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Mental Health

Barriers To Self Care


Who’s wellbeing comes first?
Is it yours, your clients, your family or friends?

Most of us have heard the oxygen mask analogy – put your own mask on first or you can’t effectively help others. But, in reality is it that easy? For many of us it’s not.

My parents grew up in the second world war. I grew up very much in a family with a stiff upper lip, dust yourself off and get on with it attitude. I’m not criticizing this. It was how my parents dealt with the massive amount of trauma they, their parents and grandparents faced. Often with no support whatsoever.

And so I have had to learn self care and I’m happy to say that nowadays I have excellent self care skills. I’ve developed these strategies through years of struggling with my own mental and physical health. I’ve learnt these from various treatment programs, both NHS and private. From self study, formal education, peer support, and by somehow finding the discipline to put these things into regular practice. Self care is often a case of trial and error, finding out what works and what doesn’t work for you.

Self care differs from person to person and changes over time. The more you practice self care the more tools you have. So when one strategy doesn’t work, you automatically reach for another one without even thinking.

Even though I know that I have to put my mask on, the reality is that I will always put the needs of my wife and kids first and give myself just enough to get by. Saying that though, I still think I’m a lot better than most at putting self care into practice.

Some barriers to self care

Gender: (yes I’m generalising here)
There can sometimes be a blokey, macho, too hard or too cool to look after myself, man thing. Personally, I’ve always felt blessed that I have never felt self conscious walking into a yoga class full of women or being able to receive a massage.

A woman’s role is often seen as that of the caregiver. Always looking after everyone else and making sure others needs are met, whilst their own are not.

Structural barriers:
Self care can be expensive. It can be time consuming. So there are also financial barriers which make self care much more difficult for some than others. If you are working multiple jobs, all zero hour contracts with no sick or holiday pay, and still not able to meet your financial obligations, how can you justify the expense of going for a swim, getting your hair cut or some time off work?

Diet:
I had a conversation with someone the other day who said they don’t buy it that it’s cheaper to buy junk food than healthy food, as you can get really cheap fresh food from Aldi, Lidl and market stalls. I gently reminded them that may be true, but you have to be in the right frame of mind to be able to prepare fresh ingredients and cook them. When you’re not feeling your best, sometimes you don’t have the energy, or maybe even feel you’re worth the effort of cooking yourself a home cooked meal for. Even just living alone, sometimes is enough to make cooking a mental challenge. It’s just much quicker and easier to pop something in the microwave or get something delivered.

Culture/Community:
Looking after yourself can also be affected by those around you. If, for example, your partner does not look after themselves and you want to, they might feel that you’re being self indulgent or you might feel guilt yourself. Adopting a healthy diet may be made that much harder if you’re living with someone who just wants to eat junk food. Imagine then how much harder it would be if you want to quit alcohol or drugs and you’re around people who are always using.

Deanna Zandt has written an excellent piece on “The Complexities of Self Care“. She does an excellent job of breaking this down into:

  • Self soothing – activities which provide comfort/distraction in difficult times.
  • Self-care – activities that help you find meaning, and that support your growth & groundedness
  • Community care – workarounds for systems that don’t inherently support care (i.e. capitalism!)
  • Structural care – systems that support community care, self-care AND self-soothing

It’s clear that self care is not as simple as it sounds. And more often than not, we need a fair amount of help in order to do this.

To quote Deanna,

No single person can do all the kinds of care that are needed all the time; we each can play a role in supporting each other in different ways, though. Now, go forth and care for each other — and yourself.

Categories
Mental Health

Yoga for Stress

I’ve worked as a yoga teacher in the field of mental health for almost 20 years.  In that time I have taught yoga for mental health in the NHS, for mental health charities and also for some of the worlds leading mental health and addiction services.

One of the best ways of improving someone’s mental wellbeing is by helping them to manage stress.

Stress is something that we all have and actually need.  It drives us to overcome obstacles and motivates us to achieve.  However, too much stress over long periods of time can have a huge effect on us physically, mentally, emotionally and socially.

Stress is a predictor and risk factor for most common mental health conditions and also suicide.

We get used to stress.  We have so many demands, so many responsibilities, things that drain our resources and time.  Stress slowly creeps up on us, it builds and builds until we find ourselves overwhelmed.  In my experience people often don’t acknowledge just how much stress they have to deal with day to day.

The good news is there are many ways to practically manage stress and yoga is one of the best.

So how can we use yoga to help us manage stress?

Conscious breathing can take us from a state of stress and anxiety to relaxation and calm.

At times of stress chemicals in your brain are released and we enter the fight, flight, freeze part of our autonomic nervous system (ANS) called the sympathetic nervous system (SNS).

When this happens stress hormones are released, your heart rate increases, your pupils dilate, blood is taken from your gastrointestinal system and directed to your skeletal muscles.  In short it prepares you to respond to imminent danger.

The parasympathetic nervous system (PNS) is the relaxation response.  Rest, digest, feed and breed – nice things, and the PNS is related to the exhale.

So, one of the simplest and most effective ways to go from this state of heightened arousal to a state of relaxation is to change the breath.

The next time you find yourself stressed out, take your focus to your breath, count the length of your inhale and exhale and then simply inhale slightly more than you already are and make the exhale slightly longer than the inhale.  It’s very important that you don’t fight with your breath.  Extend the breath but keep it satisfying.  If you find yourself straining or gasping you’re doing too much, so slow down and take your time.

You can learn more about stress and how to manage it on the Youth and Adult Mental Health First Aid and Mental Health Aware Courses.

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Mental Health

Mental Health at Work: Millennials and Generation Z

It may not come as much of a surprise that in a recent report by Deloitte on mental health at work, 48% of Millennials (born 1981-1996) and Generation Z (born 1997-2012) reported that they have felt more stressed since the start of the pandemic.  For many of us this has been a really difficult time.

Worryingly, despite more discussion about mental health in the media in the last 18 months, 60% have not felt able to tell their employers about their increase in stress or anxiety.  Which means that even among the younger workforce, mental health stigma endures.

31% of Millennials and 35% of Gen Zs have taken time off work for mental health reasons. But astonishingly 49% and 47% (respectively) of these have given their employer a different reason for their absence.  And for those who have never requested time off for mental health reasons, 46% and 51% of them said that they would not give their employer the real reason if they did. 

When you look at the figures above, it’s not surprising that one in four Millennials and Gen Zs feel that their employer is poor when it comes to supporting workers to be their true selves.  And nearly four in ten gave their employers a poor grade when it comes to supporting mental health during the pandemic. 

Fear of discrimination due to mental ill health in the workplace is still rife. With 50% of millennials and 53% of Gen Zs believing that this frequently happens.

Prioritising Mental Health at Work

As employees, socially conscious young people are demanding their concerns around mental health and inequality are addressed in the workplace.  In another recent report from The Purpose Pulse, Gen Z and Millennials are clear on diversity and inclusivity which includes mental health. 69% (almost 7 in 10) want employers to encourage them to bring their whole self to work.

Being authentic and being able to show or be your whole self includes being able to discuss concerns about mental health with your employer.  Psychological safety is one of five key elements that allow a team to excel.  Google’s Aristotle study found that when people feel safe and connected they work better together. 

The research also showed that 66% (two thirds) want to work for an organisation that actively promotes diversity and inclusion.

There are set to be rewards for brands that have a clear social purpose and a good record on workers rights.  Over two thirds of young people (68%) are looking to buy from brands that treat their employees well. With 61% saying a brand having a clear social purpose is important in their purchasing decisions. 

Just over two fifths (43%) of Millennials and Gen Z in the UK have boycotted a company over the past 12 months because they don’t agree with their values or behaviour. This is an increase of 9% from last year.

Clearly more needs to be done to end the stigma around mental ill health.  Employers must now make mental health a priority to ensure that workers can be their whole self and to help strike a better work-life balance.

The rewards for doing this are clear.  Not only a happier, healthier and more productive work force but also a more positive image for customers too.

Categories
Mental Health

What is Schizophrenia?

National Schizophrenia Awareness Day on 25 July 2021 brings attention to this much misunderstood condition. But exactly what is it?

One of the most common misconceptions about schizophrenia is that it means having a split personality. But that is a completely different illness called dissociative identity disorder.  People also mistakenly think schizophrenics are violent. But again this is not true, as schizophrenics are more likely to harm themselves than others.

Psychosis is an umbrella term for a number of conditions including schizophrenia. The word schizophrenia actually means split mind.

It is a long term medical condition where the main symptoms are:

  • delusions (losing touch with reality),
  • thought disorders (muddled thinking & speech)
  • hallucinations (auditory, visual, taste, touch & smell)

The exact cause is unknown, but it could be a combination of genetic and environmental factors. Stressful events can be psychological triggers such as bereavement, losing a job, the end of a relationship, physical, sexual or emotional abuse.  Drug use is linked to schizophrenia and there is also some research to show that people who have had complications at birth may be more susceptible.

It is a debilitating condition affecting 1 in 100 people.  Worldwide it is ranked as one of the highest causes of disability. It is one of the most expensive illnesses through physical co-morbidities (related illnesses), social impairment, inability to work and hospital admissions.

Can Schizophrenia Be Treated?

The main treatment includes anti-psychotic drugs and cognitive behavioural therapy.  Eight out of ten areas in the UK have an Early Intervention in Psychosis (EIP) team whose aim is to get people in treatment within two weeks.  Early intervention is vital, as treatment outcomes are good when this is caught early on.

One in five people with schizophrenia recover completely with treatment. But others may have times when symptoms return and it is important to learn to recognise the signs and have support in place.

Living with Schizophrenia

Here Antonio speaks about his experience of living with schizophrenia

Find out more about schizophrenia.

And if you are worried for yourself or someone you know, please speak to your GP.

Categories
Mental Health

Let’s talk about Men’s Mental Health

Three times as many men as women die by suicide and it is the biggest cause of death for men under 50.  Men report lower levels of life satisfaction than women but are less likely to discuss or seek help for their mental health concerns.  Often they don’t even recognise them.  

We live in a society that expects men to be strong and in control, making it difficult for men to reach out for support, instead turning to unhealthy coping mechanisms.  Men are three times more likely than women to become dependent on alcohol or drugs.

It’s important that we have safe spaces where men can share their health concerns.  In my own journey, a weekly men’s group was fundamental in helping me to turn my life around. I was an angry young man with physical and mental health problems.  I was off sick from work and struggling with life.  And like many men, anger was an emotion that was both familiar and something I found easy to access and express.

But what was behind the anger?

In my men’s group one day, the facilitator challenged me on my anger.  He asked me to close my eyes and said that he would say things that would make me angry but that I should not react, just stay with the emotions.  He began to speak and I found the anger building, my knuckles clenched and my jaw tightened.  He continued and I began to shake.  After a few minutes (and it may have been much less than that) I started to cry and it wasn’t just a few tears, it was uncontrollable as the years of sadness that I’d been hiding behind my anger came out.

This couldn’t have happened had there been women present for two good reasons.  Number one, and the main reason, is that I wouldn’t have let my guard down in front of females.  And number two is safety. The facilitator probably wouldn’t have tried this just in case I lashed out. So this is one example but there are many subjects that men need a safe space to talk in.

Reach out if you are worried about your mental health.  Connect with friends and talk about your concerns.  Don’t let it build up until it becomes unmanageable.  There is help out there.

And if you are worried about someone else
  • Let them know you are there for them and keep in touch, listen without judgement.
  • Encourage them to get help from their GP or find a men’s group in your area
  • Learn more about the signs and symptoms of mental ill health and how to support someone in distress by taking a mental health first aid course.
  • Check out Men’s Health Forum for more information on men’s health

Categories
Mental Health

Why do negative thoughts stick in our heads?

Have you ever had a really good day, when everything seems to go right?  Maybe you gave a presentation at work and got lots of great feedback.  But what if among the great feedback you got one bad comment?  Do you focus on the overwhelmingly positive feedback?  Or do you dwell on that one negative comment?  If it’s the latter, you’re not alone.  Most people do.

The brain sees negative information as three times more interesting than positive information.  This means we spend more time thinking about negative experiences and the memories of them last longer and are more detailed than positive ones.

From an evolutionary perspective, this helped our ancestors to survive the daily physical dangers that they lived with.  If you remember the noise of a wild animal, you know what to do next time you hear it.

But focussing too much on negative thoughts is not great for our mental health.

What can we do about negative thoughts?

The brain is designed for survival and naturally focuses on the negative so it takes effort to give equal attention to the positive.  But the more time we spend thinking positively the less we dwell on negative thoughts.

Recognise and reframe negative thoughts. If after an event, you catch yourself automatically thinking negatively (“everything went wrong, I shouldn’t have done…”), stop, and think about some of the things that went right.  Cognitive behavioural therapy (CBT) can help with this.

Celebrate the good things, no matter how small.  Share them with friends, write them down, spend time thinking about them, savour them.  It’s easy to have a moan about a bad day, but don’t forget the good bits.

Practice mindfulness.  Bringing your awareness to the present moment can help to break a negative thought cycle.  Regular practice can help to change the way you respond to your thoughts.  Watching your breath is a simple practice that can be done anytime. 

Practice gratitude. Keeping a gratitude journal or just thinking of three or four things you’re grateful for at the end the day can promote positive thinking and balance out any negatives.

Distract yourself.  Sometimes the best way to reduce the power of nagging thoughts is to distract yourself.  Do something you enjoy – listen to music, read a book, go for a walk, laugh.

Categories
Mental Health

Racism and Mental Health

The International Day for the Elimination of Racial Discrimination is observed annually on the day the police in Sharpeville, South Africa, opened fire and killed 69 people at a peaceful demonstration against apartheid “pass laws” in 1960.

Racism has had a huge impact on my life, from the age of 7 to 17 I suffered direct racial abuse from people in the streets and systemic racism from school, the police, and also the mental health system.

Even  though I struggled with poor mental health, and racism was a clear factor in this, it was never brought up by social workers or medical professionals. It seemed that my reaction to racism was the problem rather than the racism itself. And when I questioned it, I was deemed a troublemaker or I “had a chip on my shoulder”. I remember one psychotherapist who was keen to know about my experiences growing up as a mixed ethnicity child adopted into a white family. He was convinced this was the cause of my problems but was unconcerned when I told him “my family are great, they weren’t the ones abusing me”. He had no interest in hearing about me being regularly attacked by skinheads and squaddies (I grew up in a barrack town) or about being held back in schools, in sports or later in my career.

After the death of George Floyd, and because of the blatant racism I have experienced over the years and the racism I was now seeing online from the yoga and wellness communities, I was inspired to create my own anti-racism training. I am on the faculty teaching this for the leading yoga training provider in the UK, Yogacampus, and other large yoga training providers.

So what do we know about racism and mental health?

Your Race and Ethnicity have a clear link to mental health from exposure to more risk factors, access to services, how you are referred, diagnosis given and treatment outcomes.

Harassment, discrimination, bullying, social isolation, poverty, migration, trauma, unemployment, poor housing, homelessness, family history, stress and in particular social stressors and inner city life are all risk factors for mental ill health ill. And if you’re from a Black or minority ethnic background, guess what? You’re more likely to be affected by them.

What does the science say?

Leading researcher in this field, Dr Robert Carter, showed that many individuals who have suffered racial discrimination experienced it as a form of trauma similar to post traumatic stress disorder (Carter et al. 2009).

A more recent study examined this further and showed a relationship between racial discrimination and dissociation, which is disconnection from thoughts, feelings, memories, identity, surroundings and time.

Thankfully there is now a growing body of high quality research studying the effects of racism on mental health and even though there were clear links shown in previous research for some reason this was ignored.

What do the stats say?

  • People from Black and minority ethnic backgrounds felt the possible financial costs of therapeutic interventions were too expensive since the majority of Black and minority ethnic people were from poor socio-economic backgrounds.
  • Historically, ethnic minorities have been more likely to be prescribed antidepressants and other forms of medication rather than psychological and cognitive behavioural interventions which eliminate the need for dependency on drugs.
  • Out of 16 specific ethnic groups, Black Caribbean people had the highest rates of detention under the mental health act 2020.

I could go on with shocking statistics but let’s look at the impact of these three. 

The cost of counselling and talking therapies are seen to be out of reach for minority ethnic people and so the private route is seen as inaccessible.

Due to systemic racism suffered by Black and minority ethnic populations there may be a deep distrust of authority which causes fear of accessing free NHS medical services.

We know that early intervention is vital when treating mental health conditions.

If Black people are more likely to be given drugs than talking therapies this means that the symptoms are being treated rather than the root of the problem, which talking therapies seek to do. So the problem is still there and all that happens is the person becomes dependent on drugs.

And so if that early intervention and follow up treatment is not there, then it’s more likely that intervention will come at crisis level and the stats back this up as White people are more likely to be sectioned/referred by their GP or CMHT (community mental health team) and Black people by the police.

What can we do about it?

Real change is happening within mental health services but a deep distrust of authority is a very real thing and will take time to heal. If you haven’t experienced racism yourself this may be a hard, or even impossible, thing to understand.

To make active change now, we as individuals must not only become actively anti-racist we must empower ourselves and each other to learn about mental health and how we can support each other.

There are specialist mental health services available specifically for Black & minority ethnic people like Black Minds Matter who connect Black individuals and their families to free mental health services and Nafsiyat the intercultural therapy centre  which offers talking therapies in over 20 languages.

Mental Health First Aid England has an excellent downloadable PDF on supporting the wellbeing and mental health of People of Colour and Black people in the workplace.

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Mental Health

Sleep and Mental Health

Good sleep is vital to good mental and physical health

Sleep is essential for maintaining good health.  The odd sleepless night may affect your whole day, but consistently not getting enough sleep can have a serious impact on your mental health.  It can affect your ability to concentrate and make good decisions.  It can make you irritable and impatient.  It can cause anxiety and depression and increase your chances of other mental health conditions.  Conversely, having poor mental health can lead to problems with sleep.  It can become a never ending cycle.

In my work as a yoga teacher and yoga therapist, one of the main ways I’ve been able to help people is by helping them to sleep and to sleep properly.

What do I mean by sleep properly?

It’s not just how much sleep we get, but the quality of that sleep.  Some of us need more sleep than others but generally most people need between 7 and 9 hours of sleep per day.  It’s normal to wake in the night, maybe to go to the loo, but if you can’t get back to sleep quickly, then you may not get enough rest.  The golden rule is that you should awake feeling refreshed and ready for the day.

Many people, however, fall asleep exhausted and wake up feeling tired.  This means that they’re not nourished from their sleep and they may rely on coffee or other stimulants to get through the day.  Others may find it hard to get to sleep in the first place because of worry.  Then if they do sleep it may only be for a couple of hours and they wake unable to fall asleep again.  Some complain of grinding teeth, dental problems, headaches and pain in their jaw when they wake.

So how can you improve the quality of your sleep?

With my clients, I often use movement synchronised with the breath, most likely in a supine position.  I might combine this with long held (gentle) stretches.  After this I may use relaxation techniques such PMR (progressive muscle relaxation), conscious breathing (pranayama) and restorative yoga postures, followed by a long savasana (yoga relaxation pose) where I will give a guided relaxation technique called yoga nidra (sleep of the yogis).

Many people have never experienced such deep relaxation and when they do they want more of it.  It’s like they finally have permission to relax.

Try my yoga nidra for sleep. Do it for five consecutive days and see what difference it makes to your happiness, health and wellbeing.

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Mental Health

What is Self Harm?

The image that often comes to mind is of someone cutting themselves. But self harm can be any action that causes injury or pain to yourself. Over-eating, over-exercising, participating in unsafe activities, drinking too much are all just harmful to yourself as causing immediate physical injuries.

Many people think those that self harm are just attention seeking. If they were serious, they would attempt suicide, right? But in reality they will often do their best to keep their behaviour a secret. It is a coping strategy, a way of dealing with extremely difficult emotions and feeling some control over unmanageable emotions.

MHFA plenary speaker and self harm awareness trainer Satveer Nijjar discusses and explains more in this video.

According to a report published in the British Medical Journal, non-suicidal self harm has tripled in the UK in the last 10 years though people aren’t accessing services.

The co-author of the report Louis Appleby, from the University of Manchester, commented: “An increase in the prevalence of using self harm to cope with emotional stress could have serious long term implications. There is a risk that self harm will become normalised for young people, and individuals who start to self harm when young might adopt the behaviour as a long term coping strategy.”

Appleby warned, “Non-suicidal self harm may be associated with later suicide. As young people get older, reaching age groups that already have higher suicide rates, the self harm they have learned may become more serious and more likely to have a fatal outcome.”

Where to go for help

Self harm can be successfully treated when caught early and it’s important to get help as soon as possible.

Self Harm UK have launched a free online support group for 14-19 year olds called Alumina.

Young Minds are always an excellent resource for all mental health matters for younger people and they have some great pages around self harm. They also support parents of young people too.

The mental health charity Mind have useful contacts if self harm affects you or someone you know.If you’re in crisis contact The Samaritans on 116 123. In 2019, people discussed self-harm in calls with Samaritans once every two minutes.

In the Adult MHFA courses we learn about crisis first aid for self harm and positive coping strategies to help reduce stress.