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 973

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The days are just packed.

Days come and go, one after another, in a silent single file. Left to me, I would let the disciplined procession pass quietly. Luckily, it is not left to me alone. Si is an expert at creating things to look forward to. Never before has my diary been so full of fun things to do. Even when the diary is blank, he comes up with ideas that make the day go by in the most enjoyable way.

We had no plans for today but then we needed to buy hose connections to water our tiny garden. A trip to the garden centre meant we walked around with a trolley and looked at things and found a few that would be nice for the house. Before long, we had to get a second trolley for things we hadn’t thought of before we entered the store.

Dolly Parton famously quotes, “my definition of happiness is having something to do what you love to do, someone to love and something to look forward to.”

One argument against constantly wanting something to look forward to could be that it takes our attention away from the present moment. Yet, the two do not have to be mutually exclusive. Simple things like half an hour of peace to meditate or write a journal, a walk with a friend, a bike ride through the park, a warm shower or a bubble bath, trying out a new restaurant, a long chat with a friend on the phone, reading a book, cooking something nice and sharing with friends, a good stretch, a massage, a dance or exercise class can be uplifting. However, ‘doing’ something all the time is no fun. Doing less may be the answer for some.

Coming from a place of gratitude and abundance, looking forward to something is fabulous!

Thanks for helping me see that, Si.

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Day 953

Discrimination at all levels

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All anaesthetic drugs work in mysterious ways. They mainly work on the brain. One of them is Ketamine. I have used it many times as an anaesthetic and to treat resistant pain. It’s relatively safe even in hands with limited experience. It’s used in all age groups. It’s known to cause ‘Dissociative’ anaesthesia and pain relief. It works through blocking NMDA (Glutamate N-methyl D-aspartate) receptors. Unfortunately, it is known to cause tolerance and dependence. It is also used recreationally.

Recent studies have shown that Ketamine has a significant beneficial effect on patients with treatment-resistant Major Depressive Disorder(MDD). The improvement is often seen within 4 hours of administration. This is the subject of many recent research papers but much more needs to be done.

It is estimated that about 3% of the UK population, nearly 2 million people suffer from depression. A small proportion of them, about 158,000 have depression that resists treatment. Currently, only 101 people are able to access ketamine in Oxford. About 40% showed sustained improvement after taking it.

It is potentially life-changing treatment for those suicidally depressed. Michael Bloomfield from UCL says “Unfortunately, medical research spending for mental illnesses is extremely low compared to other medical conditions. Clearly this needs to change if we are to improve treatments in the future.”

 

 

 

Day 920

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He’s her son. His mother, Em, lives with Bipolar Disorder.
Here he describes how he feels about the depressive phase of her illness.
I know that feeling.

“As if it were a wild animal with flecks of foam at its mouth, I feared her depression.

Imagine you were walking in a pleasant meadow with someone you love, your mother. It’s warm and there’s just enough of a breeze to cool you. You can smell earth and cut grass and something of a herb garden. Lunch is a happy memory in your stomach and dinner awaits you – a three course meal you have devised – all your comfort foods. The light is golden with a touch of blue, as if the sky were leaking.

Suddenly, your mother steps into a patch of quicksand. The world continues to be idyllic and inviting for you but your mother is being sucked into the centre of the earth. She makes it worse by smiling bravely, by telling you to go on, to leave her there, the man with the broken leg on the Arctic expedition who says ‘Come back for me, it’s my best chance, ’because the lie allows everyone to believe that they are not abandoning him to die.

Some part of you walks on and some part of you is frozen there, watching the spectacle. You want to stay but you must go. The imperium of the world’s timetable will allow you to break step and fall out for a while, but it will abandon you too if you linger too long by your mother, now a curled up foetal ball, moaning in pain, breathing only because her body forces her to.

Granny loved Em and she thought that should be enough. It wasn’t. Love is never enough. Madness is enough. It is complete, sufficient unto itself. You can only stand outside it, as a woman might stand outside a prison in which her lover is locked up. From time to time a well-loved face will peer out and love floods back. A scrap of cloth flutters and it becomes a sign and a code and a message and all that you want it to be. Then it vanishes and you are outside the dark tower again. At times, when I was young, I wanted to be inside the tower so I could understand what it was like. But I knew even then that I did not want to be a permanent resident of the tower. I wanted to visit but visiting meant nothing because you could always leave. You’re a tourist. She’s a resident.”

Source: ‘Em and the Big Hoom’ a profoundly moving book by Jerry Pinto, winner of the Crossword Book Award 2013.

Day 904

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“Ut amem et foveam” (To love and cherish) reads one of the tattoos on David Beckham. “Quod me nutris, me destruit” (What nourishes me destroys me) reads one of Angelina Jolie’s. Dragons, spiderwebs, birds, butterflies and many other forms and words cover many a body, silently relaying many stories. Mine simply reads ‘Saagar’ – an uncompromising statement, ink sealed beneath the skin as a permanent marker of what matters most. I got it in this very town on the 3rd of October 2016 (Day 718). Yes. It was painful but well worth it.

Tattoos once signified tribal affiliations and hard line expressions of devotion to a particular gang or cult. They serve as potent conversation starters and quiet sources of strength and hope. Some people with depression pick themes such as ‘Amour’, ‘Stay strong’, the picture of an anchor, “Grace’, a butterfly signifying if I could get through this I could become something beautiful on the other side, a dream catcher and ‘Sometimes you’ve got to fall before you fly’ and many such quotes and song lyrics.

They are a form of self-expression but when all over, I wonder if they are also a form of self-harm as they do hurt, especially when combined with multiple piercings. They certainly are an effective way of covering up scars from self-harm and may inspire people to invest in treatment and recovery.

A 2015 survey of tattoo owners in Britain showed that 40% of them regretted at least one of their’s. It is no surprise that tattoo removal parlours are the largest growth sector in the cosmetic industry.

I suppose it means different things to different people. Some say you can never stop at one but I am happy with one and I know that I will never regret it.

 

Day 890

UNIVERSITIES MISS CHANCE TO IDENTIFY DEPRESSED STUDENTS
– A study from Chicago, by Marla Paul in Jan 2011.

This study surveyed 1,622 college students. One out of every four or five students who visits a university health center for a routine cold or sore throat turns out to be depressed, but most centers miss the opportunity to identify these students because they don’t screen for depression, according to new Northwestern Medicine research.

About 2 to 3 percent of these depressed students have had suicidal thoughts or are considering suicide, the study found.

“Depression screening is easy to do, we know it works, and it can save lives,” said Michael Fleming, professor of family and community medicine at Northwestern University Feinberg School of Medicine. “It should be done for every student who walks into a health center.”

The consequences of not finding and treating these students can be can be serious and even deadly. “These kids might drop out of school because they are so sad or hurt or kill themselves by drinking too much or taking drugs,” Fleming said.

“Things continually happen to students – a low grade or problems with a boyfriend or girlfriend — that can trigger depression,” Fleming said. “If you don’t take the opportunity to screen at every visit, you are going to miss these kids.”

The frequency of depression and suicidal thoughts among campus health clinic users was nearly twice as high as rates reported in general college samples.

Depressed students need treatment, which may include counseling and medication. These students are more likely to drink, smoke and be involved in intimate partner violence, the study found.

With new technology, screening students is simple. While waiting for an appointment at the health center, the student could answer seven simple questions – a depression screening tool that that could be immediately entered into his electronic health record. “They can answer those seven questions in a minute,” Fleming said. Universities typically separate mental health treatment from primary care treatment. If a student comes to a campus health center and complains about depression, he is referred to a counseling center.

“If we screen, we can try to find every student that is depressed.”

Historical perceptions and biases against preventive screenings are that kids who need treatment the most don’t go to campus health centers, and they won’t tell the truth about their depression.

That’s wrong. “Students will tell you the truth,” Fleming said. “If they are sad and depressed, they will tell you that. And, kids who are drinking too much or who are suicidal do go to the campus health centers.”