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
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.
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.
- Only use your bed for sleep (incl. sex).
- Establish a regular bed time / getting up time and keep to a regular bed time routine.
- Try having a warm bath or shower before going to bed.
- Exercise 5-6 days per week for 30 minutes in the mornings or afternoons.
- Make sure you get daily exposure to natural light.
- Try using mindful breathing or relaxation techniques before going to bed.
- Ensure your pillows and bed are comfortable.
- Make sure your sleep environment is relaxing and pleasant and the room temperature is comfortable.
- Reduce your alcohol (and drug) intake as these can disrupt your sleep.
- Try downloading screen dimming software if required. (E.g. Dimmer, Flux are both good programmes).
- Move your clock so that it cannot be seen if you wake up in bed.
- Turn off phone email and text alerts
- Keep a journal by your bed so that you can jot down things that come to mind when waking.
What not to do:
- Avoid taking naps during the day.
- Avoid drinking coffee, tea, or energy drinks and lots of liquids during the afternoon.
- Avoid taking stimulants (chocolate, nicotine, medication) near bed time.
- Don’t eat heavy meals late.
- 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 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.
If you suffer from anxiety or stress, diaphragmatic breathing is a useful technique for introducing relaxation. This short video demonstrates how to apply the technique. Practice this daily for 5-10 minutes and learn how to relax your mind and body and become aware of muscle tension. Click and follow the link.
So, 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.
In a climate of deepening NHS crisis, it is heartening news that the PM is talking about making an investment in mental health services and even addressing the issue of ‘parity’. Whether or not it is a question of ‘hard’ or ‘soft’ parity, one certainty is the fact that there needs to be new Treasury money for these investment plans. Professor Sir Simon Wessely, Regis Professor of Psychiatry at the Royal College Of Psychiatrists states that there is a need for more specialist mental health workers, Child and Adolescent Psychiatrists, nurses etc. “We have a long way to go before mental health services are on an equal footing with those for physical disorders.”
The reality is that almost 250,000 children and young people and children aged 18 and under receive treatment by specialist NHS support services each month and this is probably just the tip of the iceberg. Child and Adolescent Mental Health Services (CAMHS) account for just 0.7% of NHS spending and approximately 6.4% of mental health spending, therefore Clinical Commissioning Groups (CCG’s) will be using some of the 1.4 billion that has been allocated by ministers to improve mental health services for young people. Some mental health charities argue that just how much of this funding actually reaches frontline services is debatable. It is a great pledge, but the capacity for CAMHS to provide support is limited because their services are already overstretched with long waiting lists and high threshold levels for treatment which means that many children are being turned away from services.
Jeremy Hunt, Health Secretary has said that care for children and young people is a “black spot” needing urgent attention as the pressures of social media, cyber bullying and a big increase in self-harming is a “massive worry for parents”. He pledges that he will improve diagnosis and treatment of mental health conditions and put specialists in schools with a proposal that CAMHS and schools work closely together and for more schools to have a CAMHS specialist.
The Mental health charity Sane states that these plans need to “be matched by substantially increased funds to mental health trusts”. Mind said it is “important to see the prime minister talking about mental health” but the difference it made to patients’ day-to-day experiences would be proof.
Teresa May has pledged to help CAMHS by investing £250 million more and by offering mental health first aid training to teachers to recognise symptoms of distress. This puts teachers on the frontline when they already have heavy workloads and are driven by a target led culture that is judged by rigorous observations and inspections. The prospect of Ofsted monitored mental health support provided by schools adds further pressure. An outcome of outstanding, good or requiring improvement is not an appropriate approach to dealing with young people’s mental health issues. The focus needs to be entirely on recognition and sensitive understanding of the needs of the individual child and young person and how they are rapidly going to get the vital support required before self-harm occurs.
Recognition of mental health disorders can require a trained eye and skilled personnel are able to recognise and deal with mental health issues to ensure clear and rapid signposting to the relevant service.
The mental health of teenage girls, especially 14 year olds, has worsened according to a Cohort study recently published by The Department of Health. Teenage girls are more likely to suffer from stress and anxiety and over a third of teenage girls reported that they felt distressed, worthless, and unhappy and suffered from poor concentration.
The study reports that young people’s health and wellbeing is now slightly worse than it was in 2005 with girls faring less well than boys and with young people from relatively advantaged backgrounds being slightly more likely to exhibit social distress. Research shows that teenagers need on average, 9.5 hours sleep per night but only get 7.5 hours. Research also suggests that teenagers engaging in social media during the night could be damaging their sleep and increasing their risk of developing anxiety and depression. Girls tend to seek comfort on social media when worried and teens generally feel under pressure to make themselves available 24/7, suffering from anxiety if they do not respond to posts or texts. Girls especially feel more of a desire to be perfect and to avoid a ‘FOMO’ (fear of missing out) Hospital admissions for self-harm in the under 16’s have risen by an astonishing 52% with Head teachers in schools becoming worried.
In comparison with 2005, although girls’ mental health has worsened, teenagers are now more work focused, less likely to drink, smoke cigarettes, or engage in vandalism, graffiti or shoplifting.
Department of Health Longitudinal study of Young People in England. Cohort 2: Health and Wellbeing at Wave 2. Carli Lessof et al.
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