Category: Mental health

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The Science of Stress Hormones

Stress Awareness Month

Exploring the role of hormones for Stress Awareness Month

There are two main hormones governing the stress reaction: cortisol and adrenaline. They work together to exert the ‘fear, fight or flight’ response that was first described in the scientific literature as long as 1936. This response gives a temporary increase in energy production, at the expense of processes that are not required for immediate survival. The resulting biochemical and hormonal imbalances should ideally resolve as soon as the danger is over, due to a hormonally driven negative feedback loop. The following is a typical example of how the stress response is supposed to operate as a survival mechanism:

* An individual is faced with a stressor

* A complex hormonal cascade ensures, and the adrenals secrete cortisol

* Cortisol prepares the body for a fight-or-flight response by flooding it with glucose, supplying an immediate energy source to large muscles

* Cortisol inhibits insulin production in an attempt to prevent glucose from being stored, favouring its immediate use

* Cortisol narrows the arteries whilst adrenaline increases heart rate, increasing the blood pressure and delivering more oxygen rich blood to the tissues

* The individual addresses and resolves the situation

* Hormone levels return to normal

Unfortunately, with our over-stressed, fast paced lifestyle, our bodies are pumping out cortisol almost constantly, which wreaks havoc on our health. In times of high stress the body will break down amino acids to form glucose through the process of gluconeogenesis (a physiological process via which proteins and amino acids are utilised, instead of glucose), to produce energy. Cortisol is the major stress hormone that promotes this process. Collagen, being a structural tissue made from protein, is one of the target areas for spare amino acids; the muscles are another. Chronically elevated stress levels increase collagen breakdown. Since collagen is the matrix upon which our bones are built, anything that is likely to break it down will have potentially serious consequences for the strength and integrity of the bones.

Cortisol primarily acts on the outer layer of the bone, known as the periosteum. Research has shown that elevated cortisol levels interfere with the formation of osteoblasts and cell proliferation. This dramatically decreases bone building and lowers bone density. Without adequate rest and repair, bone mineralisation and collagen formation will be reduced for the duration of the elevated stress.  The absorption of vitamin D is also adversely affected by high cortisol levels. This gives a double whammy in favour of bone loss.

Stress can rot your bones faster than a can of fizzy drink. Stress and the negative emotions that accompany it have been shown to have a chemical structure in our bodies. And guess what? That chemical structure is acidic! With all the emphasis I place on ensuring appropriate intake of alkaline minerals in earlier chapters, and the fact that increased acidity causes increased urinary calcium excretion, is it any wonder that for prevention and reversal of osteoporosis we absolutely have to take stress reduction seriously?

The power of exercise

My favourite way of combating the stress that often accompanies a bad day at work is to get out and go for a run, or go to a karate class. Both are also excellent ways of not only de-stressing the body but also improving bone strength. Exercise is a surefire way to de-fuse. It boosts the level of endorphins in the brain, morphine-like ‘happy hormones’ which are often depleted by our daily lives. Relaxation classes and guided meditation are well worth doing, as is a meditation based on love and compassion. Thoughts of love and compassion stimulate the production of a hormone called oxytocin, whose effects in the body work in the opposite way to those of cortisol. Oxytocin lowers the blood pressure and relaxes the walls of the arteries.

This blog is taken from Love Your Bones: The essential guide to ending osteoporosis and building a healthy skeleton by Max Tuck.

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Sleeping for Health

We love bed times. Nothing beats a good night’s sleep, but it isn’t always so easy to get one so we’ve put together some of our favourite sleep facts and tips from three of our health books. If you’re catching more AAAAAH!s than ZZZZZZs we hope this blog can help you find the sleep of your dreams.

 

Prepare to snooze or prepare to lose

Ensure that you don’t eat within three hours of bedtime – easy to say, possibly harder to do. I know many people who snack in front of the TV in the evenings. Watching TV late in the evening can interfere with your sleep patterns, and we need that surge of human growth hormone that occurs shortly after we fall into deep sleep. Reading, or meditation, to calm the mind prior to going to bed allows the body to go into sleep mode more naturally. Eating too close to bedtime also causes a surge in cortisol, the stress hormone that we know is bad for bones, so don’t fall into this trap. If you have trouble sleeping, try a camomile or valerian tea before bed. These herbs are non-addictive and have no adverse side effects.

– Love Your Bones: the essential guide to ending osteoporosis and building a healthy skeleton by Max Tuck

 

Food, water…sleep?

Humans evolved to sleep when it is dark and wake when it is light. Sleep is a form of hibernation when the body shuts down in order to repair damage done through use, to conserve energy and to hide from predators. The normal sleep pattern that evolved in hot climates is to sleep, keep warm and conserve energy during the cold nights and then to sleep again in the afternoons when it is too hot to work and to hide away from the midday sun. As humans migrated away from the Equator, the sleep pattern had to change with the seasons and as the lengths of the days changed.

After the First World War a strain of Spanish ‘flu swept through Europe killing 50 million people worldwide. Some people sustained neurological damage and for some this virus wiped out their sleep centre in the brain. This meant they were unable to sleep at all. All these unfortunate people were dead within two weeks and this was the first solid scientific evidence that sleep was as essential for life as food and water. Indeed, all living creatures require a regular ‘sleep’ (or period of quiescence) during which time healing and repair take place. You must put as much work into your sleep as your diet. Without a good night’s sleep on a regular basis all other interventions are undermined.

– Prevent and Cure Diabetes: Delicious diets, not dangerous drugs by Sarah Myhill and Craig Robinson

 

Sleep and mental health

When sleep requirements are not being met on an ongoing basis, teenagers will present with fatigue, low energy, exhaustion, and a lack of motivation. It is generally recommended that teenagers get eight to 10 hours’ quality sleep a night. This is vital for the body to relax, repair and refuel. Lack of sleep has a domino effect and impedes mental and physical wellbeing, inviting the onset of self-defeatist syndrome. As I have said already, parents are advised to take their child to a GP to rule out any organic causes of fatigue. In instances where no organic cause is established it is highly likely that the Gremlin has moved in. The Gremlin loves and thrives on the darkness. It becomes alert and active, coming out to play its evil games at night when we are programmed to relax, unwind and fall into a peaceful slumber. The Gremlin is very powerful and demanding, wanting to keep us awake, bolstering and encouraging negative thinking, which leads to rumination, tossing and turning and feeling like our head is going to explode! Thoughts are negative, racing and exhausting. It is vital that teenagers who have been taken hostage by the Gremlin receive appropriate support and professional intervention so they may be facilitated in developing the tools and techniques needed to evict the Gremlin.

– Overcoming Self-Harm and Suicidal Thoughts: a practical guide for the adolescent years by Liz Quish

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Self Injury Awareness: Getting to know the ‘Self-Defeatist Gremlin’

Understanding ‘Self-Defeatist Syndrome’

A person whose head is bowed and whose eyes are heavy cannot look at the light.

Christine de Pizan

What I will term ‘self-defeatist syndrome’ is the uninvited Gremlin that moves into young minds, metaphorically speaking. The Gremlin is STRESS that leads to DISTRESS, an unruly tenant that is powerful, deceitful and controlling. Its ultimate goal is to take control of a teenager’s life in a destructive manner causing him/her to feel alone, depressed, angry, afraid, hopeless and anxious. The Gremlin’s goal is to isolate the teenager from family and friends, thus making itself even more powerful. It wants to make the teenager feel lonely and powerless, surrendering to the darkness, diminishing his/her light and self-esteem, distorting his/her belief system and sense of self.

The sense of self

The ‘self’ relates to our uniqueness and individuality, our thoughts, feelings, perceptions and sense of worth, and how we view ourselves. The self also relates to our sense of identity, our belief system and values.

A teenager with a healthy sense of self will:

  • feel confident and competent
  • feel a sense of belonging and acceptance
  • feel secure, safe and valued
  • have self-discipline and self-control
  • learn from and move on from mistakes with new awareness
  • value his/her strengths and accept his/her weaknesses
  • have a healthy set of core values

These are all the traits that the gremlin of self-defeatist syndrome despises and wants to eliminate. The Gremlin does not want the teenager to have a healthy sense of self; a healthy sense of self is its enemy. Its wish and desire is for the teenager to have a defeatist view of him/herself. In achieving this, the Gremlin has accomplished its objective and is actively compromising the wellbeing of teenagers, who are not strong enough to evict the Gremlin on their own.

The defeatist attitude

The ‘defeatist attitude’ refers to an attitude or view of oneself which is negative, pessimistic and unforgiving. A teenager with a defeatist view of him/herself will present with low self-esteem and a noticeable and ongoing lack of motivation, generally deriving little pleasure from life, with a distinct lack of belief in his/her abilities. This is a clear sign that the Gremlin has moved in and taken the teenager hostage. Teenagers in this situation will often use phrases like:

  • What’s the point?
  • It won’t work for me
  • They would all be better off without me
  • It’s just one thing after another
  • I couldn’t be bothered
  • I can’t manage this anymore
  • I am no good
  • No one cares about me
  • I can’t do it

Syndrome

A ‘syndrome’ refers to a combination of signs and symptoms that are indicative of a particular condition. A teenager in midst of self-defeatist syndrome will generally present with:

  • Low energy
  • Low self-esteem
  • Depression
  • Anxiety
  • Anger
  • Self-harming
  • Suicidal ideation (thinking)

Low energy

A teenager can experience low energy for a number of reasons. Adolescence is a period marked by a rapid increase in physical and emotional development. Puberty, hormonal changes and the soaring growth of bones and muscles can have a temporary effect on energy levels, causing many teenagers to feel fatigued from time to time; this is totally normal and to be expected. However, if low energy persists and negatively effects the quality of life of a teenager, a detailed and comprehensive medical investigation is warranted and strongly advised. A full medical investigation should uncover any organic reasons for fatigue and low energy; then, the right treatment can get a teenager’s energy levels back on track and prevent the onset of self-defeatist syndrome.

Common organic reasons for low energy uncovered through a medical investigation in teenagers include:

  • Infection
  • Virus
  • Iron-deficiency anaemia
  • Low thyroid function
  • Vitamin B and C deficiencies
  • Allergies

Harder to diagnose, and more unusual in younger people, are underactive thyroid (hypothyroidism) and pernicious anaemia/vitamin B12 deficiency.

If after a full medical investigation no organic causes for low energy and fatigue can be detected, then lifestyle needs to be further scrutinised and addressed as the Gremlin may be actively trying to move in.

Please share this blog to raise awareness of Self Injury Awareness Day (SIAD).

This blog has been adapted from Overcoming Self-harm and Suicidal Thoughts: A Practical Guide for the Adolescent Years by Liz Quish.

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Spotting the Signs of Emotional Eating

For many who are compulsively driven to eat for emotional reasons, not hunger, food has become a manifestation of self-loathing and a complex method of self-harming, or even a way of failing to thrive. These people crave food, avoid food, binge on food and obsess about food. Thinking about food fills their every waking moment. Food has become a way to celebrate and commiserate with themselves. In fact, it is their everything – except a natural way to sate hunger or be a source of healthy nourishment.

Typically, emotional eaters feel their appetite for food is out of their control and is counter to their heart’s desire to be slimmer than they are. They feel their inability to resist their food cravings proves how worthless they are as they trade their dreams of being slimmer for swallowing down foods they consider to be ‘bad’ or ‘forbidden’. They also often believe that the excess weight they carry is their own personal failing and visible proof for all to see that they are weak, inadequate or just plain greedy. The story they tell themselves continues with the common beliefs that if they were stronger, or had more will-power, or were simply just ‘better people’, then they would find it easy to manage their weight-versus-food-intake without the daily time-consuming over-thinking that they endure.

Every emotional eater has his or her own unique set of circumstances and history, but there are often similarities in thinking and in the belief system that defines each emotional eater. For instance, emotional eaters judge themselves harshly and their self-talk – the quiet voice that everyone hears within their own mind – is particularly critical and unforgiving. We also understand that emotional eaters can be triggered to binge eat when experiencing negative or challenging emotions, such as loneliness, sadness or anger.

Disordered thinking around food that emotional eaters may experience makes it particularly challenging to establish a nutritionally balanced way of eating that can be sustained for the long term. This is particularly true for those who are attempting to stabilise their weight after years, or possibly even decades, of yo-yo dieting.

Emotional eaters do not generally fare well following a type of diet that brings any of the following circumstances into play:

1. Diets that promote low-calorie eating to a level that induces hunger can quickly feel unendurable and trigger strong self-sabotaging behaviour.

2. Diets that rely on low-fat foods to restrict calorie consumption can increase the occurrence or severity of low moods, even to the risk of increasing the incidence of depression.

3. Diets that replace foods containing real sugars with chemical sweeteners can still spark compulsive sugar cravings and out-of-control bingeing.

4. Diets that replace meals with fake-foods, such as shakes, snack bars, instant soups or variations on this theme, often fail for emotional eaters when they are challenged with the inevitable reintroduction of real food.

5. Diets that promote or exclude whole groups of food, impose excessive or irrational rules or demand a specific cooking methodology can all help encourage unhelpful over-thinking about food that emotional eaters are already prone to. This includes the eating of only ‘free-from’ foods, including gluten-free (without a confirmed medical need), or following a strict macrobiotic diet, or eating only raw foods.

Do you obsessively follow all the latest healthy eating crazes, or recognise other symptoms of emotional eating? Read more from Sally Baker and Liz Hogon in their books How To Feel Differently About Food and 7 Steps to Stop Emotional Eating.

Sally Baker will be speaking at The Best You Expo at ExCel in London on 4th March 2017.

This blog is adapted from How To Feel Differently About Food by Sally Baker and Liz Hogon.

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Discussing dementia with Jeremy Hunt, Secretary of State for Health

Since I began working with a national dementia charity nine years ago there have been many improvements to the level of support that people living with dementia (by which I mean both those with a diagnosis and their families and carers) receive. It is now rare for me to meet someone who has struggled for months to get a diagnosis. More GPs are aware of the signs and symptoms and people are more likely to be referred for memory assessment. When I met Jeremy Hunt he explained that he had been campaigning for earlier diagnosis knowing that this can make it easier for people to get the help and support they need. We discussed what still needed to be done for those affected by dementia.

It seems to me that the most important thing now is to get society in general to accept those with dementia and to keep them integrated in the company they know and enjoy. Day centres, Dementia cafés and other specialist services like musical memory groups all serve a useful function and are popular -until recently I ran a very well attended and popular dementia café myself – but our real aim should be to make it possible for people with dementia to continue to go to the social groups, clubs and events which were part of their life before diagnosis.

Some things are already being done. In many places, in Britain there is a huge campaign to make businesses, shops, and public areas ‘dementia friendly’.  The ‘Dementia friends’ campaign by Alzheimer’s Society has also had a big impact in terms of making people generally aware of the difficulties experienced by those with dementia trying to function in everyday life. These are all good initiatives. But acceptance is the key. The above initiatives make people aware of dementia and they may make people more willing to help when they see someone having difficulties but do they make people with dementia more accepted?

Dementia is a problem for all of society but this is still little recognised. Most public places are now ‘accessible’ in terms of physical disability with level paths, ramps for wheeled access, better signage, bigger parking spaces and so on. We should now consider making changes to improve accessibility for those with the cognitive disability. Such changes might include material factors such as better street signs, clear demarcation of different areas and well defined entrances and exits but they should also include the vital human factor. People with dementia need support from other humans. Assistive technology can be helpful in a limited way but social interaction is what slows the slide into helplessness. Just as the public have been educated to recognise the rights and needs of those with a physical disability, so the rights and needs of those with a cognitive disability need now to be addressed in our neighbourhoods and our public places and by all of us in our local communities.

Mary Jordan is an expert in dementia care and works for a national dementia charity. Her books The Essential Carer’s Guide to Dementia and The Essential Guide to Avoiding Dementia offer invaluable insights into the condition and how to care for those with the condition.

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UK Blog Awards for Health & Social Care

The UK Blog Awards 2016 are now open for nominations, and we’re hugely pleased to announce that Hammersmith Health Books will be sponsoring the Health & Social Care category.

We love the variety and quality of blogs on all aspects of health and caring in the UK, and the UK Blog Awards are a fantastic opportunity to give much needed recognition to the blogs that mean the most to their readers. We’re so excited to be involved!

Nominated blogs pass a public vote round before the final awards are decided by specialist judging panels for each category. This year, our founder and director Georgina Bentliff will be on the Health & Social Care judging panel.

All short listed blogs will gain exposure and reach new audiences, as well as having the chance to connect with more brands.

The UK Blog Awards were created in 2014 to recognise true viral style and creative excellence across 16 UK industries, as well as awarding two sub-categories: Best Storyteller and Most Innovative award. The awards are more than an event, but a digital outreach platform that connects blogs with brands. There will also be Blog of the Year Award, sponsored by Odeon, giving winners from each category the chance to win extra prestige in the blogging community.

We’ve also teamed up with Action PR to co-host a blogger event in London where hopeful award winners can learn more about what the judges will be looking for, and network with brands and other bloggers. There’ll be a selection of our books available for bloggers to take away and read on health issues from chronic fatigue to irritable bowel syndrome, dementia care to vegan food, and everything in between.

If you’d like to follow some of our authors’ blogs check out:

Max Tuck, The Raw Food Scientist, author of Love Your Bones and The Whole Body Solution

Martyn Hooper, Chair of the Pernicious Anaemia Society, author of Pernicious Anaemia – The Forgotten Disease, Living with Pernicious Anaemia, and What You Need to Know About Pernicious Anaemia

Jenna Farmer, A Balanced Belly, book on IBS and IBD coming soon.

Dr Megan Arroll, psychologist and author of Irritable Bowel Syndrome, Navigating Your Way to Health

For more info on the awards and how to enter click here, and browse all our health and social care titles here.

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Caring for Loved Ones with Alzheimer’s and Dementia

When dementia takes hold you need outside support because, as people get worse, they cannot be left alone for any length of time and the carer needs to share the burden with others.

When it comes to dementia you cannot ‘go it alone’. It doesn’t matter whether you are independent and used to managing your own affairs, that you’re ‘not a sociable person’ or are used to ‘keeping yourselves to yourselves’. You as a couple (carer and person with dementia) may pride yourselves on one, any, or all of these virtues, but it is important once dementia strikes that you re-think your attitudes.

Why do you need a support team?

A person who has dementia can NOT live alone successfully, and in a perfect world we would never expect them to do so. ‘Care packages’ that involve carers calling in once, twice or even three times a day to help someone living alone are only a stop-gap measure. Very good carers who take pride in their work and genuinely care about their clients can make a difference, but they cannot replace the constant watchful presence that is required in all cases except the very early stages of dementia. Sometimes, however, this kind of care is the only and right option at the time and in this case it is important to get the very best care package that you can as long as it is possible to manage this way.

On the other hand, spouses and partners who live with someone who has dementia are put under constant stress as they try to look after them. Living with another person – even when they are in good health – requires constant compromise as we adjust our habits, actions and conversation in the interests of ‘rubbing along together’. Over many years these actions and adjustments become habitual, but they still remain. The most important thing to remember and take note of is that in any social situation all persons are involved in this constant compromise. Of course we can recognise that most partnerships are unequal and that one partner may take more adjustments than the other.

Usually the person who makes more adjustments to the will of another does this willingly. Nevertheless, living with someone involves a constant daily compromise between pleasing ourselves and pleasing another. But people who have dementia gradually lose their ability to see another person’s point of view – they lose their ability to empathise, to understand the everyday compromises that kept the partnership going. The partner who is the carer is left making all the compromises – possibly without even the satisfaction of a shared sense of humour or of togetherness – and certainly without the feelings of support they may have once had from their partner.

This is a burden no one, however loving and dedicated, should carry alone.

If you are a carer in this situation you can build a team to help you.

Who will be on your team?

Your support team can consist of anyone who is prepared to give time and help to you and the person you are caring for: family, friends, neighbours, professional carers, staff in a day centre and support workers from organizations such as the Alzheimer’s Society can all be included.

For more support and guidance on building your team read The Essential Carer’s Guide to Dementia by Mary Jordan, available as paperback and ebook.

This blog was published for World Alzheimer’s Month #RememberMe

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What is emotional eating?

There is no single definition of typical emotional eating. It’s a common misconception that all emotional eaters are overweight. Many are within normal weight range but only because of their obsessive dieting, bingeing and disordered eating that will be a well-kept secret they share with no one. The same negative judgements emotional eaters make about themselves are common to the overweight and the obese, and the dangerously underweight for that matter. All share the trait of unrelenting over-thinking about food coupled with harsh, critical self-judgements.

To give you a sense of a typical emotional eater you need to understand that their innate sense of self-worth – how they actually see themselves as a worthy person – is closely linked to the numbers on their bathroom scales. A pound lost, or a pound gained, can set the tenor of their entire day. Also, foods are never neutral. They are forensically studied and determined to be good or bad.

Emotional eaters battle with their own body’s hunger and cravings. They know there have been times when they have succumbed and eaten one ‘bad’ food only for it to start a tsunami of overeating, or even bingeing and purging, with all the accompanying feelings of shame and self-loathing. An emotional eater’s attitude towards him/herself and food is not logical. The extent of his/her preoccupation with food and body weight is often a private source of great personal distress and shame. The reasons for this all-consuming link between food, body weight, self-definition, and how the individual feels about being him/herself in the world, are varied and inevitably complex.

Let’s be clear, and define emotional eating as a behaviour that occurs only in the developed world, the lands of perceived plenty. Negative selfjudgements; obsessive over-thinking about calories; skipping meals; bingeing and purging; or any of the other many aspects of emotional eating do not exist in countries of food scarcity or where people struggle for survival. It’s noteworthy that as third world countries emerge economically onto the world stage they open their doors to western influences and their seductive power. The socially mobile classes of any indigenous population quickly develop a taste for western fashion, and music, as well as western foods. The Standard American Diet of refined carbohydrates, calorie-dense fast-foods and fizzy drinks is now exported all over the world. Adopting it is a way of aping western consumption, and values, and can be found in the cities of China, Russia and India, as well, increasingly, as in more remote outposts. It also causes sectors of the population of these countries to judge themselves negatively against the narrow, westernised standard of perfection. With that comes self-dissatisfaction – a step on the road to emotional eating that was not apparent just a few decades ago.

Are you an emotional eater?

Here are some questions to ask yourself if you think you might be an emotional eater:

Too much on your plate?

Swallowing down your anger with food?

Frustrated at your yo-yo dieting?

Eating when bored, or on your own?

Feeling out of control around food?

Eating in secret?

Bingeing and purging?

Feeling sad and eating to fill a void inside?

Rewarding yourself with food after a hard day?

If you answer yes to any of these questions you might be an emotional eater. For more information about how to understand and manage your emotional eating, read Seven Simple Steps to Stop Emotional Eating – targeting your body by changing your mind by Sally Baker & Liz Hogan.

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Longer GP visits will save the NHS money

Both the British Medical Association and Glasgow researchers have reinforced the Society of Medical NLP’s claims that longer sessions for patients visiting a GP will save the NHS money.

In Magic in Practice (London:Hammersmith), the authors, Garner Thomson and Khalid Khan, point out that patients who were allowed to express their “uninterrupted story” to a doctor who was trained to address the context of the complaint as well as the content would dramatically reduce the number of visits required to resolve the issue.

Four GP practices in Glasgow offered  patients with complex chronic conditions (of the kind specifically addressed by Medical NLP) consultations lasting 30 minutes or more. Not only was the condition diagnosed, but personal problems were dealt with and care plan devised and suitable goals negotiated with the patient – similar to the “Ko Mei” format of Medical NLP.

The result was a measurable drop in “negative wellbeing” and a significant increase in quality of life.

The results are published here in the journal BMC Medicine.

The BMA has also called for the rigid 10-minute timetables to be replaced with a more a flexible system enabling doctors to spend more time with patients with more complex needs.

To learn more about Medical NLP read Magic In Practice: Introducing Medical NLP by Garner Thomson with Dr Khalid Khan, and let us know what you think about saving the NHS @HHealthBooks on twitter.

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IBS: a guide for family, friends and colleagues

Although IBS is invisible, it is a very real illness and it can be hard to know how to support people we care about when we can’t necessarily see the physical symptoms of what they are going through. Dr Megan Arroll and Professor Christine Dancey have combined their extensive knowledge to provide a helpful guide for supporting friends and family members with IBS.

There are many conditions where people look fine, even very well, but they are in fact in a great deal of discomfort and pain. It can be hard when you are suffering from the symptoms but look fine on the outside. Try to remember when you last had a headache. You probably looked fine on the outside, despite being in pain. Now imagine feeling like this constantly.

Not only does suffering an invisible illness make you feel physically awful, but people with IBS often face a lack of support from those close to them. Work and social situations can also be challenging; without outward signs of ill-health, someone with IBS can feel very isolated. People with IBS often find it very hard to acknowledge their condition and to discuss it with others due to the embarrassing nature of the symptoms.

Additionally, IBS can attract stigma as it is a complex condition and there are no scans, investigations, or blood tests which can show that a person has IBS. It is a multi-faceted condition and we are only just learning about the physiological processes underlying it.

So, someone with IBS may appear perfectly fine – in fact, almost anyone will say ‘good’ or ‘well’ if you ask them how they are – this does not mean that IBS is not a debilitating and intrusive illness. All it means is that your friend, sibling or workmate who has IBS is trying to put their brave face on.

What you can do to help a friend or family member with IBS

You don’t need to know everything about IBS; just by accepting what your friend says about what he or she is feeling is a great help and support. IBS can take a long time to diagnose and is often misdiagnosed. Both the struggle for a diagnosis and the feeling of frustration engendered by being misdiagnosed can be difficult, and this is on top of feeling unwell. While it can be tricky for friends and family members to offer the right help and support to someone with IBS, here are a few simple rules to help make living with IBS a little less irritable.

Never question the existence of IBS, even if your friend looks and seems well.

Be patient with the process of diagnosis and finding an effective treatment – it can take time.

Try not to be over protective or treat the person with IBS as if they are fragile.

Try to limit giving advice, even if well-intentioned.

Be willing to find IBS-friendly activities which are of interest to both of you.

Understand that plans may be cancelled at short notice.

Offer practical support, such as help with the children, shopping, housework, gardening, etc.

If IBS is affecting your sexual relationship or damaging your relationship overall, seek external and professional support.

Overall, simply being there and accepting that the person with IBS is trying their best to overcome this misunderstood condition will be an invaluable support. IBS is an embarrassing and stigmatised illness that can challenge someone’s relationship with their body. Support, whether emotional or practical, can limit the likelihood of depression and isolation, factors which we know are detrimental to us all.

For more detailed guidance on how best to support someone who is suffering from IBS buy your copy of Irritable Bowel Syndrome: Navigating Your Way to Recovery and follow Dr Arroll on twitter.