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World Suicide Day – Spotting the signs and supporting those who may be having thoughts

One of our amazing authors, Lynn Crilly, who has published a series of books on mental health, has recently appeared in a number of press articles outlining how to spot the early signs that someone may be contemplating suicide. These articles were released ahead of World Suicide Day on September 10th – a very important day in focusing attention on the issue, reducing stigma and raising awareness among organisations, governments and the public.

Within the article Lynn provides four key pieces of advice on both spotting the signs of suicide and supporting someone who may be having suicidal thoughts:

>“Most people who attempt suicide will give some clue or warning, so it is vital to take those clues seriously, even if they are said casually. They may talk or write about death or harming themselves, or they may seek out things that could be used to take their own life, such as weapons or drugs.

> “There may be more subtle signs: hopelessness, self-loathing and self-destructive behaviour should all be taken seriously. Be alert also to those who seem to be getting their affairs in order or saying goodbye to people as if they will not be seen again. It sounds obvious, but all too often the clues are missed.”

> “If you spot any of these signs and are worried about someone you care about, it is natural to question whether you should say something. But the best way to find out is to ask them. Showing you care will not push someone towards suicide, rather it will give them an opportunity to voice their fears and feelings which could in turn help them to see that there is another way forward.

> “While talking is crucial, so is listening. Allow your friend or loved one to unload their despair and listen without judgement, remaining calm and accepting of how they feel. Reassure them that help is available and tell them how important they are to you.  Avoid arguing with them or appearing shocked.

The article concludes with a poem by her daughter to mark World Suicide Day. To read the article in full and the poem mentioned, please click here.

Lynn’s latest book ‘Hope with Depression’ is a supportive and insightful journey into the complexity and severity of depression. You can read the first chapter for free, right here on our website.. it might just help you, or someone you know.

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Beverley Jarvis – Eat Well To Age Well

international womens day

The latest book from fabulous author Beverley Jarvis is: Eat Well To Age Well. It covers some amazing recipes with a variety of delicious ingredients, all packed with healthy nutrients. The recipes are designed to be made by anyone, no matter their culinary abilities.

Beverley has filmed some fantastic video content for us to share. Firstly 2 recipes from her book, an Asian inspired pan fried Turkey and Vegetable stir fry, secondly a Sweet Potato dish with Smoked Mackerel, Horseradish and Parsley

In her second video, Beverley shares some simple healthy food swaps that we can all make to improve our diet:

Lastly, with the amazing invention of the Air Fryer, Beverley shares a beautiful Salmon Dish, along with some fantastic home-made muffins that you can do in your Air Fryer.

Click here to buy Eat Well To Age Well, directly here on the Hammersmith Health Books Website.

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A Blog Honouring those who Support People with Schizophrenia, by Erica Crompton & Stephen Lawrie

This week we took part in Schizophrenia Awareness Day, which we have seldom been aware of ourselves, let alone acknowledged, until now. With such a day comes all kinds of social media posts and blogs like this– there’s a style, fact or opinion to fit everyone with schizophrenia! We’ve decided to celebrate the occasion with a few words to honour our colleagues who devote their lives and careers on helping people like Erica, who live day-in, day-out with a diagnosis of schizophrenia.

As Erica says: “After over two decades of living with schizophrenia, one decade of which I’ve been open about it, I’ve come to learn as much about myself as I have about psychologists and psychiatrists. Like patients, some are good and some not (it all depends on who you ask!).” Just like patients, mental health professionals come in all shapes and sizes. Unfortunately, some colleagues dramatise schizophrenia or promote anti-medication messages for the sake of bolstering their own careers. Fortunately, most don’t.

Erica has been in a psychotic crisis and the only option at the time was private therapy at £45 an hour once a week: “Only after my situation improved, and I finally received NHS input (?with medication and therapy) did I realise that I had more qualifications than my private therapist who didn’t even hold an ordinary degree in anything. His qualification was, simply, living with depression and holding up a marriage at the same time. I felt ripped off and misguided.”

It’s particularly tragic (and potentially dangerous) when laymen like this set themselves up as ‘healers’ or psychotherapists.  As from the example above, there are no qualifications required – anyone can call themselves a therapist.  It’s even sadder when the charities supposed to support people with a major mental illness and cajole vulnerable patients into volunteering their stories of extremely personal trauma and abuse, named, to generate donations and support corporate charity salaries.

As Erica say: “Personally speaking I seldom give interviews about psychosis to journalists or academics these days – it is upsetting to see my own adversity shoehorned into someone else’s agenda and bias. There have been times I’ve done this in the past that have resulted in severe anxiety and tears (yet the person relaying my story has made a tidy profit from my juicy bits of misery).”

The bottom-line is that antipsychotic medication and various forms of support and psychotherapy from trained professionals work best together, and better than either alone, in treating symptoms, keeping people well and promoting recovery. Around 5% of the population will people will experience psychosis in their lifetime. Some recover without treatment. Some deteriorate, and about 5% will slip away to suicide. Others do away with hope completely – there’s a saying ‘it’s the hope that kills you’ and Erica has adopted it as a mantra herself in times of despair. But today, on Schizophrenia Awareness Day, it is important to recognise that most people with schizophrenia will recover with treatment.

Erica feels  extremely lucky to say “I feel happy with myself and have managed to recover a decent standard of life stretching over the last decade.”

We have written our self-help book to hopefully give a little useful information and hope – to prepare the way to pave little steps towards recovery. It’s good to know there will always be mental health advocates and professionals willing to go the extra mile for people with psychosis and their carers. So, to those helping for all the right reasons, we salute you today!

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Panic Attacks and Treatments

The following extracts are from author Lynn Crilly and poet Samantha Crilly from their respective books ‘Hope with Anxiety’ and ‘Hope Through Poetry’. The two pieces each give a personal perspective on the experience of panic attacks and look at some of the core causes of the condition.

Panic attacks and panic disorder

Anyone who has experienced just one panic attack will know just how frightening and debilitating they can be, sometimes seemingly coming out of the blue, without an obvious trigger. For someone with panic disorder, where these attacks occur with some frequency, the ripple effects on the way they live their life can be considerable.

Garry shares how he feels during a panic attack:

During a panic attack I would shake so much I could barely stand up. I had to sit down or lean against a wall to steady myself. Even though I knew it would pass, it was always very frightening.

Most panic attacks last between 5 and 20 minutes, but they can go on for up to an hour. Some people experience them once or twice a month, while others can be put through their effects a few times a week.[1]

A panic attack is terrifying and those who experience one can have an impending fear of death. It can typically cause a thumping, racing heartbeat, sweating, muscle weakness and a churning stomach. Some or all of these symptoms may be experienced, although the effects vary depending on the individual. Here is a list of some of the other physical symptoms that might be experienced during a panic attack:

  • Faintness/light-headedness
  • Nausea
  • Chest pain
  • Shortness of breath
  • Trembling
  • Hot flushes or chills
  • Shaky limbs
  • A choking feeling
  • Ringing in the ears
  • Numbness or tingling
  • Feeling disconnected from one’s body.

Amy, who went through a period of regular panic attacks and severe anxiety, shares her experience:

I remember when I was 21, not long after my now husband’s father passed away and I went to Australia for a holiday on my own (I got really bad home-sickness, and ended up coming home from Australia after six days), I now realise that I was having symptoms of panic attacks and anxiety. At the time I had no idea, and the doctor thought I had an inner ear infection. I was off work for six weeks and I remember I couldn’t leave the house due to severe anxiety.

The psychological impact can be even harder to bear, with sufferers worrying they are dangerously ill, that they might die, that they might cause an accident and harm others, or might pass out and cause embarrassment or harm to themselves. These understandable terrors can have an impact on the way they live their day-to-day life, as people with panic disorder can start to dread or pre-empt their next attack, leading them to live in a constant state of understandable fear, which can cause more attacks to occur, leaving them locked in a seemingly unbreakable cycle.

Important note: At the same time, it’s worth noting that the symptoms of a panic attack may be caused by another underlying medical condition, such as hypoglycaemia due to insulin resistance, so it is always wise to consult a doctor, both to rule out any other cause and to get support in seeking help if it is a mental health issue.

According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), in order to be diagnosed with panic disorder, the sufferer must have experienced more than one unexpected episode on a regular basis.[2] Mainstream treatment for panic disorder aims to ease the symptoms and lessen the number of panic attacks experienced. Talking therapies and medication are the main treatments for panic disorder offered by the NHS; depending on the severity of the symptoms, one or a combination of both of these treatments will be recommended by your doctor.[1]

  1. NHS Panic Disorder.
  2. Ankrom S. DSM-5 Criteria for Diagnosing Panic Disorder. VeryWellMind.


Glad you came

A poem about anxiety – by Samantha Crilly

It doesn’t add up like it did with high-school mathematics

Or have a narrative to follow in morning amateur dramatics.

You can’t find the square root of the problem, when the problem doesn’t exist

Or find reasoning for something when nothing was missed.

Anxiety manifests itself in so many different ways,

Often building and building over several days,

Detecting faults in situations that may never occur,

Preconditioning an event into one big blur,

Embarrassing yourself no matter what you do

On the main stage right in front of me and you,

Rubbing your knuckles, grinding your teeth,

Looking fine on the outside yet on fire beneath.

Heart pumping fast, echoing beats…

Dripping with sweat, hair slathered in grease,

Lungs tensed and twisted, unable to breathe –

If only you knew when you could leave.

But it’s okay I whispered – leave as soon as you need;

I’m so proud of you for just coming along.

To have stayed even for a little while makes you so strong.

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Perfect Picnic Recipe from Beverley Jarvis

Author of ‘Eat Well to Age Well’ Beverley Jarvis has provided recipes from her fan-favourite cookbook that are the perfect, delicious addition to any picnic.

Minty Dressed Salad with Grapes and Melon

This makes a deliciously light starter. You could double the recipe and prepare enough for 4, but only add the dressing to half of it, packing and chilling the remainder to be used the next day. For a change, use honeydew melon rather than watermelon.

1 little gem lettuce, washed, drained and shredded
1 kiwi fruit, thinly sliced, without peeling
1 small bag pea shoots and baby leaves, from the supermarket, or 1 large handful baby spinach, washed Handful mint leaves, chopped
6 cherry tomatoes, halved
8 small broccoli florets, blanched for 2 minutes, in boiling water, then cooled in ice cold water, drained and dried on absorbent kitchen paper
2 thick slices of water melon deseeded and chopped
12 seedless red grapes, halved

For the Dijon dressing:
3 tbsp olive oil
Juice ½ lemon
1 tsp runny honey
1 tbsp freshly chopped parsley
1 clove garlic, chopped
2 tsp Dijon mustard
Salt and freshly ground black pepper

To Serve:
2 tbsp toasted pumpkin seeds

You will need a chopping board and knife, salad bowl, teaspoon, tablespoon, 2 salad serving spoons, citrus juicer, small saucepan with lid, small screw-top jar and salad bowl.

Nutritional Note:
Fibre, vitamins B6 and C are provided by the kiwi fruit, as well as magnesium. Pea shoots provide valuable fibre plus vitamins A, C, E and K, and the mineral potassium. Vitamins A and C are in the tomatoes, as well as lycopene which is beneficial for prostate health. Melon provides vitamins A, C, B6 and B9 and magnesium.

1. Put the little gem lettuce leaves into in a salad bowl with the kiwi fruit slices, pea shoots and baby leaves, or the baby spinach and mint. Throw the tomatoes, broccoli, melon and grapes on top.

2. Make the dressing by putting all the dressing ingredients into a screw-top jar and shaking well.

3. When you are ready to serve the salad, pour the dressing over it, toss well to coat all the ingredients and serve immediately sprinkled with the crunchy pumpkin seeds

Experienced cookery teacher and writer Beverley Jarvis has put together this book of 75+ delicious recipes to inspire her super-ager peers to eat well, with all the nutrients that are increasingly needed as we get older, and to cook whole-foods from scratch quickly and easily so that meals are enjoyable but never a chore. To read the first chapter for free, click here.

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The Process Behind ‘The Gut Chronicles’

As the release of her anticipated book, ‘The Gut Chronicles’ draws near, renowned gut health expert and author Sandra Mikhail has opened up about her inspirations and the creative journey that led her to explore the sometimes uncomfortable and often taboo world of gut health. 

Sandra Mikhail - Chelsea Green Publishing

The Gut Chronicles has been a venture that I’ve wanted to bring to life for so long but the timing was never right. The book was finally conceived during the pandemic as I joined a writer’s group with fortnightly meetings behind our screens, which set the ideal scene for an accountability group that actually made the writing happen. You can think of this book as a passion project dedicated to my gastroenterologist father but also, to everyone that has suffered in silence not knowing where to turn to.

My infatuation with gut health was definitely born out of a mix of being the daughter of a gastroenterologist and experiencing the unpredictable and painful symptoms of irritable bowel syndrome. Throughout my career, I’ve also made it a mission to break the taboo around poo talk and to reassure everyone that digestive problems, no matter how mild or severe, need to be addressed out loud. Growing up, our dinner table talk involved a lot of hospital calls my dad would have to answer, shouting out things like ‘rectal bleeding’, ‘anal fissures’ and, yes, lots more dinner-inappropriate terminology. The horror on our friends’ faces whenever they visited was hysterical to say the least. However, that was our norm, where bowel talk was nothing to be ashamed of.

As I began to put this book together, I didn’t want this to be “just another gut health book” on one’s shelf, given how saturated the market is. Reflecting back at my practice in hospitals and my own clinic, I decided that The Gut Chronicles should cover the seven most common gut conditions that many find themselves secretly “googling” about. It features easy-to-digest guidance on the lifestyle management of the following, through storytelling and humour: Reflux disease, Bloating, Constipation, Diarrhoea, Irritable Bowel Syndrome, Food Intolerance and Haemorrhoids.

The book also offers a roadmap to a blissful gut, which covers my 4-pillar approach and addresses the relationship between gut health and mental health, given how the recent pandemic has had an impact on both. The characters in the book were all inspired by my clients, which makes it relatable to the reader and I also included snippets of my own personal gut struggles as well as my own turbulences with mental health. Most importantly, I wanted to ensure that the backbone of the information provided was based on the latest science but communicated in a way that would not lose the reader.

It was only fitting to end the book highlighting how our poo has literally opened up a portal to a world that may be central to health and wellbeing and reminding everyone that a little bloat never killed nobody, but a lot of uncomfortable bloat with dramatic changes in poo has.

Sandra Mikhail’s ‘The Gut Chronicle’ comes out on June 25th. Use code ‘TGC2023’ at checkout to receive 20% off your first order.

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There is always someone behind Dementia


The following is an extract from ‘The Dementia Whisperer’ by Agnes B. Juhasz, which looks at the importance of a ‘person-centred’ approach in dementia care and how to understand the person hidden behind the condition of dementia.

There is a personality in every single human being, an absolutely unique code and pattern built up over a lifetime, and the way to understanding the person hidden behind the condition of dementia must not be blocked by obstacles such as language differences, communication problems, short-term memory loss or other physical and mental causes. This is the fundamental aim of the person-centred
care model I have always used – to help overcome these obstacles while finding out what the person with dementia really needs and what he or she really want. That is why the person must be taken into account first, before the disease.

I cannot emphasise too strongly the importance of the person-centred approach in dementia care. Taking each affected person as an individual, carers must start to learn their life history, habits, hobbies, fears, things they are proud of and all the tiny elements that make them happy or sad. They must get to know the subjective world of dementia, the world of the forever ‘I don’t know’. Carers must try to make contact with the personality that is hidden behind the barricades and search for an indirect connection while constantly checking on the physical needs of each person in their care, ensuring their comfort and doing their best to make them feel at home and safe. It is not good enough only to hear what people with dementia say; carers must let the words reach their innermost minds, if not their souls, if they really want to understand what dementia sufferers are trying to communicate.

Efforts to make a connection with a person with this condition will be much more effective if these guiding principles are kept in mind. In this way, carers can build up a kind of ‘special manual’ that quickly provides the answers to questions about the whys of seemingly odd or
annoying behaviour patterns.

If somebody desperately wants to go ‘home’, insisting that where they are is not the place where they belong, such behaviour can be
understood as communicating the fact that they do not feel safe or comfortable at that moment for a variety of reasons, and that they want
to go somewhere where they will feel reassured.

If the individual keeps saying they must go to work, even though they have been retired for years, it can mean they yearn to be useful and
busy again, and are feeling bored, worthless and useless.

If a person with dementia is looking for a wife or husband who died years earlier, it might highlight an individual’s lack of company and
need for emotional support.

Speaking this unique ‘language’ helps carers not only to understand different situations but means that they can also be the rock on which these people can rely and trust.

During my time working with Sylvia, I have noticed that it has become an involuntary habit of mine to speak to her more slowly and with more articulation than I usually do with other people. She speaks clearly and deliberately, perhaps because of her background in languages, and at first I think I copied her, which incidentally was very good for my English. Now, I believe that my speaking slowly has the added benefit of giving her the chance to think during the conversation and the time to find and select the right words to express as clearly as possible what she really means or wants to say. I also always take care to eliminate every possible barrier or extraneous noise from our verbal connection.

When Sylvia is watching TV, she usually has the volume up high because of her hearing impairment. Although she has got hearing aids, she prefers not to wear them at home, especially when she is watching television, as they make not only the speech but also the background noise far too loud. Naturally there are moments when she wants to say something during a Poirot or Miss Marple episode, and I always automatically turn the volume down immediately to get rid of a very disturbing communication barrier.

In verbal communication I have learnt never to switch topics quickly as people suffering from dementia are unable to follow quick changes of idea. If I have asked a question and I realise that Sylvia’s response has nothing to do with the question asked, or she says something totally incoherent, I try to rephrase what I have just asked or said, and that usually solves the problem.


Reminiscence therapy is a crucial part of dementia care work. This person-centred approach concentrates on the personal life history and
the most pleasant memories and occasions of the life of a person with the condition. Recalling personal experiences and skills that the person used to have, while showing a lot of love and interest, provides very strong support to the current mental state so that the mind can function at its maximum. If a person’s mental and emotional states are well balanced, they have a positive effect on the person’s physical health too.

‘The Dementia Whisperer’ by Agnes B. Juhasz is based around real-life stories and provides insights into what she has found works and does not work, and candidly reveals her own emotions of frustration, irritation and – sometimes – amusement, and how she has learnt to cope with these.

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Difficult Conversations about End of Life

Author of upcoming book ‘Dodging Dementia: Understanding MCI and other risk factors: Second edition of The Essential Guide to Avoiding Dementia’ Mary Jordan has written the following blog which provides insightful support on the difficult conversations surrounding end of life. Her newest book will be available on Hammersmith Health Books and other online vendors in September!

A diagnosis of dementia is an opportunity to come face to face with our own mortality – and that of those we love. It may not be an opportunity everyone wants to embrace but in some ways this diagnosis gives us all a chance to accept our mortality and, if desired, to plan for how we would like our own end of life to be. Carers have told me that although they found the subject difficult to face, they have often been strengthened by the experience of considering their own end and have achieved some measure of peace from doing so.

Understanding the end-of-life wishes of someone with dementia

Establishing end-of-life wishes can be a very important part of caring. Even if discussing these matters after diagnosis is difficult, carers can at least be sure that they are doing an important and loving thing. It can be very difficult for people with dementia to make their wishes known. An important factor in dementia is the loss of the ability to foresee or understand the consequences of one’s actions or even to think clearly about the future. People with dementia have a tendency to exist ‘in the now’ and may find it very difficult to engage in discussion about a theoretical future. This means that effort to establish feelings about the end of life may have to be inferred.

It is important not to transfer our own feelings onto the person we are caring for. Just because we may feel that we would ‘rather be dead than demented’, this may not be how a person with dementia feels. We should listen to the way someone talks rather than trying to use direct questions. People with dementia may use expressions such as: ‘It’s awful’ or ‘There is nothing left’ or ‘I’m angry’ when asked how they are and this can be indicative. Others will answer ‘I’m fine’ or ‘I feel Ok’ or ‘Very well’ to the same question.

Reality vs. our preferences – the value of making a plan

Unfortunately, the final days of life often come in an unexpected manner. We would all like to imagine a final peaceful ‘drawing to a close’ of life, perhaps surrounded by loved ones, well cared for and pain free. The actualities can be quite different. Perhaps a fall or an infection is followed by an emergency admission to hospital and a fast deterioration. Sometimes residential care homes are so worried about possible accusations of neglect or mismanagement that residents at the end of their life are admitted to hospital instead of being cared for in the surroundings they are used to. There may not be time to consider wishes and advanced plans in these circumstances but remember that where these have been discussed and recorded it is more likely that they will be adhered to. Hospitals are generally bad places to die (they are designed to care for and cure) and privacy and peace and calm are rarely obtained there. Nevertheless, my experience is that families who have discussed end of life and who have planned and considered ahead often feel more comfortable about events leading up to death even if things have not turned out the way they planned.

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Spreading the word about Carers

The following blog is by Sara Challice, award-winning author of ‘Who Cares? – How to care for yourself whilst caring for a loved one.’

Have you heard of Health and Wellbeing boards? No, I hadn’t either, until I was asked to be on one a few years ago to represent carers within my borough of Richmond.

There are 153 Health and Wellbeing boards across the country, and their purpose is to establish collaborative decision making, planning and commissioning across councils and the NHS, informed by the views of patients, people who use services and other partners.

At present, I believe I am the only one on one of these boards, but we need a Carer Representative on every board – to ensure carers are represented across the UK, and are considered and supported within the various upcoming papers and proposals. Because if there is a paper on residents living with long-term health conditions, you can guarantee there will be a carer behind the scenes supporting them – but carers can often still be overlooked.

Please do get in touch with your local council and ask your Health and Wellbeing board if they have a Carer Representative.

Supporting Working Carers

Did you know 600 working carers quit every day due to the insufficient support? And inadequate support for working carers costs UK businesses £8.2bn every year.

But there is a better way.

Businesses Virgin Media O2 and Sainsburys recognise carers in their workplace need support, and I give online sessions supporting staff caring for loved ones. Often given during lunchtime hours, these invaluable sessions allow space for carers to learn self care tips, insight and psychology to help them become more resilient and regain balance, whilst juggling work with caring. These sessions can also include their line manager, so there is a learned experience for all, creating a supportive collaboration within the workplace, allowing for better communication.

Sharing Learned Experiences

Have you heard of Caregivers Burnout, the Helper’s High or Compassion Fatigue?

This invaluable insight, and much more, is shared in my sessions to support those caring for loved ones. Whilst engaging carers, I share stories and tips to help improve their health and wellbeing, and each session focusses on a particular topic, helping them gain clarity on all that is happening to and around them, whilst they take back control and find ways to enjoy their lives again – guilt free.

Of recent, carers have been asking for a session on, ‘Preparing for life after caring,’ because often, we just never know when our caring role may suddenly come to an end.

What can carers expect, and what steps can they put in place now to safeguard their own needs for when this big life event occurs? In this particular session, I share my own experience during my transitions once my caring role had come to an end, and I share insight and strategies to help carers with their transition, creating resilience whilst boosting their own health & wellbeing.

“I so could have done with this information. It would have made life so much easier!” – says Sara

Finally, Sara is giving a keynote speech in London for Carers First, a charity supporting carers over a number of counties. In sharing insight and knowledge, the event brings together trustees, staff and volunteers to collaborate, celebrate and plan for the future.

“Sara has delivered many online sessions for Carers UK, and we were delighted when she ran a series of Wisdom to Empower sessions for us, which were some of our highest attended online meet ups of the year.  The sessions were highly valued by the carers, providing them with vital support during one of the most challenging times of their lives. Sara shared lots of tips and insight to help them gain the clarity to make positive changes in their lives and maintain wellbeing – not only for themselves, but for those they care for.” – Michael Shann, Head of Membership and Volunteering, Carers UK

Read the first chapter of ‘Who Cares?’ for free here and to get in touch with Sara to learn more about her engaging sessions for carers, please email, or to learn more of her expert information, advice and support, transforming the lives of carers, go to

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The Damaging Effects of Chronic Stress

chronic stress

The following is an extract from ‘The Plant-Based Dietitian’s Guide to Fertility’ by Lisa Simon RD and looks at the effects stress can have on fertility. The book will be available for purchase on Hammersmith Health Books and other online vendors this month. 

I cannot emphasise enough how significant an effect chronic stress can have on your health. I would go so far as to say that it is at a level playing field with nutrition and, if it isn’t addressed, quite simply you will not improve your health.

Your body’s response to stress is instant and starts in your brain. It begins a series of interactions between the hypothalamus, pituitary and adrenal glands. This results in the release of adrenaline and cortisol, two of the ‘stress hormones’, from the adrenal glands. Once the stress has passed, your cortisol and adrenaline levels reduce back down. This step is really important as the communication between the glands in your brain and the adrenal glands above your kidneys also influences the production of sex hormones. If the stress doesn’t pass, the stress response doesn’t stop and this results in disruptions to your reproductive hormones. It is because of this that chronic stress may lead to poorer sperm quality and infertility in both men and women.

The effects of chronic stress on fertility

So, the effects of chronic stress on general health but also on fertility can be significant, and sometimes it feels like a bit of a vicious circle. Struggling to conceive is stressful, going through fertility treatment is stressful, and worrying about the effects of stress is stressful! Add that to general life stressors like work, relationships, social pressures, financial strains etc, and you can see how present stress is daily, even if you are not always aware of it. This is when the effects of such stress can start to become apparent in your state of health and affect your fertility, and this is why it is so important for both your mental and physical wellbeing to have in place some great stress management techniques. In terms of fertility treatment, data show that men report feeling stressed providing sperm samples on the day of egg retrieval, and this may negatively affect overall semen quality, with effects on sperm concentration and motility. However, it is difficult to say whether stress results in reduced semen quality, or whether it is a consequence of decreased semen quality.

Being diagnosed with infertility, frequent medical appointment, and failed IVF treatment are all very stressful events. It isn’t just the stress itself though that can affect sperm quality; how you respond to stress may also play a part. Responding by being assertive or confrontational may negatively affect fertility by increasing adrenaline production which then results in the blood vessels in the testicles tightening. This reduces testosterone production and the making of new sperm, so for men, stress management techniques are just as important as for women.

As stress causes an increase in cortisol and subsequent suppression of sex hormones, this can lead to a decreased sex drive and can also lead to undesired weight gain. Whereas acute stress is more likely to result in a reduced appetite, chronic stress is more likely to decrease behavioural control and increases impulsive behaviour. An estimated 35-40% of those experiencing stress increase their food intake. The types of food likely to be chosen are foods high in sugar and/or fat, with low-energy, high-nutrient foods, particularly fruit and vegetables, decreasing. This may then lead to overeating, which in turn can lead to weight gain and potentially increase feelings of anxiety and depression. Conversely, some experiencing chronic stress may decrease their food intake, leading to weight loss, with potential adverse effects on their mood, energy, concen­tration and, for women, their menstrual cycle.

Managing Chronic Stress

Managing stress is the third pillar of lifestyle medicine and essential to improving your chances of conceiving a healthy baby. In terms of techniques for doing so, everyone is different, and what might work for one person may not necessarily work for the next. For example, I’ve had patients telling me that meditation is their idea of ‘hell’, but then when I explore further, I find their concept of meditation is sitting on a yoga mat, cross legged, with both hands raised, fingers touching, while gently humming. This stereotypical image does not reflect the broad spectrum of meditation and is very different to most people’s practice.

Note from the author: In my new book, The Plant-Based Dietitian’s Guide to Fertility, I recommend the following from which you can pick and mix what is right for YOU. Please do see the book for the full information:

  • Guided meditation
  • Controlled breathing
  • Positive visualisation
  • Laughter therapy (yes! You heard right)

My experience of managing stress after embryo transfer

I can’t say that I didn’t worry at all during the two week wait after embryo transfer as I think some degree of anxiety is inevitable when you are pinning so much on something working, but every time I felt as though my anxiety was starting to get too high, I would apply some or all of the stress management techniques I describe in the book to bring it down.

Another thing I would highly recommend, if it is possible for you after embryo transfer, is to book those two weeks off work, or at least the first week. You want to remain as calm and stress-free as possible during that time, not having to deal with the commute if you are not working from home; work stress is something that you just don’t need. Also, finding something to occupy your mind is crucial so you don’t spend long periods trying to second-guess whether you are pregnant. That can be really counterproductive, and please, STEP AWAY FROM GOOGLE! It can be so tempting to search the internet for ‘signs I am pregnant’ or ‘what does implantation feel like?’ but this can raise stress levels and mean that you are obsessing over the slightest little sensation. Try and spend those two weeks doing lovely things with either your friends or your partner. Go out for relaxing meals, watch a film in the cinema, organise a pamper evening, do some crafting – anything that helps you to relax and distracts you from negative thoughts.

And remember, if none of these techniques are for you, there are many other forms of stress management that can be equally as effective. These can be going for a lovely walk, or a gentle run outdoors in nature, curling up with a cuppa and your favourite book, or having a lovely warm (not hot) bubble bath. As long as you take some time out, away from your phone and other screens, and just focus on being present, you will feel much better for it.