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Recent rise in eating disorders

Blog post written by Lynn Crilly, author of Hope with Eating Disorders.

 

Since the start of the coronavirus pandemic, eating disorder cases have risen tremendously, especially in younger children. The Royal College of Paediatrics and Child Health snapshot survey suggests in some parts of Great Britain doctors have seen a three or four-fold increase in cases compared to last year.

Eating disorders often stem from trauma, stress, anxiety and feeling out of control; the coronavirus pandemic has reinforced a lot of these negative emotions. Isolation from friends during school closures, exam cancellations, loss of extra-curricular activities like sport, and an increased use of social media could all be credited with the rise in those suffering. Sadly, reduced access to face-to-face therapy and support may have led to young people becoming severely ill by the time they were able to be seen by a professional.

As a mental health counsellor myself, I have also seen a rise in those relapsing from their recovery. The worry the beginning of the pandemic brought, with fears of food shortages, lack of face-to-face support and therapy, the dramatic change in people’s routine and the constant uncertainty have severely impacted those who were on a good recovery path prior to the pandemic.

If you or a loved one is struggling with an eating disorder, there is a lot of help and support online; the charity SANE have some wonderful services to guide you in the right direction for help and support – “Although our previous SANEline number cannot operate at the moment, you can leave a message on 07984 967 708 giving your first name and a contact number, and one of our professionals or senior volunteers will call you back as soon as practicable. You can also contact us, as before, through our Support Forum, Textcare and other services.”

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Family approach to therapy

Blog post written by Lynn Crilly, author of the Hope with Mental Health series, available here. 

Counselling and therapy have a number of benefits for those suffering from mental ill health. Firstly, it allows them to feel valued; it also provides a forum for them to explore their feelings and, by its very nature, is tailored to the individual.

There is no set format for counsellors, which means that they must, to some extent, treat everyone’s case individually. As such, it is crucial in counselling, perhaps more so than in any other type of therapy, to find the right ‘fit’ in terms of a practitioner. A good counsellor should make their client feel safe, secure and valued at all times. They should establish a bond of trust with their clients and make it easy for them to discuss potentially painful or difficult issues.

As a mental health counsellor myself, I ensure I have met with a sufferer’s parents or carers before I commence working with them, if they are under 18. Many people are surprised that I insist on this. I have always been of the opinion, however, that rehabilitating any mental illness is a group effort and one which will involve constant channels of communication between the client and the people who are most influential in their life. If a client is over 18 and they have approached me independently, I will usually bring carers into the process a little further into therapy. Under the Data Protection Act, I of course have to gain the client’s permission to share information with the carers. Once I have explained the paramount importance of trust and communication, this permission is normally granted. I like the families of my clients to understand my methods and the work I will undertake with their loved ones, so, they can be as helpful and supportive as possible throughout the recovery process. Recovery can sometimes be a long process, with the sufferer’s mind-set changing at each stage, sometimes on a day-by-day basis.

It is important that carers are aware of the changes to help them to gain a real insight into how their loved one is thinking and feeling at each juncture within the process. This is why I prefer to keep them in the loop so they can give the support, non-judgmental communication and empathy that I give in my sessions, at home.

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Mental Health Awareness Week Blog Special

Blog post written by Dr Trevor Griffiths and Dr Marian Langsford, authors of Emotional Logic. Available for pre-order now, launches 27th May.

The authors of Emotional Logic: Harnessing your emotions into inner strength have been married for nearly forty years. Marian still practices medicine under her maiden name of Langsford. They both now teach internationally the Emotional Logic method of preventing stress-related mental and physical illnesses, which Trevor developed while in medical practice. The best compliment they have received, they say, was from a medical student in Bulawayo, Zimbabwe, who stood up after a training session and said, “I have learnt today that it is really cool to be old, and married, and still together, ‘cos you get to travel the world and inspire people like us!” We don’t look very old; we received that as the honour it was intended to convey in that culture.

Learning to activate your inbuilt Emotional Logic helps to build more responsive relationships in any new situations you face. And it can be learnt at any age. An active schools programme in the UK has a wide range of age-appropriate materials, such that a five-year-old boy took an emotion leaf from a ‘Talking Together Tree’ they had made in the classroom, and took it to the teacher saying, “I would like to tell the class why I am feeling angry about something.” Imagine the difference that ability to talk sensibly about emotions rather than only act them out, or regulate them, might have.

In Chapter 1, Trevor comments on Marian’s story about a misunderstanding with a friend who had offered to help tidy her garden one autumn. She had told how understanding the emotional logic of her many loss reactions that followed helped to avoid a break-up. Here is an extract from Trevor:

As the eldest daughter in a Devon farming family, Marian grew up on a mixed dairy and horticulture farm overlooking rolling hills, surrounded by buckets of early flowers that needed bunching each evening for market the next day. They were not rich. She loved it. She has a wisdom from nature that I had missed, having been brought up in the London suburbs. For example, she once said, “Gardening isn’t all about pulling up weeds. You have to plant something in the earth in its place, and care for it.” A comment like that can leave me fixed into a garden chair for ages while I watch her getting her hands covered in earth and planting. Something simple like this can lead me to a lot of thinking, which I consider is my core skill.

So, what do I think about? I think a lot about human nature. I think things like, ‘Seemingly small things that break out on the surface of people’s lives can have deeper roots than we realise at first.’ It took me a few decades to realise that it did me a lot of good to listen to Marian. I think many men discover the same at some point in their married lives…

Emotional Logic was born out of years of experience in general medical practice, and out of a disrupted family background that Trevor experienced as traumatising. With a depth of emotional memories to draw upon, Emotional Logic harnesses the language of emotions into the inner strength needed to come through times of trouble stronger and healthier. Post-traumatic growth is encouraged as a way forward from post-traumatic stress. As a senior Community Psychiatric Nurse who uses Emotional Logic in her work said, “Emotional Logic heals the broken heart behind mental illness.”

Once learnt, people can share their new trauma-responsive conversational skills in their daily encounters with others. This prevents isolation following hurts. It reduces the risk of illness by building greater resilience and a realistic hope for recovery into relationships. Even if setbacks and disappointments occur, knowing how to activate one’s inbuilt Emotional Logic provides a world of constructive options to talk about. And where is there better to talk and to explore new ways forward than in nature, where the seeds of something beautiful in life can take root and grow.

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How not to be blue this Blue Monday

Blog post written by Lynn Crilly, author of the Hope with Mental Health series. 

The third Monday of every January has been named ‘Blue Monday’; the theory behind this is that this time of year is when it is cold, we find ourselves stuck with credit card bills and less money, our New Year’s resolutions (if we have made them) have often already failed or are not going to plan which creates an element of guilt and we are just not feeling our best. This year, in the UK we have the added anxiety of being in a lockdown due to the COVID-19 pandemic.

I would like to help you to feel more positive and hopeful this January and to feel more optimistic about what the now has to offer and what the future holds. Below are some – I hope – helpful ways to change how you think and to turn some of the ‘blue’ negative thinking into positive.

At the moment we are all looking at updates on the news about the COVID-19 pandemic, which are often quite depressing and rarely the good news we are hoping for. Instead, try to look for the good news that is going on in the world. Whilst writing this blog I came across a website that focuses on good news only: Good News Network. Take some time to learn all the positives that are happening around us. Dwelling on the negative will keep you stuck in a dark place.

We all have a way of thinking we can predict the future; even though we have no idea what will happen tomorrow, we still like to predict the doom and gloom scenarios we think are going to happen. When we imagine negative scenarios, whether it is about the current pandemic or a work meeting, this negative ‘guessing game’ can turn into a self-fulfilling prediction if we are not careful. Focus on the now. If you want to look to the future, look at the positive scenarios that could happen rather than the negative.

This last tip might be the hardest to achieve but, once you nail it, it is the key to a more positive outlook, replacing negative with more realistic and motivating thoughts. This can inspire you to create the kind of life you want to live. For example, instead of thinking to yourself, ‘at this rate I will never be able to afford my own place’, this negative thought could be replaced with, ‘I am unsure of what the future holds, but if I make a clear savings plan, it is possible I may be able to afford my own place.’

I do hope these simple but effective changes can help to create a more optimistic mindset, for you or someone you know who may be struggling with Anxiety or Depression. You can learn more about these mental illnesses and ways to cope in my books Hope with Anxiety and Hope with Depression.

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How The Beginner’s Guide to Sanity was co-produced

Blog post written by authors of The Beginner’s Guide to Sanity, Erica Crompton and Professor Stephen Lawrie. The Beginner’s Guide to Sanity has been shortlisted in the Non-Fiction category of The People’s Book Prize 2020/21. Click here to give it your vote. 

Our self-help guide for people with psychosis is, we believe, the first written by a doctor and a patient. In a review in Therapy Today our book is described as ‘the epitome of co-production’. Unlike some accounts of co-production in clinical or academic settings, we’ve come together on an even footing to write this – and even shared the advance equally. Here’s how we got started and created something we feel is equal in every way.

How we met

Erica: Stephen and I met at a conference in London titled ‘Schizophrenia: new routes to better outcomes’ in March 2014 where we were both speaking about our areas of interest regarding schizophrenia. It was my first conference and I attended in glittery tights.

I’d been invited to the event by a speaking agent in Sweden who approached me on Twitter. What made me stand out to her was my pro-medical stance on treatment for schizophrenia and my journalism about my experiences with this. I jumped at the chance to present at the conference and pre-recorded an interview with Elyn Saks for this too. It was while this was showing on a big screen to the packed auditorium, that Stephen came over to my table and introduced himself. He asked if maybe he could tempt me to give a lecture on the stigma I’d experienced as a result of my illness at the University of Edinburgh, where at the time he was Head of Psychiatry.

Stephen: We do a regular external speaker ‘Special Lecture’ slot in Psychiatry in Edinburgh and are always looking out for new speakers and topics. I have always admired Elyn Saks and the account of schizophrenia in her book The Centre Cannot Hold and remember Erica doing a great job of interviewing her.

How we got started

Erica: It’s been a life-goal of mine to write a book for as long as I can remember but a few things were holding me back – my inexperience writing long-form copy, and ‘getting it right’. I wanted to write about my experiences of psychosis but felt another voice (in particular a ‘sane voice’) would add weight to all that I could say.

There are a lot of other voices from people with experience of psychosis I could include too. Every piece I write about my own journey with illness usually means someone gets in touch on email or via social media who can relate. I hoped to include these people’s thoughts in a book, too.

It was his mix of seriously impressive clinical expertise but also approachability that inspired me to ask Stephen if he’d be interested in working with me on a book.

He’d already helped with many articles I’d written for newspapers and Stephen is always an utter pleasure to work with.

Stephen: Thanks and ditto! I had been wanting to write an accessible book about schizophrenia for a general audience for many years but hadn’t really appreciated the importance of getting the voice of lived experience until around the time I met Erica – and when I also attended an event for pitching ideas to agents, who told me the same thing.

The write-up

Erica: We used a shared Google Doc to write the book and both added content, and notes over the course of a year. During this time I learnt so much from Stephen that is helpful for me in managing my psychosis. As I get very little time with my own care team, reading everything Stephen thinks we should know about psychosis has answered many of the questions I’m left with after an appointment with my own psychiatrist.

Stephen: The writing was a shared and fairly dynamic process. I put in everything that I thought someone with schizophrenia or any other psychotic condition, and those who care for them, might want to know. I tried to keep it as simple as possible – and then had to make it even more so and easier to digest after feedback from Erica and others.  Erica brought the text to life with quotes from others and was remarkably open about her own experiences.

Twitter trashing

Erica: One thing that unnerved both of us was a potentially negative reception from the latter-day anti-psychiatry and anti-meds brigade on Twitter. However, we’ve been lucky enough to avoid that so far. I do think some of these prolific ‘pill shamers’ on Twitter – many with fancy psychology doctorates – may have some unpacked attention seeking issues of their own.

Stephen: Yes, I remember saying to a friend that Erica would probably ‘get shit’ for co-authoring a book with a psychiatrist which is unashamedly pro-diagnosis and pro-medication – and him being appalled to hear that. Maybe we have got away lightly so far  because we are also pro-many other ways of handing psychosis – or maybe it’s because it was genuinely co-produced – or maybe the abuse will kick off later on. Even if that happens, the positive feedback we’ve had from people who have been helped by our book is hugely encouraging.

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Welcome to Society by Samantha Crilly

In honour of National Poetry Day, Samantha Crilly has provided a moving poem from her debut book Hope through Poetry. Launches 10th October, available for presale now.

Welcome to Society

Hello and welcome to society, we hope you enjoy your stay

We will make it as relaxing as possible as long as you do things our way

First of all and most importantly, make sure you fix up your exterior

If you slack at any point we will soon make you feel inferior

Secondly your life will be controlled by pieces of paper,

We will count it up and decide how important you are later

Thirdly, we want you to make your time here look as perfect as possible

Even if you’re having a bad day this is not optional

Fourthly make sure you post everyday on social media

One is fine at first, but we’ll soon get needier

In fact we can guarantee we’ll be getting greedier and greedier

Oh and In terms of your meals

We tend to advertise things to make you ill

Keeps our drug company’s going if you will

Trust us the more pills you pop, the better you’ll feel ……..

Lastly, just so you know, our planet is on its way out

But it has to keep up with our needs so that’s not something we talk about

So good luck and we hope everything is clear

Oh and don’t smile too much, people will think you’re weird.

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Coping with loneliness and depression if someone has to self-isolate

Lonliness

The word ‘isolation’ can also be described as ‘the condition of being alone’, so it is no surprise that many of us are struggling with being lonely, low mood and depression. This is especially worrying for those who are over 70. In the younger generation, the term ‘self-isolate’ means staying at home with family, for those who are older, they may already live on their own, and their only human connection is when they go out and visit friends.

If you have an elderly loved one, or neighbor who is self-isolating, check up on them as often as you can, it need only be a short phone call, but you may be the only person they have spoken to that day. If you are the person who is struggling with the loneliness whilst having to self-isolate, there are many help lines who can offer support and a friendly voice when in times of need, such as The Silver Line, who offer a confidential, free helpline or telephone friendship for the elderly; call them on 0800 470 80 90.

Encourage your loved one or neighbor to limit their intake of the news. The more you hear, the more you buy into the panic. This only adds to the current anxiety. Instead, encourage them to watch a lighthearted TV programme or film.  You can even watch it alongside them whilst chatting on the phone so it gives them the feeling of company.

Encourage them to stay in touch with the outside world via Skype, WhatsApp or other messaging apps. Many of the elderly now have smartphones and will be aware of these forms of contact, even though it might not be their instinct to use them.

I hope some of these tips will help to keep our loved ones and neighbours in a positive state of mental wellbeing, after all…..self-isolation does not have to mean mental isolation.

Blog post written by Hammersmith author, Lynn Crilly, author of Hope with Depression, Hope with OCD and Hope with Eating Disorders

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Coping with anxiety in this time of crisis

anxiety in a time of crisis

As we are all already aware, this is a very distressing and unsteady time for many. I would like to offer some hope to those who are suffering from anxiety and anxious feelings, whether you are  or have been a sufferer of anxiety in the past, or whether the unsteadiness of this current time has caused the feelings of anxiousness and unease, I hope some of the strategies below will be able to help you cope.

  1. If you have read any of my ‘Hope’ books, you will be very aware that I am a great advocate for positive exercise and mental well-being. Many of us would leave the house on a regular basis, whether it was walking to work, or walking to drop the children at school, or a regular member of the gym, we are finding ourselves suddenly cooped up with our regular activities on hold. Making sure you are still getting regular exercise is paramount to our mental health, there are so many exercise videos on YouTube and online from beginner HIT sessions to yoga and Pilates. If you are able to leave the house, taking a brisk walk whilst getting fresh air will be invaluable. A good nights sleep and eating a balanced diet also complement exercise for their benefits on the mind.
  2. Onto my next topic….the media….whilst it is extremely important that we are all keeping up to date with the current situation, it is also important that we take our minds off it for our own sanity. Having a ‘media free’ or ‘tech free’ time each day will help us to focus on other topics and calm our minds. I love doing puzzles and find them very therapeutic. Other activities could include, reading a book, or even cooking a nice dinner.
  3. Spending more time at home is probably on most people’s wish lists, however, when it is suddenly thrown on us, we don’t know what to do with ourselves. The risk of not being able to socialize as we usually would could lead to a low mood slowly setting in. Getting up each day and giving yourselves a little self-care will go a long way to keep our minds positive and fresh.Wash your hair, shower regularly, put on fresh clothes, and you will feel ready to face the day.

Blog post written by Hammersmith author, Lynn Crilly, author of Hope with Depression, Hope with OCD and Hope with Eating Disorders

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The reasons behind Male Anorexia

The reasons behind male anorexia

Although the risk of anorexia nervosa is higher in females, boys and men are not immune. Interestingly, atypical eating disorders, such as ‘selective eating’ (very limited food choices) are more common in boys than girls before puberty. These are often related to developmental disorders, such as autism spectrum disorders, or to severe anxiety. However, very few of these eating problems develop into anorexia nervosa after puberty.

About 10% of people with anorexia known to health services are male. On the other hand, large community-based epidemiological studies have recently shown that as many as 30% of participants reporting a lifetime history of anorexia were male, but only a minority sought treatment. Eating disorders are associated with women and this may be an impediment to seeking treatment for men. John Prescott’s disclosure of his bulimia could be a typical example of this situation.

However, even if as many as 30% of sufferers were male, the imbalance towards the female sex is most extreme amongst psychiatric disorders. Interestingly, there is some evidence that homosexuality/bisexuality is a specific risk factor for eating disorders (particularly bulimia) in males. According to a recent study, attending a gay recreational group is significantly related to eating disorder prevalence in gay and bisexual men. The reason for the higher prevalence in non-heterosexual males is unknown at present. In some cases, the drive for weight loss may be an expression of the rejection of male sexuality, such as in men with gender identity disorders.

The motivation for initial weight loss is usually different for men than for women. Preoccupation with a muscular but ‘fat-free’ body is more common, sometimes resulting in excessive exercise and steroid abuse. This is consistent with male sexual attractiveness, but paradoxically, these strategies damage normal sexual functioning. Biologically, abnormally low weight does not allow muscle building, not just because of lack of nutrients, but also because testosterone levels fall during starvation. The low testosterone does not just affect libido and sexual performance, but also the body’s ability to build muscles. Steroids illicitly used for muscle building also interfere with normal sex hormone production, and can be harmful in the long run.

Illicit substance misuse has also been associated with anorexia in males, for a number of reasons. Firstly, amphetamines, heroin and cocaine all reduce appetite. Secondly, some underlying personality traits may present a risk for both conditions.

Research on anorexia in boys and men is limited. This is mainly because only a small proportion of clinic populations are male, so it is very difficult to recruit sufficient numbers of male participants into studies. Furthermore, the majority of research studies concerning anorexia nervosa exclude male patients from recruitment or the analysis in an attempt to keep the methodology simple. The Minnesota Semi-Starvation study, which will be discussed later, included only male participants. Hence, this study has provided invaluable information about the consequences of self-induced starvation in males.

Medical complications are more common in men than women during starvation. However, a recent study in Sweden showed that the long-term recovery rate of men hospitalised for anorexia was good. The same research group has also shown that the outcome of eating disorders in females has improved in Sweden (in contrast to many other countries). These findings may be true only for the Swedish populations, due to the effective screening programmes and early intervention in this country’s highly developed and equitable healthcare system. Finnish researchers also found better outcome for males in terms of weight restoration, but additional psychological problems were common.

 

This extract was taken from Anorexia Nervosa by Dr Agnes Ayton.

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The ‘D’ Word: Rethinking Dementia

When the brain is affected by dementia, logical thinking and reasoning ability are affected quite early on. However, the amygdala – the part of the brain that is the integrative centre for emotions, emotional behaviour, and motivation – is less affected. People with dementia (PwD) who have trouble processing logic and reasoning do not have a similar problem with their ability to feel emotion. Indeed, as far as research can show, people with dementia still feel happy, sad, afraid and so on, even after they can no longer speak or recognise people they know well, even when they need total support to live their lives. It seems, though, that most people – including many well-meaning carers – are unable to adjust their own behaviour and thinking to accommodate the continuance of emotional experience, along with the decrease in reasoning ability of the person they care for.

If someone has a broken leg we do not assume that they could walk on it ‘if they tried’. We do not suggest that they listen very carefully whilst we explain how to walk. We do not try to divert their attention so that they can walk without thinking. No. Instead we set the broken bone and maintain it in position with support (a leg-plaster). We allow them to rest the leg. We give them a crutch to aid movement and we accept that walking will be slow and difficult until the leg is healed. Similarly, if someone has part of their brain which is not functioning we should make allowances. We should try to keep the parts of the brain that do function in as good order as possible – by encouraging social interaction, physical exercise and general health. We should allow the brain to ‘rest’ when it needs to by not demanding actions which are no longer essential. We should supply a ‘crutch’ using memory aids, providing unobtrusive help and support. We accept that everything cannot be as it once was because this brain is not what it once was.

It is important, though, that society should recognise the relative importance of the emotions which come to predominate when logical thought and thought processing are deteriorating. Society in general does not much like domination by the emotions. ‘Civilised’ people should learn to control emotion and apply logic and reason to manage their everyday life, it is thought. But what if we can no longer use our logic and reasoning to help us come to terms with emotions? Suppose we are unable to understand and work out why we feel sad or happy? Imagine if we feel these emotions overwhelmingly, but we are unable to deal with them by a change of scene, by talking through our feelings, by taking actions to alleviate the misery or express the happiness. Imagine being no longer able to speak coherently enough to tell anyone how frightened you feel or how angry. What might you do? How might you try to express yourself? Perhaps you would try to hide somewhere, or to run away and escape. Or you might shout and get angry. Perhaps if no one made any effort to understand, you might try to use physical methods to show them how you feel.

This blog is taken from The ‘D’ Word: Rethinking Dementia by Mary Jordan and Dr Noel Collins