1 month ago ·

How should we talk about mental health?

By Andy – Arch Care Services

It can be very confusing, knowing what we should and shouldn’t say. Certain words that we use all the time can accidentally end up offending someone, or may be old fashioned or out of date, and it can be difficult to keep track. People who suffer from a mental illness or people like me who work in the industry use these terms all the time, and it can sometimes be difficult for us to remember that not everyone knows the right thing to say, or what words they should avoid. Well, today I’m going to give you some advice about how to talk about mental illness without accidentally putting your foot in your mouth!

Let’s start by considering the most important thing of all; how do we describe a mental illness in the first place? There are lots of words that used to be used all the time but that we would advise everyone to avoid, as they sound quite old-fashioned and out of date, and in some cases are actually quite offensive! The one that we hear most often is that someone suffers with ‘mental problems’.

I can only assume that it comes from all the American media that we consume, because in America ‘mental problems’ is a fairly common phrase. We tend to avoid the use of words like ‘problem’ when it comes to describing a mental illness for the same reasons that we wouldn’t describe someone with diabetes as having a glucose problem, or someone with asthma as having a windpipe problem; it’s a little simplistic and vague. It also suggests that people who are mentally unwell have a ‘problem’ of some description, which is the kind of thing that we try to avoid. We also hear the term ‘mental disability’ quite regularly, which makes sense but is quite old fashioned. It also suggests that someone with a mental illness has reduced abilities of some kind, which isn’t always the case. Not the most offensive thing in the world, but not very accurate and probably best avoided.

It goes without saying that you should completely avoid terms like crazy, schizo or insane. They are very offensive and unpleasant and are used as a way to make fun of people. No one in the industry would ever use those words to describe the people that we support, and you shouldn’t either.

So, what is the correct thing to say? Well, you may have noticed that I’ve been using it all the way through this blog. We would always say that someone has a mental illness, they are mentally unwell, or they struggle with their mental health. Some people use the term psychological health instead of mental health, and that’s fine as well. These terms are used because they incorporate a number of different conditions and diagnosis’ and don’t lump everyone in together, and they also highlight the fact that it is an illness, and therefore something that is out of our control, can happen to anyone, and can be treated. This might change at some point in the future, but for now this is the best thing to say.

Now lets consider some things that you might say casually and innocently that are actually quite offensive to some people, and should probably be avoided if possible.

Enjoying having a clean house doesn’t mean that you have OCD!

Have you ever described yourself or someone you know as being ‘a bit OCD’? Maybe they’re quite a clean person, or they like things to be organised. Maybe they like to use a specific font when they type up a documents, or they alphabetise their DVD collection. I imagine that most of you have, I imagine that I’ve done the same thing at some point, but I make a deliberate effort to avoid using this term incorrectly, as Obsessive Compulsive Disorder is actually a very serious condition, and one which can have a massive impact on the lives of those that suffer from it. The symptoms of OCD can ruin lives, and are far more than just wanting things to be neat and tidy or not liking it when things aren’t organised properly. And how about bi-polar? Have you ever heard someone describe themselves as being bi-polar because they have mood swings, or because sometimes they feel annoyed for no identifiable reason? As with OCD, bi-polar disorder is a serious illness that can have serious symptoms, and is far more than just feeling like your mood is changeable. Organisations and individuals with these conditions have asked that these terms not be used casually as they may minimise the experiences of suffers, and we should do all we can to respect this. This isn’t to say that we should belittle experiences or assume that people are exaggerating when they use these terms, we should just try to be mindful about when we say them and whether they are really appropriate descriptions.

It’s also vital that we understand the difference between a mental illness and a learning disability. Sometimes people use the two terms as if they mean the same thing, or are parts of the same category of condition, and this couldn’t be further from the truth. Anybody can develop a mental illness at any time in their life, and it may be treated and then go away, whereas people will have a learning disability from birth, and it cannot be cured. The symptoms, behaviours and experiences of people who suffer from a mental illness are very, very different to those who have a learning disability, and confusing the two is quite offensive to some. It’s a bit like confusing asthma with blindness, the two are not comparable and it would be strange to suggest that they are.

Some of you may remember this encounter from the news:

As you can see, the woman approached Theresa May to ask what steps she planned to take to support people with learning disabilities, and in her response the Prime Minister made reference to planned changes to mental health provision. She was criticised following this incident specifically because she seemed to fail to understand the difference. Maybe this was nothing more than a slip of the tongue, but it feeds into a common misconception and is quite damaging to public perception when the Prime Minister is making such an easy mistake.

I know that this can sound complicated or difficult to understand. You may even be wondering what the big deal is, they are just words after all! Well, the words that we choose have power, and if not chosen and used carefully they can be hurtful, rude or thoughtless, even if that isn’t our intention. A small amount of effort can make a big difference, and can contribute towards tackling the stigma that people with mental illnesses face on a day to day basis.

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1 month ago ·

Understanding: Schizophrenia

By Andy – Arch Care Services

Is there a more misunderstood mental illness than schizophrenia? Be honest, when you think of the term schizophrenia, or think of a schizophrenic person, what comes into your mind? I bet that at least some of you thought of someone with a split personality, someone like Jim Carrey from the film Me, Myself and Irene. I bet that a few of you imagined a murderer, someone who is dangerous and needs to be locked away so they don’t hurt people. It’s ok, it’s not your fault, the media has done a fantastic job of making you believe those things, almost everywhere you find the word schizophrenia in pop culture it’s accompanied by one of these images, but I’m here to tell you that it’s not the case. In fact, the most common symptoms of schizophrenia are:

  • A lack of interest in things
  • Feeling disconnected from your feelings
  • Difficulty concentrating
  • Wanting to avoid people
  • Hallucinations, such as hearing voices or seeing things others don’t
  • Delusions (which could include paranoid delusions) – strong beliefs that others don’t share
  • Disorganised thinking and speech
  • Not wanting to look after yourself

Not very dramatic, right? Also, did you notice that there’s no mention of split or multiple personalities? That’s because this has nothing whatsoever to do with schizophrenia, and is actually a completely different, and very rare, disorder, now known as Dissociative Identity Disorder. Again, you can thank Hollywood for that misconception!

Difficulty concentrating is one of the most common symptoms of schizophrenia.

So what actually is Schizophrenia then? Well, as you can see from the list above, schizophrenia is actually lots of different things and it can be difficult to define it properly. There are a lot of conditions that have very similar symptoms, and some people even believe that schizophrenia isn’t actually a single diagnosis, but is instead a collection of different disorders and illnesses all presenting at the same time and overlapping. It can develop slowly and in stages, or can appear suddenly and seemingly without warning. Around 1% of people will suffer from schizophrenia at some point in their lives.

Like most mental illnesses, schizophrenia can look and feel very different depending on the person who suffers from it, but one of the more common and distressing symptoms, and the one that makes people the most nervous, is hallucinations. Hallucinations can come in a variety of different forms, and are mostly broken down into the following categories:

Visual – Seeing things that are not present. Visual hallucinations can take the form of objects or people, but sometimes is more like shapes or lights or flashes of colour.

Auditory – Hearing things that are not present. Sometimes people hear voices and sometimes they hear random noises or jumbled sounds. When they hear voices, sometimes those voices appear to be coming from objects or spaces surrounding them and sometimes the voices are inside their heads. Sometimes the voices talk to them, and sometimes they talk to each other or just chatter.

Olfactory – Smelling things that are not present. This could be smells from objects, the environment or the person themselves.

Gustatory – Believing that food or drink has an odd or unexpected taste.

Tactile – Feeling things that aren’t present, such as tickling, stroking or poking.

The categories of hallucinations all relate to one of our five senses.

Sounds pretty unpleasant doesn’t it? Suddenly starting to experience things that no one else is experiencing can be terrifying, and most people who start to develop these symptoms find it incredibly distressing. And remember, it’s not just the experiences themselves that are distressing and frightening, it can also become very difficult to know what is real and what isn’t and trusting your senses would become increasingly difficult. This is why a lot of people who start to develop schizophrenia can isolate themselves inside, struggle to keep working or spending time with friends, and may become suspicious or confused or frightened of seeking help; they don’t know whether the things that they can see and hear and feel are actually happening.

What Causes Schizophrenia?

I get the feeling that this section is going to be the same every time we talk about causes of a particular mental illness! Just like with depression nobody really knows for sure, but there are some things that appear to make it more likely, and in most cases it is a combination of lots of different things. In order to understand the process by which someone starts to develop schizophrenia, we need to think about two separate things; causes and triggers. Causes are things that make someone more susceptible to schizophrenia, triggers are events that can cause schizophrenia to emerge.

Causes

Genetics – There is no ‘schizophrenia gene’ that we’re aware of, but there is strong evidence to suggest that a combinations of various genes make people more vulnerable to the condition. If one twin develops schizophrenia the other twin is much more likely to develop it as well, even if those twins are raised separately. The chances increase if the twins are identical.

Brain Development – Brain scans have shown that people with schizophrenia have subtle differences in the structure of the brain than those without the illness. The evidence is a little messy on this one, as not everyone with schizophrenia has these differences, and not everyone with the differences has schizophrenia, but there is some evidence to suggest that they may be connected.

Neurotransmitters – There is some evidence to suggest that an imbalance between serotonin and dopamine, or the level of sensitivity to these chemicals in the brain, may cause schizophrenia. When schizophrenics are given medication that alters the levels of these chemicals they find that some of their symptoms may decrease.

Pregnancy and Difficult Births – Studies have found that infants who are born with a low birth weight, are deprived of oxygen during birth or who are born early have an increase chance of developing schizophrenia later in life, although we don’t necessarily understand why this is.

Triggers

Stress – Stressful situations such as breakups, house moves, job loss or bereavement are a significant trigger for the development of schizophrenia. It’s important to note that stress on its own won’t cause schizophrenia, but it can cause schizophrenia to develop in individuals who are vulnerable to the illness in the first place.

Drug Use – The use of drugs, particularly cannabis, cocaine, LSD or amphetamines, has been shown to trigger schizophrenia in individuals who are already susceptible. Again, it is not believed that the use of these drugs on it’s own will lead to schizophrenia or related symptoms, but can act as a trigger.

Drug or alcohol use can act as a trigger for schizophrenia.

Three major studies have shown teenagers under 15 who use cannabis regularly, especially “skunk” and other more potent forms of the drug, are up to four times more likely to develop schizophrenia by the age of 26.

Are People with Schizophrenia Dangerous?

Admit it, when we got to the section above where I told you that schizophrenics sometimes hear voices, you probably assumed that these voices were telling them to hurt people. Again, it’s alright if you did, this is another huge misconception that has been propagated by Hollywood for years now. Sometimes you’ll even see it on t-shirts or stickers; “The Voices told me to do it!”. Well, this is another example of a poor understanding of how this stuff actually works. When someone hears voices, they can be positive, negative or completely neutral. They can give instructions or engage in conversation or just make random sounds and noises. I once knew a man who heard voices, and he described them as his ‘affirmations’ because they were always so positive!

So, is there any truth at all to the idea that schizophrenics are more likely to hurt people? Well, that’s slightly more complicated, and depends on which study you’re reading. But the important thing to remember is that even if the chances are slightly higher, the vast, vast majority of people with a diagnosis with schizophrenia will never be violent or hurt anyone. In fact, alcohol intake, gender and age are much better predictors of violence than schizophrenia.

However, there is one person that schizophrenics are much more likely to harm; themselves.

The sad fact is, around 40% of people with schizophrenia will attempt suicide at least once in their life, and around 10-15% will succeed. Compare this to the general population, where around 6-7% of people will attempt suicide at least once, and you start to see that in reality people with schizophrenia are much more likely to harm themselves than they are to commit a violent act against someone else.

How is Schizophrenia Treated?

As with most mental illnesses, schizophrenia is usually treated with a mixture of medication and talking therapies.

Anti-psychotic Medication – Anti-psychotics work by blocking the effects of dopamine in the brain. They can reduce symptoms of aggressive or anxiety very quickly, but generally take longer to start to tackle other symptoms such as hallucinations. This kind of medication is usually only prescribed following a thorough physical check up, because they can have a lot of side effects. More detailed information about anti-psychotic medication can be found by clicking here.

Cognitive Behavioural Therapies – I’ve already spoken about CBT and how it works, so you can find full information on our Understanding: Depression blog. Alternatively you can click here for more information.

There is also some evidence that shows that art therapy can be very effective as a way to alleviate the negative symptoms of schizophrenia in some people, although this should only be carried out by a trained art therapist with experience working with individuals with the diagnosis.

I hope that this blog has been useful, and that you now feel more able to correct some of those harmful stereotypes that we mentioned at the start! It’s important to remember that people with schizophrenia are suffering from an illness and need our support and empathy, and that we shouldn’t always rely on the media and Hollywood to give us an accurate representation of how people with schizophrenia feel, act and relate to others.

If you have any concerns about your own mental health, or if you believe that you are suffering from any of the symptoms of schizophrenia, you should contact your GP straight away. If you feel low and need someone to talk to, you can contact The Samaritans 24 hours a day, 7 days a week on 116 123. If you need immediate help, or are worried that you may harm yourself or someone else, you should always contact 999 immediately.

For more information, you can check out these links:

Mind – Schizophrenia

Information about Hearing Voices

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2 months ago ·

Understanding: Mental Capacity

By Andy Ryan – Arch Care Services

Something that we get asked a lot is whether people with mental health concerns are able to make decisions for themselves, or whether someone else makes their choices for them. It’s an interesting question, but it’s also a lot more complicated than it seems! This week, we’re going to explore the concept of Mental Capacity, including things to watch out for if you’re concerned that someone might lack capacity, how capacity is assessed, and what happens if someone isn’t able to make their own decisions.

Making decisions can be tough, but does that mean that we lack capacity?

First, we need to understand what we mean when we talk about capacity. Simply speaking, mental capacity refers to an ability to make decisions. We all make decisions all the time, whether those decisions are big, like where to live or whether to seek medical treatment, or small, like whether to have tea or coffee or what t-shirt to wear. We are all constantly making decisions throughout the day, and most of the time it is so mundane that we don’t even realise that we’re doing it, but this process is vitally important and without it we can find every day things to be a real struggle.

A common misunderstanding is that anyone with a mental health issue, learning disability or other impairment of the mind or brain will automatically be unable to make decisions, and that isn’t the case at all. In fact, the vast majority of people that we support have complete capacity, and make all of their decisions themselves, and that is exactly the way that it should be! After all, taking away someone’s ability to make their own choices is serious, and it shouldn’t be taken lightly. How would you feel if I told you that you weren’t allowed to drive to work any more, and instead I was forcing you to take the bus? Not very happy I would assume!

A second assumption is that only people with serious or ongoing impairments can lack capacity. Also untrue! Have you ever been drunk, unconscious or on strong painkillers? If so, then during those periods of time there’s every chance that you lacked capacity, if only for a short while.

We have the right to make bad (but delicious) choices about our diets!

A third common misunderstanding is that we either have capacity or we don’t, and that if we aren’t able to make one decision then we are automatically unable to make all decisions. Using this logic, someone who is unable to understand and sign a complicated legal contract would also be unable to decide what to eat for breakfast, which is obviously not the case. In reality, capacity constantly changes, and will be different based on the specific decision itself and when it has to be made. In fact, someone can lack the ability to choose what to have for lunch at 12pm, but regain the capacity at 1pm!

The most common misunderstanding that we face is that someone who makes bad decisions or poor lifestyle choices must automatically lack capacity, and we are often asked why we would allow people to make those kinds of choices. Well, it’s usually because we don’t have a choice! Most people make poor decisions on a regular basis, otherwise nobody would smoke, drink or eat junk food and we would all be running 5 miles a day. Even deciding to stay up late watching one more episode of Game of Thrones instead of getting your eight hours of sleep is a bad decision, but no one kicks down your door and turns off your television if you make that decision! A fundamental principle of mental capacity is that we are all allowed to make poor decisions if we want to.

If this all sounds very complicated and messy, it’s because that’s exactly what it is! Fortunately we have devised a test that we use when we’re trying to work out whether someone can make specific decisions, which is conducted by a trained capacity assessor and is based on the following questions:

Does the person have an impairment of the mind or brain?

In this context, an impairment could be a mental illness, physical damage, a learning disability, dementia or even something temporary such as intoxication or unconsciousness. If the answer to this question is yes then we can move on to the next stage of the test. If the answer is no, then the person has capacity.

Is the person able to understand, retain and use the available information in order to make a decision?

If the person does not understand what is being said, cannot keep the information in their mind for long enough to assess it properly, or is unable to draw on that information in order to come to a conclusion then they may lack capacity.

Can the person communicate that decision?

If the person is unable to express the decision in some way, they may lack capacity.

This test will often take a long time and be presented in multiple ways and at different times in order to make sure that everything has been done to help the person to make the decision themselves. Often this might mean using pictures, sign language or gestures, or asking the question in multiple different ways based on what is known about the individual, and this is vitally important. Just because someone is unable to speak does not mean that they cannot make decisions, for example, so we always have to do everything we can to help someone through the test.

There are lots of factors to consider when assessing capacity.

Now we have reached the point where we have established that someone is unable to make decisions, what happens next? We just start making choices for them, right? Wrong! It’s not that simple. First of all, who gets to make those decisions? Often it will be a family member or a friend, someone who knows the person well and who the person trusts to make good choices. This person then needs to apply to become a deputy. There are two kinds of deputy, a Property and Financial Affairs Deputy (someone who manages finances, income, bills and things like that) and a Personal Welfare Deputy (someone who makes decisions about health or care arrangements), and the type that the person applies for will depend on the outcome of the capacity assessment and discussions with everyone involved. Once the paperwork is complete and has been sent and signed off, this person will then be given the authority to make certain decisions on behalf of the person who lacks capacity (Click here for more information about becoming a deputy for someone who lacks capacity). If there is no one who is willing or able to take on this responsibility, it will usually be given to someone who works for the local authority and acts as a deputy for lots of people.

Even then, there are more rules and guidelines that the person must follow whenever they make decisions on behalf of another person. They must:

  1. Always make sure that all decisions are made in the person’s best interests. Sometimes this is simple and easy to establish, and other times it may require meetings and discussions with professionals. It is not acceptable for a deputy to make decisions based on the outcome that they want or is easier for them to achieve.
  2. Always make decisions that create as few restrictions as possible. For example, if someone regularly falls out of bed, it wouldn’t be appropriate to tie them down. Instead you might consider a bed rail or other device.

Also, just because someone can’t make the decision themselves, it doesn’t mean that they shouldn’t be involved! Someone without capacity can still express preferences and these preferences should always be taken into account and all efforts should be made to respect what they would like, even if it is more complicated or requires more work.

As you can see, mental capacity is a very complicated concept that requires a great deal of consideration, effort and sensitivity. But when it comes to taking away someone’s ability to make choices about their life, it’s vital that we get it right.

If you have any concerns that someone you know may lack capacity you should contact their GP or Social Worker.

If you’re an organisation and you’re interested in setting up some Mental Capacity training for your staff, we provide training courses at your place of employment. For more information, please send us an email or call us on 01275 342266 and ask to speak to Andy.

For more information about mental capacity, you can check out the following resources:

The Mental Capacity Act

Becoming a Deputy

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2 months ago ·

Living with Anxiety

The following blog was submitted by a member of staff at Arch Care Services. They have asked that they remain anonymous.

I had a very normal upbringing with loving, supportive parents, but everyone always described me as an anxious child. I remember distinctly worrying about the end of the world when I was 4 or 5 years old, and I developed a form of social anxiety at a relatively young age which manifested as a profound fear of looking stupid or annoying people. I didn’t really know what it was at the time, I just remember monitoring my words and actions closely and being hyper aware of how other people responded to me. In fact, one of my earliest memories of childhood was being driven home from school by a friend of my Mum. She was having a conversation with a friend in the front seat while I sat in the back and I attempted to join in, which made them laugh. Looking back I can see that it wasn’t malicious, they were finding humour in a child making an adult-like comment, but that stayed with me, and I felt nervous about making comments in adult conversations from that point onwards. That should tell you what kind of child I was!

School was always a challenge for me.

This continued throughout my childhood, and my overriding memories of school are of feeling anxious, uncomfortable in my own skin and intimidated by kids my own age and how easily and smoothly they seemed to socialise and make friends. I wasn’t miserable by any means, I was generally quite positive and cheerful in most aspects of my life, I had friends and was doing fairly well academically, there was always just this nagging sense that I didn’t quite fit in, which led to a couple of years of over-compensating, acting up and behaving badly in an attempt to make friends. I thought that if I could be loud and funny and disruptive then this would cover up my insecurity, but really it just made me feel worse. Knowing what I know now about mental illnesses, I can see that I was suffering from an anxiety disorder, but I didn’t have the language or the experience at the time to identify exactly what it was that I was feeling, I just kind of assumed that everyone felt that way.

I spent a lot of time alone in my first year of university.

When I reached university at age 20 my mental health really started to decline. I suddenly found myself in a huge city for the first time, surrounded by new people who all seemed so much older and more comfortable than I was. For someone with some hang-ups around fitting in and making friends this was a terrifying situation, I was overwhelmed by the constant need to be social and present this image of myself that was polar opposite to the way that I was feeling. The pressures of the course and my studies were fine, I could handle that, but having to constantly present myself in the way that I wanted to be seen by my peers, living in the same building as a collection of loud, drunk strangers, having no retreat where I could go to hide and recharge at the end of the day, that was a struggle. And to make things worse, I suffered from an unexpected bereavement at around the same time, which only exacerbated my blossoming mental illness. I started to find it difficult to spend time with people, which led to me finding it difficult to go outside, which eventually led to me finding it difficult to leave my room at all. My laptop and my DVD’s and my bed all became my comfort blankets and my safe space, which I became reliant on in unhealthy ways.

It all reached a tipping point one day around exam time. When I was anxious I found revision comforting because it allowed me to lose myself in a world of logic and facts for a few hours, which blocked out some of the cyclical negative thinking that had become my normality. I also used to gravitate towards a nocturnal lifestyle, staying up later and later each day and sleeping for longer and longer, or managing on very little sleep when I had lectures to go to, all so that I didn’t have to interact with people. During exams these two factors coalesced into manic revision sessions, hours spent hunched over a textbook in my poorly lit room in the halls of residence scribbling notes and drawing mind-maps, downing cups of black coffee until my hands shook and I felt sick. On this particular night I had been writing for what felt like a couple of hours and decided to take a short break, but when I looked at my clock I found that I had been scrawling notes in my exercise book for 9 hours without stopping. The sun was starting to rise outside, and I hadn’t even noticed that it was night time. I went into the bathroom to splash cold water on my face and caught sight of myself in the mirror, and for a terrifying moment I didn’t recognise the reflection staring back at me. I had gained weight, my face was grey and drawn and I had been wearing the same clothes for two days. Which also meant that I hadn’t been outside or spoken to anyone in two days. Before this I had always taken a lot of care of my appearance, and I was shocked at how terrible I looked, and how far I had allowed things to decline.

I found it difficult to make friends and fit in.

I skipped my lectures that day and went for a long walk along a river near to my student accommodation. For the first time I stopped and examined my thoughts and my behaviours and started to understand that this wasn’t normal, that I wasn’t doing alright. Up until that point I had never really considered that there might be something bad happening to my mind, I just assumed that this was what life felt like, but as I watched the other students walking to lectures, looking fresh and well rested and chatting happily to their friends, I realised that this wasn’t the case. They were carefree, relaxed and happy. It didn’t look like they were struggling to speak to each other. They were wearing clean clothes and smiling, and I couldn’t remember the last time that I had felt how they looked. I went home and showered and changed my clothes, and then I booked a doctor’s appointment. When they asked what the appointment was for, I told them that I thought that I might be depressed.

I actually ended up being diagnosed with an anxiety disorder, and was given a prescription for Citalopram, one of the most common kinds of SSRI based anti-depressant. It was a relatively low dose, but I was told to take it daily and to come back in six months. I had the usual reservations about medication, and was worried that it would lead to personality changes or would make me dull or zoned out, but once I had been taking them for a few weeks I started to notice the changes. I didn’t feel any different in ways that I could easily identify, but I wasn’t worrying as much. Spending time with people was still tiring, but it wasn’t an anxiety minefield in the way that it once was. I could go shopping again without having to spend hours working myself up and mentally preparing. I would deliberately test myself by sitting and thinking about all the things that used to make me feel nervous and twitchy, but they didn’t have the same impact, it was like the part of my brain that had caused me to overthink and obsess and worry had been switched off. The knock-on affect of this change was significant. My sleeping improved, I started eating better and spending more time outside. I made friends and chose to leave my room because I wanted to, rather than because I felt like I should. It felt like a grey fog had been lifted from my eyes and everything suddenly seemed clearer and brighter, and I had the sudden realisation that this is what life is supposed to feel like, this is how other people experience the world!

Things aren’t always perfect, but i’m happier than I’ve ever been.

A lot of people have some negative impressions of anti-depressant medication, but they gave me my life back, and gave me the mental freedom that I needed to identify problems and make changes in an effective way and with a clear head, changes that would have been impossible a few months prior. When I decided to stop taking the medication around a year later (with help from my doctor, you should never stop taking medication suddenly and without seeking medical advice), I found that the feeling persisted, because I had made changes to my life and thought patterns that stayed with me.

That was a long time ago now. I’m older and wiser and have a career and a family and that dark patch seems like it was a lifetime age. Don’t get me wrong, I still have bouts of anxiety, I still struggle with social situations sometimes, and I’m still prone to obsessive, circular thinking when things get stressful. Once I even had to take some time off work and go back onto the medication for a while. But nowadays I can understand my anxiety, and generally we’ve found a way to co-exist peacefully. I think that I’ll always suffer with it in one form or another, and part of me thinks that it has taught me some really important lessons about myself and given me insight that I wouldn’t have without it. I’m now confident that I have it under control; I know my triggers, I know when I start to feel low and the steps I can take to manage it, and I’m conscious of when I need to practise some self-care. Anxiety may be a part of who I am, but it’s not the main part.

If you think that you may be suffering from anxiety, depression or any other mental illness, you can speak to your GP and ask for help, or contact the Samaritans on 116 123 if you need someone to talk to. If you ever feel suicidal or like you may harm yourself or other people, you should always call 999 immediately.

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2 months ago ·

Understanding: Depression

By Andy – Arch Care Services

Depression is the most common mental illness across the world. The Office of National Statistics estimates that around 20% of the UK population aged 16 and over show some signs of depression. In fact, in 26 countries depression is the most common kind of disability reported. But despite being so common, depression is also widely misunderstood, and there are a lot of misconceptions floating around regarding how depression presents itself and how to treat or manage the condition. This week we’re going to be looking at the causes of depression, how depression manifests for different people, and the various ways that it is treated and managed.

What causes Depression?

The truth is, we don’t exactly know. If you injure yourself physically it’s usually pretty easy to work out how you did it. If you fall off your bike and afterwards are told that you have a broken arm it’s probably fairly straightforward to work out what happened! But if you’re suffering from depression it’s difficult to isolate the exact cause, as it’s probably a variety of things or sometimes nothing specific at all. But we can identify some common trends that seem to apply more often than others:

  • Childhood Experiences

Nowadays we don’t tend to ask people to lie down on the sofa and talk about their parents when they go for counselling, but there is a lot of evidence that suggests that things that happen to us when we’re children can have a major impact on our emotions when we get older. And it’s not always major traumatic events, although these can also cause depression as well. Sometimes it’s a general instability or a lack of support, things that may not seem too significant but add up over the years. It certainly appears that what happens to us when we’re younger can have an effect on our mental health when we’re adults.

  • Genetics

Now we’re getting into the old ‘Nature vs Nurture’ debate! There is a lot of evidence out there that seems to suggest that if we have close family members with depression, we’re more likely to suffer from depression ourselves. Now, whether this is because there is a ‘depression gene’ hidden away somewhere in our brains, or whether it’s because we’re likely to have been brought up and had experiences that are similar to close family members isn’t as obvious, but there certainly seems to be a connection.

  • Life Events

This is one that most people will understand, because we’ve all had sad, stressful or emotionally difficult experiences that impacted us afterwards. The death of a loved one, a breakup or a major change such as a house move or job loss can be emotionally straining, and sometimes that strain can stay with us for a while. For some people, these events can be a trigger for a more serious episode of depression.

  • Physical Health Problems

Our physical and mental health are very closely linked, and changes to one can cause or contribute towards changes in the other. Sometimes those connections are direct, such as a brain injury that may affect the physical structure of the brain, or hormonal problems that impact on the way that the brain produces certain chemicals, or they may be indirect and caused by stress or difficulties in managing a condition, such as chronic or life threatening illnesses, or disabilities that may cause significant changes or limitations to your lifestyle.

Exercise and diet can also affect our mental health, with depression being a common outcome of unhealthy lifestyles and habits. There is significant evidence that physical exercise and a healthy diet can have a major positive impact on our mood, so consider digging out those running shoes! But remember, it’s ok to seek alternative treatments (including medication) if that works for you, lifestyle changes may not work on their own for some people.

  • Drugs, Alcohol or Prescribed Medication

Drug and alcohol use can be both a cause and an effect of depression, which can lead to a vicious cycle whereby people feel low, use drugs or alcohol in an attempt to feel better, which only makes them feel worse, leading to increased use of the very same substances. I could write an entire blog on how street drugs affect mental health, but for now Mind have a fantastic guide.

Depression can also be a side effect of many prescribed drugs, including some anti-depressant medication. Make sure you always read the leaflets that some with your medication and take them as prescribed, and if you have any concerns you should contact your GP immediately, as these side effects can be serious.

The causes of depression are far from clear-cut, and in most cases are likely caused by a variety of different things all acting in conjunction. It’s also important to remember that we all cope with things differently, so people will have varying degrees of tolerance to stress or trauma and will react in completely different ways. The same life event could cause me to become depressed and have no affect on you whatsoever, and that doesn’t mean that you’re emotionally stronger than I am or that I’m a weak person! We are all different and deal with things differently, and that’s absolutely fine.

Symptoms of Depression

Depression has come to be used as another word for sad, so when we say the word depression we naturally think that depressed people must feel sad. Personally, when I hear the word depression the following picture pops into my head:

These kinds of pictures are used a lot in the media when they talk about depression, but they’re not really a good representation of what a mental illness actually feels like. This might be why some people find it really hard to understand just how serious and difficult depression can be. After all, they know what it’s like to be sad, they felt a bit sad last week and then they watched some television and went for a walk and then they felt fine, so why is everyone always complaining about feeling depressed all the time? Since we already know that around 20% of adults will display some symptoms of depression at some point in their lives and that not everyone who has depression is sad all of the time, maybe a better image to use would be something like this:

Or this:

Or even this:

Of course, depression is much, much more than just a feeling of sadness. Some of the most common symptoms of depression are:

  • Low self esteem, or a feeling of worthlessness.
  • Intense sadness or unhappiness that doesn’t improve.
  • Being unable to enjoy or appreciate things that would normally make you happy.
  • Weight loss or weight gain.
  • Sleeping too much or too little.
  • Difficulty concentrating or focussing.
  • A sense of hopelessness or despair.
  • Physical aches or pains, especially in the head, shoulders, back or stomach with no obvious cause.
  • Feeling isolated or detached and avoiding people or social situations
  • Mood swings.
  • Use or increase in consumption of drugs, alcohol or tobacco.
  • Moving very slowly or feeling anxious and agitated and moving too much.
  • Self harm or suicidal thoughts or actions.

Have you noticed that some of these symptoms are complete opposites? That’s one of the most unusual things about depression, it can cause completely different symptoms in different people or at different times, but is still classed as the same illness. One person could be tired all the time and sleep too much, gain weight and struggle to speak to people, and another could lose weight quickly, struggle to sleep and have too much energy throughout the day and they could both be diagnosed with depression. This is one of the reasons why it can be so difficult to identify and diagnose, and some people may be depressed and not even realise it, because they don’t feel sad.

How Depression is Treated.

Unlike some other illnesses, there is no single treatment for depression that works 100% of the time. The treatment plan will depend on the person and their preferences, the symptoms and how serious the depression appears to be. In general, treatment can be split into three groups:

1. Medication

There are multiple different kinds of medication that are used to treat depression and other mental illnesses, all with their own positives and negatives. Some people are nervous about taking medication because they are worried about side effects, or that the medication might take something away from their personality or ‘turn them into a zombie’, and this is understandable but may be based on some misconceptions about how some of this medication works. Some people also say that if you use medication that you are somehow masking the problem rather than dealing with the cause, and that it’s better to deal with depression ‘naturally’. Again, this is an understandable way of thinking about it, but may not be entirely accurate. The evidence suggests that medication can be a very effective way of treating or managing a mental illness, and for lots of people medication has been invaluable. There is no shame in using medication to treat depression or any other mental illness, just as there would be no shame in taking antibiotics for an infection. However, you should always talk to your doctor about any concerns that you might have prior to agreeing to try them out, and follow the instructions carefully. A general guide to the kinds of anti-depressants that are available can be found here.

2. Counselling or Talking Therapies

As I mentioned earlier, this won’t usually involve lying on a sofa and talking about your childhood (although sometimes it might!). Nowadays the main kind of therapy available on the NHS is Cognitive Behavioural Therapy, or CBT for short. CBT can be delivered one-on-one or as part of a group, in person or online, and is a short term therapy designed specifically to help us to understand how we think and behave, and how these things might be connected. It is very practical, so you won’t be digging through your past or talking about previous trauma, it’s more likely that you’ll be exploring tools and techniques that can help to manage low mood as it arises. You can find more information about CBT by clicking here. Availability and access to CBT will depend on your symptoms and the area that you live in, you can always ask your GP about any local groups that you could be referred to.

You may also be encouraged to try out some mindfulness techniques, either as part of a broader course of CBT or more informally. Mindfulness encourages us to focus on our daily experiences in the moment, and spend less time worrying about the future or feeling regretful or guilty about the past. Understanding how we respond to certain triggers can help us to change those responses, although this does take patience and practise! You can find more information about mindfulness here.

More traditional talking therapy is still available, but mostly through private practise and you may need to fund it yourself.

3. Lifestyle Changes

This will generally be utilised when the depression is milder, or used in conjunction with other types of treatment. Changes to your lifestyle, whether that be improving your diet, trying to exercise more, cutting down on drugs or alcohol, considering a change in jobs or relationships or spending more time socialising can have a significant impact on mood, and can play a major role in the treatment of depression. It is likely that this process will be your responsibility, although general advice from a GP may be helpful when starting out. For some general tips about the kinds of habits that encourage good mental health, you can read one of our previous blogs here.

The evidence suggests that people may need to try several different things or a combination of different types of treatment in order to identify the most effective plan for them, and this will often take some time, but that all of these approaches are effective at treating and helping people to manage the symptoms of depression.

To summarise what we have covered today:

  • The causes of depression are complicated and difficult to isolate, and different people will have completely different causes and respond differently to different triggers or life events.
  • Depression is not just a feeling of sadness. Depression can be a very serious illness.
  • There is a wide variety of different symptoms caused by depression, and people will experience it in vastly different ways. The same person may even have different experiences over time.
  • There is no single treatment for depression, and most people will try various plans and combinations of treatments before they find the one that works for them.

If you are worried that you or someone you know may be experiencing depression or any other mental illness, you should either contact your GP or advise them to contact theirs to ask for help. If you need someone to talk to, you can contact the Samaritans for free on 116 123, 24 hours a day, 7 days a week. If you need immediate help or feel suicidal, you should always call 999.

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2 months ago ·

The 4 Most Important Skills for Support Workers

By Andy – Arch Care Services

If you’ve ever spent time supporting other people, in either your personal or professional life, you’ll know that it is one of the most satisfying and enriching things you can do, but it’s also challenging, emotionally and physically. It takes a special kind of person to work in the social care industry, and you need a particular set of skills, but here at Arch Care Services we believe that everyone has the ability to be a support worker, and we will always be happy to recruit people who are looking to enter the industry for the first time. If you’re thinking about a career change, or you’re just starting out and are considering support work, these are the skills that you should focus on.

1. Compassion

Let’s show people that we care!

It seems obvious, but having a caring, warm attitude and an ability to empathise is one of the most important skills you can have in this industry. Support workers spend time with a wide range of individuals, some of whom have lived challenging lives or may have experienced things that impact their emotions, their behaviour and their outlook. Our role is to work with our service-users in a non-judgemental manner, and make sure that we provide a service that is based on warmth, understanding and patience. It is claimed that the most important factor in the recovery of individuals who suffer with mental ill-health is their relationship with their support networks, so it is vital that we do all that we can to foster those relationships. This can sometimes be challenging, and we will always provide our support workers with all the support they need to ensure that they can continue to provide a high quality service.

2. Flexibility

Not that kind of flexible!

This one is slightly less obvious! As a social care provider, we organise and deliver support across wide geographical areas to hundreds of people every single day, so as I’m sure you can imagine the organisation of this support is a complex undertaking! We also provide support during times when most people aren’t at work, including evenings, weekends and occasionally overnight. Support workers need to be able to work flexibly, taking on shift work at unsocial hours sometimes and ideally being available to help to cover shifts when needed. In return, we also try to be as flexible as possible with our support staff, and will always do our best to work around unusual hours of availability and accommodate time off during the week if this is needed. There’s a reason why a lot of our support workers are parents and need time off for the school runs!

3. Confidence

Grow a fantastic beard if it helps you to feel confident!

We love it when our staff bring their personalities to their role! We all have skills and talents in different areas, and the people that we support appreciate getting to know you and your own individual approach. We encourage our staff to be creative and energetic, because we believe that this is the best way to provide a great service! We trust our support workers, and allow them to operate without us constantly breathing down their necks, which means that confidence and an ability to work without supervision is vital to being a good support worker, although we will always be available to support our staff if things get difficult!

4. Attention to Detail

Expect paperwork and you won’t be disappointed!

Everything that we do in social care is based on a plan, an assessment, a report, a policy or a regulation, and all of these things are vitally important. No one likes paperwork, but when you’re a support worker paperwork is a big part of your life, and completing that paperwork accurately, punctually and in full will be required. There’s nothing worse as a social care employer than needing a log or record for something very important and finding that it hasn’t been completed, or it lacks detail, or something important is missing. Learning to pay attention to details of the service users you support and log that information accurately is not only important, it will help to get you noticed and progress within the industry, because the higher you go within social care the more time you spend on paperwork, and the more important that it will be that it’s completed correctly!

If this all sounds overwhelming, don’t worry! Support work is one of the most fulfilling jobs you can do! Every day is different, you meet some really interesting people, and you get to go home at the end of the day knowing that you really made a difference.

If I’ve convinced you, why not head over to our Careers page here and check out our current vacancies? We’re always hiring and we’d love to hear from you!

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2 months ago ·

7 Habits that Encourage Good Mental Health

By Andy – Arch Care Services

A healthy mind is just as important as a healthy body, but sometimes we can forget just how important it is to form habits that ensure that you are happy, confident and secure. We all understand that we should eat well and get plenty of exercise, but what can we do to make sure that we are emotionally strong, resilient and content, as well as physically healthy?

 

1. Get some rest!

Sleep is vital, although the adorable puppy is optional.

We spend around a third of our lives in bed, and sleep is just as vital as eating, drinking and breathing, and going just a couple of days without a good nights sleep can have a huge impact on your emotions, memory and critical thinking abilities. A common misunderstanding of people with mental health concerns is that they should just ‘pull themselves together’, or ‘get up and do something!’, but in reality it’s probably more important that these issues are addressed and understood, as they can often be both a contributing factor and a side effect of a mental illness.

Make sure that you have an established sleep schedule and stick to it. Go to bed at a set time, and this means no television or mobile phones! In fact, it’s probably best to keep screens out of the room altogether if possible, and only go to bed when you intend to sleep. Your brain is fantastic at making connections, and it’s important that your brain connects your bedroom with sleeping. Make sure the room is comfortable and free of distractions, and if you can’t sleep pick up a book and read for a while rather than scrolling through Facebook!

2. Think positive thoughts!

Try to start the day on a positive note!

Sometimes when we feel low, positivity can feel like an impossible task, but there’s loads of evidence that says that positive thinking can have a major impact on your mood, which makes you feel more positive, which increases your mood even further! It’s a fantastic, happy cycle, and we should do everything we can to get ourselves into that cycle.

Start small. Every morning, tell yourself out loud that today is going to be a good day. When something good happens, notice it! We are all excellent at remembering the bad and forgetting the good, try to pay special attention to the good things in your life, even if they’re small. A random encounter with a stranger that made you smile, a particularly delicious sandwich, even something as small as doing the washing up, pay attention to them and remind yourself that they exist.

3. Exercise and eat well

Sometimes something as simple as a quick stroll can make all the difference.

I know it sounds cliché, but the saying ‘healthy body, healthy mind’ is absolutely true! We are biological machines, and if we use the wrong type of fuel or allow our joints to rust then everything else will be impacted. You don’t need to enter a triathalon, or eat only protein shakes and broccoli, you’re not entering the Olympics! Start by getting outside and moving around, even if it’s only for 10 minutes a day. Just a small amount of exercise and fresh air can have a huge impact. Try to make sure that you eat something green with every meal, avoid junk food, cut down on the carbs and sugar, maybe consider brushing up on your cooking skills! You’ll be amazed at the difference that these small changes will make to your mood. And it’s a great excuse to brush up on your cooking skills while you’re at it!

4. Give yourself a break!

Smartphones can be a blessing and a curse!

We live in a high pressure, fast paced world. Social media and the internet mean that we get our information quickly, we’re always on the go, absorbing information and responding emotionally. In some ways this is great, we’re more connected than ever before, we can communicate with friends and family wherever we are, and we have new support networks available to us that we wouldn’t have been able to access 20 years ago. But it can also cause stress, anxiety, a feeling of being overwhelmed and huge pressure to be available at all times. Go easy on yourself! Practise some self care, and make sure you put aside some time for yourself. Go out into nature and spend some time away from your screens, try to reduce the time you spend on social media, and if you’re a news junkie like me, maybe consider reducing the amount of time you spend reading about current affairs! It’s alright to have some downtime and focus on things that relax you and make you feel happy, whatever those things may be.

5. Pick up a hobby!

Learning to play an instrument is a fantastic creative outlet!

One of the best ways to maintain a healthy mind is to keep your brain active and occupied. If you have a hobby already, try to make sure that you keep it up. One of the first things that we tend to do when we feel low is stop doing things that previously made us happy, and it’s important that you avoid that if possible. If you have lost track of your hobbies, don’t worry! Just try to take some small steps to pick it up again and get back into it. Or maybe consider something entirely new! It could be anything, from sewing to fishing to whittling to collecting stamps, anything that interests you and gives you something to focus on in a positive way. The internet is an incredible resource for picking up information about possible new hobbies that are cheap or free and can be started almost immediately. Some of them may even have local organisations or clubs that you could attend, which has the added bonus of encouraging you to meet other people with similar interests. Don’t worry if this doesn’t appeal, there are plenty of hobbies that you can do on your own if that’s more your style.

6. Be mindful!

Take time to stop and appreciate your surroundings.

Mindfulness is a technique that teaches you to try and focus on how you are feeling in the moment and paying attention to physical sensations and emotional reactions. There is a mountain of evidence that suggests that practising mindfulness regularly encourages us to let go of negative encounters from the past and anxieties about the future and pay attention to our experience of life as it occurs. Try to pay attention to the physical sensations, sounds, smells, or tastes of your day to day routine, notice how things make you feel and how your body and mind react to them. Don’t try to deny emotions or run away from them, just notice them, understand them and move on. Don’t worry if it doesn’t work immediately, mindfulness is a technique that takes practise and needs time to develop, but if you stick with it then it will help enormously.

7. Open up!

Sometimes a friendly word from someone you trust can make all the difference.

Despite all our best efforts, it can sometimes still feel difficult to be honest about your struggles with mental health. We don’t always know how people are going to react, and that can be scary. But being honest with yourself, allowing yourself to be vulnerable, and asking for help is a really important part of staying mentally healthy. We’re not made of stone, everyone struggles sometimes, and the best thing we can do for ourselves, and for everyone else, is to be honest and open. That could be something as small as calling a friend and asking to talk, or going online and finding an anonymous support network if that’s easier, or it could be something bigger like calling a doctor and asking for help or attending a local support group. Whatever route is best for you, talking to other people and asking for advice, support and guidance can be an incredibly fulfilling experience. And who knows, maybe one day you’ll be the person that someone turns to when they need help or advice, and you’ll be able to offer them the same help that you received when you needed it the most.

It can be easy to forget just how important it is to look after our mental health, but if you take steps to embed healthy habits now, they will pay off in the future. The steps above are a great place to start!

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