Monthly Archives: June 2012

Essential skills for giving online peer support – a course in development.

The essential skills advisors and peer supporters need for giving advice, information or support online

These are some of the basic skills that supporters and advisors find useful when working young people on keyboard onlineonline. The support offered might be one to one (email style), peer or expert support, moderating forums or moderating real time chat. Depending on the type of support being offered I’ve emphasised certain areas or added additional advanced skills to my training. This training tends to be offered to people who are taking on a specific supporter role, rather than individuals who are part of the community. With adjustments, it can also be offered to community members to help them look after themselves and get more out of their experience online. Continue reading

Writing my mind – some thoughts about the benefits and impacts of public and private journalling

Childhood diaries

I’ve always used writing to know and to guide my mind in one way or another. Usually, this haswriting taken the form of a diary or journal. In thinking about the part that writing has played in managing my mind, I had an interesting evening going through my old diaries and notebooks. The entries were initially quite amusing and nothing but a day by day record of what went on.

‘’Today Richard got his new high chair it was white with blue stripes and the seat dad got was the same pattern with frills round the edge and mum said she didn’t like it.  Me and Paul might be able to have the box” (3rd Feb 1992)

 

“I dumped Simon today. He practically ignored me all the time. I did it nicely. I haven’t seen him since I did as he is in a different technology group. Had lots of fun second lesson of technology”(28th March 1996)

However, it wasn’t long until they became more difficult to read. This still one causes me pain, and shame at how I treated my parents when I was down.

“Mum says if I treated my friends like I treated my family, I wouldn’t have any. Why do I have such twisted anger and tension in me I have to take it out on people and get in moods” (1999)

Continue reading

Giving help that makes a difference – the subtleties of emotional support online

A question of jealousy

Take a look at this relationships question about jealousy:

“I’m always worried my boyfriend is going to cheat on me when he’s out with his friends. I’m always texting him when he’s out and it annoys him but I have no confidence that he won’t cheat. We live together and have been together for nearly two years. I can’t help thinking ‘what if?’ even tho he says he has never cheated. I can just imagine that in the future he’ll decide he’s had enough and I will lose him. I really don’t want that. I’m pushing him away, I don’t want to but I am. Help me.”

How would you go about writing an answer?

Photo by Alyssa L Miller 

Photo by Alyssa L Miller

 

At the moment, I’m thinking a lot about the skills needed for peer support online – whether that be in mental health, relationships or other areas of support. You can have a look at a slideshow I did at a conference in Antwerp about using the web to provide peer support for emotional health and wellbeing here. Continue reading

Mind the gap – GPs, antidepressants and mental health support for young people.

“I’m not going to give you another prescription”
“What… but I need it.. (panics)”
“Don’t worry, I was just testing to see if you really did still need them..and I think you do”
GP in Fenham, Newcastle

“Just take them when you feel you need to”  – to me aged 17.
GP in Cumbria

“So, do you want to kill yourself then?” – on a routine prescription pick up.
GP in Bow, London

“It’s important you stop taking this medication as soon as possible, we have no idea what impact it can have, especially if you start taking it when you are under 18”
GP in Fenham, Newcastle

“It’s fine for you to take it as long as you need to, even for ever”
GP in Tower Hamlets, London

“They’re not addictive”
GP in Cambridge

“You will get withdrawal symptoms”
GP in Byker, Newcastle


The above is a selection of the contradicting information and advice – as well as frankly bizarre approaches and attitudes I have experienced in the twelve years I have been seeing GPs regularly. 

(2016 note – I wrote this piece in 2011 when I was just getting started blogging – but a lot of it is still relevant)

Personal and practical barriers to getting support from a GP

I’ve spent lot of time supporting young people to take the first steps to support. Their GP is usually the gatekeeper for services.  A lot of young people really struggle to get the mental health support they need, facing a number of personal or practical barriers along the way. As well as support in articles, live chat and on discussion boards, one of the projects I was involved in at YouthNet (now The Mix) was crowdsourcing and discussing experiences in order to create community content to help others overcome these barriers. The project really highlighted the frustrating reality of trying to get the support you need from local health services. Continue reading

How can exercise help depression?

what role does exercise play in managing depression

Earlier this week, when the ‘exercise no help for depression’ stories were published on the BBC and the Guardian, I quickly pulled together some of my initial thoughts and frustrations with the way the research was reported. Since then, I’ve had a chance to think about it in a bit more depth.

The debate on exercise and depression

I watched the debate and discussion throughout the day. Those involved came from a range of perspectives and angles. Many people who got involved had experienced depression themselves. Some were in the middle of a bad episode, others had experienced it in the past or felt that they were ‘managing’ their depression to prevent relapse.

Some had found exercise improved their mood or helped them manage, others not. For some it depended on the severity of the depression experienced. For some, exercise was not considered ‘helpful’ unless it formed part of a ‘treatment’ leading to a cure. For others if it enabled them to manage better on a day-to-day basis this was enough.

What was interesting was that while some were supporting or arguing against the research itself (that one particular form of facilitated ‘encouragement’ to exercise doesn’t help in treatment) many were responding to the simplified message in the headline – that exercise doesn’t help depression.  And many responded with the simple answer, ‘Well, it helps me get by.’ While the Department of Health can conclude that TREAD, in the way it is currently delivered, does not work, the mass of anecdotal evidence that this study has generated should give them pause for thought. Continue reading

My thoughts on exercise and depression

Bad journalism

The BBC  headline ‘Exercise ‘no help for depression’, research suggests’ (note – the BBC have 

photobikequietly changed this headline now!) – and indeed Guardian headline Exercise doesn’t help depression, study concludes (note – this link has since broken and I can no longer find the article) – really frustrated me today. It’s classic bad science reporting, which we all know is nothing new, but it touched a chord with me on a personal level so I wanted to get down my thoughts and personal experiences over my lunch break.

There is a lot more to be said and I’m really aware of my own experience biasing my opinions so do add your comments and thoughts.

The headline is misleading

 

The main frustration is the misleading nature of the headline. If you read the article, what patients were actually given was “advice on up to 13 separate occasions on how to increase their level of activity. It was up to individual patients what activity they chose to increase and by how much.”. The report – which you can read in full here – is actually investigating one particular method (the TREAD method) of encouraging depressed patients to increase their activity. This is a very different study than the one the headlines lead you to believe. Continue reading

Keeping the beast asleep – Mindfulness Based Cognitive Therapy and my experience of how it can help prevent relapse

Recurrent depression

I recently found something I wrote a couple of years ago, while trying to make sense of a particularly difficult period of depression;

“Recurrent depression is cyclical. It comes and goes in longer periods than just days or weeks. Each low episode can last months, and within that time it can make everything much harder, with deep lows and any better times feeling fleeting and insecure. The hardest part of the fact it is recurrent is in the way that when you’re low you forget the good months and better years and just remember the  times in the cycle where you were fighting it, and it feels like you’ve spent your whole life feeling low, that every time you thought you’d beaten it, it comes back and that there’s nothing to look forward to but more of the same. I can understand why depression is a killer. The only way to give each apparently endless low a meaning is to try so hard not to see it as a setback or as a return to the hardest darkness but to try and learn from each one, to gain as much practice in management and insight from each time to help the next time become easier. And maybe each time it comes around, each low period, be it weeks, months or longer, will get easier to manage and survive through as a result. And perhaps the low times will come less often.”

It’s been the recurrent nature of my depression that has kept me on varying doses of monstiCitalopram for almost 11 years. It is the recurrent nature of depression in general that seems to present such a challenge to both sufferers and those providing treatment. I’ve often wondered if one can ‘recover’ from something that has been part of one’s life for so long? Or does one just end up learning to manage it more effectively, becoming ever more aware of those tiny changes to the delicate balance of your mind that could, without proper attention, tip you downhill again? Can ‘recovery’ be more than just a lasting period of absence of symptoms if at any moment the black swan of relapse could ‘disprove’ it ever was.

Preventing relapse

For me, on a day to day basis, it’s about finding and using the tools that I know keep my mind healthy. That’s not to say I don’t have bad times, but I’m becoming increasingly better at stopping those times spiral down into longer darker times and, in general, I can function ‘normally’. These tools have become even more important recently as I start the long (and never previously successful) process of trying to cut down my dose of Citalopram.

MBCT – ‘the integration of core cognitive therapy principles with sustained mindfulness practice’

Among the more common tools of diet, a lot of running and swimming (I can’t overemphasise the importance and impact of exercise on my mood), writing, militant amounts of sleep and my SAD light, I attended an eight week course at Breathing Space. This is a course designed by Segal, Williams & Teasdale in their book Mindfulness Based Cognitive Therapy for Depression – a New Approach to Preventing Relapse and taught by trained members of the Buddhist community, supervised by a consultant psychiatrist. Continue reading