Day 571

Posted by kidsaregifts20

Two things tend to greatly suffer in mental illness- creativity and human relationships. Sarah Wheeler believed this as she lived with Borderline Personality Disorder and Depression. She set out to create a space that was open-hearted, connecting, non-judgemental, creative and safe – The Dragon Cafe on Borough High Street in London. And it is exactly that – a little bit of heaven for those who’ve been in hell.

Sarah set up “Mental Fight club”. It’s mission is to put on imaginative events for people of all mental health experiences. Every event seeks to connect our inner and outer world and ourselves to one another, whoever we may be. It is no wonder that I intended to be there only for a couple of hours but ended up spending more than double that time, feeling totally relaxed and quite happy.

All visitors are called patrons. Each one is important. You don’t have to do anything. You may do some art, read poetry, dance, sit around and chat, drink tea, have some heavily subsidized, freshly cooked vegetarian food or have a nap on a bean-bag in the Quiet Room.
I will definitely be back there next Monday.

From our conversations it was clear that it is the focal point of many lives. It gives them hope, some thing to look forward to and a strong sense of acceptance and belonging. These are basic human needs that are so often unfulfilled.

Maybe mental illness is not a disease of the brain, but that of society.

This poem by Ben Okri is one of Sarah’s inspirations:

An illusion by which we can become
More real.
A moment unremarked by the Universe,
By nature, the seasons or stars.
Moment we have marked out
In timelessness.
Human moment.
Making a ritual, a drama, a tear
On eternity.
Domesticating the infinite.
Contemplating the quantum questions,
Time, death, new beginnings,
Regenerations, cycles, the unknown.

Day 567

Posted by kidsaregifts20

In an office in the City, it’s time for the annual appraisal. The young man in question is a graduate trainee, about 22 years old. He is not considered quite up to the mark. His very sweet and steady girlfriend broke up with him by text out of the blue one day and it took him as long as 2 weeks to gather himself back together again. A definite cause for concern! Is his sensitive temperament suited to a career in the City?

Angad Paul, a 45 year old businessman killed himself in November 2015 while the balance of his mind was disturbed. Months prior to that his steel business, Caparo industries went into administration as a result of economic forces well beyond his control but he somehow held himself responsible.

As per an article in the Financial times on 2^nd May titled “Taboo over executives’ mental health issues needs to be challenged” by Jonathan Guthrie, senior executives at the apex of an organisation can feel tremendous strain from their isolated positions. In addition, depression and burnout can result from lack of control. However, they are ‘desperately afraid’ that people will know that they have a problem. Stigma everywhere.

However, in 2011 Mr Horta-Osorio, Chief Executive of Lloyds bank went on sick leave after 5 days of insomnia. After a couple of months of rest and medication he came back to steer the bank through an exceptionally difficult phase. 4 years on, he is still in the job.

Stigma gets in the way of sufferers asking for help. It is a huge obstacle to overcome but so worth doing.

Day 565

Posted by kidsaregifts20

What people do may be a better marker of depression than how people say they are feeling. Behavior can be objectively measured using mobile phones. It is an active sensing and prediction platform to identify behavior changes when individuals suffer from common colds, influenza, fever, stress and depression.

Studies have found a strong relationship between location (using GPS) and clinical PHQ-9 scores. The daily pattern, variability and extent of communications can also be analysed to give valuable clues to changing trends in activity. It is possible to monitor depression passively using phone sensor data. This has significant public health implications. Most people are unwilling to answer questions repeatedly over long periods of time, while passive monitoring could improve the management of depression in populations, allowing at risk patients to be treated more quickly as symptoms emerge or monitoring patients’ responses during treatment.

The efficacy of smartphone sensors and self reporting for mental health care has not been proven yet and remains a very important research question in the pervasive health community.

2 billion people already carry their smartphone with them most of the time. Even the cheaper models have sensors that can track movement and activity, generating data to provide insights into our wellbeing.

StayClose is a free family care app, powered by Touchkin’s predictive care platform. The app helps families care for loved ones while being afar by enabling them to know how they are, without having to ask. They can also share a touch or video moment, or do something to help, like send a ride to take them to the doctor.

For example, when a person is depressed, their phone is likely to show more time spent at home, unusually low activity, changes in communication or sleep patterns. It is possible for a machine learning engine to learn anyone’s phone’s normal sensor patterns and generate alerts if unusual activity indicates any health issues.

I look forward to collaborating with Touchkin for a few pilot studies in London.

Day 543

Posted by kidsaregifts20

In 2009 Thomas Joiner proposed the Interpersonal-Psychological (I-P) theory of suicidal behaviour.

Author of over 385 peer reviewed journals, Thomas Joiner has worked extensively in the field of psychology, neurobiology and suicidal behaviour.
As per the I-P theory, an individual will not die by suicide unless s/he has both, the desire and the ability to do so.
Who desires suicide?
There are 2 specific psychological states in their minds simultaneously:

Perceived burdensomeness
Low belongingness/social alienation.

Perceived burdensomeness:

“My death will be worth more than my life to family, friends, society, etc.” – a view that often represents a potentially fatal misperception. Studies have shown that this is a robust predictor of suicide attempt status and of current suicidal ideation, even controlling for powerful suicide-related covariates like hopelessness.

Low belongingness:

Not feeling like an integral part of a family, circle of friends, or other valued group. As with the research base on perceived burdensomeness, there is abundant evidence that this factor is implicated in suicidal behaviour. A study by Joiner in 2008 showed that college students’ suicidal ideation peaked in the summer semester when the campus is less active. This accounted, in part, for the association between semester and suicidality.

How does one overcome the powerful instinct for self-preservation?

By developing a fearlessness of pain, which is acquired through a process of repeatedly experiencing painful events such as previous self-injury, repeated accidental injuries, numerous physical fights and occupations like physician and front-line soldier in which exposure to pain and injury, either directly or vicariously, is common.

The Interpersonal-Psychological theory is a promising one with growing evidence base. It suggests that clinicians be cognizant of their patients’ levels of belongingness, burdensomeness, and acquired capability (especially previous suicide attempts), as this knowledge may aid clinicians in the task of suicide risk assessment and of targeting ttreatments.

Day 536

Posted by kidsaregifts20

It’s nice to have texts, Facebook and Whatsapp messages from friends staying in touch. It’s nicer to get a phone call and have a chat about things. It’s even better to sit with a friend or acquaintance for a while and talk. Tea and toast on top is just the best.

Lately I met a young man of about 30 who is a keen swimmer. In general conversation, sitting in a circle with other people the topic of horse-riding came up and all of a sudden I saw a quiver run across his lower lip, his face tightened and his eyes lowered. In that moment a dark shadow seemed to have engulfed him. In due course it emerged that he had had a riding accident in his adolescence which had left him deeply traumatised. A diagnosis of PTSD had been made and he had received treatment for a few years before he felt better. If I had been speaking with him about this on the phone, I would probably have missed the subtle clues that came through his body language.

They say 93% of communication is non-verbal. By paying attention to posture and facial expressions it is possible to guage someone’s feelings and to some extent thoughts. Our subconscious speaks through the way our body holds itself.
“How are you?”
“I am ok.”
How often do spoken words not match body language. The incongruity is apparent in person but not on text, Facebook or whatsapp.
It’s easy for us to think we have got in touch with our friends through these electronic media and be reassured by their answers but it is not difficult for them to hide behind these media and not reveal the whole truth.

September/October is the time when most students go back to their school or university and get busy settling down with their new friends, routines and courses. Saagar’s friends did the same while he stayed at home. We talked about that year being the ‘gap year’ which he had never taken. Once he got better we planned to go travelling. His friends couldn’t be there for him in person but they kept in touch with him through social media and the phone.

On the morning of ‘Day 0’ I called Saagar from work as usual around 10 am to wake him up. I noticed that he was a bit quieter than normal but that wasn’t entirely surprising. I texted him in the afternoon to ask how he was doing. Saagar’s last text to me was, “Just on a walk x”. The truth, but not the whole truth.