The best way to support a friend or family member through anxiety and depression.

I have been asked by my friends to write an article about how best to support someone through a mental health issue. There is not a one sized fits all answer, due to the fact that every illness and person is unique with their own brain chemistry and life experience. However, I am  going to offer a few tips on what you can do if someone is suffering from an anxiety disorder or depression (for this article I am going to leave out other illnesses eg bipolar, schizophrenia, psychosis, addictions but will speak about them at a later date)

So what can you do if your loved one is suffering from  an anxiety disorder/ depression?

Anxiety disorders are a group of multi faceted disorders which can include things like generalised anxiety, social anxiety, health anxiety, OCD, PTSD and more. Your loved one may be suffering from lack of sleep, nightmares, inability to sit still, palpitations, racing or obsessive thoughts, panic attacks and hyperventilation. They may feel more on edge, or in the case of OCD- be checking and analysing everything. Anxiety disorders run in certain patterns and all are unique to the individual- what one person with anxiety may have will be different to another, however there are some general patterns to anxiety.

When a person is suffering from anxiety, they may also have physical health symptoms as above due to the increase in adrenaline and the stress hormone, cortisol.

Depression or depressive disorders are sometimes caused due to a chemical imbalance in the brain (not enough seretonin) and can require medication to return the brain to its usual state. Some are a mixture of chemical imbalance and challenging life experiences or brought on from a period of stress eg divorce, moving house, losing a baby, having a baby, being unemployed etc . Symptoms typically can include loss of motivation, feeling tearful, low and hopeless, not wanting to engage socially or be involved with activities one enjoys.

If your loved one is suffering from anxiety or depression the best way you can help is by speaking and interacting with them calmly- not judging them or accusing them of anything bad, but simply being a laid back, supportive friend or partner. If someone can’t socialise, its best to just text once in a while and check up on how they are doing- or send a hand written note or card. Most importantly, do not pressure the person to see you, talk to you or go out.. but just be there for them calmly as a listening ear and encourage them to do small achievable things for themselves.

It is good to encourage your friend to go out with you but not to pressurise. Similarly, getting a bit of fresh air can help. If your friend or loved one is at crisis point ie threatening to take their own life, feeling suicidal, not eating or sleeping and being involved in self harming or risk taking behaviours, it is very important to do the following:

1) If a friend is suicidal, listen to them but do not promise to keep it a secret. You must tell their nearest relative/ best friend/ someone they trust if you believe they are in danger of a suicide attempt or at harm to themselves . Encourage them to see their GP immediately or speak to a help line and the GP will be able to tell you if a psychiatric referral is needed. A psychiatrist and team known as the Crisis Team will then  step in to help.

2) If a loved one you live with is suicidal, go with them to the Doctor or get a doctor to come out to you. There is stigma around this BUT if your loved one is really ill and their brain is effectively temporarily ‘broken’ much like a broken leg, it needs fixing. Your loved one needs help and support to recover whether its medication, counselling or more support at home. Do not blame yourself. This is an illness- not something you have done.

Ultimately, be loving, caring and supportive and CALM- however angry or frustrated you feel. Being frustrated to someone who is unwell can cause them to have feelings of guilt, low self esteem or worthlessness which the depression/ anxiety may perpetuate.

Be there as a support and listening ear but make sure you have a break and take time for you too.

My time recovering in the Acute Day Treatment Unit

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(my art therapy)

As I have previously written, in 2014, I suffered from a very acute period of mental illness- a manic bipolar episode. I had to stay in hospital for 3 months before I began my recovery process at home. Part of that recovery process was being referred to an Acute Day Treatment Unit (ADTU).

ADTU is effectively a hospital day therapy ward- where groups are run on things like anxiety management, recovery techniques, anger management, assertiveness, relaxation/ meditation to music, arts and crafts and groups such as playing games eg table tennis or quizzes. It is there as a short stay intervention. Some like me had been in hospital already very unwell and some had been referred to ADTU to stop them having to go into hospital and to get them better through therapies.

People are referred there with all kinds of illnesses- depression, bipolar, schizophrenia, eating disorders, drug, alcohol and gambling addictions, psychosis, acute anxiety disorders eg PTSD/ OCD and more.

As well as the therapy groups with occupational therapists, the ADTU has psychiatric nurses, psychiatrist and therapists who support you during your stay. I was there largely because I had been through a very traumatic period of bipolar illness and also because I had decided to change medication to a new mood stabiliser- Lithium.

This meant that as well as the therapy sessions, I had to get used to a new medicine regime and weekly blood tests to determine my Lithium level. When you start Lithium, the level in your blood fluctuates- if it goes too high your body can have a toxic reaction. Luckily this never happened to me but there were times when I was quite low and depressed as the Lithium level was too low. So for about 8 weeks, I had regular blood tests.

In ADTU, you get given a key worker- an occupational therapist or nurse who works with you through your stay and acts a bit like a therapist- they are your support team for when you are there. At ADTU, I lived at home and went in every day 5 days a week. It was challenging as there were constantly new people coming in and out- some very poorly. However I made some incredible friends.

My first important friend I met on my first day! We both began at ADTU at the same time and started our induction. She also has bipolar disorder and we were quite similar- both loving all things girly, glittery and of course- unicorns! We got on well from the beginning, sat with each other in therapy groups, where we both regularly fell asleep in the relaxation to music sessions. She is an amazing and brave woman- who I am honoured to call a friend and we are still in touch today!

I made other friends as well, from sitting in the lounge and chatting in the mornings. One of these was my friend who loves sport and we would chat about what she was doing on her degree. She is also another amazing one who I am still in touch with!

ADTU is meant as a short stay intervention but due to my acute illness and change of medication I was there longer than almost anyone else. This became frustrating as I kept seeing people being discharged and I was still there. In the end after 12 weeks where I became used to all the staff and therapy groups and felt a bit like a veteran (some people are only there for 2 weeks) I emerged still fragile but stronger than I had been.

I owe so much to the wonderful staff- especially my occupational therapist key worker and the therapist running the arts and crafts and recovery groups. The staff were so supportive and kind.

In the UK, there are now only two ADTUs in the whole country as funding has been cut. However, I can honestly say that without the staff there and my new friends- I would have found life so much harder. I owe them so much.

Here are  some of my photos from the therapy folder I kept.

This blog is dedicated to my friends from ADTU who are making amazing strides- my 2 closest friends are now studying for Masters Degrees!

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Guest post: 5 easy yet effective ways to calm yourself down when feeling anxious

By Lystia Putranto and Karina Ramos at www.bookmeditationretreats.com

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Anxiety is a thin stream of fear trickling through the mind. If encouraged; it cuts a channel into which all other thoughts are drained.

– Arthur Somers Roche

Sometimes nothing feels quite as awful than anxiety. In this state of mind, we tend to think of only the worst case scenarios. It robs us of our joy, makes us lose focus and leaves us feeling as if we have no control over our own lives.

Fortunately for us, there’s much we can do to reduce anxiety and its effects on our mind, body, and soul. Here are simple and fuss-free tips to apply that I have found to be effective to help me establish and maintain a calmer peace of mind in situations that previously would send me into a tailspin:

  1. Take Deep Breaths

It seems hard to believe that one of the simplest actions that you can take – taking deep breaths – may just be one of the most effective ways to calm ourselves down when we feel an anxiety attack coming on. Breathing deeply differs from our normal breathing (shallow breathing) as it requires your focus to breathe from your diaphragm as opposed to just breathing from your nose. Moreover, shallow breathing may often feel tense and constricted, whereas deep breathing induces relaxation.

By just taking a minimum of 10 deep breaths whenever you find yourself feeling anxious, you can instantly feel more peaceful and more importantly, it could bring our focus back to the present moment even in moments of panic or extreme anxiety. Through focusing our attention in the present moment, we are able to give our best effort in finding solutions to the issue(s) we worry about. Another great thing about this anxiety-reducing tool is that it is also accessible to you whenever and wherever you need it.

If you’re looking to gain a more lasting effect that you get from deep breathing, I highly recommend that you take up the practice of meditation. Not only will you be able to feel more at ease and calmer, you’re bound to also reap the many other benefits that come with meditation!

 2 Listen to Inspiring Tunes

I’m a true believer in the power of music and great tunes can be a great tool in lifting our spirits whenever we feel anxious or overwhelmed. Create a special playlist of your favorite inspiring (preferably upbeat) tunes and be sure to have them on hand to give you a spirit boost whenever you feel less than stellar. If you’re up for it, why not kick it up a notch and have yourself a dance party of one while you are listening to favorite music! It may sound silly but I personally have found it to be a great and quick way to lift my spirit and shake off those pesky anxieties.

 

  1. Let it Out

When we are plagued with anxiety, one of the best ways to alleviate yourself from that palpable worry is to talk it out with someone you trust. One of the toughest things to deal with when it comes to anxiety is the facade that you are alone and that you are the only one in the world who is going through challenging times. Feeling anxious and feeling like you have to keep it all bottled up is unhealthy and can often feel excruciatingly difficult.

The truth is, all of us have experienced anxiety and worry and this is why it is crucial for us to be able to turn to our spouse, friend, parent or sibling and share our troublesome thoughts. More often than not, you’d find that they too have experienced similar situations and would able to offer solutions to help you or at the very least, lend an emphatic shoulder to lean on.

 

  1. Jot it Down

If for one reason or another you feel uncomfortable sharing your feelings and thoughts to others, an alternative tool you can use is to keep a journal. That way, you can “spill” whatever you are going throughout and/or feeling in private. There’s something soothing and cathartic in writing out your inner most thoughts into paper that often leaves you feeling calmer and more at peace.

As someone who has journaled regularly since her early teen years, it became evident that most of my anxieties were just stories that I created and that my worries were far from being real. In writing our thoughts down consistently, you too may found most things that you have previously felt anxious or worried about in the past never actually end up happening. Our minds like to play tricks on us, making us focus on the worst scenarios of situations as opposed to what’s actually real and this is definitely something worth keeping in mind the next time we find ourselves filled with worry. As Dan Zadra, a renowned author said, “Worry is a misuse of imagination”.

 

  1. Get Physically Active

Science has provided much evidence that physically active people have lower rates of anxiety and depression than sedentary people (those who are not physically active). Exercise may also improve mental health by helping the brain cope better with stress and feelings of worry. In one study, researchers found that those who do regular vigorous exercise were 25 % less likely to develop depression or an anxiety disorder.

Whatever type of exercises you prefer, aside from being extremely beneficial to our health and fitness, making sure that you get your regular dose of exercise is a great way to reduce anxiety. Though it sounds counter-intuitive, exercise actually increases our endorphin levels which are our body’s “feel good” chemicals and this, as a result, helps us burn off excess adrenaline that we produce when we are at a heightened state of anxiety.
About Lystia Putranto

Lystia is a personal & professional development blogger who seeks to inspire and to motivate people to create and to live out their best lives. A proponent of meditation, she actively encourages those who seek to become their best selves to integrate meditation as part of their daily routine.

 

Guest Post: Quite Great- Psychotherapy to combat stress in the Music Industry.

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Todays guest post is by Quite Great and Helen Brice, psychotherapist and music industry professional.

Music PR and Marketing Company, Quite Great, has formed a unique partnership to help musicians overcome the day to day stresses and strains of the music industry. By teaming up with Helen Brice, a specialist psychotherapist and skills coach, the pioneering PR company has introduced a new psychotherapy service.

 Quite Great have twenty years experience working with musicians of all styles, from all over the world. During this time they have developed an exceptional understanding of musicians and the challenges they face – from the emotional strains of building a career, to the psychological issues that can be developed as fame grows.

Specialist psychotherapist, Helen Brice, has over twenty years experience in the music industry; covering music arrangement, performance, audio production, publishing, artist management and A&R. She is a music graduate and regularly performs in the UK and overseas with the London Bulgarian Choir and the BBC Symphony Chorus. As an active musician Helen has a unique attunement to the pressures and psychological issues that musicians encounter – making her the perfect person to head up the new service.

As Pete Bassett, founder of Quite Great, elaborates: “Every recording artist and performer of music has to have at least two sides to their personality in order to really reach the heights that they wish to achieve. As they go through each stage in their musical career they have to deal with many pressures – from demands made on them by managers, labels and agents, through to handling being ‘dropped’ by labels, and at times, coming to terms with the fact that their popularity is diminishing.”

“These differing stages,” he continues, “can cause real emotional turmoil needing a specialist approach to be taken. There are also other more straight forward challenges that musicians need help with, for example how to overcome ‘stage fright’, and how to build the confidence and thick skin required to face media reviews and online critics. In order to believe they can overcome all problems to become a star, musicians need the self assuredness of an Olympic athlete!”

Helen Brice, (UKCP, MUPCA Accred, MBACP, FRSA) founded Stimmung Therapy Services in 2009 at Harley Street, and receives referrals and enquiries relating to her specialist psychotherapy and skills coaching from all over the world. Helen offers complete flexibility for appointments at her central London practice, as well as via Skype – perfect  for the working lifestyle of musicians and performers. A service unique to Stimmung is emergency onsite psychotherapy and coaching for performance anxiety. This would be backstage at the performance venue, or off set at a live broadcast, or even at the recording studio.

By combining their expertise, Quite Great and Helen Brice, are offering a distinct psychotherapy service that will make a huge difference to both the personal lives of musicians and their careers. For more information, please visit www.quitegreat.co.uk or contact ask@quitegreat.co.uk

Fighting mental health stigma: a personal journey

I have had bipolar disorder for almost 13 years, along side depression, anxiety, psychosis, hypomania and manic symptoms- which ebb and flow and fluctuate. Now that I am on the right medication these bipolar symptoms are kept under control. For most of these 13 years, I didn’t feel I could speak out about my conditions.

My family and close friends have always been very supportive but I felt ashamed. Ashamed of where my brain could go to when unleashed and its chemistry got confused. Ashamed of why I was either suicidally depressed or hyper and manic to a point of having to be sectioned to a psychiatric ward. Ashamed of my illness, confusing my identity with the illness, which made me worried about others judgement of me.

I was diagnosed at a very vulnerable age- 16 years old and as we know teenagers can be cruel. Although I experienced a lot of kindness and empathy, after a hypomanic episode abroad where I was disinhibited, I experienced a lot of cruel rumours from other teens I knew. Rumours that were stupid but that called me many names and compared me to evil things that I do not want to repeat. What was at the most basic of these insults? In my opinion, fear.

People fear what they cannot see and cannot understand.

People in their teen years do not want to be different- and I was the embodiment of difference.

If people can’t comprehend something and it is threatening- they judge or use name calling to feel better.

At 16, I represented a world of chaos at which many could not understand. Perhaps now they will.

I have spent a long time coming to terms with my illness and what it means, finding the right treatment and medication and the right support networks around me. I have incredibly supportive friends and family.

So what does the above treatment boil down to?

Stigma.

Stigma is according to an online dictionary- ‘ A mark of disgrace associated with a particular circumstance , quality or person’

For so long, I felt this ‘mark of disgrace’ and until I was 25, although close friends and family knew about my illness, I didn’t write blogs the way I do now. This was because I wanted to hide this illness that lodged in my brain chemistry.

I don’t want to hide any more and neither should I.

In 2014, I was hospitalised and sectioned for a severe manic episode encompassing psychosis, delusions and hyperness/ disinhibition.

It was shortly after going through the most traumatic experience of my life that I realised. Life is short. I need to help others. If I can break down the stigma and help others through my writing and other work then I will.

Mental Illness must no longer be a ‘mark of disgrace’ but must be seen as a partly physical illness in the brain, deserving and worthy of good treatment and empathy from others.

This post is dedicated to those friends who asked me to write on this and all my friends for their love and support