By Dr John Baker

In support of Mental Health Awareness Week we highlight five common mental health conditions. The theme of this year’s week is Body Image #bebodypositive so we’re starting with Body Dysmorphic Disorder.

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Body Dysmorphic Disorder

Many of us can find our mood affected by changes in our weight and appearance and most people would readily identify physical aspects of ourselves we’d gladly change. But for some people their dissatisfaction with their appearance and specific perceived flaws can become more obsessive and distressing. People with Body Dysmorphic Disorder (BDD) can experience obsessive anxiety and demonstrate obsessive behaviours related to aspects of their physical appearance.

Physical characteristics that might be unnoticeable or appear very minor to other people can be fixated upon and amplified by someone with BDD. Symptoms can vary in severity but at the extreme people may feel unable to carry on day to day activities and interactions, or may feel compelled to engage in obsessive controlling behaviours to soothe their body-related anxieties or improve the perceived flaw.

If you recognise the symptoms of BDD in yourself or someone else more information is available on the Mind website here.

 

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Obsessive Compulsive Disorder

Obsessive Compulsive disorder (OCD) is a serious anxiety related condition affecting approximately 1.2% of the population.  OCD-UK describes it as involving ‘frequent intrusive and unwelcome obsessional thoughts, often followed by repetitive compulsions, impulses or urges.’ It can be experienced by children, young people and adults and often involves checking, contamination, hoarding or ruminations.

OCD is very treatable with psychological interventions using techniques such as Cognitive Behavioural Therapy and mindfulness, all of which I can provide.

Here is an extract from OCD-uk website highlighting the usefulness of ‘externalising’ as a technique to ‘fight back’ against OCD.

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Anxiety

Anxiety affects everyone at some point; for example exams and job interviews, but sometimes this feeling can become out of control and start affecting everyday life.

Anxiety is the main symptom in a lot of conditions such as panic disorder, phobias, and Post Traumatic Stress Disorder.  One common condition is Generalised Anxiety Disorder (GAD).  GAD is estimated to affect up to 5% of the UK population and is a long term condition that makes people feel anxious about a wide range of situations and issues, rather than one specific thing.  This can cause both physical and psychological symptoms such as feeling restless or worried, having trouble concentrating or sleeping, and heart palpitations.

For more information look at the Mind website here.

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Depression

Depression is a common mental health difficulty affecting young people and adults, men and women.  The severity of symptoms can change over time and may range from low mood to feelings of self harm and suicidal thoughts.  It is always best to see your GP when you first start to notice these feelings.

There is often a trigger for depression but it can also appear to come out of the blue.  There are many things that can help and qualified healthcare professionals are the best people to advise on what treatment is most suitable for each individual.

This recent article from The Independent offers some insight into a psychological treatment that has been found as useful as anti-depressant medication.

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Psychosis

During a psychotic episode the way in which people perceive or interpret things are affected, commonly experiencing hallucinations (seeing or hearing things that aren’t real) or delusions (thinking things that aren’t real).  Often the cause of psychosis is a specific mental health condition such as schizophrenia, bipolar disorder, or even severe depression.

If you’d like more information the following leaflet may be useful.

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Stress is a modern epidemic. 

74% of UK adults have felt so stressed at some point over the last year they felt overwhelmed or unable to cope.

While you may be able to eliminate the external causes of stress in your life, there’s a lot you can do to reduce the adverse effects of stress on your physical and mental health. Understanding the fundamentals of your nervous system biology and how it responds to stress is a great starting point to creating the space to reclaim your power over your stress responses.

Your Autonomic Nervous System

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Your Autonomic Nervous System is the part of your nervous system that controls and coordinates your body’s ‘automatic’ processes (like breathing, digestion, blood flow). There are two parts of the system: the sympathetic and parasympathetic nervous systems. When they are working well together they ensure that the body remains in balance in response to ever-changing circumstances.

The sympathetic nervous system is action-focused: it stimulates the heart, lungs and major muscle groups and triggers the ‘fight or flight’ response in response to threats.

The parasympathetic nervous system essentially calms and restores the body to a resting state and–when activated properly–helps us to renew when we are at rest.

When you experience stress (physical or emotional) your nervous system has to work harder to maintain equilibrium. It is the sympathetic branch that tends to dominate during times of stress and it is important to note that this is not harmful in the short term, and may even be beneficial.

However, if stress levels remain high for too long then physical and mental changes can begin to show. Because the nervous system controls and supports so many of our bodily structures and functions, stress-related symptoms can show themselves almost anywhere.

 

Physical Stress Symptoms

  • Difficulty falling asleep or staying asleep
  • Muscular aches and pains
  • Poor digestion
  • Headaches
  • Breathlessness / chest pain
  • Elevated blood pressure
  • Skin breakouts
  • Fatigue
  • Frequent infections / poor immunity

Emotional Stress Symptoms

  • Anxiety
  • Difficulty concentrating
  • Restlessness
  • Irritability
  • Irrational worries and panic attacks
  • Depression
  • Feelings of isolation and hopelessness
  • Addictive behaviours e.g. over-eating, over-drinking
  • Over-emotionality
Stress isn’t necessarily a problem in itself (nor entirely avoidable); it’s how we respond to stress and how well or poorly we recover that can cause problems.
 
In a healthy stress response, we have a consistent wave-like line that goes from baseline (rest and digest) to peak arousal (fight or flight) and recovers fairly quickly .
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Problems occur when we function outside of that nice up and down line, i.e. if we stay around peak arousal for too long. If this happens the body will initiate a freeze response as it is unable to sustain that high arousal charge. However there is still a sympathetic charge under the freeze so it’s a bit like hitting the accelerator and the brake at the same time.

Chronic stress response

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If our stressors go beyond a certain intensity or duration, the sympathetic response becomes more intense. When we are unable to “complete” the stress response and come down from peak arousal, the ‘rest and digest’ portion of our parasympathetic system is unable to kick in.
Without the ability to “digest” properly, you can see how chronic cases of gut problems can start and become exacerbated over time. Furthermore, if we are unable to “rest” properly, our sleeping is disturbed, and this can lead to further health issues down the line.
Many people may actually be walking around in a ‘functional freeze’ whereby you are able to get through your day only by being constantly busy. Often, this state will ‘mute’ our capacity to feel joy and happiness because we our body’s resources are fundamentally being marshalled for a fight or flight response which is then papered over by a freeze response.
How can you restore a healthy stress response? 
 
Through appropriate intervention you can return your nervous system to a more healthy and functional state; without such action the hyper-reactive state could last indefinitely, but not without wider health implications.

In order to restore a healthy stress response to ourselves, we have to become aware of when we get triggered into an automatic response (that creates a negative feedback loop), and start to unwind this response.

In the process of doing this, we can further work on increasing our nervous system capacity, as well as building exit pathways to allow a smoother flow of stressors in and out through our system.

 There are many ways we can do this kind of work on ourselves–here are a few:

1) Meditation and mindfulness

At the top of the list, but quite often these are perceived as difficult techniques for people to access easily as beginners.

There are lots of groups, classes, and apps that can help you to develop these skills or you might like to have a few one to one sessions with a practitioner who specialises in these techniques.

2) Reiki
 
As well as being a very relaxing therapy which benefits our parasympathetic nervous system, reiki has been shown to positively influence our locus of control which, in turn, can reduce the perceived danger of external threats.
3) Aromatherapy
 
Our sense of smell is closely connected with the parasympathetic nervous system. When scent molecules connect with the cilia (tiny hairs in our nose) the olfactory cells produce a nerve impulse which reaches the Limbic System.
The Limbic system is one of the most primitive parts of the brain concerned with survival instincts and emotions. Scientists believe that the activity of the nerve signals passing through this region cause mood change by altering brain chemistry.
Proper utilisation of essential oils can positively impact our bodies and our nervous systems, thereby helping our bodies and minds return to a state of balance.

4) Somatic Body Practices and Visualisation

Somatic bodywork can help enhance our internal perceptions of our bodies and then helps us integrate these perceptions with our sense of ourselves in our external world. Utilised in conjunction with visualisations, this can become a powerful way to ground into our bodies and help start the unwinding process in the case of a messy and/or incomplete stress response.

Combined with reiki and aromatherapy, this can be a self-nourishing and pleasant way to help us juggle the stressors in our lives and maintain balance.

If you are interested in finding out more, please don’t hesitate to contact the clinic, or stay tuned for future posts diving into these areas in further detail.

 

Joli Knott, Reiki master

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We are inundated with choices in every area of life compared to previous generations. There are now thousands of electricity and gas tariffs and suppliers that you can compare on hundreds of comparison sites. There are almost as many choices of hot and cold beverage in your high street coffee shop. While choice and personalisation can feel like a nice thing it can also leave us feeling overwhelmed and even when we do make a choice we often end up wondering whether we’ve really made the best one anyway.

It’s difficult enough choosing a coffee let alone choosing a clinic or a healthcare professional to help you deal with a chronic health condition. If you have a chronic health problem (or problems) it’s likely that you’ve tried various different ways of tackling it – from seeing  your GP or a specialist, to researching for yourself, self-help, or consulting other healthcare professionals. If all of these endeavours have not got to the bottom of your problem you’re likely to feel frustrated and disappointed at the waste of time, money, and hope – and the fact that you’re still suffering.

When you’re continuing to look for help and solutions it can be incredibly confusing. Even if we confine ourselves to back pain (approximately 1,110,000,000 Google results) the information and misinformation out there is truly mind-boggling. You want to make the best possible choices for you but how do you even begin to narrow down your options?

As a clinical team specialising in helping patients with chronic back pain we have some advice for you to consider when choosing (or not choosing) a clinic.

  1. Don’t choose a clinic or a clinician who can’t talk to you about and demonstrate the positive (and less positive) results that they have achieved with patients like you. By that I mean patients with very similar conditions to you. Back pain isn’t a condition, it’s a symptom. Back pain can have a myriad of causes. If someone simply says they ‘treat back pain’ they may not have the sufficient expertise to help with YOUR type of back pain.
  2. Don’t choose a clinic or clinician who can’t provide you with any patient testimonials or who nobody you know has ever had good results with. Check out their social media reviews or there are lots of social media forums (support groups for health conditions, local community groups etc. or just your friendship groups) where you can ask for recommendations or post about a clinic you’re thinking of visiting to see if anyone has any experience. Of course just because others have had good or bad experiences doesn’t automatically mean you will; but it can help to reassure you and make your choice easier.
  3. On the other hand don’t choose a clinic or clinician just because they helped your friend / auntie / brother-in-law’s half-sister. Their problems and needs might have been quite different than yours. Also speak to the clinic about your specific healthcare and personal needs to better establish if they are right for you.
  4. Don’t choose anything or anyone who claims a 100% success rate or to be able to treat every type of back pain. There is no clinical evidence of a single product or individual being able to demonstrate this kind of success.
  5.  Don’t choose a clinic without speaking to their team and asking lots of questions. You need to feel comfortable with the personality or ‘vibe’ of the clinic as well as its clinical reputation. If you don’t feel that they ‘get’ you and that you can put your trust in them you are far less likely to achieve satisfactory results. Some clinics (like ours) are very happy to have you visit the clinic to speak to someone in the team and have a look round before you book an initial appointment. This is a good thing. Take advantage of it.
  6. Don’t choose a clinic just because it has a shiny website or marketing materials. While this can sometimes indicate that the clinic is successful and professional it can also indicate that they have focused more on brochureware than on patient care. Have a look for yourself at the premises – perhaps pop in and speak to the reception team prior to booking an appointment. This will give you a better sense of the real clinic.
  7. On the other hand don’t choose a clinic just because it’s cheap. It’s often the case that you get what you pay for. Even good clinics run offers from time to time but clinics that consistently charge under the market rate for a service might have to do so because they aren’t good enough to hold on to their new patients.

Of course there are lots of other factors that can come in to your choice of clinic. But we’ll leave it to 7 for now. After all, you already have more than enough choices to consider. Venti Soy Quadruple Shot Latte with No Foam anyone?

Running Technique for recurrent injuries

Whenever you head out these days you are sure to see people running, donning the latest activity wear, water bottles, headphones and tracking technology. And why not, running is after all a great way of exercise, get out, gain stress relief and become a part of a community heading out for parkrun, fun run, marathons, travel …

However, the enjoyment for the majority is hindered by the utter frustration of injury and recurrent injury. It’s not surprising really, considering that a keen runner will put in a quite a few hours per week, each step taking 3 – 5 times the bodyweight in impact. If you weigh 75kg for example, that would be between 225 – 375kg per step for tens of thousands of steps per week. Much moreso if your technique is not good.

Answers to injury are often sought in the latest pair of trainers, exercises, and blogs. Perhaps rest is the answer, let it settle and try again, only to be disappointed. Of course keen Runners are desparate to get back out there and will just as soon as they can. Unfortunately, injuries lead to many giving up on the activity they love.

Were you ever taught to run?

Have you ever been taught and trained on HOW to run? Perhaps you went to swimming classes, golf lessons, your parent taught you to kick a football or throw a netball, the PE teacher taught you to forward roll or throw a javelin. Were you ever taught to run though?

For a few maybe, but for the majority No, of course not, you just do it don’t you, you crawl, walk and then run, right? Well in theory yes, but running is a skill and can be trained. Running technique can be the difference between efficient, enjoyable injury free miles or struggling and recurrent injuries. Overstriding, hip drops, a collapses, a cross-over, are some of the habits that may have developed but for that individual they aren’t helping.

Thankfully these can be assessed and re-trained. David Brown BSc (hons) is a Movement Coach at Core Clinics, Warwickshire and has a program to help. An initial assessment will consist of a Video Biomechanical Analysis to identify any areas of your technique that may add to your injury risk or lack of efficiency. A Functional Movement Analysis will also cross-check these factors. If changes are needed a program of 6 sessions of re-patterning is usually sufficient to retrain these habits, although some may need additional sessions or may need some preparation or rehab sessions before the program.

Sam recently ran 50miles, ‘I loved every minute, I can definitely tell the difference’, Shimmy had his assessment session due to recurring ankle pain, the following day he beat his Parkrun personal best and ran pain free! Debbie was suffering with her hamstring, but enjoys pain free running now. Helen arrived with knee pain, a few sessions later she was pain free, we then corrected her running pattern and now she’s happily putting in the miles…

Suitable for every runner, from Beginner to Serious Amateur, for Adults and Kids, for those who struggle and want to improve, for those who run in other sports and for those who are good and want to get better.

If you are enjoying injury free efficient running then there’s probably no need to change, however if you are blighted by recurrent running injuries book in now for an assessment session with David Brown, Movement Coach.

Core Clinics also have a range of clinicians to support Runners, from Sports Therapists, Podiatrists, Physio’s, Chiropractors, Dieticians, Psychologists, and Massage Therapists.

At this time of year, many people resolve to make changes that will positively impact their health and wellbeing. Gym memberships soar, smoking cessation products sell, and charity campaigns encourage us to go ‘dry’ for January. Commendable and beneficial as these efforts are, it’s striking that they almost always focus more on ‘physical’ health.  The promotion of health (and happiness) by improving our mental and emotional habits is often overlooked, and the benefits under-estimated.

In fact, the health benefits of improving our psychological health may even exceed the benefits of quitting unhealthy habits like smoking and drinking. In her fantastic book ‘Mind over Medicine’ Dr Lissa Rankin says that ‘healthy relationships are medicine for the mind’ and psychologist John Cacioppo, who has devoted his life’s work to studying the effects of social isolation and loneliness believes that curing loneliness is as good for your health as giving up smoking.’

You may be put off the idea of ‘improving your mental health’ because it seems like a complicated and difficult exercise, or perhaps you feel that this doesn’t apply to you – there’s nothing ‘wrong’ with you psychologically. But, just as we can always eat better or improve our exercise habits, we can all improve our mental health in lots of positive ways.

To get you started, here’s our top 3 easy for everyone tips:

  1. Join in

People who have an active social network – be that friends, neighbours, an extended family, colleagues, or people with shared interests – benefit in many health-related ways. They are less likely to become ill, and more likely to recover from all kinds of illnesses.

You don’t have to be a social butterfly or a super networker to enjoy the benefits of connection. Joining a group, taking a class, or taking part in any activity that strengthens your existing social bonds can have an immediate and lasting effect on many aspects of your physical and mental health

2. Meditate or practice ‘mindfulness’

Whether you are religious, spiritual, or a confirmed atheist, the health benefits of meditation and mindfulness are now widely acknowledged by the medical and scientific community. There are many books, audio books and even apps (try ‘Headspace’ or ‘Calm’) that can help you get started. Like any physical habit, the skill and benefits of meditation and mindfulness have to be practiced and increase over time.

3. Challenge your negative thinking and improve your happiness

Psychological research suggests that although to some extent our level of optimism and positivity is predetermined (about 50% determined) by our genetics and early life experiences, and about 10% is determined by what happens to us, we all have the power to affect about 40% of our positivity and subjective feeling of happiness. If you’re a ‘glass half empty’ kind of person you might have to do a bit of work to reset your default negative thinking, but there’s plenty of evidence that it’s very possible.

For tips to get you started check out chapter 7: Happiness is Preventive Medicine in ‘mind over medicine’.

If you’d like some help with improving your mental – and your overall – health, we have people in our team who can help you take the first steps. Give us a call on 01926 801111 or email helpme@tcpn.co.uk.

 

Psychologists Dr Nikki Mills and Dr John Baker of Core Clinics and Advance Psychology Services have some expert advice on making your resolutions stick

The new year can be a time for reflection on your past year’s behaviour and a chance, if you wish, to consider making some positive changes.  However, for many of us, our list of New Year Resolutions becomes overwhelming  and before you know it you’ve given up and you’re feeling bad for ‘failing’.

In 2015 the University of Scranton, USA, surveyed 3036 adults and found that 45% of them had made new year’s resolutions.  The top 3 things on the list were to lose weight, get organised and spend less/save more.  Unsurprising then that come January magazines will be filled with diet promotions, gym membership deals, and money saving tips.  What’s more surprising though, is that of the 45% who made resolutions, only 8% considered that they had achieved what they wanted to.

So what can you do to maximise your chances of successful change and be in that 8%?

Here’s our top tips!

~ Understand why you want to make the change.  Without a clear rationale for making a change it is very easy to lose sight of your goal.  Come February telling yourself ‘I will be more organised’ is going to be less motivating than reminding yourself that ‘when I encourage the children to lay out their school uniform and bags the night before I am less likely to shout at them in the morning and the walk to school will feel nicer for us all’.

~ Make your resolutions realistic.  Start small and build up to bigger goals because aiming too high, too soon, is likely to create a sense of disappointment and failure if your goal isn’t achieved.  It might be more realistic, in the first instance, to set yourself the challenge of walking round the block 4 times a week rather than immediately attempting the Solihull half marathon.  You may end up running that event, but get there gradually.

~Focus on one thing at a time.  It’s very tempting to get carried away and list all your faults that you plan on rectifying but, not only does this make you feel inadequate, but who wants to deal with that list all at once! Pick one of the more important, attainable goals for you and start with that one.  Once you gain confidence and develop the skills to succeed then you can apply these strategies to other areas and take it from there.

~Talk about it and ask others for help.  Letting other people know what we are planning helps consolidate the idea in our minds.  It also makes us feel accountable to others which can be motivating for some.  Don’t be afraid to ask for support-it might feel easier to go for a run or attend a new group if you have some company.

Most importantly of all

~Be compassionate to yourself.  Unhelpful habits don’t develop overnight so be patient and be kind to yourself when trying to make positive changes.  There are likely to be set backs or obstacles along the way but reminding yourself that you are trying your best and that it’s ok to have a break now and again can help you to refocus and not be too harsh on yourself.  Try to avoid ‘all or nothing thinking’ and remember that it’s better to do something than nothing

So what are our resolutions for the coming year? And can we take our own advice? Guess time will tell, but we’ll certainly try.

Core Clinics have a team of psychiatrists and psychologists with expertise in all aspects of mental health and in all age groups. To book a consultation or for more information contact Core Clinics on 01926 801111 or helpme@tcpn.co.uk