Thursday, February 24, 2011

A healthy mind in a healthy body

6 simple, scientifically proven tips for better mental and physical health

It's such an old adage I'm surprised people still feel they need to prove it right or wrong.
A new paper by Roger Walsh, professor of psychiatry and human behavior from the University of California rewieved available research on the effects of Therapeutic Life Changes (TLC; do not confuse with TLC= Tender Loving Care, although it's not as much different).

TLC are simple changes in everyday life from nutrition, to relationships, recreation and spiritual involvment. They cheap, effective, enjoyable and don't have as many side effects as pills. Moreover - it's you who can make them happen.
You can make your life happier and healthier.

Here are the summary of Prof Welsh's findings:
6 Super-simple sientifically proven tips for better mental and physical health:

1. Exercise outdoors - it will boost your sense of well-being, improve your cognitive performance and reduce the risk of memory loss

2. Eat your fruts and veggies, and fish -  it will help you keep those grey cells top notch, and if you suffer from schizophrenia or an affective disorder (e.g. depression, bipolar affective disorder) it may also reduce the symptoms

3. Surround yourself with people you love and who love you, make up with your ennemies - having good relationships with other people improve your chances of being well physically and mentally

4. Learn to relax and manage stress - you will be able to manage your anxieties, insomnia and panic attacts

5. Meditate - it will help you become  more stable emotionally, enhance your ability to empathise with other people, reduce your stress and increase your brain size (sorry, brain only ;-)!

6. Get involved in a local community or become a volunteer for a charity - altruism and contribution foster joy and generosity and generally boost mental and physical health.

Same old same old? Yes, but now it has been oficially proven by science. Do you need any more evidence?
Don't wait for it.

Go for a walk.

Friday, February 18, 2011

Effective treatment for chronic insomnia

photo by graur razvan ionut

is a problem which affects milions of people every night (one third of adult population). If you ever had difficulty falling asleep, maintiaing your sleep or early awakaning, you know that insomnia is not only a nighttime problem. Lack of sleep seriously affects ability to function during the day, reduces quality of life, affect physical and mental health.
Here you can read more about types of insomnia and its causes .

Even one sleepless night can be a horrible experience (as an parent, been there, done that), but chronic insomnia is a struggle on several levels. One of the biggest challenges is treatment. Unfortunately, the medication which is currently used (succesfully!) in insomnia creates tolerance and dependence. It means that the longer you take your sleeping pill, the less likely it is to help you sleep, you are more likely to need higher doses, and if you stop taking it you may experience very unpleasant withdrawal symptoms.

Is there any non-drug effective treatment for insomnia then?
Many doctors would use antidepressants or antipsychotics, even if the sufferer doesn't have any of these disorders because these drugs have sedative (soothing, calming) effects. However in many countries these medication are not licenced to treat insomnia. Moreover, as Dr David M. Allen warns in his post, there may be other potential side effects of long term use of antipsychotics for patient without psychotic illness.

If not medication, what then?
You should always start by improving you sleep hygiene.
If your sleep problems are not related to any other physical or mental health problems (chronic primary insomnia) American Academy of Sleep Medicine recommends the following non-pharmaceutical approaches:

1. Stimulus control therapy
(training, which helps the sufferer re-associate the bed and bedroom with sleep and re-establish sleep-wake cycle)

2. Relaxation (learning different techniques to help you relax your muscles and deal with intrusive thoughts at bedtime)

3. Sleep restriction (this approach suggests that you don't stay in bed when you are not asleep)

4. Cognitive behaviour therapy (CBT) with or without relaxation (CBT part is focused on helping you change your beliefs and attitudes to insomnia)

5. Multicomponent therapy (a combination of sleep hygiene, stimulus control and sleep restriction strategies)

6. Paradoxical intention (in this method the sufferer is told to stay passively awake and avoid any effort to fall asleep)

7. Biofeedback

You can read the AASM report here.

Have you ever try any of these approaches? Did they work for you?

Wednesday, February 16, 2011

Toxic People part 1 - The Sellotape Girl (or boy)

photo by JMJast

'How is your new girlfriend?'
He cringed. The subsequent 'Aaaarhg riiiight' made me think he didn't really want to talk about it.
'You've even stopped coming to the club. No time for old mates and pool,' his friend carried on.
'Been busy,' he mumbled looking nervously in the window.
'Busy-busy,' the friend gave a sharp laugh. Nudge-nudge, wink-wink. 'Busy snuggling in the park, hey? I know. I saw you the other day. Holding hands and things. She was all over you, mate!'
'Yeah, she is a bit over the top.'
'She's quite dishy though.'
He sighed.
'I can't play pool in the club 'coz she's joined it. Get it?' His voice grew a little stronger. 'She's got no clue about pool and thinks it's boring but joined the club to spend more time with me. She's changed her uni timetable to go to the same classes. She likes whatever I like. She wants to be friends with all my friends. I've got nowhere to hide!'
'Oh, s..!'

He got off at the next stop. She was waiting for him. Slim, pretty, gaping at him with her mouth open. She tried to grab his hand but he hunched and he put his hands in his pockets.
She was all over him before the bus left the stop.

I don't know that guy, but he reminded me of a teddy bear wrapped with sellotape. And his lovely girlfriend seemed like a perfect example of a Sellotape Girl.

The Sellotape Girl (or Boy)
wants to be liked and loved so much they don't care about the price. They are nice, sickly nice, they always say 'yes'. They listen to you, they agree with you. They take up your hobbies, your political views, your friends, your breathing space. They want to be with you for the rest of their lives. They want to hold hands, do everything together - even go to the toilet. They wait for you. They give up their hopes and dreams (if they have any left as they have always given up their own things for other people) to live your hopes and dreams. They always laugh at your jokes, even the really bad ones.

They are organically unable to make decisions, take sides or argue. They are unable to exist without other people - they've never lived alone. They're terrified of being alone.
Their biggest fear and the drive of their all actions is the fear of being abandoned, so they do everything to avoid it, to keep you close. They need constant reassurance that you like/love/accept them. They want unconditionnal, neverending love. Their needs are so huge no one can possible meet them. They are like a bucket with a hole - however much you pour into it it never fills up.

Inevitably, they get abandoned. No-one mature and sane enough can stand this level of closeness and neediness for this long.

Sellotape People wrap around you so tight you can't to breathe. They have no spine and are transparent. They stick so close, peeling them off can be painful.
They are like sellotape.

What may attract you to them?Their affection, attention and dedication to you. For some people it maybe alos the illusion that you are The One Who Can bring them love and attention they need and deserve.

Don't confuse it with?
Many relationships start with the need for closeness, intimacy and sharing, holding hands and wearing the same clothes. This is normal in the first stage of love called The Enchantment.
The same is also true in close friendship (minus physical intimacy).

Why are they toxic?They wrap around you like ivy (or sellotape) and will take anything and everything you give them. They are extremely needy but also like buckets with a hole. Their needs are so immense, they can never be 'filled up'.
What they need is everlasting, unconditional love only mother can give them, with the closeness of 'two people being one' intensity possible only in prenatal and newborn stages. You can't give it to them, can you?

When should your alarm bells ring?When you realise you're feel stifled, constraint, can't be yourself, or can't fill that void they want you to to fill.
Or when you feel you want to dump them.

Do you recognise this type? What made you think this person was/is toxic for you?
What would you advise to people in a similar situation?

Saturday, February 12, 2011

How to recognise toxic people (introduction)

'I'm depressed again,' C would say slumping into an armchair. 'My energy is at zero. I've been sick. I can't eat. I feel like the life have been sucked out of me.'
'Have you seen your sister lately?' I would ask.
'Yes. We had a family do last Saturday.'

It would take C a couple of weeks to recover and she would function fairly well until the next meeting with her sister. C's sister was a 'professional critic'- ready to find a flaw in anyone and anything, and particularly C. She was very outspoken when it came to finding someone to blame for anything not up to her standards. She drained life and light out of C, but C was unable to defend herself, nor avoid her sister.

'My mum always told me that we had to stick together, because we only have each other in this world.'
It took C many months of therapy to be able to let her mother's death-bed message go and just take care of herself.

This is just one of many examples of toxic people. I'm sure you all have know someone who has made you feel the way C felt after the meeting with her sister.
I have met quite a few in person, and heard of many more from friends, colleagues and patients. As a result I had to learn how to recognise and deal with them to preserve my sanity.
I want to share my experience and knowledge with you in this little series of posts.

Here are 13 signs of a toxic person:

1. Talking or even thinking about talking to this person evokes bad emotions in you (anger, frustration, fear, disgust)
2. After talking with her/him you feel sad, stupid, nervous, inadequate, you lose your confidence and your self-esteem suffers.
3. You feel as if this person sucked life or joy out of you.
4. You feel constantly judged and/or unappreciated
5. You feel this person does not respect you, or you find it hard to respect him/her
6. You feel used, emotionally blackmailed, or abused.
7. You have cried, got drunk or ate a lot after talking with this person.
8. You feel relieved after this person is gone and don't want to see her/him any more.
9. You have felt like hitting this person at times.
10. When with this person you don't behave in usual way: you're tense, unpleasant, 'on edge' or stutter
11. You have to chose your words carefully and make sure you don't hurt this person when talking to them.
12. You have headaches, backache, feel sick after a chat with them.
13. You would rather never talk talk to this person again.

Do you recognise any of these signs? Is there any particular type of person who makes you feel this way?
What do you do to cope with the feelings they provoke in you?

These people may (and usually do) have their own 'issues' - reasons why they interact with others the way they do, but this doesn't mean you should put up with their behaviour at your own expense.
If you want to know how to deal with toxic behaviour, come back here. I will be writing about different types of toxic people over the next few week.

Saturday, February 5, 2011

Do these bones make me look fat?

How unhealthy relationships can maintain a deadly illness

6-12 February is a National Eating Disorders Awareness Week in Canada as announced by Canadian Mental Health Association. This event aims at providing information on eating disorders and dieting, encouraging individuals and their families to acknowledge the problem and seek help, provoking changes in social attitudes and celebrate the natural diversity of body sizes.

Why is it so important to be aware of eating disorders?

Anorexia, bulimia and binge eating are becoming increasingly common, particularly in westernised countries, and are affecting younger people, also males. Eating disorders are associated with several complications, including osteoporosis, infertility, tooth loss, kidney failure or cardiac arrest. The most dangerous of eating disorders, Anorexia, has the highest mortality rate among psychiatric problems. 5% of all patients will die prematurely.
Anorexia is a deadly illness.

The beginnings of an eating disorder are often benign - a young person wants to lose weight to look better. But somehow they don't stop when they reach their goal.
WHY? What keeps this battle with their own body going?

As with any mental illness, it is impossible to pinpoint a cause or a reason for a person to develop this particular problem. Instead, we look at the predisposing (what we are born with), precipitating (triggers) and perpetuating (maintaining) factors in the bio-psycho-social model.

We don't have any influence over our predisposing factors, we can't turn back the time and avoid triggers, but we can try to change what keeps it going.

What keeps anorexia going?

What are the kind of interpersonal relationship that maintain the deadly course of anorexia?
1. Overprotection (kangaroo strategy) - too much emotions and too much controlWrapping the sufferer in cotton wool or treating them with kid gloves can make the sufferer feel suffocated, disempowered, unable to grow and become self-efficient. This approach reinforces the vicious cycle of co-dependency and 'eternal infant' feeling.

2. Criticism (rhinoceros strategy) - too much logic and too little warm emotionsUnfortunately, logical arguments about food and weight can't win with the illness. The sufferer's mind is so affected by starvation, it believes you inhale calories from the aroma of food or absorb them through the skin. Shouting and attempts to control the sufferer's behaviours may make them more rebellious and resistant.

3. Anxiety and hostility (jellyfish strategy) - with too much emotions and too little controlBursing into tears, cutting the family off the world, being angry, self-blame or attempts at being a perfect parent won't work either. This approach can make the sufferer feel bad for causing so much stress to the family, so they may avoid contact and stop telling the family what is happening.

4. Disengagement (ostrich strategy) - too little emotions and too much controlAvoiding talking about the problems at all not only reduces the chances of the sufferer receiving help, but also makes them feel unloved and worthless.

Which approaches do work?
* Just enough caring and control (dolphin strategy)
* Just enough compassion and consistency (St Bernard's strategy)
source: Treasure J., Schmidt U, Macdonald P. The Clinician's Guide to Collaborative Caring in Eating Disorders.

Here are links to trusted sites with more information on Anorexia, Bulimia and overcoming Eating disorders

Wednesday, February 2, 2011

Games people play

A: 'I hate my job. I'd rather be a hairdresser.'
B: 'So why don't you become one?'
A: 'I don't have qualifications.'
B: 'Why don't you enrol on a course?'
A: 'I don't have time. I've kids to look after.'
B: 'Can't your husband look after the kids twice a week?.'
A: 'No, he's too tired after work.'
B: 'Could your mother babysit while you're at college?'
A: 'Yes, but it's pointless asking her because...'

Do you recognise the pattern?

I'm sure many people have met someone who plays the game 'Why don't you - Yes but'.
Once upon a time I lived with a girl who played it. She was a nightmare to live with. One day the girl read Eric Berne 'Games people play' and recognised herself in this game, as well as in Kick Me, Look How Hard I've Tried, Ain't it Awful and... She felt very, very embarrassed and decided to change it.

Several months of therapy and years of much happier life I still keep coming back to this book. It provides good introduction to Transactional Analysis (TA), talking about our inner Child, Adult and Parent and how these interact with different ego states of other people. But most of all Berne provides interesting perspective on the nature of human relationships, showing why people engage in games, invest so much in such destructive patterns of interations and why they are sometimes willing to put even their own life at risk to win.

Games people play can be deep-seated, engrained, incredibly distructive, and suck other people in. Are you an active player? Have you ever been manipulated into any of these games?
Would you like to be able to recognise them, or even stop playing?

Berne's book is an eye-opening, life-enhancing read, which is entertaining at the same time. Shame that while providing so much insight Berne does not give advice how to stop those games. Ability to recognise a game is not always enough to stop playing it.

Read more reviews on Amazon and an interesting application of Berne's theory to online interactions by Adrian Chan here
More about Eric Berne and his works here.

My Rating:
Life changing factor: 5/ 5
Easy-to-read factor: 4.5/5
Help-me-fix-it factor
: 3.5/5
Total: 13/15 (changed my life in a major way)