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Anxiety & Depression

Look after yourself

I can't recall where I saw this but it was along the lines of "self-care doesn't mean scented candles".Maybe that's where we go when we think about "treating ourselves". However, looking after ourselves requires us to look after our most basic of needs.

Attending to our very basic needs when depressed or anxious can seem overwhelming.
By basic needs I mean, enough sleep and rest, nutrition and fluids, personal hygiene and physiological homoeostasis (bodily functions).

Maslow's Hierarchy of Needs (diagram on the left) illustrates how we need to have our basic physiological needs attended to before we can move up to the next level (Safety).

I have found that often these needs are neglected when anxious or depressed and stressed clients come to therapy. People come to see me with issues such as Love/Belonging and Esteem levels further up the Hierarchy of Needs

Good enough self-care starts with sleep hygiene, setting regular times to go to bed and get up, even at the weekends! Keeping your bedroom cool and dark and only using your bedroom for sleeping. Having a warm bath or shower before bed to help your body produce sleep hormones and avoiding caffeine and alcohol in the afternoon and evenings. Exercise is helpful but not 3/4 hours before bedtime and avoiding the use of blue screens on phones, laptops or tablets.Breathing techniques can also help, both for initiating sleep but also a useful technique to cope with anxiety/overthinking:

Breathing in through your nose until you feel your lungs full, don't force this and then open you mouth and breathe out fully. Follow this link for a helpful graphic.
https://media.giphy.com/media/xThuWfz7fNOXwiBLY4/giphy.gif

Sleep is vital for our physical and mental health and well being, it's so much more difficult coping day to day with low mood or anxiety when tired.

Looking after yourself can also include counselling or talking therapies to attend to these very basic needs and then to work on Safety, Love and Belonging and Esteem.

Take care of yourself!!!!















Being Busy

I have been reflecting recently about how client's have been presenting with what seems to be surface issues such as a general feeling of unhappiness or dissatisfaction with relationships.
Scratch the surface and under this veneer lies stuff that's been hanging around for years going back to early childhood or even infancy.
Client's manage these feelings into adulthood by filling time with being busy, working hard, achieving high grades at school, getting a good degree, high achievers at work, being the brightest and best at what they do. 
Often they are the envy of their friends, appearing to "Have it all", and yet............
They come to see me feeling depressed and anxious, lacking joy and happiness realising these feelings have been dogging them for years. They have tried pushing these feelings down "maybe if I work harder, achieve more I will feel better?" as if working harder, longer will make these feelings disappear.
Sometimes client's will "self-medicate" with drugs, alcohol, food, shopping, tobacco, gambling, sex and overworking to "fill a hole in their soul".
They sort of know something is wrong or there's something wrong with me? Why aren't I happy? From all appearances and the outside world I have everything, but inside I feel worthless, empty.
Something happens that slows things down or speeds this up; the breakdown of a relationship, a partner leaves, someone close dies suddenly or diagnosed with a terminal illness, work becomes too much with work-related stress, they can't sleep or function anymore and thoughts of suicide emerge. The client visits his GP and is diagnosed with anxiety and depression and given medication. They think "I must be weak" something else to chastise themselves over!
Perhaps someone close to them suggests they see a counsellor "What me?" "I just need to pull myself together""talk to a stranger!!". They think about this suggestion and do a quick Google search to see who what where there are counsellors nearby or maybe further away from home. They find me on myVistaprint website, Counselling Directory, Adwords or NaturalTherapyForAll. 
Clients often comment on the warmth of my photo and the content of what I write strikes a chord with them.
This is a fairly typical case study of clients who come to see me.
So what do I do? First and foremost I listen and hear about how they have been feeling and thinking and find out about their lives, struggles and achievements, what has made them the person they are today. What happened to them over the years and how did they decide to be the person they are today?
We then make a plan together for the work ahead... sound OK to you?

View from the Bridge ( trigger warning contains reference to suicide)


An Alternative View from the Bridge
Last Thursday morning I was driving over the Tay Road Bridge on my way to work with the Women’s Rape and Sexual Abuse Centre in Dundee. Half way across I noticed a red shape on the outside rail and squinted to see what I thought might be a new road sign.
As I drove closer the shape became clearer, the shape became a woman, a young woman sat astride the outside rail looking over the edge into the water below. She was hunched over holding the rail. At that moment I knew why she was there, her presence out of context with the monotony of the grey bridge. She was dressed in red with short bright blonde and purple hair, not a road sign, but the signs of her intention was clear.
I stopped, but realised quickly that I had already travelled past her, I put my hazard warning lights on whilst traffic continued to thunder past me. The cars and lorries seemed not to have seen her at all, they didn’t even slow. I couldn’t drive on, I couldn’t leave her in the balance between life and death. I was scared. I phoned 999, they told me they had received a lot of calls, where was she on the bridge, I replied half-way, she was half-way over the bridge and half-way over the rail and half-way between life and death. She had been seen.
I had to get out of the car, no one slowed behind me, the lorries swept past, and the bridge vibrated beneath my feet, then a white car stopped behind me, she was on the phone, I got out of my car carefully, watching the traffic, this was dangerous for me, I had stopped to help and scared I was going to get run over. I moved back past the white car and towards the girl on the rail, the white car gave me a feeling of protection and shelter from the speeding traffic.
I stood below and near to her, she lifted her head, I told her my name and asked her for her name “Doesn’t matter what my name is as I am going to die”, she looked over the rail into the water. The wind was blowing and I felt the chill, I too looked into the water which swirled and eddied beneath the bridge. I felt sure if she allowed herself to fall, she would disappear into and under the water. I didn’t know how long she’d been there; she hadn’t jumped or fallen so there was hope. I knew this meant she was feeling ambivalent about falling off and ambivalent about dying, she was holding the rail tightly and she was astride but there was a look on her face as she seemed to be considering letting go. She had one leg on the bridge side, the living side and one leg on the outside, the dying side.
I didn’t stand very close, touch her or try to pull her in, I needed to keep myself safe. I began to talk with her, I told her my name and how I had seen her. I wanted to know her name, Anna, what had happened to her? She was an inpatient waiting to have ECT which she was sure wouldn’t work, nothing was working, she was a burden to her family and friends, things would be better for everyone if she was dead.
I was beginning to recollect the ASIST suicide training I had done 3 or 4 years ago and Tony Whites work on suicidal ambivalence, to make contact with the “death side” of the psyche before the “life side”, to understand and hear what’s happened to bring her to this point. I said to her that she must be in unbearable pain to want to die, she agreed, she had been thinking that dying was the best thing to do, she couldn’t stand feeling this way anymore, she had suffered with depression and nothing had helped or worked (medication, psychiatric help, hospital, mental health care) and no one really cared about her anyway. I told her I felt very sad hearing how much she had been through, how hard life had been for her and that she wanted to die.
At this point the Police arrived, the traffic on the bridge stopped and there was an eerie silence while the cold wind whipped around us. A police officer approached and introduced herself and I told her about what had happened to Anna. Anna began to look more and more into the water, at one point she moved her inside leg up the rail, signalling her intention to fall. We asked her about who she loved, her partner and her cat (no one else did, especially not her family or mother), and began to talk about them, that they cared for her and how sad they would be if she died. I told her that I cared, she began to cry, I cared enough about her to stop and come and talk with her, the police officer concurred. Anna began to make eye contact with us and then look again down into the water. She then said “You’re going to arrest me if I come down, aren’t you?” to the police officer who replied “No Anna,  I am not going to arrest you, you are clearly in crisis and when you come down I am going to take you back to the hospital and tell them about what’s happened”. I said to Anna that I had coffee in my car and hoped she liked cappuccino, the coffee was for her. 
Anna looked at us in turn and briefly into the water and began to move her outside leg slowly, she was very cold and this took effort, we didn’t touch her until she was over the rail and safe, she began to cry and we touched her then. I went to my car and brought her my coffee. I had promised her this, she took the coffee and sipped it slowly, I told her how glad I was that she was safe, I touched her shoulder and her cheek to make contact and to show her that I cared. The police officers either side of her held her arms gently and led her to the police car. I walked back to my car along the silent empty bridge, got in and turned the hazard lights off, I felt so cold, I put the heating on full and continued my journey to work. As I left the bridge and joined the busy traffic in Dundee it was as if what had happened felt as if a dream, I had woken up from an eerie interlude and carried on my day, no one around me had known what had happened gave this a feeling of unreality.
Once I arrived at WRASAC I told my fellow therapists what had happened and had a de-brief of the whole incident, they were wonderfully supportive and offered me positive unconditional strokes. I was so happy to be with them and felt safe and cared for throughout the day. My family were very supportive, although my husband expressed his anxiety about having put myself in danger, I had told him about what I had done to risk assess the situation and acknowledged to him and myself that this was risky and how glad I had been to see the police.
I attended clinical supervision 2 days later and recounted the incident there in the safe and supportive environment of my peers and supervisor who gave me more positive unconditional strokes, I felt very cared for and well stroked! I feel fortunate to have such wonderful support.
On reflection I know that I couldn’t have driven past her, I felt a connection with Anna, as a fellow human and had some understanding of her distress. I also felt that if this had been a friend or member of my family about to harm themselves, I would want someone to stop and offer a caring presence, even if they hadn’t been trained or know what to do.
If you are reading this, I would encourage you to consider taking an ASIST course, or First Aid Mental Health course in the same way that you may have done basic Life Support or Resuscitation training. So many people’s lives have been saved by passers-by acting quickly to resuscitate after an accident or heart attack. What’s so different in being trained in offering someone a lifeline when they are in distress? Of course I know not everyone can or will be saved whether it’s from a physical or mental injury and not everyone feels they have the skills to stop and help and that’s OK. All I ask is that you take a few moments to think about it. (Carol Remfrey Foote: May 2016)
  

Today is National Depression Screening Day

Today is National Depression Screening Day in the USA. What a great idea!

To my knowledge, I don't think we have this event in the UK, but maybe you know if we do? What about my regular blog readers, do they have this day in your country?

Depression is a common mental health issue and no doubt you may have suffered with this illness or know someone close to you who has had or has depression?

The American Psychiatric Association (APA) has an excellent website and a link to test yourself to see if you might have depression...try it if you think you do. Copy and Paste this into your browser.



The website test is very quick and can also check for Generalised Anxiety Disorder, Bipolar, PTSD, Alcohol Misuse and Adolescent Depression.

At the end of the screening the site can put you in touch with useful resources and advice on what to do next.

If you do have a score which indicates that you may have a mental illness then do seek help from a medical practitioner (GP) or contact a counsellor or therapist who is trained to help you.








Stress, Anxiety and Depression: The benefits of "Talking Therapies"


NHS Choices website includes a section called Moodzone. A very useful site to have bookmarked as one of your favourites if you have anxiety, depression, suffer with stress or have an enduring mental health illness.

This is the link and it's well worth a look:


They include a 4 minute video on the benefits of talking therapies with counsellors, psychotherapist and other mental health professionals.

There's no doubt talking therapies work for most people, having someone listen, not give advice, but support you through difficulties and help you find ways to help yourself.

The website gives very helpful signposting to other useful resources and free online self-directed courses taking you through ways to self-help.

The internet and respected sites such as the NHS give research and evidence based information.

Give it a go and if you decide to contact me I can talk with you about your issue and how I might help you.

Have you been feeling worried and anxious for a long while?

We can all feel worried and anxious from time to time, but for some people anxiety begins to rule their lives.
 
So how do I know if I am a "worrier" or have anxiety? Think about how you've been over the last 2 weeks.
 
Maybe this might help you decide:
 
Do you feel nervous, anxious and on edge most or nearly all of the last 2 weeks?
Not being able to stop or control your worrying?
Do you worry about a lot of things?
Do you have trouble relaxing and sitting still?
Do you get irritable and annoyed easily?
Are you worried that something awful might happen?
 
If you have answered Yes to all of these questions and felt anxious most or nearly all of the time over the last 2 weeks or longer then you may well have anxiety. If this has started to affect and impact severely on your life and enjoyment then it's time to get some help. Perhaps those close to you have suggested this to you as well?
 
You may have tried helpful techniques such as relaxation, meditation, distracting yourself, taking exercise, taking herbal remedies, massage, talking to family or friends or seen your own doctor and been given medication. These strategies may be helping you from a little to a lot.
 
I guess if you are reading this blog article then you have had enough of feeling this way and are actively considering approaching a counsellor to get to the bottom of why you have been feeling this way for so long?
 
Counselling and psychotherapy can offer you a safe, supportive and professional way to explore your anxiety and work with you to help alleviate your distress.
 
Spitzer,RL, Kroenke,K,Williams, JBW, Lowe, B. (2006) A brief measure for assessing generalized anxiety disorder.Arch Inern Med. Vol 166 pages 1092-1097
 
 
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