I am not my diagnosis.

While I continue to struggle to figure out Twitter, forget how to update my website, get confused while recording podcasts, consistently get my innumerable passwords mixed up, stay oblivious about Instagram and Snapchat, the digital world gallops ahead.

Digital Interventions in mental health Conference 2017 was recently held in London. It explored topics across psychiatry, technology and culture to identify innovative ways of addressing mental health needs.

Dr Becky Inkster is a Neuroscientist, passionate about digital interventions in mental health, social media data analysis, genomics, molecular biology, and neuroimaging. She co-founded Hip-Hop Psych as she is passionate about working with hard-to-reach, disadvantaged groups and youth culture.

‘Views from the street’, ‘Prison transition tools’, ‘Beyond the bullets’ and ‘The Digital Psychiatrist’ are some of the workshops that were conducted at the above conference. The range of topics was rather fantastic. It was aimed at improving our understanding of how social media is helping to create and facilitate new spaces for mental health practices and support, exploring the benefits of social media and social networking to improve a sense of identity, self-expression, community building and emotional support through examining a few popular international examples. Participants and facilitators engaged in interactive sessions to understand how new tools for self-expression via pictures, videos, captions and short personal narratives can help break down the stigma surrounding mental health and perhaps even lead to more people seeking help. They explored how to empower young people to use social networks in a way that promotes their mental health and wellbeing, how to harness the power of social media to nurture mental health innovations that the future holds.

Impressive stuff. I carry on doing what I do. I write another article for the Huffington post – Darkness to light. I talk about my darling Saagar and emphasise the importance of us, the people, educating and empowering ourselves so that we can help ourselves and each other through the light of knowledge and empathy. I continue to speak with ordinary people living extra-ordinary lives. Here is a conversation with Sara Muzira, mother of the beautiful Simba. Both, mum and son are artists. She talks about the state of inpatient mental health services in her experience and things that can be made better for patients and their families. Thank you Sara.

 

 

 

 

 

 

 

 

 

 

It takes a whole village to raise a child.

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When I was 9, a music teacher came home every Tuesday evening to teach me singing and Kathak dance. That was my favourite time of the week. One week I waited and waited for what seemed like a very long time but he did not come. That evening I had a very high fever and had to be taken to the doctor.  Last week I have been having a high temperature, a cough and a cold. Withdrawal?

Growing up in the UK’, a report published by the BMA in 2013 found that we fail many children and young people every year. 2.6 million children in the UK live in absolute poverty. Children are at higher risk of living in both relative and absolute low income than the overall UK population. 14% of the most severely materially deprived kids from 30 EU countries live in the UK – same percentage as Romania. The severe economic hardship from the 2008 financial crisis in the UK and consequent spending cuts have been disproportionately detrimental to children, young people and low income families, particularly those who were already at a disadvantage such as migrant children and lone parent families.

‘We like to think of ourselves as a child-friendly society, but the facts do not support that comfortable, complacent assumption’  – James Appleyard, treasurer of the BMA.

Nelson Mandela said: ‘There can be no keener revelation of a society’s soul than the way in which it treats its children.’

According to the World Happiness Report 2013, Dutch kids are some of the happiest in the world. Here are a few possible reasons. Dutch parents are the happiest people. Dutch Mums have found the perfect work-life balance with 68% of them working part time, 25 hours per week or less. They don’t care so much about being charming or about how they look. Dutch dads are more hands on and play a large role in child care. Many of them also work part time. Dutch kids feel no pressure to excel at school. They have no homework before the age of 10. There is no competitive university application process. They can simply attend school for learning rather than competing in academic performance.

The Dutch breakfast mostly consists of a slice of white bread with butter and chocolate sprinkles on top. The United Nations called it healthy. What makes it ‘healthy’ is that breakfast is taken as a family every morning. The kids have a right to express their opinions as they are meant to not just be seen but also heard. Grandmothers have an active role in bringing up the grandkids and that has a huge positive impact on the kid’s self-esteem. The Dutch government gives money to families to help with expenses. People, including kids safely cycle everywhere. A huge emphasis is placed on ‘gezellighied’, a concept of pleasant togetherness that is more bracing than coziness and more exciting than contentment. ‘Gezellighied’ is an untranslatable Dutch word. Its closest meanings are convivial, sociable, fun, nice atmosphere resulting from general togetherness of people giving rise to a strong sense of belonging and a warm feeling. People work hard to bring this into their everyday family lives.

Why do we fail so many kids in our country?

Politicians make blunders because they surround themselves with like-minded people who are completely disconnected from the general populace. There is a failure in advocacy for children. As a society we need to examine and change our attitudes towards the importance of children. Mentally and socially some people manifest a bunker and silo attitude leading to isolation and exclusion. We need to create nurturing communities locally which could be based around the arts, music, exercise, spirituality, sports, play groups and after-school clubs.

Families, government and education policies and practices need to emphasise the importance of creating nurturing environments for kids.

 

Day 999

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The G Word

Grief is the normal and natural reaction to significant emotional loss of any kind. Grief is the mixed bag of conflicting feelings caused by the end of, or change in, a familiar pattern of behaviour. Grief is the feeling of reaching out for someone who has always been there, only to find when you need them one more time, they are no longer there.

The following statistics are heart breaking and could be avoided in many cases. Over half a million people die in the UK every year with an average of 5 grievers per death. That’s 2.5 million new grievers each year due to a death. Over 250,000 grievers per year due to divorce. This figure does not include the children grieving this significant loss. 25% of children in the UK are in single parent families1. By the 10th anniversary of moving in together just under 4 in ten couples will have separated. A Harvard study has found that when a husband or wife dies, the remaining spouse’s risk of dying is 66 per cent higher in the three months after their partner’s death.

Unresolved grief is everywhere.

Common myths about grief:

1. Time heals: Time does not heal. Time is an abstract concept – a unit of measurement that has no healing power. We know people who have waited 10, 30 or 40 or more years to feel better. However actions taken over time can heal.

2. Grieve alone: Often this advice is subtly implied “just give her some space” or “he needs a few minutes alone in the other room”. As children we learn that this means sad feelings should be hidden or experienced alone.

3. Be strong: Usually the griever is asked to be strong for others. “You have to be strong for your wife/Mum/children”

4. Don’t feel sad: This is usually followed by an intellectually true statement that is emotionally useless to the griever. “Don’t feel sad, his suffering is over” or “Don’t cry, at least you had him for 20 years”

5. Replace the loss: This is really common with pet loss or the end of a romantic relationship. “We’ll get you a new dog” or “there’s plenty more fish in the sea”

6. Keep busy: “If I just keep busy I won’t have to think about the loss”. This one is sad because some people spend their whole lives with this mentality and never get the chance to grieve and complete what was unfinished with the particular loss.

The G word – Guilt.

The word “guilty” is often used by a griever.
Griever: My son died alone, I feel so guilty.
Grief Recovery Specialist: Did you ever do anything with intent to harm your son? Griever: No, of course not (This is an almost universal response)
Grief Recovery Specialist: The dictionary definition of guilt is “intent to harm” and you didn’t do that. You are devastated enough by his death, please don’t add to it an incorrect word that distorts your feelings. Would it be more accurate to say there are things you wish had been different, or better or that you’d done more of?
Griever: Oh yes!
Source: ‘Guide to loss’ , 61 tips on grief:  free download from http://info.griefrecoverymethod.com/mainpage-ebook

Day 994

Stop carefully

“I felt like I had been run over by a bus,” says James Moore, a mental health campaigner. When he tried to stop taking his antidepressant, Mirtazapine, he got severe dizziness, headaches and nausea.
Around 1 in 10 people in the UK are on antidepressants. Many find them helpful and even life-saving. Some struggle to stop taking them when they are ready as they experience severe withdrawal symptoms along with panic attacks and memory problems.
Cinderella Therapeutics, a Dutch charity helps people safely come off a range of 24 different medications.  It creates personalised tapering kits with precisely weighed out tablets that gradually reduce in strength over several months. Since 2014, the project has distributed around 2000 such kits, mostly within the Netherlands as the kits are legal there. The site only sends kits to those with a doctor’s prescription and recommends people use the kits under medical supervision.
Severe withdrawal symptoms are managed by some doctors in the UK by prescribing liquid formulations of their specific medicine which can be measured out in small amounts. Liquid medications are often more expensive, so GPs are reluctant to prescribe them. Switching to Prozac is the other option suggested by some but that does not work for everyone.

 

 

Day 993

Ruth

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Broken glass

“You are well enough to safely go home now”, said the panel.
“But I can’t! I need one more day to complete my church!”, said Di, who was being treated at Bexley hospital for Postnatal Depression in 1966. She had a brilliant occupational therapist who took them to the swimming pool, organised hair-dressing days and helped patients to make things. Di made a church with bits of shattered wind-screen glass, put together with resin but the spire wasn’t on yet. This beautifully tactile piece of art was named ‘Faith’ by Ruth, her daughter.

Ruth

Ruth was a talented young lawyer. She was an actor and singer. She was kind, generous and gorgeous! She travelled extensively. She was diagnosed with Bipolar Disorder in her late 20s. She coped well with the help of health services, her friends and family but tragically lost her battle at the age of 47.

Di is in her second year of missing Ruth terribly. She has created the most beautiful garden in her memory. Some of the plants there are from Ruth’s house. Her mediterranean wall is stunning.

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Being bereaved by suicide is a huge risk factor for suicide. Around 125 youth suicides a year occur soon after the person involved has experienced a bereavement. One in four (25%) of under-20s and 28% of 20 to 24-year-olds had lost a relative, partner, friend or acquaintance around a year or more beforehand. In 11% of suicides among under-20s, the person who those involved had lost had also taken their own life.

In a recent inquiry, bereavement was found to be an important theme in many deaths, said Prof Louis Appleby, the director.

People who have been bereaved need greater support to reduce the risk of them killing themselves. Agencies who are meant to help are not good at recognising this risk and need to improve.

This morning I caught up with Di over a cup of tea. We both believe that if Saagar and Ruth have met each other wherever they are, they must get on famously. The link below is a conversation with Di. She talks about her insights on mental health services over 5 decades. Thanks a lot Di!

Day 991

Light and day and night.

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The longest day of the year is behind us.

It’s well known that lack of sunlight has an adverse effect on our brains. It might stop a part of the brain called the hypothalamus from working properly:

  • Production of melatonin – Melatonin is a hormone that makes us feel sleepy. The hypothalamus may produce it in higher than normal levels.
  • Production of serotonin – Serotonin is a hormone that affects our mood, appetite and sleep. Lack of sunlight may lead to lower serotonin levels, which is linked to feelings of depression.
  • Body’s internal clock (circadian rhythm) – Our body uses sunlight to time various important functions such as the time we wake up. So, lower light levels may disrupt our body clock, mood and alertness.

A recent study by Klaus Martiny of the Psychiatric Centre in Copenhagen shows that people being treated for severe depression were discharged almost twice as quickly if their rooms faced south-west in comparison to those whose rooms had a north-west orientation. Depending on time of the year, the intensity of daylight in the south-west rooms was 17-20 times brighter. The results support findings in previous studies of the importance of architectural orientation providing natural daylight as a factor for improvement. “We don’t know the precise mechanism, but I think it’s to do with exposure to the morning light, which advances and stabilises their sleep-wake cycle,” says Martiny.

Light acts as a powerful reset switch, keeping the clocks in our brain synced with the outside world. This clock can weaken as part of ageing, Parkinson’s disease, strokes and depression. To tackle this problem several hospitals are installing dynamic ‘solid state’ lighting which changes like daylight over the course of the day : whitish-blue in the morning, growing warmer and dimmer through the day and turning orange or switching off at night.

Light can be a drug.

 

Day 989

Accidental findings

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In the mid 80s, Dr Vincent Felitti ran an Obesity clinic in America. Many people enrolled and hundreds of pounds were shed by them. But he found that the drop-out rate from his programme was as high as 50% despite good results. He did not understand this and went back to look closely at patient notes.

“I had assumed that people who were 400, 500, 600 pounds would be getting heavier and heavier year after year. In two thousand people, I did not see it once. When they gained weight, it was abrupt and then they stabilized. If they lost weight, they regained all of it or more over a very short time.”

The turning point in Felitti’s quest came by accident. He was running through yet another series of questions with yet another obesity program. How much did you weigh when you were born…when you were in first grade…when you were in high school…when you first became sexually active…

One female patient replied – “Forty pounds” and broke down in floods of tears, “I was four years old.” He found similar common themes emerging from various stories and went on researching this subject for the next 25 years.

The obese people that Felitti was interviewing were 100, 200, 300, 400 overweight, but they didn’t see their weight as a problem. To them, eating was a fix, a solution like IV drug user calls a dose a “fix”.

Eating made them feel better. Eating soothed their anxiety, fear, anger or depression – it worked like alcohol or tobacco or methamphetamines. Not eating increased their anxiety, depression, and fear to levels that were intolerable. For many people, just being obese solved a problem. In the case of the woman who’d been raped, she felt as if she were invisible to men.

Felitti went on to further explore the  impact of childhood trauma on people and coined the term – ACE, Adverse Chilhood Experience. He found a strong co-relation between the number of ACEs and early death.

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Film: https://www.youtube.com/watch?v=v3A_HexLxDY