check out this selection of articles from the BBC about those who are struggling and thriving in lockdown.

So what do these premises mean?

Well, we all came into lockdown from a different starting point, some of us were mentally healthy, some of us had mental health issues, some of us didn’t consider our mental health and wellbeing at all. We have all come from different socio-economic backgrounds which have profoundly affected our experience of lockdown, whether you were un-employed, disabled, unable to work, shielding, an essential or keyworker, able to work from home, furloughed or still attending your place of work. Looking after children or vulnerable family members and neighbours also has had an effect on what lockdown has felt and looked like for each of us.

A picture of a street sign saying lockdown, to show we are leaving lockdown in the UK
Leaving Lockdown

Some of us have been directly affected by being unwell with Covid-19, or losing a friend or family member to it. You may have also experienced anxiety or worry over contracting it, or a feeling of unreality about it or even ‘it won’t happen to me’. Some of us may have put aside our health concerns to participape in The Black Lives Matter protests, others may have found other ways to support the movement through petitions, social media and Blackout Tuesday.

The point is whether you worry we are moving out of lockdown too fast, can’t wait for the world to reopen or are somewhat on the fence. Whether you have had a big revelation about your life during lockdown or you are finding your depression and/or anxiety is worse. What I want you to know is your experience is valued and valid.

There is no right answer or way to feel, and anyone who tells you there is is lying. What I would say is that if you are feeling low, and your mental health has suffered, or you have been unable to access your usual sources of support, REACH OUT. Talk to someone, a friend, a therapist, DO NOT SUFFER IN SILENCE.

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The Fear Of Chanting

As you know I run a meditation class and inevitably once every 3-6 months I will schedule a class that involves chanting. Invariably this will mean I will have less people turn up on the night with excuses that vary from ‘I have a family thing planned’ to no response at all, so what’s going on?

It’s not coincidence that a lot of people suddenly have something to do, at first I thought it was me, something I wasn’t getting right, then the penny dropped. It was FEAR.

The fear seems to be less around internal chanting, and more around actually using one’s voice.

Chants can come in many forms, some religious, some as sounds and some as affirmations; all are useful in different ways. Much like music can change and influence our mood, thoughts and wellbeing, so can chant. The difference is, the sound in chanting comes from the inside outwards, rather than the outside in. This projection of your own sound, your own voice is really difficult for some people.

The people who struggle and avoid chanting are often the ones who need it the most, to have their voices heard, to be able to find themselves and their voice, to actually listen to themselves.  It requires courage to project your voice and be heard. I often find that the people who fear chanting are the ones who find it hard to say ‘no’, they are the givers, carers and worriers of the world.

Yet when they do find their courage, the strength to listen and to make themselves heard, the transformation in them is astounding. Their faces lighten and they sing from their heart and soul. They take back their power, and express themselves beautifully.

So the next time you have the opportunity to chant, take a deep breath and face your fear, sing loud and proud, of who you are and who you want to be.

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Overthinking

We all do it, especially when we are stressed or worried. Mental health issues like depression, anxiety, loss, social anxiety, obsessive compulsive disorder, borderline personality disorder, attachment disorder etc often have overthinking as a symptom.

So what is overthinking?

Overthinking is defined as thinking about something for too long or analysing it in a way that is more harmful than helpful. Very often it has a repetitive quality, someone with social anxiety for instance may overthink how they were in a social situation, what they did or said and will repetitively do this for most, if not all sociable experiences.

Why do we do overthink?

It is often because we care, we care about what someone else thinks, we care about what will happen next, and we care about how others see us. This caring leads us to be concerned about the outcome of a relationship, a conversation or result. So our ever ‘helpful’ brain decides that if it analyses all the possible outcomes we can be prepared, it’s so good at this it will even analyse an event, meeting or result BEFORE it’s even happened. There are two main issues with our brains doing this:

  1. Our brain cannot possibly compute every outcome
  2. Our brain is influenced by any biases we have whether they are positive or negative. (If we are worriers or have a mental health issue this is usually a negative bias, but in mania, and some other conditions it can manifest as a positive bias.)

We can experience overthinking as:

  • Not being able to think of anything but the subject/person we are worried about.
  • Interfering with our ability to function.
  • Insomnia.
  • Increased stress levels.
  • Things feeling bleak.
  • Avoiding situations you are worried about.
  • Conversely, if you have a positive bias, getting into situations that are risky or more complicated than you had imagined.
  • Difficulty eating or eating too much in a bid to feel better.
  • A form of self-harm
  • Causing anxiety.

So what’s normal?

We all worry at times. We get nervous about things that matter to us like exams, job interviews, going on stage etc and during these periods we may experience overthinking. Overthinking becomes a problem when it doesn’t end after the specific event is over, when it becomes more generalised and we do it everyday. If overthinking is taking over your life, you should seek help from a qualified professional like a counsellor.

What we can do about overthinking?

So you are tired of overthinking, the sleepless nights, the constant worry, life feeling overwhelming and that you can’t seem to get out of your own head. So what do you do?

Especially when talking to others about their overthinking and worry, I find that most people use short to medium-term solutions, tips and tricks they have picked up to help in the moment. These include:

  • Distractions like: talking to someone, listening to music, listening to podcasts, and watching TV.
  • Mindful approaches like: grounding, breathing techniques, and fingertip touching.
  • Facing the problem: checking the facts, testing your assumptions, and talking it through with someone.
  • Getting support: help from family or friends when you are going through an tough time that needs extra support like exams, stage fright, PIP appeals.

Whilst all of these approaches can help you to feel better, people will repeat them over and over again because they still overthink.

My treatment plan for clients experiencing overthinking is a two-pronged approach, I will initially use short to medium-term interventions to give clients tools to help in the moment. But I also recommend more.

At the same time I will teach you a longer-term strategy to help you stop overthinking altogether so that eventually you don’t need the tips and tricks anymore.

So what do I recommend for chronic overthinkers?

Firstly we will try out and choose a short-term strategy that works for you, nursery rhymes or other distraction techniques are a favourite of most of the people I work with.

Next we work on the habit of overthinking. Noticing when you overthink allows you to name it, then you can catch yourself doing it and then you can change the habit to something else. One of my clients for instance will catch herself overthinking and acknowledge that she is worried about a particular issue, but the will choose to focus on something else and deal with the problem later. By the time later comes, the problem has often resolved itself.

For some people (especially those where the overthinking is more generalised and doesn’t have a specific cause) learning the first steps in meditation, where you focus on an object, sound, your breath or a sensation, can teach their mind to slow down and stop overthinking.

Learning to relax through Reiki or meditation can help to reset the balance in our bodies. letting go of the tension and stress that overthinking places in our bodies can be really helpful and replaces the the habit of overthinking with one of peace and calm.

Sometimes if your overthinking is part of a larger condition like anxiety, depression, Borderline Personality Disorder/Emotianlly Unstable Personality Disorder, Obsessive Compulsive Disorder or due to trauma or abuse, counselling can be a way forward. Counselling will provide support in the moment and help you to work through the issues you are facing, to help you find a better tomorrow.

None of these approaches is mutually exclusive, you can mix and match what works for you. My hope in writing this is that, as well as the short-term tips and tricks to beat anxiety and overthinking you see on Facebook and in ads, you will also consider using a long-term strategy alongside it so you find you don’t overthink in the first place.

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Can’t Sleep?

I came across this article in the Independent: getting less than six hours sleep a night increases risk of early death

And it prompted me to think: What causes a lack of sleep and what can we do about it?

Aside from a ‘whole number of factors such as having small children, having other health issues and environmental factors’ cited in the article by Lisa Artis of the British Sleep Council; many Clients I see state one of the largest causes of lack of sleep is stress.

Whilst stress is aggravated and worsened by lack of sleep, the article fails to mention how worry and stress also raised cortisol levels which can themselves disrupt sleep. Cortisol changes in our blood is an important part of our day/night rhythm as well as our fight or flight response.

It has long been known that ‘depression and other stress-related disorders are also associated with sleep disturbances, elevated cortisol.’ 1 Therefore it would be sensible to think that managing and working with stress and other stress-related disorders to reduce the levels of cortisol in the blood in general will improve your ability to sleep.

So how can this be done?

  • Exercise can burn off adrenaline that is linked to cortisol production making less available for use.
  • Meditation and relaxation can allow us to tell our body’s they are safe and in the present, reducing anxiety, depression and helping us to control the over-thinking that often happens in response to the problems and stress of life.
  • If you have experienced trauma, abuse or have a chronic mental health issue, counselling can help you to find better coping strategies, find a way forward and share your fears and anxieties.
  • Amy Cuddy 2 has shown how changing your body language can help change how you feel and your blood chemistry, lowering cortisol. To find out more check out her TED talk cited below.

All these strategies can help although they can take some time to work, particularly if your experience of stress has been chronic.

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  1. Arborelius L, Owens M, Plotsky P, Nemeroff C. The role of corticotropinreleasing factor in depression and anxiety disorders. J Endocrinol. 1999;160:1-12.
  2. <a href="http://www.ted.com/talks/amy_cuddy_your_body_language_shapes_who_you_are“>http://www.ted.com/talks/amy_cuddy_your_body_language_shapes_who_you_are

Research And Depression

This week I came across two articles that I think are quite important. The first was by the NHS. The Adult Psychiatric Morbidity Survey is published every seven years and is based on the results of a household survey in England. Key findings show:

  • One in five women (19 per cent) had reported symptoms of common mental health problems, such as depression and anxiety disorders
  • One in four 16 to 24 year old women (26 per cent) surveyed has self-harmed, more than twice the rate in young men (10 per cent)

So what we are saying here is that for whatever reason, including the possibility that women are more likely to report mental health issues, there seems to be a disparity between mental health presentation in men and women.

The second article was about a study from Denmark which was published in the Journal of the American Medical Association (JAMA) Psychiatry, it found that women who take the contraceptive pill or have hormonal implants, patches and intrauterine devices are more likely to be treated for depression, with adolescent girls appearing to be at the highest risk.

I’ve been wondering: Is there a link here?

We know that some medications can cause depressive or anxious symptoms in patients, many of them have depression listed as a side-effect on the leaflet you get with your medication. There are anecdotally many women who choose alternative forms of contraception due to mood changes and depression, but this is the first time a study has validated their experiences.

Whilst I would never advocate just stopping a medication without speaking to your doctor, if you feel you are possibly affected I would encourage you to speak to your GP, to have the discussion about depression and medication.

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