Tag: Depression

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

~ Eleanor Segall ~ 1 Comment

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.

The Anxiety Wave: On waking up with anxiety

~ Eleanor Segall ~ 8 Comments

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In previous posts about my mental health journey, I have mentioned having an anxiety disorder. Anxiety disorders are triggered in the brain and can be very hard to keep under control. Thankfully, most of the time, I can function at optimum health. Yet, sometimes stressors come along and throw me a little off course.

The main anxiety issue I have is usually morning anxiety. This is when you wake up and almost freeze from fear- you feel like you can’t do anything or enjoy the day, panic floods the body. Sometimes, after a few hours this form of terror dissipates. You can distract yourself and it goes – but sometimes it takes a little longer for it to go and it causes exhaustion. This is due to the hormones adrenaline and cortisol which are triggered pre or during a panic attack.

I am still learning to ride the anxiety wave- it can make you feel very tired and far less productive. For me, it often happens after I have had time away from work or a disruption to my routine, the anxious thoughts and feelings will flood back, making life that little bit harder again.

It is not easy nor straightforward dealing with this. I have to be kind to myself and know it will pass. Breathe, and distract my mind. Try and use meditation techniques to keep it under control.

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

~ Eleanor Segall ~ Leave a comment

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.

Living with Uncertainty- Life and Journeys with Mental Illness

~ Eleanor Segall ~ Leave a comment

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*Trigger warning- talks about severe depression. Please be careful when reading*

There is so much I want to write on here that I havn’t yet written. Some topics  are too deep or painful for me to address- particularly surrounding certain aspects of previous hospitalisations. I hope one day I can share these with you. However, as a writer, I often get into the flow and just want to spill whats in my heart. So, this blog is about what living with mental illness can mean- its uncertainty and coming to terms with my own brain.

As most of you know, I was diagnosed with bipolar affective disorder, a mood disorder, as a teenager. I was poorly with depression and a mixed state in hospital when diagnosed and I don’t think fully came to terms with what the diagnosis meant until a few years later.

Being diagnosed so young instilled a lot of fear in me and a lot of avoidance. I decided not to drink alcohol or try drugs- as I didn’t know their effect on my brain and I was already  pretty anti drugs for many reasons. I knew my illness meant that the chemistry in my brain wasnt the same as everyone else without it- I had either too little seretonin causing depression, or too much causing hypomania and manic episodes. I felt often that despite taking mood stabilising medication and anti depressants and tablets to help PMS- that everything was uncertain. I had no idea when the next episode would strike- or if I would  be well enough recognise it.

I am lucky. My illness is very severe when it happens. Yet, I went 10 years without a manic episode or hospitalisation, though I suffered from acute depression that got truly so bad I didn’t want to be here anymore- which is quite a common side effect of being depressed. I was able to be supported at home and with my psychiatrist. I knew it was my depressed thoughts and not me- but this uncertainty  was incredibly stressful to myself and my family. I spent years being depressed and anxious and trying (and failing at times) to function- because my medication wasn’t holding me and my brain correctly.

Despite the uncertainty of so many things- dating, the effect of stressors in my life, work, etc- I am doing well at the moment. However, the uncertainty of the illness makes you worry that you could suddenly get ill again.

I practise a lot of self care- try to get to bed early, eat well, take my medication, tell my family or friends if feeling low etc. However, I always live with the knowledge that my Bipolar may pop up at different times in my life- and important times.

Due to having had this for 13 years- I am used to living with the chronic nature of my mental health condition. It can still be frightening and distressing and down right annoying. Yet, with the right support network and medical team, I know I can stay well for as long as my brain allows me- and I can get well and recover.

Recovery makes you stronger, Living through the pain makes you stronger, Surviving an episode makes you stronger.

You are not alone.

Guest post: Loneliness at Valentines (by Eugene Farrell, AXA PPP)

~ Eleanor Segall ~ 4 Comments

Valentine’s Day. For some, it’s a day full of romance and spending time with loved ones, yet for others, this focus can make them feel more isolated and alone.

According to the Office for National Statistics, Britain is the loneliness capital of Europe, with many Brits unlikely to know their neighbours or feel they have friendships that they believe they can rely on in a crisis.

Research by the charity, Relate, found that 9% of Brits of all ages don’t have a single close friend, while separately, a study by AXA PPP healthcare that British adults aged 18 to 24 are four times as likely to feel consistently lonely than those over 70.

 “The build-up to Valentine’s Day and the day itself can be quite intense, which is difficult for those who are already feeling isolated or lonely,” explains Eugene Farrell, Head of Trauma Support Services at AXA PPP healthcare.

“Although loneliness is often associated with the elderly, it’s actually an issue which can affect the physical and mental wellbeing of people of all ages.”

“In fact, studies have found that loneliness can increase the risk of high blood pressure, and have an impact on cognitive decline, dementia and depression. While addressing your experience of loneliness may take time, taking steps to build new and improve existing connections will help to improve your overall wellbeing.”

Here, Eugene gives his top tips on how to overcome feelings of loneliness:

1.     Making new connections can be an obvious way to combat loneliness and yield positive results, for example joining a group or class you are interested in will increase your chances of meeting like-minded people to connect with. Increasingly too we are turning to the internet for companionship, with community groups existing in almost every niche interest group you could imagine.

2.     Be more open. If you feel that you have plenty of connections but don’t feel close to any of them, the underlying issue may be that you need to open up to them more to deepen your connection, as an example letting the friend or acquaintance in on a vulnerability felt or your honest opinion about an issue.

3.     Stop comparing yourself to others. The desire to ‘keep up with the Joneses’ is not a new one, however the rise of social media has only exacerbated the problem by giving individuals the chance to constantly compare themselves to others. If you’re already feeling lonely, the idea that everyone else’s life is more idyllic than yours can make you feel even more isolated and alone. This can lead us to ‘compare and despair’ – which further exacerbates our negative experiences. Remind yourself that people only share what they want others to see about their lives. Don’t form unrealistic expectations about life and friendship based on what you see online.

4.     Keep all lines of communication open. Having a chat with a friend or relative over the phone can be the next best thing to being with them. Or you can stay connected with loved ones online. Video chat, exchange photos and keep up to date with the latest news from friends and family with Facebook, Instagram, Snapchat or simply keep in contact by email.

5.     Volunteering is also a great way to meet new people and feel good about helping others. It will not only allow you to give something back to your community but will also help you to feel more connected, involved and needed. There are lots of volunteering roles that need your skills and experience. It can also have a positive effect upon your mental health through helping others.

6.     Pride comes before a fall. Don’t be afraid to reach out to people and ask for help, companionship or just a chat. They may be feeling lonely too!

7.     Take it slow. If you’ve felt lonely for a while, or experience anxiety around new social situations, throwing yourself in at the deep end could only act to exacerbate the problem. Instead, dip your toes into the water first by going to a local café or sports event where you are surrounded by people, and just enjoy sharing their company. Or try a class where you can dive into the activity itself to distract you from the pressure of introducing yourself to people straight away. With loneliness, slow and steady often wins the race.

If you think you might be struggling with symptoms of loneliness, find more tips and advice at AXA PPP healthcare’s Mental Health Centre.

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

~ Eleanor Segall ~ 1 Comment

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.

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

~ Eleanor Segall ~ Leave a comment

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

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.