Youth Mental Health

There’s been a lot of stories in the news recently about young people’s mental health. More young people than ever before are being referred to child and adolescent mental health services (CAMHS), young people are experiencing delays in trying to access treatment, and they can also have problems continuing to access care when they reach the upper age limit of CAMHS. But why is there an apparent crisis within youth mental health services?

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We know that there has been an increase in the number of young people who are experiencing problems in their mental health, whether this is due to an increased incidence, increased awareness and identification, or both.  Adolescence in particular is a period of increased risk of the onset of mental illness, with three quarters of all mental illness beginning by the age of 24, and half by the age of 14 (Kessler et al, 1995). Current estimates suggest that about 1 in 10 children in the UK under the age of 16 are affected by some form of mental health problem (Murphy & Fonagy, 2012).

Despite this life stage being a period of high risk for mental illness, young people can often be the group who are least likely to access help (MacKinnon and Colman, 2016) and are difficult to engage in care (O’Brien et al., 2009). As identified in some of the news articles linked above, when young people do try to access help they are often turned away as they are not ill enough for treatment. This is something I have also experienced through my work as a researcher on MILESTONE (Tuomainen et al, 2018), a project which is aiming to improve mental health services for young people. As adult services have much higher thresholds for care than children’s services, once young people reach the upper age limit of CAMHS they may be told they are not ill enough to qualify for ongoing care. If there is no service for these young people to be transferred to, many drop out of treatment all together.

Some of these problems have been attributed to services being under-resourced and under-funded. For example, one survey of child psychotherapists found that 61% of respondents said that the main NHS service they work in was facing downsizing (ACP, 2018). The current problems in CAMHS were also having a negative impact on both the quality of care they were able to provide, and staff morale. This report also identified a decline in the number of specialist services for young people, and inadequacies caused by the unsuccessful redesign of services.

One commissioner for CAMHS services in London has identified some specific targets to improve, including faster access to crisis teams, extending opening hours of existing services, and reducing the number of young people sent to inpatient units in a different part of the country (Cassell, 2018). It would be my hope that these changes are adopted throughout the country, and that young people and their families are able to access timely and appropriate care.

References:

ACP (2018) ‘Silent Catastrophe’ Further evidence of NHS CAMHS failing children and young people with most severe needs. Association of Child Psychotherapists, London.

Cassell (2018). NHS England. Accessed 19/10/18 https://www.england.nhs.uk/blog/transforming-child-and-adolescent-mental-health-services/

Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R. & Walters, E. E. (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Archives of general psychiatry, 62, 593-602.

Mackinnon, N. & Colman, I. (2016) Factors associated with suicidal thought and help-seeking behaviour in transition-aged youth versus adults. The Canadian journal of psychiatry, 61, 789-796.

Murphy, M. & Fonagy, P. (2012) Mental health problems in children and young people. Annual report of the chief medical officer, 1-13.

Tuomainen, H., Schulze, U., Warwick, J., Paul, M., Dieleman, G. C., Franić, T., Madan, J., Maras, A., Mcnicholas, F., Purper-Ouakil, D., Santosh, P., Signorini, G., Street, C., Tremmery, S., Verhulst, F. C., Wolke, D. & Singh, S. P. (2018) Managing the link and strengthening transition from child to adult mental health care in Europe (MILESTONE): background, rationale and methodology. BMC psychiatry, 18, 167.

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Yoga and mental health

Yoga is something that I really enjoy, and try to practice at least 3 times a week. As well as doing something which challenges me physically, I have found that yoga has been so useful for my mind. It helps me to switch off, something which I can find quite difficult, and I definitely feel more relaxed afterwards. I wanted to write this post to explore what other benefits yoga can have for mental health and wellbeing.

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Several studies have explored the impact of yoga on stress reduction in an otherwise health population. Some of these findings were synthesised in a recent systematic review by Sharma (2014). This review found that although some of the included studies were of poor quality, there is sufficient evidence to show that yoga has benefits for reducing stress in a variety of settings and populations. Another systematic review has explored why yoga can help to reduce stress (Riley & Park, 2015). They examined different mechanisms by which yoga could reduce stress, both psychological (e.g. mindfulness, increased self-awareness) and physiological (lowering cortisol levels, decrease in stress biomarkers in brain activity), however concluded that there is currently not enough evidence to draw any firm conclusions.

Researchers have also explored whether yoga can have a positive impact for people with anxiety or depression. One study compared anxiety levels of women before and after completing two 90 minute yoga classes for two months, and compared these with a control group (Javnbakht et al 2009). They found that participants who took part in yoga classes showed a significant decrease in anxiety, compared to participants in the wait list group.  A systematic review has explored the impact of yoga on depressive symptoms (Pilkington et al, 2005. Again, whilst the findings show a positive impact, the authors stress that the results should be interpreted with caution due a variability in study methods and quality.

Yoga can also have some benefits for physical health conditions, in particular helping to reduce pain (Büssing et al 2012). The authors hypothesise that this could be due to improved flexibility, calmness, and focusing the mind, which reduces anxiety. More research is needed to explore other potential benefits of yoga in physical health conditions.

 

References:

Büssing, A., Michalsen, A., Khalsa, S.B.S., Telles, S. and Sherman, K.J., 2012. Effects of yoga on mental and physical health: a short summary of reviews. Evidence-Based Complementary and Alternative Medicine2012.

Javnbakht, M., Kenari, R.H. and Ghasemi, M., 2009. Effects of yoga on depression and anxiety of women. Complementary therapies in clinical practice15(2), pp.102-104.

Pilkington, K., Kirkwood, G., Rampes, H. and Richardson, J., 2005. Yoga for depression: the research evidence. Journal of affective disorders89(1-3), pp.13-24.

Riley, K.E. and Park, C.L., 2015. How does yoga reduce stress? A systematic review of mechanisms of change and guide to future inquiry. Health psychology review9(3), pp.379-396.

Sharma, M., 2014. Yoga as an alternative and complementary approach for stress management: a systematic review. Journal of Evidence-Based Complementary & Alternative Medicine19(1), pp.59-67.

Shyness

How would you describe shyness? Stereotypically, shy people are portrayed as being quiet, often loners who don’t want to stand out from the crowd, but is this really true? I was inspired to write this post whilst reading Quiet by Susan Cain, as it really got me thinking. What is shyness, and why do we see it as a disadvantage?

In her book, Cain starts by explaining the difference between shyness and introversion (for more on introversion, read my post here). Introversion is a personality trait in which people prefer lower amounts of stimulation, they may choose to spend time in their own company rather than with others or prefer quiet over loud music. Shyness, on the other hand, is more about how we perceive other’s judgments of ourselves, in particular a fear of looking silly or being disliked. Of course it’s possible to be an introvert and be shy, but they don’t necessarily have to go hand in hand.

shy

Shyness is also separate from society anxiety disorder – a type of anxiety disorder in which individuals have an extreme fear of social situations and will often try to avoid them all together. Whereas shyness is a personality trait and isn’t necessarily negative, social anxiety disorder involves intense anxiety during social interactions, for example when meeting new people or speaking up in front of others (Stein & Stein, 2008).

Cain argues that shyness and introversion aren’t inherently negative personality traits, despite the fact that modern society often prioritises people who fit within a more extroverted personality type. As a child who was often shy, I have consciously tried to move away from this label as I’ve got older, both socially and at work. I’m also definitely an introvert as I need to recharge by relaxing alone. I wouldn’t classify myself as shy now, despite the fact that I don’t always feel comfortable speaking in public (I feel that’s quite normal!). Although trying to push myself out of my comfort zone to alleviate some feelings of shyness has helped me, reading Quiet definitely made me reconsider how I view shyness and introversion, and view them in a much more positive light.

What are your thoughts on shyness and introversion? Let me know in the comments below, and thanks for reading!

 

References:

Cain, S., 2013. Quiet: The power of introverts in a world that can’t stop talking. Broadway Books.

Stein, M.B. and Stein, D.J., 2008. Social anxiety disorder. The Lancet371(9618), pp.1115-1125.

 

Food and Mental Health

You’ve probably heard the phrase “you are what you eat”, but can the food we eat affect not only our physical health, but our mental health too? A relatively new branch of research has started to investigate the links between our diets and our mental health, with really interesting results coming from this field so far.

Research studying the links between diet and mental health have found evidence to suggest that a poorer diet is correlated with some types of common mental illness. For example, Jacka et al (2011) studied the diets and mental health of over 5700 adults in Norway and found that participants who ate a better quality diet (for example one containing more fruit & vegetables, fish, wine (!) and unprocessed meats) were less likely to have depression. This study also found a link between a higher intake of processed and fatty foods and increased levels of anxiety. Another study exploring the link between diet quality and mental health in Wales has also shown similar results, although only in the female participants (Cook & Benton, 1993).

One study which explored the link between diet and mental health is the SMILES trial (Jacka et al, 2017), which compared a dietary intervention to a social support control for participants with depression. Participants were randomised to each of these groups, and over a 12 week period either received a dietary intervention which aimed to improve the overall quality of their diet by incorporating foods from the Mediterranean diet, or the social support control. The image below shows the basis of the dietary intervention.

ModiMedDiet-Food-Pyramid

This study found that participants who received the dietary intervention reported a significantly larger reduction in depressive symptoms at the end of the 12 week period than those in the control group. At the end of the study, 10 of the 33 participants in the intervention group had experienced such a reduction in symptoms that they were classified as being in remission, compared to 2 out of 34 in the control group.

Although the above study involved relatively small numbers of participants, the results of this trial show promising results of the impact of a good quality diet and improvements in mental health. Results of studies such as these suggest that lifestyle interventions such as diet could be one effective (and cost effective) way of helping individuals to manage their mental health. However, it must be noted that dietary interventions are not being suggested as a method to replace treatments such as medication or CBT, but a method to work in conjunction with them.

If you want to find out more about how the food you eat impacts on your mental health, then MIND have some really useful tips e.g. making sure you stay hydrated, managing your caffeine intake and eating enough protein are simply ways to start. Follow the link here for more information.

If you found this post interesting and want to read more about potential links to our diet and mental health, why not read my post on the gut microbiome and mental health here?

References:

Cook, R. and Benton, D., 1993. The relationship between diet and mental health. Personality and individual differences14(3), pp.397-403.

http://foodandmoodcentre.com.au/media/smiles-trial/

Jacka, F.N., Mykletun, A., Berk, M., Bjelland, I. and Tell, G.S., 2011. The association between habitual diet quality and the common mental disorders in community-dwelling adults: the Hordaland Health study. Psychosomatic medicine73(6), pp.483-490.

Jacka, F.N., O’Neil, A., Opie, R., Itsiopoulos, C., Cotton, S., Mohebbi, M., Castle, D., Dash, S., Mihalopoulos, C., Chatterton, M.L. and Brazionis, L., 2017. A randomised controlled trial of dietary improvement for adults with major depression (the ‘SMILES’trial). BMC medicine15(1), p.23.

 

Social Support and Health

Having a strong network of family and friends around us is generally perceived as a good thing, meaning we have people to talk to if we have a problem or help us when we are in need. However, what if there’s more to it, and having a social network (the real, not the Facebook kind) can actually improve our health, and make us live longer?

To start – how have scientists defined social support? Rather than just being about the number of people in our social network, “social support refers to the clarity or
certainty with which an individual experiences being loved, valued, and able to
count on others should the need arise” (Turner & Lewis Brown, 2010). Therefore the quality of our social relationships is important, not just quantity.

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The health benefits of having strong social bonds have been studied for decades. One of the first studies to suggest a link between social support and health was conducted in America in the 1970s (Berkman & Syme, 1979). They studied a random sample of almost 7000 adults, and followed them up for nine years. The results showed that people with lower social ties were more likely to die in this follow up period than those with higher levels of social support. Importantly, this finding was independent of general health, socio-economic status, and lifestyle factors such as physical activity and smoking.

As well as improving our physical health, social support also has benefits for our mental health. Research has found that perceived social support is correlated with depression, with those perceiving higher levels of social support experiencing fewer depressive symptoms (Stice et al, 2004) One other aspect of mental health which is thought to be particularly improved through social support is stress. Social support acts as a ‘buffer’ to stress, influencing whether we see stressful events as a threat, and how well we are able to cope with them (Lakey & Orehek, 2011).

We’ve seen that increased social support can lead to an improvement in our physical and mental health, but how does this effect occur? Uchino (2006) hypothesises that social support could influence health via two different pathways. The first states that social support acts as a positive influence and promotes health behaviours, such as taking medication or going to the doctor when ill, having a balanced diet, or not smoking. The second pathway states that social support directly influences our mood and emotions, which in turn helps to keep us healthy.

As described above, social support can help to act as a buffer and make us more resilient to stress. A reduction in stress levels can help cardiovascular health: several studies have shown that higher social support is correlated with lower blood pressure (e.g. Gump et al, 2001). Social support could also improve our health through our immune system: one study found that cancer patients with higher levels of social support had higher levels of tumour-fighting cells than those with less social support (Levy et al, 1990).

Of course, having a strong social network isn’t going to guarantee perfect health and a long life. But there’s a strong case to suggest that investing more time in our real world friendships could improve our health, as well as the health of those around us.

 

References:

Berkman, L.F. and Syme, S.L., 1979. Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents. American journal of Epidemiology109(2), pp.186-204.

Gump, B.B., Polk, D.E., Kamarck, T.W. and Shiffman, S.M., 2001. Partner interactions are associated with reduced blood pressure in the natural environment: Ambulatory monitoring evidence from a healthy, multiethnic adult sample. Psychosomatic medicine63(3), pp.423-433.

Lakey, B. and Orehek, E., 2011. Relational regulation theory: A new approach to explain the link between perceived social support and mental health. Psychological review118(3), p.482.

Levy, S. M., Herberman, R. B., Whiteside, T., Sanzo, K., Lee, J., and Kirkwood, J. (1990). Perceived social support and tumor estrogen/progesterone receptor status as predictors of natural killer cell activity in breast cancer patients. Psychosom. Med. 52: 73–85

Stice, E., Ragan, J. and Randall, P., 2004. Prospective relations between social support and depression: Differential direction of effects for parent and peer support?. Journal of abnormal psychology113(1), p.155.

Turner, R.J. and Brown, R.L., 2010. Social support and mental health. A handbook for the study of mental health: Social contexts, theories, and systems2, pp.200-212.

Uchino, B.N., 2006. Social support and health: a review of physiological processes potentially underlying links to disease outcomes. Journal of behavioral medicine29(4), pp.377-387.

Self Care and Mental Health

Self care is a bit of a buzz word at the moment, with tonnes of articles about the benefits of taking time out to look after yourself. Sometimes, self care is used as another way to describe pampering, with things like bubble baths or face masks cited as a type of self care. Self care can also be more basic, for example simply eating regular, balanced meals, or getting enough sleep. This post will examine the science behind the magazine articles, to see what self care is, and whether it is really beneficial for your mental health.

Self care is really just another way of saying ‘look after yourself’ or taking time to do things you enjoy. The mental health charity Mind list different ways self care can help improve your mental health. Their suggestions include being aware of your mental health, being kind to yourself, making sure you interact and feel connected with others. They also suggest taking time to relax, either through mindfulness or getting outside, as well as keeping physically healthy. If you’d like to find out more about self care strategies, click here for further information.

 

Self-care

 

But what is it about self care which improves our mental health? One hypothesis is that  taking part in these activities helps people have a sense of purpose and gives life more meaning, which in turn increases self-esteem (Deegan, 2005). Some participants in this study reported that taking part in self care activities which gave life more purpose (e.g. belonging to a singing group, or volunteering) had helped them stay well, decreasing symptoms and avoiding negative outcomes such as hospitalisation. Other more routine aspects of self care, such as shopping or talking on the phone were used as strategies to reduce anxiety or other unwanted symptoms.

Meditation, or mindfulness has also been explored as a way of using self-care to reduce burnout and stress in healthcare professionals. One study by Shapiro et al taught trainee therapists a mindfulness-based stress reduction programme, and found that participants who received the training had lower stress & anxiety levels, less rumination and higher levels of self-compassion than participants who didn’t receive the training. These results suggest that mindfulness is a way of improving the mental health of professionals at a high risk of burnout.

The evidence suggests that taking the time to engage in self care activities could be something we can all do to improve our mental health. Self care is more than just bubble baths; it includes look after our physical health, changing our diet or doing something like volunteering which gives us a sense of purpose. Have you tried self care before? Let me know in the comments if you think it worked for you!

References:

Deegan, P.E., 2005. The importance of personal medicine: A qualitative study of resilience in people with psychiatric disabilities. Scandinavian Journal of Public Health33(66_suppl), pp.29-35.

https://www.mind.org.uk/information-support/types-of-mental-health-problems/mental-health-problems-introduction/self-care/#.WzPZQEgvy00

Shapiro, S.L., Brown, K.W. and Biegel, G.M., 2007. Teaching self-care to caregivers: Effects of mindfulness-based stress reduction on the mental health of therapists in training. Training and education in professional psychology1(2), p.105.

image reference: Sacha Chua via http://ryersonian.ca/a-post-election-guide-to-self-care/

Not Ill Enough

Imagine living with depression. It affects every aspect of your life, from your work to the time you spend with your family. You experience intrusive negative thoughts. You begin to suffer from insomnia, which in turn increases feelings of anxiety. Imagine living with depression, but being told you are not ill enough to qualify for mental health treatment.

This scenario is unfortunately far too common in those seeking help for mental illness. Adult mental health services are often only able to treat the most severely ill, with their treatment focus on those with severe and enduring mental illnesses, such as psychosis or bipolar disorder (McGorry, 2007). This has led to strict eligibility criteria to be put in place when assessing whether someone is suitable to be cared for at their service, something thought to be in part due to a lack of funding and resources (Belling, 2014). If someone visits A&E with a broken arm we don’t wait for it to get worse before we treat it, so why does this happen if someone goes to their doctor with signs of an eating disorder? A recent investigation by the British Medical Associate found waiting lists of up to 2 years in some parts of the UK, (BMA, 2018). Once again this shows the disparity between our attitudes to physical vs mental healthcare.

According to the eating disorder charity BEAT, some people had to wait an average of 182 days to access care in some areas of the UK. This is despite all evidence pointing to the advantages of early intervention: an individual with an eating disorder is 50% less likely to relapse if they can access treatment early. Treatments have also been shown to be more effective if accessed at an early stage (BEAT, 2018).

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This problem isn’t just specific to the UK – one study of carers with mental illness in Australia found that they had to push for their relatives to access appropriate care, with one of the main barriers being that they were not ill enough to be admitted to hospital for their mental health, in some cases despite being suicidal (Olasoji, 2017). Another study looked at the treatment gap in different countries (the percentage difference between the numbers needed treatment and those receiving treatment for it) and found the treatment gap for major depression to be between 36% in the Netherlands to 73% in Finland (Kohn et al, 2004). The international nature of this disparity in mental health care shows how global attitudes to mental illness need to change to allow people to access appropriate treatment as soon as they need it.

Young people can also experience disruption to care due to not meeting the eligibility thresholds in adult services, despite being eligible in the children’s service. In contrast to adult mental health services having high thresholds for care, those at children and adolescent mental health services can be much lower. Children’s services are generally perceived as being more supportive and nurturing than adult services, with a focus on treating emotional and developmental disorders, including autism and ADHD (McGorry, 2007). However this means that when young people reach the upper age limit of children’s services (at around 16-18 years old), they cannot be transitioned to adult care, as they do not meet the eligibility threshold. Therefore at this transition boundary, young people can ‘fall through the gap’ between services despite still being unwell. One study in Ireland estimated that two-thirds of young people do not receive a referral to adult services, despite still being unwell when they reached the upper age limit of children’s services (McNicholas et al, 2015). Those who do receive a referral can still experience a gap in care: adult services can have waiting lists of up to 6 months (Hovish et al, 2012).

It is clear that something needs to change to ensure that people with mental illness are able to access timely and appropriate support, without having to wait for their condition to get worse in order to qualify for treatment.

Please share and let me know your thoughts using the hashtag #MHAW18 and help raise awareness.

 

References:

image reference: https://www.beateatingdisorders.org.uk/early-intervention-strategy [accessed 13/05/18]

Belling, R., Mclaren, S., Paul, M., Ford, T., Kramer, T., Weaver, T., Hovish, K., Islam, Z., White, S. & Singh, S. P. 2014. The effect of organisational resources and eligibility issues on transition from child and adolescent to adult mental health services. Journal of health services research & policy, 19, 169-176.

https://www.bma.org.uk/news/2018/february/the-devastating-cost-of-treatment-delays %5Baccessed 13/05/18]

Hovish, K., Weaver, T., Islam, Z., Paul, M. & Singh, S. P. 2012. Transition experiences of mental health service users, parents, and professionals in the United Kingdom: a qualitative study. Psychiatric rehabilitation journal, 35, 251.

Kohn R, Saxena S, Levav I, Saraceno B (2004). The treatment gap in mentalhealth care. Bulletin of the World Health Organization 82, 858-866

McGorry, P. D. 2007. The specialist youth mental health model: strengthening the weakest link in the public mental health system. Medical Journal of Australia, 187, S53.

McNicholas, F., Adamson, M., Mcnamara, N., Gavin, B., Paul, M., Ford, T., Barry, S., Dooley, B., Coyne, I. & Cullen, W. 2015. Who is in the transition gap? Transition from CAMHS to AMHS in the Republic of Ireland. Irish Journal of Psychological Medicine, 32, 61-69.

Olasoji, M., Maude, P. and McCauley, K., 2017. Not sick enough: Experiences of carers of people with mental illness negotiating care for their relatives with mental health services. Journal of psychiatric and mental health nursing24(6), pp.403-411.

 

Gut Microbiomes and Mental Health

One exciting and emerging field of mental health research which is gaining in popularity is the relationship between microbiomes in our gut, and our mental health. Our gut microbiome contains up to 1 trillion bacteria, as well as viruses and fungi, which form a kind of ‘eco-system’. Our microbiome begins forming after birth, and can be influenced by factors such a environment, diet, travel, hormones and illness (D’Argenio & Salvatore, 2015). It is crucial in digestion and our immune system, and recent research suggests that having a healthy microbiome is important for a healthy brain and nervous system (Foster & Neufeld, 2013).

Research into the link between the gut and brain (known as the microbiota-gut-brain axis – see image below) has found links between dysfunction in the microbiome and mental illness such as depression and anxiety (Foster & Neufeld, 2013).

Gut-Brain-axis

For example, one study carried out at Stellenbosch University compared the gut microbiomes of people with and without Posttraumatic Stress Disorder (PTSD) after experiencing a traumatic event. They found that three bacteria were different in people who did and did not have PTSD, with those with PTSD showing lower levels (Hemmings et al, 2017).

Lots of research in this area has also been carried out using mice, which has shown that the microbiome can directly affect behaviour. For example, one study transplanted bacteria from mice who had high anxiety to mice who had low anxiety. The mice who had received the transplant then started to show symptoms of anxiety (Bercik et al., 2011a).

The interaction between the gut and brain can also work the other way, as stress and emotions can influence the microbiome via the hypothalamus–pituitary–adrenal (HPA) axis (Montiel-Castro et al., 2013). The HPA axis is involved in cortisol production and controls our immune system. Stress results in increased inflammation, which impacts the equilibrium of the microbiome which can lead to diseases, allergic reactions or risk of infection (Glaser & Kiecolt-Glaser, 2005).

This field of research could influence therapies for mental illness, with anxiety and depression treated by interventions targeted to alter the microbiome, as well as traditional drug or talking therapies. What are your thoughts about this new branch of medicine? Let me know in the comments below!

 

References:

Bercik, P., Park, A. J., Sinclair D. Khoshdel, A., Lu J. Huang, X., Deng, Y., Belnnerhassett, P. A., et al. (2011a). The anxiolytic effect of Bifidobacterium longum NCC3001 involves vagal pathways for gut–brain communication. Neurogastroenterol. Motil. 23, 1132–1139.

D’Argenio, V. and Salvatore, F., 2015. The role of the gut microbiome in the healthy adult status. Clinica Chimica Acta451, pp.97-102.

Foster, J.A. and Neufeld, K.A.M., 2013. Gut–brain axis: how the microbiome influences anxiety and depression. Trends in neurosciences36(5), pp.305-312.

Glaser, R., and Kiecolt-Glaser, J. K. (2005). Stress-induced immune dysfunction: implications for health. Nat. Rev. Immunol. 5, 243–251. doi: 10.1038/nri1571

Hemmings, S.M., Malan-Müller, S., van den Heuvel, L.L., Demmitt, B.A., Stanislawski, M.A., Smith, D.G., Bohr, A.D., Stamper, C.E., Hyde, E.R., Morton, J.T. and Marotz, C.A., 2017. The microbiome in posttraumatic stress disorder and trauma-exposed controls: an exploratory study. Psychosomatic medicine79(8), pp.936-946.

Montiel-Castro, A.J., González-Cervantes, R.M., Bravo-Ruiseco, G. and Pacheco-López, G., 2013. The microbiota-gut-brain axis: neurobehavioral correlates, health and sociality. Frontiers in integrative neuroscience7, p.70.

image reference: https://www.nature.com/news/the-tantalizing-links-between-gut-microbes-and-the-brain-1.18557

Time to Talk Day 2018

Today, February 1st, is Time to Talk day in the UK. This campaign aims to reduce the stigma and discrimination around mental illness, and encourage people to talk about their mental health.

Days like today which aim to raise awareness of mental health problems are important to change the conversation around mental health. By raising awareness they also highlight the problems of funding and resources: mental illness is still not treated with the same importance as most physical health problems, with some people left on long waiting lists to access care (e.g. Hovish et al 2012).

These statistics reproduced from Mental Health UK show the scale of the global burden of mental illness:

  • Mental health problems are one of the main causes of the overall disease burden worldwide.
  • Mental health and behavioural problems (e.g. depression, anxiety and drug use) are reported to be the primary drivers of disability worldwide, causing over 40 million years of disability in 20 to 29-year-olds.
  • Major depression is thought to be the second leading cause of disability worldwide and a major contributor to the burden of suicide and ischemic heart disease.
  • It is estimated that 1 in 6 people in the past week experienced a common mental health problem.

Did anything surprise you? If an estimated 1 in 6 people are currently experiencing a problem with their mental health then why is it still not something we feel we can talk about openly? By joining in the conversation, you can make a difference in how mental illness is perceived and help reduce the stigma. Talking about mental health can also make a big difference to people struggling with mental illness at all stages of their recovery.

thunderclap-image

If you’re interested and would like to find out more then click here to access their website.

One of the great features about the website is that it contains clear advice on what to do if you think a friend, colleague or family member is struggling with their mental health. If you’re worried about someone and would like some help then follow this link to find out more: https://www.time-to-change.org.uk/about-mental-health/support-someone

Thanks for reading – if you liked this post then please share, with the hashtag #timetotalk

 

References:

https://www.mentalhealth.org.uk/statistics/mental-health-statistics-uk-and-worldwide

Hovish, K., Weaver, T., Islam, Z., Paul, M. and Singh, S.P., 2012. Transition experiences of mental health service users, parents, and professionals in the United Kingdom: a qualitative study. Psychiatric rehabilitation journal35(3), p.251.

Effects of Sleep Deprivation

How are you feeling today? If you’re anything like me and my friends the answer might well be ‘tired’. In modern society it can seem as though everyone is trying to cram as much as possible into their day, with work, family commitments, studying, exercising and fitting in a social life. This coupled with increased smart phone use (hands up if you scroll through Instagram before you go to sleep..), especially in the evenings can lead to people just not getting as much sleep as they should be.

Sleep deprivation is defined as having less that 7-8 hours of sleep a night for adults (Colten, & Altevogt, 2006). However, a recent survey in the UK found that 70% of adults say they sleep for less than 7 hours each night and over 25% said they regularly slept badly (Sleepcouncil.org.uk).

In today’s society it appears to be normal to be sleep deprived. What effect is this having on our mental health?

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Perhaps unsurprisingly, sleep deprivation has been shown to impair our ability to focus. Studies which have examined the effects of sleep deprivation on driving and found participant’s ability to stay in lane was as impaired as a group who were over the legal alcohol limit (Fairclough & Graham, 1999).

Another study looked at the effects of sleep deprivation in students and found that those who had gone without a night of sleep performed significantly worse at a cognitive task than those who had 8 hours sleep the night before (Pilcher & Walters, 1997). Interestingly, the sleep deprived participants in this study rated their performance on the task as higher than those who weren’t sleep deprived! This suggests that when we’ve not slept enough we might not always realise the effect it can have on our performance the next day.

As well as affecting your ability to focus, sleep deprivation has the largest effect on mood (Pilcher & Huffcott, 1996). One study asked participants to go without two nights of sleep, and compared scores on a personality trait questionnaire at baseline and again after they had been awake for 56 hours. When they were sleep deprived, participants showed higher scores of anxiety, depression and paranoia (Khan-Greene et al 2007). Another study has shown than just losing one night’s sleep can increase anxiety scores (Sagaspe et al, 2006). These research suggests that going without sleep can affect the parts of your brain involved in mood regulation such as parts of the prefrontal cortex.

For tips on how to improve your sleep – the full report by the Sleep Council has some useful tips (and more surprising stats) here: https://www.sleepcouncil.org.uk/wp-content/uploads/2013/02/The-Great-British-Bedtime-Report.pdf

 

References:

Colten, HR.; Altevogt, BM. Sleep disorders and sleep deprivation: An unmet public health problem. Washington, DC: The National Academies Press: Institute of Medicine; 2006.

Fairclough, S.H. and Graham, R., 1999. Impairment of driving performance caused by sleep deprivation or alcohol: a comparative study. Human Factors41(1), pp.118-128.

Kahn-Greene, E.T., Killgore, D.B., Kamimori, G.H., Balkin, T.J. and Killgore, W.D., 2007. The effects of sleep deprivation on symptoms of psychopathology in healthy adults. Sleep medicine8(3), pp.215-221.

Pilcher, J.J. and Huffcutt, A.I., 1996. Effects of sleep deprivation on performance: a meta-analysis. Sleep19(4), pp.318-326.

Pilcher, J.J. and Walters, A.S., 1997. How sleep deprivation affects psychological variables related to college students’ cognitive performance. Journal of American College Health46(3), pp.121-126.

Sagaspe, P., Sanchez-Ortuno, M., Charles, A., Taillard, J., Valtat, C., Bioulac, B. and Philip, P., 2006. Effects of sleep deprivation on Color-Word, Emotional, and Specific Stroop interference and on self-reported anxiety. Brain and cognition60(1), pp.76-87.

https://www.sleepcouncil.org.uk/wp-content/uploads/2013/02/The-Great-British-Bedtime-Report.pdf