Category Archives: psychotherapy

Shame and Psychosis article for Time to Change

My latest article for Time to Change, a campaign in the UK aiming to end mental health discrimination. (name has been changed)

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Three years ago last month, my mind lost touch with reality in a very rapid turn of events that culminated in an acute manic episode of bipolar affective disorder. Having been diagnosed with bipolar in 2004, I had not experienced any mania or hypomania (a lesser manic state) in ten years, although I had fallen into a suicidal depression just six months earlier. So when my brain fell into full blown psychosis – with delusions and grandiose thoughts, fearful thoughts about loved ones and being in danger and a complete change in rational perception – it ripped apart the fabric of my life and all I knew. I am writing this to explain what psychosis is really like.

I was just 25 and although I had experienced a mixed state which left me hospitalised at 16 (and had experienced some psychosis then), this was by far the most challenging, lengthy and painful bout of mania and psychosis that I had experienced. I began to believe that my step father was behind why I was in hospital and wouldn‘t let him see me, I thought that the doctors and nurses were a gang holding me hostage. I was fearful of everything, talking and singing to myself, unable to sit still and became quite agitated at times with the staff and patients, which is completely out of character for me. I simply didn’t know what was real or unreal and I was so frightened of the staff and others while my brain was in this state. Eventually, I recovered after about two months of being given anti-psychotic medication and tranquilisers to help me rest (often I was pacing around due to agitation/ mania), in combination with individual and group therapies. I left hospital after three months.

I rarely talk about my psychotic state, which led me to be sectioned under the Mental Health Act. This is due to shame: I was ashamed of myself even though it wasn’t my fault – rather down to faulty brain chemistry and my medication that had stopped working. There is still a huge amount of stigma about psychosis and anything that makes you lose your sanity. My psychosis is part of my bipolar illness and happened completely out of the blue. My mood stabiliser hadn’t been holding me for some time but no one could have predicted quite how rapid my descent into psychosis and illness could have been (it took only a number of days and escalated at a weekend, leaving me to be admitted via A&E, which proved traumatising).

The shame of losing your mind is great and also acting out of character shatters your self-esteem. When I left hospital, I sunk into a depression due to the shame of how I acted in hospital and how my brain and its chemistry could go so catastrophically wrong. Kindness goes a long way when you are feeling ashamed. If you have a friend or family member struggling with this – be calm, show kindness, and show up for them. They need your support at what is an incredibly painful time. Let the person with feelings of shame about their illness know that they are human, that they are an important friend to you, and stand by them.

What truly helped me in those dark days was the attitude of my psychiatrist in hospital and in the day recovery unit I attended after. Despite being psychotic and unwell in hospital and quite agitated at times, my doctor persevered to get me on the right medication and put up with my changing moods. She knew that if I took anti-psychotics and then agreed to go on lithium carbonate (the main mood stabilising medication for bipolar disorder) that I would recover – even if it took me months to get there. It was a slow recovery but I got there in time. Her patience, perseverance and kindness saved me from a very acute episode of illness. Similarly, the psychiatrist and all the staff at the Day Recovery Unit helped me in my down days starting on lithium and having regular blood tests, recovering from being very unwell and they treated me like a human being, when I had felt so ashamed.

If it wasn’t for the Doctors, nurses, occupational therapists and other staff who looked after me  and helped build me back up, I wouldn’t be here today.

There is no need to feel ashamed, although you may do.

Although I still find it hard to talk about my descent into a psychotic state – I am so grateful to the NHS for all the help I was given and have been well for some time. I hope this article helps others in a similar position – you are not alone and don’t let anyone make you feel ashamed.

https://www.time-to-change.org.uk/blog/there-should-be-no-shame-experiencing-psychosis

Guest post by Karen: Being a Mental Health Professional with Anxiety, my Recovery

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Working in an outpatients’ mental health service in the NHS I was well-placed to recognise the signs and symptoms of a mental health problem. I have seen most ends of the spectrum from working in a secure men’s forensic unit, treating people experiencing psychosis in a clinic and in their homes, to treating outpatients with mild to moderate depression and anxiety. Yet none of this prepared me for my own mental health crisis that crept up on me suddenly and unexpectedly last year.

I have experienced anxiety in my life on many occasions before. I developed a fear of panicking and losing control going on the tube and was starting to avoid taking tubes and trains and places I felt I could not escape from easily. Later on I realised this was panic and agoraphobia and since I was considering dropping out of my Masters degree because it involved travelling long routes by tube, I knew I had to get some help. I had a course of CBT privately using graded exposure therapy which I had to get on board with and be committed to, and was incredibly effective for me. My CBT therapist was a real lifeline for me and we had an effective rapport which really helped.

I have since moved out of London and abroad. In September last year I started a number of new part-time teaching roles (not in mental health) in my relatively new European city. I was really worried about my ability to speak the language and to be able to communicate if there was a problem. In fact, I had pretty much spent my entire summer holiday dreading, worrying and catastrophising about all the things that could go wrong, and didn’t really tell anyone exactly how I was feeling.

I started in one of my jobs and it seemed to be going just fine the first week. I did experience a lot of worry after each class and before the next one. I was really concerned about how other people would perceive and judge me, particularly as I was not yet fluent in the language and could not understand 100%. I continued to be anxious about how other people thought I was doing my job for the next few days and had consistently negative thoughts that would not go away which were concerning as they seemed to upset me more and more. I remember that on the last day of that first week, I had been introduced to my new colleague, a really lovely lady who seemed really helpful. She was really experienced and obviously had a lot of knowledge and I started to feel inadequate in that moment. That was the moment everything spiralled out of control.

I went home and over the weekend I experienced constant racing thoughts of things going wrong and worst case scenarios. My husband and I were watching TV in the evening and I just could not focus on anything as my mind was racing so much. What surprised me the most was how physically I felt the anxiety this time and how different it was to any anxiety I had before this. I felt hot and cold every few minutes, had the sweats and could not sleep for days. I could not seem to regulate my emotions and rationalise them. I retreated to bed to warm up and calm down and called my mum for moral support. I lost my appetite and could physically not put anything in my mouth apart from forcing some sugar down me.

This pattern continued the closer it came to Monday. I found it really hard to get out of bed – I was heavy, anxious and tired due to lack of sleep. It was hard to sit up straight and I forced myself to have breakfast. I have never felt before the way I felt that day. I was inconsolably crying, paralysed with terror, and curled up on the sofa. I called in sick to work and spent the best part of the entire day on the phone to my parents who flew out the next day to be with me. All of this was entirely alien to my husband. He knew I worked in mental health but I guess I never realised that he totally didn’t understand what I did and what mental health looks like. He had no idea what was going on with me and had to learn how to support me.

I am really lucky to have found a supportive and really competent GP when it comes to managing mental health. I wanted to be put on a course of medication as I know that medication is a key part of the treatment equation and the SSRIs I am on have helped tremendously. My GP also gave me a temporary course of benzodiazepine very closely monitored by her to help me with the initial stage of going to work, coping with the anxiety and helping me sleep initially.

All in all, this was a really acute depressive/anxious episode and I did go back to work the following week with a LOT of positive self-talk, support from husband and family, and a chill pill. My recovery was gradual and I guess I realised that we are all vulnerable at one time or another. My parents have both experienced anxiety and depression over their lives and I know that having a depressive episode makes it more likely that we will experience further episodes.

Recovery means making your mind your priority and this is what I’ve tried to do. I have regular follow-ups with the GP every few weeks as I’m still taking medication. I am concerned about how coming off the medication might affect me but I have a good relationship with my doctor and trust that she will manage that process with me in the next few months. When I’m feeling anxious and restless I know I need to up my exercise to channel my adrenaline elsewhere. I try to facetime friends and family more often and say what I’m feeling more. My friends have been so supportive and didn’t judge or change their behaviour towards me when I told them- I found it really hard to tell them though. Having a good night’s sleep helps too- going to bed and waking up at regular times. I have also found Acceptance and Commitment Therapy (ACT) self- help reading to be extremely helpful too and highly recommend “The Happiness Trap” by Russ Harris- a refreshingly easy way of managing difficult emotions and learning to live with them.

The biggest piece of advice I can give anyone who is struggling with negative thoughts, depression, anxiety, stress, is to tell the people closest to you what helps you. Sometimes it’s the fact that our family’s, partners, friends don’t know what helps or what to say which causes more stress or potential conflict. Tell them what you would like them to do or say to you when you are feeling a certain way. I told my husband that every time I start to feel anxious, inadequate and catastrophising about my work, to remind me of how much enjoyment I have had at work and the positive things I say when I get home from work.

I don’t believe that a cardiologist should have experienced a heart attack to make them more capable of treating a patient effectively, but as a Mental Health Professional, I do have that bit more compassion and understanding of the vulnerability that we all have, no matter which chair you are sitting in.

 

 

Guest Post: The Efficacy of Online Cognitive Behavioural Therapy- CBT by Dr Stacey Leibowitz- Levy

We are delighted to have Dr Stacey Leibowitz-Levy, psychologist writing about Cognitive Behavioural Therapy for us. As with any therapeutic practice, it is very much individual as to whether it will work for you and CBT will not work for everyone- but has been proven to work for many. Here Dr Leibowitz-Levy explains how it can work online.                        

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Online counselling is a growing field with more and more people turning to the internet to seek out counselling help. Counselling services offered online incorporate the range of therapeutic approaches that have been developed within the field of psychology. Approaches to understanding mental ill health and treatment include therapeutic approaches such as logo therapy, psychodynamic therapy, systemic therapy, psychodynamic therapy and Cognitive Behavioral Therapy (CBT). How do these therapeutic modalities translate to the online environment? This article will address the compatibility of CBT in particular as an online counselling approach.

CBT is a widely-utilised mode of therapy that focuses on an awareness of the relationship between thoughts, feelings and behaviour. The aim of CBT is to address difficulties through modifying distorted thoughts, unhelpful behaviour and unpleasant emotions. In order to achieve this end, the client works collaboratively with the therapist in building awareness and understanding of his/her condition, and an accompanying skill set for evaluating and changing distorted beliefs (as well as modifying dysfunctional behavior). The therapist develops clear objectives and a treatment plan that requires active participation from the client during sessions, and follows through on homework assignments between sessions.

This form of therapy is characterized by a structured, time limited and outcome focused approach to managing mental health challenges. Often CBT is focused on a specific issue such as anxiety or managing depressive thoughts and, as such, many CBT interventions are available in a protocol format. CBT offers a delineated and clearly defined intervention that is largely directed by a clearly defined process and structure. This is in contrast to many other therapeutic approaches that have less defined parameters and take their cue on a session to session basis from the client.

The format and approach of CBT lends itself to an online format in that the structure and process are not only defined and constrained by the relationship between therapist and client but are also defined by a clearly delineated therapeutic procedure. This procedure offers a framework within which to deliver support which can easily be translated to an online process. CBT follows a set format. It is driven by the imperative of building an understanding of the issues the client is experiencing and imparting a certain skill set to assist the client in managing his/her mental health issues. CBT is thus based on specific content and has a strong psychoeducational aspect, which means that delivery online can be located in tangible and clear cut content and outcomes for the client.

This also allows for versatility in the delivery of CBT online. While face to face time with a therapist may be desirable for some clients, the option of online delivery of psychoeducational as well as skills based elements in other formats also works well. For instance, the psychoeducational aspect could be communicated very effectively through a video delivery. CBT lends itself to the format of online courses where clients are guided through a process of identifying and understanding their particular issues and developing the skills to manage them. Interspersing this with face to face time or the opportunity to clarify or ask questions in a chat or e-mail format makes for a very effective online intervention.

While many of the issues addressed in CBT are personal to the client, the possibility of locating these issues within a more general format is very much part of the CBT approach. There is a set way of getting information from, and accessing and understanding the client’s experience, with the client having to act on this information between sessions. This more “scientific” process also makes for an approach that lends itself to an online format.

The efficacy of CBT as an online intervention is borne out by the number of sites specifically offering online CBT in a variety of formats (for some examples, see here and here). The online availability of this well researched and well-verified approach to managing mental health problems offers increased affordability, accessibility and greater choice for mental health consumers.

Dr. Stacey Leibowitz-Levy is a highly-experienced psychologist with a Master’s Degree in Clinical Psychology and a PhD in the area of stress and its relation to goals and emotion. Dr. Stacey has wide ranging skills and expertise in the areas of trauma, complex trauma, anxiety, stress and adjustment issues. Stacey enjoys spending time with her husband and children, being outdoors and doing yoga.

Guest Post by Diamond EhealthInformer: Can some Mental Health Problems be treated with Technology?

As we move into 2017 going full steam ahead, we can see how far technology has come in recent years. I wanted to set myself the task of finding out how far this tech had come in terms of treating mental illnesses, as there is some speculation and fogginess to the science and results that people are supposedly getting.

It turns out that there are multiple useful and FDA approved technologies that do indeed help treat mental health problems. In this article, I aim to uncover some actionable, useful data and solutions that will aid sufferers of various mental health issues.

Crisis Centres

This solution may surprise you, but it utilizes technology and has proven to be very effective in serious circumstances. When people feel pushed to the end of their tether with anxiety and depression, they need to be talked to, supported and experience a sense of connection to alleviate the feeling of alienation. Sometimes your best friends and family members aren’t available or you don’t feel like talking to them. You want something completely confidential, which is why text and call centres are so effective.

They’re always open and running, plus the staff are fully trained for both mild and severe cases of anxiety and depression and other mental illnesses. You can always rely on someone picking up at the other end that will know how to talk to you and do their best to bring you back to a state of calm through grounding techniques.

Having the option to text message or call is also beneficial for those who prefer to communicate in different manners. Some sufferers may not feel like talking, but texting will work for them and their mood at that given time. On the contrary, hearing a soothing and reassuring voice on the other end of the line may be more effective for certain sufferers. Both options are there to use, whenever and wherever a person may need them.

Using Apps for Improved Mental Wellness

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There are thousands of mental health apps available for both iOS and Android phones. That being said, it’s important that before you download anything, that you do your research. Given the fact that there are so many apps to choose from, you can take an educated guess and see that a lot of them won’t be very effective.

Also, be sure to check the privacy settings for the apps you’d like to download, as you’ll most likely be entering personal information and data into them. You can always protect your information using privacy tools, removing some of the worry and stress from using specific apps.

Apps such as Pacifica help to monitor and alleviate stress levels so that individuals can work out and reduce anxiety symptoms through cognitive behavioral therapy and relaxation techniques. By using an app such as Pacifica, you can prevent your symptoms from worsening and control your stress levels to produce a healthy state of mind.

Spire

 

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Spire works through wearing a clip-on device that measures your emotions, sending signals through to your smartphone which will alert you as to what your body is currently experiencing. I know this may sound a little “out there,” but Spire has been proven to reduce stress levels by up to 50 percent in certain scenarios. When emotions are detected, the device will send signals to your phone, which then pop up on your screen telling you how you can improve your mood and emotional well-being.

The nifty device is easily clipped to a belt or bra for completely anonymous use. Repetitive high-stress levels can lead to physical health issues affecting the digestive and reproductive system (as well as other areas of the body). Stress can leave you feeling drained and lethargic, so having a device that alerts you to your emotional wellbeing and gives you advice and tips on how to reduce those stress levels is very useful.

 

Conclusion

I set out to discover whether technology really could help to treat mental health problems and to see what some of the most effective and accessible treatments available are. I think it’s fair to say that there are many ways in which technology can aid sufferers of various mental illnesses. Using apps, crisis centres, and body measuring devices we can stay on top of our stress levels, and use signals to prevent our conditions and symptoms from worsening.

I feel that using these technological solutions will work best in collaboration with any existing treatment a sufferer is undergoing- with a supportive medical team. Through using medication and counseling, these modern alternatives can provide additional beneficial results that could  boost the recovery of a patient.

Guest Post by Juno Medical: 9 Things People with Anxiety Disorders Would Rather not Hear You Say

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Anxiety disorders include generalized anxiety disorders, panic disorders, and social anxiety disorders. 1 in 12 people suffers from anxiety globally, and women are twice as likely as men to experience anxiety.

If you feel overwhelmed by the behaviour of a person with anxiety, try to put yourself in their shoes, and show understanding, not stigma.

For more see www.junomedical.com

 

Full Circle- From Bipolar and Mental Illness to Recovery

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It was summer 2014. I sat on a sadly impersonal green NHS couch in a quiet side room , my feet dangling over the edge, holding my wordsearch book and counting down the hours until I could leave the Day Unit. I had been feeling exhausted from my new medication, wobbly, teary and lacking in confidence all day and I had just started taking Lithium as a therapeutic medication. As such I had weekly blood tests as the Lithium level in my blood fluctuated between 0.4 and the optimum dose of 0.8, where you start to feel much better.  Lithium has to reach a certain amount in the blood to work on your brain (where it stops or tames mania and mood disorders).  They also had to check it didn’t become toxic in my blood and so weekly tests were needed which were exhausting at the time.

I had just received test results that day informing me that I was feeling a bit fragile because the Lithium was only at 0.4 in my blood. All I wanted to do was hide away from the rest of the therapy group in that little room, peacefully colouring in photos and doing wordsearches to keep me occupied. All I really wanted to do was go home, to where I felt safe and I didn’t have to face the reality of being ill.

This was at the beginning of my recovery journey in 2014. I had left hospital as an in patient after a manic episode and was a voluntary patient at an Acute Day Unit specialising in group therapies. Eventually, I grew to love it and the other people there- although I always wanted to leave faster than the Doctors thought I was ready! I stayed there 3 months in total and some people stay there 2 weeks. I very much needed the healing nature of the therapies even though I didn’t feel it at the time.

I realised these past few weeks how far I have come in my journey- from ill service user needing the support of my psychiatrist, nurses and OTs, to not needing that support currently (on 6 monthly psychiatrist meetings) and helping others in a similar setting in my new job.

I really have come full circle. There may be times when I am ill again in the future or not feeling at my best. I may need more support again. I may get panic attacks or mania or depression. However, for now I am feeling positive and hoping I stay well for a long time on my medication.

Recovery is possible. I am so thankful to all who have helped me on my journey and continue to provide guidance and love.

Be Ur Own Light is One year old!

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I can’t believe my blog, Be Ur Own Light – started on March 1, 2016 is 1 year old today.

My journey with blogging has been so exciting, inspiring and wonderful. It has reached every part of the world and a huge number of countries in UK, Europe, USA, Canada and South America, China, India and other Asian countries, Africa, the Middle East and Australasia. It is such a blessing to be read world wide!

When I began this blog it was a diary to explain and help recover from my anxiety disorder. However, over time it has evolved into so much more!

As I grew in confidence and found other kindred spirits in my writing, I began to write for other organisations and also receive and upload guest posts on mental health topics.

This year I have written blogs for Rethink Mental Illness, Time to Change, Bipolar UK, Self Harm UK, Phobia Support Forum, Counsellors Cafe, Monologues Project and the Bossing It! Academy. I have written 4 blogs for Rethink and have loved collaborating with each charity and organisation. Special mention to Louie Rodrigues at Rethink.

I have also received amazing guest posts from these wonderful charities and writers who shared their hearts in order to battle stigma. Thank you:

– Breathe Life
-Ashley Owens at Generally Anxious
– ISMA stress management
– Stephanie at Making Time for Me
– Adar (PTSD)
– Deepdene Care
– Joshua (bipolar article)
– Michael J Russ
-Richie at Live Your Now
– Megan at the Manic Years
– Quite Great Music psychotherapy
-Lystia Putranto and Karina Ramos
-Eugene Farrell at AXA PPP
-Marcus at Psychsi
– Paradigm Centre San Francisco

I can’t wait to receive more guest submissions over time!

In the past year Be Ur Own Light has grown into a #lighttribe of thousands. On Twitter we are now 2,287 , Facebook 265 of my friends and family, Instagram is 2156,  and we have 127 dedicated WordPress followers. Thank you to each and every one of you for following, commenting, sharing and reading and for helping fight stigma through talking..

This blog has also raised money for Jami mental health charity and I am excited to be starting work for Jami soon.

Its been an incredible year of sharing, writing and breaking down barriers. Its OK to talk about mental illness and mental health. Its alright to feel lost or broken or ill. Seek support for recovery and you can get better. You are not alone.

With gratitude and love on our first birthday