Category: Anxiety

CBD as an alternative to pharmaceutical drugs

Cannabidiol (CBD) is a chemical compound that is extracted from the cannabis sativa plant, a compound that has been gathering considerable interest in the potential treatment of a spectrum of neuropsychiatric disorders. Depression, anxiety and insomnia are commonly treated with pharmaceutical drugs, like benzodiazepines, serotonin reuptake inhibitors, (SSRI’s), tricyclics and monoamine oxidise inhibitors (MAOI’s). However, these medicines widely used in psychiatry, can have limited responsiveness, carry residual side effects and can be dependency forming, as in the long term use of benzodiazepines. Preclinical evidence gathered from neuroimaging and human psychological studies support the considerable potential that CBD has as a healthy alternative to pharma drugs in the acute treatment of anxiety and in preventing long term adverse effects of stress with minimal sedative effects. It also has analgesic, anticonvulsant, anti-arthritic, anti-flammatory, antioxidant, antipsychotic and antiemetic properties and it can slow the growth of cancer.

The medicinal properties of cannabis plant have been understood and used by many cultures for several millennia and its use as popular medicine had been referenced by the Chinese in 2900 BC. Medicinal cannabis use can be can be traced back to the Egyptians, Scythians, ancient Chinese and by the Indus Valley civilisation in Ayurvedic medicine. It was also used by the ancient Greeks, across the Arabic world during Roman times and also by the Romans to modern times.

CBD is legal in the UK, however the law around its purchase and use is unclear, as is its role in current medical treatment. Most CBD in the UK is imported and British farmers are compromised on selling by restrictions imposed on harvesting methods. There are an array of costly CBD products stacked up on chemist’s shelves but there are labelling inaccuracies (*Journal of the American Medical Association, 2017;318(17):1708-1709). Many products do not supply what they promise on the label and are sold at very low concentrations. Furthermore, CBD is not yet fully evaluated in the UK and undeniably further clinical studies are required to measure its longer term effects as a treatment in both adult and child populations.

In 2018, following controlled clinical trials, a prescriptive oral CBD product (Epidiolex) was given approval in the USA for the treatment of two rare and severe forms of epilepsy in children aged two years and under. In the UK, evidence of its therapeutic value remains anecdotal and parents would be advised to learn as much as possible about the effects of CBD before giving it to their children. There is a wide variation in the quality and dosage of CBD products, with a possibility of contaminants in the products and an overall lack of knowledge about how CBD may interact with other medicines a child may be taking. The World Health Organisation (Cannabidiol (CBD) Critical Review Report, 2018) recognises the evidence that CBD is generally well tolerated with a good safety profile and it ‘may be a useful treatment for other medical conditions’ besides epilepsy. Considerable evidence supports the potential of CBD in treating anxiety, however clinical evidence is required to evaluate its use among children for treatment for Attention deficit and hyperactivity disorder (ADHD), Autistic spectrum disorder (ASD) or Asperger’s disorder.

Regulation of CBD in the UK market combined with an emergence of a new medical model would help to dispel spurious moral assumptions about a drug that has provided medicinal value to cultures for six thousand years or more. Medicinal cannabis use in the UK has not rolled forward as it has in Canada and the USA, where cannabis is still illegal under federal law but is sold by licensed producers. Britain is poorly prepared for amendments to cannabis law reform that are already flourishing in other areas of the globe. This is a missed opportunity, not only to cultivate a new growth industry on which to raise tax revenue and boost economy but especially in conducting research on a treatment that would undeniably benefit the health and emotional well-being of millions of people.

Are there alternatives to drugs for maintaining our children’s mental and emotional wellbeing?

If you missed this BBC documentary, here is the link to catch up with Dr Chris van Tulleken as he investigates whether there are alternative treatments to drugs (in particular Calpol) to treat our children. He focuses on a small group of children who are medicated for Attention Deficit and Hyperactivity Disorder, otherwise known as ADHD.  https://www.bbc.co.uk/iplayer/episode/b0b4jjq3/the-doctor-who-gave-up-drugs-series-2-episode-1

Social anxiety


 

Also known as social phobia or fear of social situations. It often starts when a person is in their teens but it can last into adulthood and it can severely affect your ability to cope with social situations. Social anxiety is fear that can wear away your confidence and cause distressing symptoms which can undermine your ability to function at home, school or at work. It can cause an intense dread of everyday social situations, of doing things in front of people and it can limit your ability to engage in activities such as meeting friends, initiating conversations, walking into rooms where there are people, attending parties, engaging in phone conversations and social outings. It can result in staying away from places where there are people which can lead to withdrawal and isolation.

There are various symptoms, such as thinking that people are judging or watching you, or a fear that you will embarrass yourself or that you are not socially capable or competent. Consequently, one’s sense of self-esteem is lowered, confidence is adversely affected causing shyness, leading to avoidance of eye contact and social withdrawal. It may become very difficult to make and keep friends. As a result, you may also experience palpitations, along with a feeling of sickness, sweating and panic attacks. Two young people, Khalid and Laura, who have suffered from this form of anxiety, share their experiences in this short video. (courtesy of Voice Box, Childline’s weekly video chat)

https://www.youtube.com/watch?v=LqDX9rntbQs

Social anxiety can be treated with counselling and psychotherapy, such as talking therapy. If you experience social anxiety, the following organisations can offer further advice and information :-

Social Anxiety UK

Anxiety UK

Young Minds

Anxiety Alliance

Mind

 

How to deal with panic attacks

A panic attack can be caused by anxiety and stress or by an underlying physical condition. Although not life threatening, panic attacks can be scary and distressing because of intense feelings of dread and irrational fears. Attacks tends to come in waves, varying in intensity and peaking for approximately 10 minutes. The attacks can last for minutes up to a couple of hours and their underlying causes are not always easy to identify. Certain situations, circumstances and certain activities can act as triggers, however in certain circumstances panic attacks can occur randomly. Physical symptoms often accompany panic attacks in the form of palpitations, sweating, shaking or trembling and breathlessness or hyperventilation. These symptoms are the result of adrenaline being released into the bloodstream, which prepares the body for defensive responses as it enters a state of heightened arousal. If our nervous system is unable to stabilise to a calmer state, it can cause an over-exaggeration of threat causing increased anxiety and panic.

There are strategies you can adopt to cope with panic. Firstly, face up to the fear of panic so that it does not control you. Ride out the attack and remain in the situation until the panic subsides. By so doing, you will allow yourself the opportunity to learn that nothing is going to happen. When the panic subsides, continue with what you were doing before the attack. It is helpful to have someone with you who can offer you reassurance that the sensation will pass and you should try not to worry.

Control your breathing

Avoid the urge to take short, shallow breaths. Take longer slow, deeper, gentle breaths. Breathe in through your nose, counting from 1 to 5 then breathe out slowly, deeply, gently through your mouth counting 1 to 5. Do not hold your breath but try to continue breathing in a much slower way. Don’t worry about feeling yourself wanting to yawn but are unable to. Close your eyes and focus on your breathing. Practice breathing each day to prevent panic. Also view our blog on diaphragmatic breathing.

Eat a healthy diet

Regular healthy meals regulate blood sugars. Be aware that caffeine, tobacco, alcohol and drugs can exacerbate panic and anxiety.

Take regular exercise

Exercise, especially aerobic exercise, helps to alleviate stress and anxiety and release tension. It boosts confidence and can lift mood.

Seek professional support

A trained therapist or counsellor can offer you professional advice and support for anxiety and panic attacks. A short course of Cognitive Behavioural Therapy (CBT) can help you to find strategies to cope with negative thoughts that accompany panic attacks.

For further information contact Revive Counselling and Therapy.

Email: sue@revivecounsellingandtherapy.com

About sexting

Sexting involves sending a sexual text, image (nudes) or video.  Once you send out an image though, you can’t control what happens to it. Consequently, sexting can lead you to feelings of exposure, anxiety, embarrassment and guilt. It can also lead to bullying, blackmail and harm. If you’re under age 18, sexting is illegal and it remains illegal even when the person in the image, text or video turns past age 18, if the image was taken when the person was under age 18.

If you are passed on a sexual image or video THINK BEFORE YOU SEND… DON’T SHARE….. DON’T PASS IT ON!  Instead think about how the person in the sext might feel if other people saw their image or the video. What could the consequences be for them? For you? Be aware.

If you wish to get an explicit image removed, you can report the image to the hosting site and Net Aware give information about reporting to social media providers. You can also notify CEOP (Child Exploitation and Online Protection) of the incident if the person may be at risk of harm.

Think before you click.

Childline and the NSPCC at http://www.nspcc.org.uk offer practical and legal advice about sexting and other issues like bullying, online grooming, sex and how to look after your digital footprint.

Click on this video link to view a video by Childline which offers practical advice about sexting. If you want to learn more about sexting or want to talk to someone about it, you can call Childline free on 0800 1111. You can also download the Zipit app at https://www.childline.org.uk

https://youtu.be/392azAUlUk0

Handy tips for helping you sleep

Insomnia means a lack of sleep, but it also refers to non-restful sleep, early morning waking, waking in the night, or difficulty falling asleep. Sleep forms an integral part of our daily routine and a lack of it can cause irritability, reduce our ability to concentrate and focus and even impair our motor function. Sleep loss can also raise blood pressure, increase the risk of heart disease and diabetes and even weaken the immune system. Sleeplessness can also be a sign of anxiety and depression and it can exacerbate them both. People vary on the amount of sleep they need but on average, a person needs approximately 7-8 hours daily.

Here are some handy tips for helping you sleep.

Do:

  1. Only use your bed for sleep (incl. sex).
  2. Establish a regular bed time / getting up time and keep to a regular bed time routine.
  3. Try having a warm bath or shower before going to bed.
  4. Exercise 5-6 days per week for 30 minutes in the mornings or afternoons.
  5. Make sure you get daily exposure to natural light.
  6. Try using mindful breathing or relaxation techniques before going to bed.
  7. Ensure your pillows and bed are comfortable.
  8. Make sure your sleep environment is relaxing and pleasant and the room temperature is comfortable.
  9. Reduce your alcohol (and drug) intake as these can disrupt your sleep.
  10. Try downloading screen dimming software if required. (E.g. Dimmer, Flux are both good programmes).
  11. Move your clock so that it cannot be seen if you wake up in bed.
  12. Turn off phone email and text alerts
  13. Keep a journal by your bed so that you can jot down things that come to mind when waking.

 

What not to do: 

  1. Avoid taking naps during the day.
  2. Avoid drinking coffee, tea, or energy drinks and lots of liquids during the afternoon.
  3. Avoid taking stimulants (chocolate, nicotine, medication) near bed time.
  4. Don’t eat heavy meals late.
  5. Don’t watch TV or mobile devices in bed or engage in activities that stimulate the brain.

 

Finally, if you are not asleep after 20 minutes of going to bed, get up and do something relaxing such as reading, try a hot milky drink, then return to bed later.

Natural and herbal remedies may assist you to sleep, however these suggestions are recommended without the use of prescribed hypnotics and medication.

If, after a period of time of trying these tips you are still suffering from insomnia, a course of CBT may help you to find ways to sleep.

Mindfulness reading for all

Mindfulness has definitely been the trend for a while and has become mainstream over the course of the past decade. This new age concept has transformed into a multi-million pound business and the number of books on mindfulness has mushroomed, bringing a range of meditation methods that are now easily accessible to all and practiced by many. Millennials aspire to Scandinavian notions of ‘Hygge’ and ‘lykke’, words of Danish origin that have been adopted into the English language expressing notions of comfort, happiness and well-being. As high tech, high speed, frenetic lifestyles and increasing reliance upon social media and technology can prevent people from being deeply aware of themselves, let alone of each another. Humans are in danger of becoming deprived of giving face to face contact, of a sense of deeper awareness and sense of being human, of feeling healthy in mind and body. Stress, anxiety, depression, pain, illness and addiction pursue, especially amongst young people where the anxieties and stresses can easily commence early in life. Mindfulness can deal with many issues including teenage depression, addiction, pain and anxieties.

The roots of mindfulness originally lie in the heart of Buddhist meditation in which awareness is cultivated and the mind is calibrated and stabilised. The idea is to help one find a state of being in which the person may reclaim the present moment, anchoring oneself in the here and now, free from distortion and interpretation so they may reframe their narrative. It can be practiced by anyone, virtually anywhere and I use it in my practice.

Jon Kabat-Zinn, Professor of Medicine Emeritus, developed the Mindfulness-Based Stress Reduction program (MBSR) at Massachusetts Medical Centre Stress Reduction Clinic and his methods have been adopted by a host of notable cognitive psychologists and developed into the practice of Mindfulness Based Cognitive Therapy (MBCT). These include Dr Zindel Segal at University of Toronto, Oxford based John Teasdale and, Prof. Mark Williams, founding Director at the Oxford Mindfulness Centre. Dr Patrizia Collard at University of East London has written ‘The little book of mindfulness’ and Christina Feldman at The Insight Meditation Society offers meditation retreats.

Let the teachers get on with teaching

Children's mental health at risk
Children’s mental health at risk

teenager-422197_1280So, teachers in secondary schools are to receive mental health training! £200,000 has been pledged by a Government funded scheme known as Mental Health First Aid and the scheme will also be rolled out into primary schools by 2022.  It is fair to say that teachers are on the front line,  not just for safeguarding, but additionally for helping to build resilience in children and young people.

Evidence given in a recent report on Social media and children’s mental health by the Education Policy Institute, demonstrates that 37.3% of UK 15 year olds are classed as extreme internet users (6+ hours daily). Evidence of the correlation between extreme internet use and the harmful effects on young people’s well-being makes teachers uniquely well placed to educate about the strong links between periods spent on social media and mental health and well-being problems. Especially to raise their concerns about vulnerable pupils or pupils who are exposed to problems relating to their mental and emotional well-being.

It is also fair to say that the government should ‘get real’ about the mental health problems facing children and young people. Talking therapies are in desperately short supply and underfunded, specialist services, like CAMHS, have long waiting lists. Dumping the problem onto teachers is a pitifully inadequate way to tackle serious mental health issues affecting our young and which require much more specialist input than schools-based first aid. Teachers already have overwhelming workloads and schedules and are driven to attain high targets. Target crunching is not the mind set required to understand and deal with mental health problems.  To expect teachers to be able to recognise and cope with mental health issues as well, is not only naïve but it undermines the skill and experience of a properly trained mental health professional. How would a teacher be expected to have the time or skills to successfully deal with a child or young person with a full blown psychosis or offer counselling support to a suicidal teenager?

Funding needs to be pumped into specialist mental health services for children and young people so that trained and skilled mental health professionals can meet the needs of children and young people with emotional and mental health problems. Meanwhile, let the teachers get on with what they are trained to do, and do best, which is to educate.

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