Thursday, November 26, 2009

Positive Psychology and below the line mood

Depression and Mania come and go and we are left in the intervening times with so called normal mood. But what is normal mood. Are you as happy as you can be? Let’s do a scale of mood from Depression to Mania.

1    Severe Depression
2    Moderate Depression
3    Mild Depression
4    Not Depressed but Grumpy
5    So called Normal
6    Hypomania
7    Mania

Lets assume that number 5 above is the best possible way to be where all the happy people reside. The utopia that people with mood disorders spend most of their lives aspiring to. The reality is that I have spent most of my life at number 4. I have recovered from depression but then felt that I my mood slips back that little bit. So I would deduct that we can control or influence these smaller changes in mood. And what a difference this would make to our lives if we could shift our baseline of happiness up a little.
The problem is there little treatment out there for this malady. Once your Depression has lifted and you’re not in the manic area the Doctors don’t see it as a problem. The see their job as treating illness and being a bit grumpy is not seen as an illness. But in reality being grumpy everyday and being content everyday are two different worlds in terms of enjoying life. Enter Positive Psychology which is concerned with increasing happiness as opposed to reducing Depression. Where do we get such treatment and are there positive psychologists out there waiting for patients to treat. In my experience I don’t think there are many as it’s still a relatively new area. Here are a few tips that you can use yourself to treat this below the line mood.

  • Remove the little negative thoughts and feelings when they start at the earliest possible stage. See Prevention of Depression using Mindfulness-based Cognitive Therapy for help on this. Prevention of Depression and increasing happiness go hand in hand. It sounds obvious but it’s worth mentioning, If you are happier you are less likely to slip into Depression 
  •  Find out what your signature strengths are. These are the things that you are passionate about doing and feel most content doing. Your strength could be something like Love of learning. If it is you would need to find something to learn. You will find that when you exercise your signature strengths you will feel happy and content and positive about the future.
  •  Work on your relationships – Whether it is your spouse, friends or work colleagues. This means learning from and about the other party in the relationship and changing the old patterns which have kept the relationships from prospering in the past.
  • Work on your Self-Esteem – Very often our level of happiness is dragged down by a poor level of self esteem. Low self esteem is very common in the general population and is a big contributing factor with Depression also.  Challenge the core negative beliefs which are at the root of your low self esteem.
  • Attain and maintain a state of flow – Have you ever done something where you lose track of time, where you are totally immersed in what you are doing. This is known as flow and is one of the happy states. Get lost in your work or your pleasurable activity if you can.
  • Gratefulness – Personally I sometimes feel great because I am not depressed. It feels like everything is a bonus in life since I have come out of the Depression. If you can feel lucky to be alive and not depressed, this will contribute to your happiness

Thursday, November 12, 2009

Prevention of Depression using Mindfulness-based Cognitive Therapy

When it comes to Mental illness why do we relapse and why do we recover ?
It is said about depression for example that we can spontaneously relapse into illness and spontaneously recover despite the intervention of medication and psychotherapy.
But can we also influence when we relapse and when we recover. Better still can we influence whether a relapse occurs at all. With Cognitive Behavioural Therapy and Mindfulness meditation the focus with depression is on prevention. The trick is to become aware of the dysfunctional thoughts before they take hold of our emotions, for example the idea is to see your anger or sadness off in the distance and divert your attention away from  it. This can be achieved by taking notice of your bodily reactions such as changes in the breath or heart rate accompanied by vigorous detection of negative thoughts and feelings. When you learn to detect these thoughts and feelings you will have achieved the first major step. The reason why this is so difficult is because these thoughts occur without us being fully aware of them. They occur in a repetitive pattern everytime we are faced with stress or misfortune often without us fully realising it. For this reason they are often called automatic thoughts. Stopping these thoughts altogether is difficult but even reducing them will have significant impact on you mood and can prevent or reduce depression. The process of prevention is worth summarising as follows

  • Become aware of your dysfunctional thoughts as early as possible. If they are making you feel depressed or angry then more than likely they are dysfunctional. Bodily changes such as breath, heart rate or perspiration are good hints of changes in thoughts and emotions.
  • Recognize that these thoughts exist but divert your attention away from them and then attend to the moment to whatever is currently happening.
  • Depending on the stressful event and your tendency to ruminate your automatic thoughts will tend to come back. Don’t be concerned about this, the mind will always drift. When it happens again gently divert your attention away from these dysfunctional thoughts and back to the present moment

It may take some time and practice but you will find that if you follow these steps repeatedly as required there will be a significant improvement in your mood and you will be less likely to slip into depression.

Tuesday, November 3, 2009

Drugs and Mental Health

Drugs are synonymous with mental health/Illness whether it be the prescription variety or the street variety.
Psychiatry has come along way in the last 50 years. For most if not all psychiatric conditions there is a drug available on the market to treat it to a greater or lesser extent 
Antidepressants were introduced in the 1950’s  and anti-psychotics for the psychotic disorders such schizophrenia and Bipolar. These all revolutionized psychiatry and the treatment of mental illness to the point where the sale of psychiatric drugs is a massive worldwide business. But are we over medicated in relation to mental illness ? Are there other / better alternatives in some cases. There is no doubt that medication is a critical part of treatment for vast number of people but perhaps they don’t seek or are offered other therapies such as talk therapy.
What bugs me about antidepressants is that they can take so long to work. Sometimes it can be weeks or months and sometimes not at all. When you do start to feel better your left wondering was it the antidepressant or just the natural course of the illness or other factors such as on going psychotherapy. Personally I like to know what’s working and what’s not so that you can use the effective treatments if needed in the future. In practice maybe we never know for sure if the medication is working but I would still say to those who don’t like taking medication to take it because my feeling is if there is any chance of it working it’s worth taking. When I am depressed any prejudice towards taking medication goes out the window amidst the desperation of seeking an improvement.
In relation to street drugs and I include alcohol in this they are best avoided if possible especially during periods of depression or mania or any psychiatric episode. Alcohol is a known depressant and if you are drinking regularly and depressed it can be difficult to diagnose for a doctor. The thing to do is to stop drinking for a few weeks and see if the mood improves. If it does you can suspect that the alcohol is causing the depression, if not there maybe there is an underlying mood disorder. Other drugs such as cannabis  have known links to psychosis in younger people and cocaine and heroin have devastating addictive qualities.
Basically it comes down to this, with mental illness there is often a chemical imbalance in the Brain. Prescription medication is there to try and redress this imbalance in so far as possible and treat the symptoms of the illnesses . Street drugs upset this imbalance further and nearly always make things worse. Taking prescription drugs which has not being prescribed such as buying medication on the internet is not recommended  because  sufferers are not qualified to self medicate.

Saturday, October 10, 2009

Cognitive Behavioural Therapy

How useful or effective is Psychotherapy for the treatment of psychological problems or problems of living. Would you recommend it to your friends who had a few issues or to someone in the depths of depression? If you have had psychotherapy you are in the minority of people who have sought treatment for your problems. Most people with depression for example don’t seek any type of treatment. If you went for talk therapy there are numerous types to choose from. The following is a list of some of the most common forms of therapy

•    Cognitive Behavioural Therapy
•    Psychoanalysis
•    Counselling
•    Behaviour Therapy

CBT (Cognitive Behavioural Therapy) is the most common and effective therapy for the treatment of depression, anxiety and related illnesses. It’s also being applied in an ever increasing range of disorders such as schizophrenia and addiction problems. It’s based on the premise that if we can change the way we think we can change the way we feel. It teaches that disorders are reinforced or in some cases caused by dysfunctional thoughts and if we can change to more rational alternatives we will start to feel better. Unlike psychoanalysis CBT is not entrenched in past or childhood experiences although it is recognised that dysfunctional thoughts often start in childhood and that we are shaped by our past experiences. Instead CBT is about changing how you feel today based on what you are thinking today. Because of it’s popularity CBT can be hard to come by and public waiting lists are long in many countries. Private treatment is available and can be expensive but if you can afford it it’s worth it because mental health is one of the best and most important things you can enjoy if not the most.
Depending on your condition the frequency of sessions will vary and thus the cost. Typically a private therapist may require to meet for sessions every 2 to 3 weeks.
CBT is different from other forms of therapy in that the emphasis is on giving back control of mental well being back to the sufferer

Tips on Cognitive Behavioural Therapy

  •  Work hard on your homework. In CBT the work is done by you outside the therapy sessions. The    therapist should be seen as guide on the road to recovery not as some sort or fixer or healer who does his/her magic during the therapy sessions.
  • A therapist will often recommend a book to work on as part of your treatment and this book will        sometimes be used as the basis for the work you do between sessions. If you are waiting a number of months for your first session find out the name of the book and get it. Read it and familiarise yourself with the treatment in advance
  • If you are very Depressed CBT will probably not be that effective in treating you until your mood has lifted somewhat because you will simply be too low for the intervention to effect your mood. Your doctor or therapist will be in the best position to make this judgement. Don’t write off using CBT as your severe depression lifts.
  • Email your homework to your therapist in advance of your sessions. This means he/she will have had time to read it in advance of your session and less time is spent going over what has being done since the last session and more time can be spent on moving forward. The 50 or 60 minutes that you have with your therapist should be maximised. It’s also wasteful to spend this time ruminating or complaining how tough live is. You need to spend this time discussing solutions to your problems and planning a way forward
  • Make a short list of issues you want addressed at the next session and bring them up at the meeting. Compile this list over time between sessions. This will help focus you and your therapist on what your problems really are that effect you on a daily basis.
  •  Define a set of goals that you want to achieve from therapy. For example
  1.     Alleviate Depression  ( Learn to live with it )
  2.     Improve Self Confidence
  3.     Reduce Anger
  4.     Improve relationship
Show this to your therapist at the first session and he/she can discuss how realistic this is to achieve and in what timeframe.You can review this after a certain period to establish if the therapist and the form of treatment is right for you. If you are not making progress on your goals you may need to change things. Don’t be afraid to be open and discuss progress with your therapist and don’t be afraid to change therapist if there is a consistent lack of progress.

Basically the more effort you put into CBT the more benefits your will reap from it. Once your sessions are over with your therapists you can continue to practise CBT on a daily basis. The idea is that you perform the CBT techniques on the fly as everyday challenges occur in your life. In effect you will apply alternative rational thoughts automatically. 

You will know the CBT is working for you if you start to feel better before you feel bad…….

Wednesday, September 30, 2009


What a perennial topic and a huge industry. As long people put food in their mouths they will be concerned about the effect it has on them. Practically everybody in the western world who can afford to choose what they eat will think about healthy eating at some stage. There are endless diets and opinions about what’s good for you. Conflicting advice abounds and added into the mix is the question of weight which is very often given a higher priority. But how do we wade through this advice and information, How does it effect our food choices.
In reality most of us are on autopilot when it comes to what we eat, influenced by years of marketing by food and drinks companies which have penetrated us on a conscious and unconscious level and also of course by the inherited habits of our parents.  How do we decide what is good and what is bad for us in the knowledge that eating the right foods can help prevent cancer and heart disease. There are many diets but the general consensus is that the following food types are good for your health

•    Fruit and Vegetables
•    Raw foods or food that is cooked as little as possible
•    Complex carbohydrates (Wholegrain)
•    Essential Fatty Acids (Fish, Nuts, Seeds)
•    Protein

These foods are considered by most experts to be bad for you

•    Refined carbohydrate ( White Bread, White Rice, White Pasta)
•    Sugar
•    Saturated Fat

So it should be a simple as eating more from the first list and less from the second and we are well on the way to healthy eating. But of course it’s not that simple because we want to enjoy our food and feel full after we eat. Let’s face it a stick of raw celery, rye bread and a bowl of porridge can be fairly boring. How do we spice things up and make eating healthy food more interesting. Here are some tips

  • Learn how to prepare and cook the healthy food
  • If possible grow your own, a small patch is a good start or if you live in an apartment block some local   authorities provide allotments. This is surprisingly good fun and you will be more motivated to eat the healthy stuff that you grow yourself.
  • Eat foods that make you feel better. For example if you get a good energy boost from changing your foods  it is good positive reinforcement rather than living for the abstract benefit that healthy eating may improve you chances of preventing disease in the future
  • Understand what unhealthy food does to your body and also what the good food does. It’s easier to motivate yourself when you understand the costs and benefits of the food you’re eating. Don’t just go with the general wisdom, do a bit of research if necessary.
  • Promote healthy eating among your family, it’s much easier when everybody wants to try it

Enjoy your nourishment...

Wednesday, September 16, 2009

Taboo, Stigma and Acceptance in Mental Illness

Do you suffer from a mental illness or from time to time are you a bit depressed, obsessed or paranoid? Do you sometimes meet some of the criteria for a mental illness without crossing the line? Many experience symptoms below the clinical range but those people wouldn’t like to accept that they have taken a step closer to the unspoken mental problem. Ironically this early stage could be the best time to treat and prevent these problems
In my experience we don’t like our mental illness to be known by everybody or in some cases by anybody. Is this a good or a bad thing? On the plus side the secrecy protects one from taboo and stigma, for example you are shielded from employers who discriminate against people with mental illness or people in your social circle who are uncomfortable with these kinds of problems.
As long as society holds these views it’s understandable that sufferers don’t “come out” about their illness. However there are considerable benefits to openness regarding mental illness.

• While some may ostracise or judge you others will be understanding and helpful. Fellow sufferers may approach you about their illness and share their experience.

• Through your openness you will get more opportunity to help fellow sufferers when you have recovered

• Being open will also help with your acceptance of the illness. This is also true in reverse if you accept you illness it’s easier to be open.

However accepting the illness yourself and that you suffer from it is not the same as overcoming the fear of how others will react which is the main barrier to openness.
The stigma or lack of understanding is evident when someone tragically dies by suicide. A common reaction is “I don’t understand why he did that”. For sufferers of Depression suicidal thoughts are commonplace so they can more easily understand these tragedies.
Why does stigma exist for mental illness? Mental problems are viewed as something that can be overcome by freewill, something that you can simply snap out of. People find it hard to understand that an illness can take away your enthusiasm, your ability to reason, self motivate and importantly your ability to project a positive image of the future.
To be fair taboo and stigma has reduced a lot in recent years but we still have a long way to go before mental illness is treated like physical illness and a sufferer can feel confident about declaring their aliment to the world.

Sunday, September 6, 2009

Anger in our everyday lives
By Paraic Walsh

Does anger have a place in the modern world ? Can it be used as a force for good or is it something to be avoided at all costs. We all know the damage it can do in it’s extremes and Anger in Christianity is counted as one of the seven deadly sins.
But anger and anger problems are one of the greatest taboos in today’s world. Nobody likes admitting to an anger problem so much so that anger is barely recognized as a problem requiring intervention

For some with anger problems it is like the beast within and it can quickly take control of it’s host given a set of circumstances or events. The resultant behavior ranges from shouting, damaging property, verbal abuse through to road rage, violence and homicide to name a few.
But how do we control this anger, this force of nature ? Here are some tips

  • Don’t Vent it. Some people believe there is a definite amount of the stuff inside you and by letting it out it’s goes away. In practise the more you get angry the more angry you get and it can be habit forming. If you blow up with your wife this morning you can be snappy all day at work
  • Learn to see it coming from as far off as possible. Learn to observe the signs both physically and mentally. Identify the Self angering thoughts, these are the seeds of anger. When you identify them you can stop and replant new thoughts which will settle your emotions and produce a sense of well being
  • Come up with a plan in advance if you tend to explode from time to time and leave a trail of destruction physically or emotionally ( Which is much more damaging ) of what to do when your anger gets the better of you. The idea is If you’re ready to scream or put a hole in the wall with your fist it’s good to go for a walk, leave the scene of the anger before you do or say something that you will regret afterwards. This can be pre agreed with loved ones or friends.