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Tag: Trauma

The Fundamentals of Sleep

25/06/2024 / / 0 Comments

Much of this post is taken from research by Dr Matthew Walker – UC Berkeley with protocols by Dr Andrew Huberman – Stanford School of Medicine.

Sleep Fundamentals: QQRT

Quantity: the total amount of sleep. The typical adult needs 7 to 9 hours of sleep per night, which gives sufficient time for deep sleep and REM sleep, so you wake up refreshed and restored. Some people need less, others more, especially babies, teens, and those combating an illness or infection.

Quality: the continuity and structure of sleep. Frequent awakenings (even if you don’t remember) or fragmented sleep represent poor sleep quality.

  • Wearable sleep trackers measure sleep quality through sleep efficiency scores. An efficiency rating of ≥ 85% is a good goal.
  • Note: For some, sleep trackers can lead to anxiety about sleep quality (termed “orthosomnia”), which can paradoxically lead to disrupted sleep. Consider reviewing your sleep scores less often. For example, weekly, not daily, to minimise constant monitoring.
  • For those who don’t use sleep trackers, poor sleep quality often manifests as excessive daytime sleepiness even if they slept sufficient total hours.

Regularity: stick to a consistent sleep schedule. Consistently going to bed and waking up at a similar time each day improves overall sleep patterns and quality by anchoring your body’s circadian rhythm, or internal clock.

  • Aim for consistent bedtimes and wake times with a ± 30 minutes margin of error, whether it’s the weekend or a weekday. No one is perfect about this, but that’s a good goal.
    • In addition to your morning alarm clock, consider adding a “bedtime alarm,” which tells you when to go to sleep.
  • Studies have shown that regular sleep patterns reduce all-cause mortality and may reduce the risk of cancer and cardiovascular disease more effectively than other metrics, such as sleep duration.

Timing: align your sleep schedule with your natural chronotype (morning person, night owl, versus typical sleep-wake schedule). Chronotype is primarily determined by genetics, and yet your preferred sleep time will vary across your lifespan. You can find your natural chronotype using the Morningness-Eveningness Questionnaire (MEQ). Sleeping out of sync with your chronotype will result in poorer quality sleep. But, of course, we have to adhere to life’s demands as well.

What  Happens When You Fall Asleep?

Data on the two types of sleep was published in 1954, then in the 1960s William DeMent carried out studies and coined the name REM (Rapid Eye Movement). Every time someone went into REM sleep they would be woken to do a mathematical task. After day three of selective REM sleep deprivation they started to show signs of paranoia, then to have hallucinations and delusions and by day five they were having aspects of severe psychosis.  This research was summed up by an American entrepreneur called E Joseph Cossman. He summarised it in a single sentence as ‘the best bridge between despair and hope is a good night of sleep’ and to this day that’s exactly what the data demonstrates in terms of basic emotional brain function.

In the first 20 minutes of falling asleep, you enter non-REM sleep, which has four stages, 1 & 2 are light and 3 & 4 are deep non-REM. During these first 20 minutes, your heart rate slows and brain wave activity reduces. After 20 minutes you enter stages 3 & 4 and your heart rate drops dramatically,  muscle tone drops and hundreds and thousands of cells in the Cortex all fire up and then go silent. At around 60 to 70 minutes into the sleep cycle, you return to stage 2 non-REM and at around 90 minutes go into REM sleep. 

Just before you enter into REM sleep a signal is sent through the brain stem to the alpha motor neurons in the spinal cord to prevent them from working. This effectively paralyses your body during this dreaming phase allowing you to dream safely. Your involuntary muscles are not paralysed ensuring you can breathe and your heart continues to beat, nor are the eye or ear muscles paralysed. 

This sleeping cycle continues throughout the night with more 3 & 4 non-REM in the first half of the night and more 1 & 2 non-REM in the second half, along with more REM sleep.

Sleep Deprivation

One of the earliest and strongest effects of a lack of sleep is the absence of motivation, not interacting with the world, not wanting to be social, not wanting to learn, not wanting to exert effort, not wanting to exercise, not wanting to do much of anything.

A lack of sleep will impact every physiological system in your body and every operation of your mind. If limited to 4 hours for one night, there will be a 70% drop in natural killer cell activity; these cells are critical anti-cancer immune cells. A global experiment called Daylight Savings Time is carried out twice yearly in 70 countries with 1.6b people participating. In the Spring, when 1 hour is lost of sleep, there is a 24% increase in heart attacks the following day. Conversely in Autumn, when 1 hour is gained in sleep, there is a 24% decrease in heart attacks. It has also been noticed that in the Spring not only is cardiovascular health at risk, but there is also an increase in diabetes and obesity, poorer mental health, lower cognitive performance, and an increase in the risk of motor vehicle accidents. Lack of sleep reduces levels of testosterone in men and oestrogen in women, and systolic blood pressure increases along with heart rate contractions. The progression into obesity diabetes, cardiovascular disease, mental health issues, anxiety, depression, suicidal ideation, and immune-compromised infection will be mid-term consequences with a longer-term slide into premature mortality.

A group of healthy people with no signs of psychiatric illness or emotional instability were given a full night of sleep and the next day they were placed inside a brain scanner and shown a range of emotional visual images ranging from very neutral to quite unpleasant and negative. The study was to see how the brain reacted to those emotional experiences with and without sleep.  The structure that was initially focused on was the amygdala situated on the left and the right side of the brain. The amygdala is the centrepiece region for the generation of emotional reactions both positive and negative but this study focussed on the adverse, negative aspect. In people who were sleep-deprived relative to those who had a full night of sleep, there was a 60% increase in emotional response rate. This was a dramatic heightening of sensitivity to the initial triggering of the emotional response, and the more the emotion became the more separate the two sets of reactivity curves came from the amygdala.  The question then became why is the amygdala so reactive and uncontrolled when you are absent of sleep? Another analysis was carried out and a structure in the frontal lobe that sits right between your eyes, the medial prefrontal cortex, was investigated. This acts like a control rational mechanism on the deep emotional brain centres, placing the context to an appropriate or inappropriate reaction to a situation. With sleep deprivation, it was found that the connection had been severed so the emotions could not be modulated effectively. A Japanese research group replicated this more rigorously and their published findings had the same response.

Sleep Hygiene Basics

Light & Dark

The hormone Melatonin has many functions, one is to make you sleepy. Darkness allows the release of melatonin to signal the onset of sleep. Bright light, especially at night, potently inhibits melatonin. This causes you not to feel as sleepy and, consequently, to get poorer quality sleep.

  • In the evening, dim the lights in your home to signal the body that it’s time to wind down. Avoid viewing bright overhead lights between 10 pm and 4 am. Here is a simple rule: only use as much artificial lighting as is necessary to move about safely at night. Use low-positioned lights (rather than overhead) and yellow or, even better, deep orange/red lightbulbs, if available; they are less stimulating than typical lights.
  • Minimise screen time at night. If you’re on a screen, dim it way down. Additionally, many computer operating systems show warmer colours at night. There are also apps like f.lux (zero-cost) that allow for dimming. This also applies to mobile phones, if possible leave your phone outside the bedroom.
  • Add blackout curtains or wear an eye mask to maximise darkness in the bedroom.
  • Within 30-60 minutes of waking, go outside for 10-15 minutes of morning sunlight. Sunlight suppresses Melatonin and resets your circadian rhythm. Morning sunlight also triggers Cortisol release to help you wake up and stay more alert during the day. On overcast days look towards where the sun will be as plenty of light (photons) penetrate cloud cover. On bright cloudless days: view morning and late afternoon sun for 10 min; on cloudy days: 20 min; on very overcast days 30-60 min. Consider an artificial daytime simulator source if you live somewhere with minimal light.  If you wake up before the sun is out and want to be awake, turn on artificial lights and then go outside once the sun rises.
  • Looking through an indoor window does not work. Don’t wear sunglasses for this practice if you safely can, but contact lenses and eyeglasses are fine. Don’t look directly at the sun, and never look at ANY light so bright it is painful to view!
  • If you can’t get natural morning sunlight due to geographic location or schedule, artificial bright lights like seasonal affective disorder (SAD) lamps are a substitute, though less effective.

Temperature

Temperature plays a crucial role in sleep regulation and to fall asleep, core body temperature must decrease by approximately 2-3°F (1°C).

  • Keep your bedroom cool (~67°F or ~19.4°C), or use a temperature-controlled mattress cover.
  • Place your hands or feet from underneath the covers to help cool down.
  • Taking a warm bath or shower before bedtime is a science-supported method to improve your ability to fall asleep and improve deep non-REM sleep. The warm water initially raises core body temperature, but subsequent cooling occurs to help to fall asleep.

Food & Meal Timing

The effect of food on sleep largely depends on appetite, circadian rhythm, and personal preference. Experiment with different foods and timing to see what best supports your sleep.

  • For most, eating approximately 2 hours before bedtime doesn’t typically impact sleep. Eating closer to bedtime can increase the likelihood of gastric reflux (heartburn) and impair sleep in some individuals. Again, this is highly individual. If you do, make it a smaller snack or meal, but also don’t try to sleep while overly hungry. Most people can’t.
  • Avoid excessive fluid consumption before bedtime to reduce the likelihood of waking up throughout the night.

Caffeine

The health benefits associated with coffee drinking are good from a health perspective. However, it has nothing to do with the caffeine, It’s because the coffee bean contains a large dose of anti-oxidants, the most powerful being chlorogenic acid. Studies with decaffeinated coffee give very similar health benefits so drink caffeine but limit yourself to about 2 cups of coffee, 3 cups of coffee maximum. Caffeine is a stimulant it does not reduce the need for sleep; it only temporarily masks sleepiness. Once caffeine wears off, a buildup of adenosine, a chemical that promotes sleepiness, causes a “caffeine crash,” which usually occurs in the early afternoon.

  • The timing of drinking caffeine is crucial for sleep quality. So, if you have trouble sleeping, don’t reach for a late afternoon cup of coffee. Instead, consume caffeine early in the day and not within 8-10 hours of bedtime. caffeine has a quarter-life of somewhere between 10 to 12 hours so if you have a cup of coffee at midday a quarter of that caffeine is still in your brain at midnight
  • Note: some people say they can sleep after ingesting caffeine in the afternoon or evening. This is likely due to tolerance and/or differences in how they metabolise caffeine. Do what works for you, but know it can negatively affect sleep structure, including REM duration.

Alcohol

Alcohol is a sedative, not a sleep aid. While a ‘nightcap’ may help you get to sleep quickly, alcohol impairs the natural structure of sleep. You don’t remember how you have slept but the quality is poor alcohol is very good at blocking your REM sleep and disrupting your deep non-REM sleep. Also, even the smallest amount of alcohol causes fragmented sleep.

Taking Naps

Naps can improve cardiovascular health, lower blood pressure, and improve your learning and memory abilities. Negative emotions can be de-escalated and positive emotions increased. However, be careful if you take naps. Try not to nap for longer than 20 minutes because once you go past 20 minutes you fall into the deepest stages of non-REM sleep. If you wake up after about 45 minutes or 60 minutes you’re going to feel almost miserable and worse than you did before the nap because you have sleep inertia, essentially a sleep hangover and it can take you almost an hour before you feel like you’re back up to operating normally. In addition, don’t nap too late in the afternoon (3 pm) and if you’re someone who has insomnia or sleep difficulties do not nap because when we’re awake during the day we build up a sleepiness chemical called adenosine and the longer that we’re awake the more adenosine builds up. After sleeping a full night the brain has evacuated all of the adenosine so that when we wake we feel refreshed and restored. When you take a nap you’re releasing some of that healthy sleepiness

Wind-Down Routine

Much like slowing down a car before stopping, a ‘deceleration’ from the day’s activities is essential for good sleep. Establish a wind-down routine to prepare the body and mind for sleep:

  • Engage in relaxing activities, such as meditation, listening to music, podcasts, sleep stories, or reading a book.
  • Avoid stimulating activities before bed, such as watching television, reading the news, strenuous exercise, or social media.
  • Expect to feel alert ~1 hour before your natural bedtime. This is a naturally occurring spike in wakefulness that sleep researchers have observed and will pass.

Trouble Falling Asleep?

Walk It Out: If it’s taking longer than ~20-25 minutes to fall asleep or back asleep, leave your bed and go elsewhere in the house to engage in a relaxing activity. The goal is to prevent an association between a state of wakefulness and your bed, as this can lead to future difficulties falling asleep. Only return to bed when you are truly sleepy and be mindful not to fall asleep in another location; you want to relearn the association of sleep with the bedroom.

Do Nothing: After one poor night’s sleep, avoid compensatory behaviours such as sleeping later, going to bed early, increasing caffeine intake, or excessively long or late-day napping. These behaviours can disrupt your natural circadian rhythms and may negatively affect sleep-wake cycles—in other words, they will make it hard to get back on your usual schedule.

Mental Walk: If you have trouble falling asleep, take a “mental walk” and visualise walking a familiar route. This technique will redirect your focus away from ruminating thoughts to help you fall asleep.

Other Help – YouTube. If you wake up in the middle of the night and cannot fall back asleep, consider doing a Non-Sleep Deep Rest (NSDR) protocol when you wake up. Enter “NSDR” into YouTube and the top 3-4 options have different voices and durations for you to select from. Or do a “Yoga Nidra” protocol (enter “yoga nidra” into YouTube).

Limit Daytime Naps: Keep naps short (≤ 20-30 minutes) and no later than the early to mid-afternoon to avoid impacting your nighttime sleep.

If you try these protocols and don’t notice a difference, you might be suffering from a sleep disorder. Seek professional help if you experience persistent problems, which might be due to sleep apnea or true insomnia.

Cleansing the Brain

Sleep expert Dr Matt Walker (professor of neuroscience at the University of California, Berkeley) says,

‘We have not been able to discover a single psychiatric condition in which sleep is normal so there is a direct relationship between your sleep health and your mental health’.

One of the functions of emotions when it comes to memory is to prioritise that experience instructing the brain that this information is relevant to us as an organism. During good quality sleep between the initial experience and the later recollection of that emotional memory, the brain has divorced the emotion from the memory so on recollection at a later time, the emotional memory is no longer as powerfully emotional as it was at the time of the experience. The sleeping brain can detox the emotional memory. In a study, a biological model of exactly how this works was carried out studying a sleep group that had eight hours of sleep which was measured. It was found that the greater the amount of REM sleep the greater the amount of emotional detox experienced the next day. 

Something utterly unique happens during sleep, with levels of noradrenaline completely shut off, the only time during 24 hours there is a complete cessation of adrenaline in the brain. (The chemicals noradrenalin (UK) and norepinephrine (US) are the brain equivalent of adrenalin and epinephrine found in the body). The neuromodulator Serotonin is also blocked. So the stress-related chemicals in the brain are switched off during REM sleep.

However, levels of another chemical Acetylcholine increase in the brain. Acetylcholine also acts at various sites within the central nervous system, where it can function as a neurotransmitter and a neuromodulator. It plays a role in motivation, arousal, attention, learning, and memory. There is almost a 30% increase in some brain regions than when awake pointing to REM sleep as the perfect condition for emotional overnight therapy where you can reactivate, experience and process those emotional memories in a chemically safe environment that allows you to strip away the emotion. 

This resembles behavioural desensitisation therapy used to treat trauma, whereby under the care of a qualified psychiatrist or psychologist somebody will be encouraged to recall in great detail some traumatic event and through repetition and with support will be allowed to encounter the experience safely over several sessions so the emotional load of the event is diminished

To be your best emotional self and access positive emotions to their full amplitude, the best and cheapest non-psychological way to enhance your sleep is to sleep an extra 15 or 20 minutes.

Anxiety

Anxiety is probably one of the greatest enemies of sleep and is one of the principal reasons that underlies insomnia. If you have stimulants in your system before going to bed such as alcohol, drugs or caffeine your fight-or-fight branch of the nervous system is triggered and you feel what is called the tired but wired phenomenon. You start to worry, then you start to ruminate and when you ruminate you catastrophise and when you catastrophise you are awake for the next two hours or so. We have the sense that in the darkness of night, things are so much bigger than they are in the brightness of day and we start worrying. A study on the consequences of a cup and a half of strong caffeine intake before bed showed it strips away your deep sleep by somewhere between 15 to 30% . To put that into context if you drop your deep sleep by 30% it would be the same as ageing you by about 40 years. Even if you fall asleep and you stay asleep you’re not aware of the lack of deep sleep that you’re not getting because of the caffeine. Deep sleep is critical for regulating your cardiovascular system and replenishing the immune system, it also regulates your metabolic system, controlling hormones such as insulin that will regulate your blood sugar. Deep sleep will strengthen, consolidate and secure new memories in your brain preventing those memories from being forgotten, deep sleep is also the time when we cleanse the brain of metabolic toxins, particularly those related to Alzheimer’s disease. 

Suicide

It has been found in studies that insufficient sleep is a precursor to suicide. Sleep disruption seems to predict suicidal ideation; suicidal thinking, suicide planning and tragically suicide completion as well.

PTSD

Paul Conti, the renowned psychiatrist, defines trauma as some adverse event that changes the way that our nervous system works such that we function less well in the future. The diagnostic criteria for PTSD is not just being able to fall asleep it’s specifically having repetitive nightmares. As mentioned earlier, in normal REM sleep noradrenalin is switched off and emotions are stripped away from the memory. However, it has been found that PTSD patients have heightened levels of noradrenalin as a basal state as well as during REM sleep so the trauma remains a vivid emotion linked to the memory.

Alzheimer’s Disease

Whilst diet and genetic factors dictate the risk of developing Alzheimer’s in later life, there is causal evidence both in animal models and in human models that if a human being is deprived of deep sleep for a single night the risk of developing Alzheimer’s increases. Sleep deprivation causes an immediate increase in the two proteins, beta-amyloid and tau associated with the development of Alzheimer’s, circulating in the bloodstream and cerebral spinal fluid that bathes the brain. Maiken Nedergaard, professor of neuroscience at the University of Rochester, USA discovered the brain has a cleansing system called the glymphatic system named after glial cells that make it up. This system is switched into overdrive during deep non-REM sleep and washes away the build-up of beta-amyloid and tau proteins. If you’re not getting enough good quality sleep every night it doesn’t mean that you’re going to get Alzheimer’s disease next week or in a year but over time it is now believed through this causal mechanism that insufficient sleep is a risk factor for Alzheimer’s disease. 

Rachel’s Reviving Remedies

17/01/2024 / / 0 Comments

In February 2024 I was invited by AVIXA to speak on a panel at ISE 2024, about mental health in the workplace. Although not an expert in this field, there has been much written on the subject and I shared my findings with the audience. I have included links to my favourite sources but there are many more for you to discover.

There have been several traumas in my life and most go back to my childhood. This is quite common and whilst traumas are often different they trigger a similar response in all of us and are the most common cause of long-term stress, depression and suicide. Gloomy or what? Do not be dismayed it can be reversed and there are remedies for short-term stress and ways of building resilience against medium-term stress. However, if you feel you cannot cope seek medical advice, especially for long-term stress.

Our responses to a situation depend on the context of what is happening. If the situation is traumatic the surrounding narrative should be shared with those you trust or written down. Internalising the trauma will prolong the shame and the blame we all attach to it.

You have to start somewhere and you may be surprised by what my list consists of but it is all backed up by expert research, see links provided. I also recognise we have to live our lives in our own way and this is just a guide to help us improve our mental state and longevity.

  1. On awakening try and remember your last dream and write it down. 
  1. Go outside for a morning walk, preferably within 1 hour of waking and if possible surrounded by nature, fields or trees – 4,000 steps or more is OK.  
  • Look towards the sun, or if overcast where the sun would be for as long as is practicable. This suppresses melatonin and resets your circadian rhythm. It also triggers the release of cortisol to help you wake up and stay alert during the day.
  • If you meet someone wish them good morning, strike up a conversation or at least smile.
  • Links: Dr Andrew Huberman – https://www.youtube.com/ watch?v=WDv4AWk0J3U
  1. Good quality nutrition, how much you eat and when you eat is essential for brain function and a healthy body. 
  • Cut out ultra-processed foods completely. 
  • Boost your gut biome and include amino acids, and protein, at least 30 different fruits and vegetables per week, this can be nuts, spices, herbs, vegetables, fruits and berries. You can also have lean meats and omega-3 fatty acids like oily fish for instance. 
  • Introduce fermented foods such as yoghurt, kefir, kimchee, sauerkraut and kombucha.  
  • Reduce the amount of alcohol consumed. 
  • There are three natural pathways for you to need to consume sugar and the brain’s preferred food is glucose. The food companies know this and put sweeteners in foods and drinks (including zero sugar) to trigger your brain to want more. Be aware too much sugar is bad for you and you will receive the right amount by eating the aforementioned. 
  • If you drink coffee make sure it is during the day, preferably the morning, to enable a good night’s sleep. 
  • Arrange a time of fasting every day, perhaps finish eating at 8 pm and have breakfast at 8 am. This gives the body and brain time to remove dead cells, build muscle from the day’s exercise and repair systems. The longer the fast the better the repair.
  • Links: Dr Andrew Huberman – https://www.youtube.com/watch?v=xjEFo3a1AnI,  Dr Michael Mosley – https://www.youtube.com/watch?v=DpnOVX0Dc5E, Professor Tim Spector – https://www.youtube.com/watch?v=xGY05t_sImc&t=22s
  1. After 40 years of age, you reduce muscle mass, speed and power so exercise is essential for a healthy body and mind and longevity. Daily movement, either cardiovascular or resistance training is very important. 
  1. We are sociable mammals and regular social interaction can impart many emotions to lift mood and happiness and increase metabolic rate and neural output. However, at work, for instance, there is no choice but to interact, therefore be aware of those you interact with. People can be grouped into three sections, those who give you net savings on stress (you feel at ease with), those who are neutral and those who are taxing. Try to avoid those in the taxing section. Link: Dr Lisa Feldman Barrett – https://www.youtube.com/watch?v=FeRgqJVALMQ&t=7385s
  1. Stress happens to all of us and there are tools to help manage and alleviate acute stress. The quickest and easiest way to alleviate acute stress in real-time is the physiological sigh, this immediately slows the heart rate down. Medium-term stress can be handled by training oneself to cope better under stress conditions. This involves taking cold showers or plunges and whilst immersed practising the physiological sigh to bring you to a state of normality. The more you practice the better you will be at regulating and coping with stress.  For long-term stress or at any point where you feel you cannot cope, seek qualified medical help. Links: Dr Andrew Huberman – https://www.youtube.com/watch?v=ntfcfJ28eiU, Dr Peter Attia & Dr Paul Conti – https://www.youtube.com/watch?v=HoGBkn_1Z14&t=6s
  1. You need good sleep to allow your brain and body to rejuvenate itself. The important factors here are the quantity, the quality, the regularity and timing (Chronotype) of sleep (QQRT). Try having 7 to 9 hours of the best possible sleep per night (no phones allowed). This should be in a darkened bedroom. Go to bed and arise within 30 minutes of your sleep routine to form a habit and enhance your circadian rhythm. Temperature plays a large part in sleeping and your bedroom should be cool – around 19°C. Place arms, hand and feet outside of the covers, take a hot bath or shower before going to bed – this will actually cool down your core temperature. Link: Dr Andrew Huberman – https://www.youtube.com/watch?v=h2aWYjSA1Jc&t=118s

Mental Health in the UK

02/01/2024 / / 0 Comments

Mental health refers to our emotional, psychological and social wellbeing. It affects how we think, feel and act. It also impacts how we cope, interact and form relationships with others, as well as our daily functioning. Most but not all mental health problems around the inability to cope are trauma-related, whether it be from childhood, watching bad things happen on the news, broken relationships or having a poor lifestyle. We have to deal with traumas every day but when the emotional impact outweighs the logic of the situation and we can no longer cope then anxiety and depression begin to take over.

The UK Office of National Statistics states that for the year, up to July 2023, the leading cause of death is heart disease followed by dementia & Alzheimer’s, cancer, strokes and lung diseases.

Leading factors for heart disease and strokes are high blood pressure, high cholesterol, diabetes, smoking & smoke exposure, obesity, unhealthy diet and lack of physical activity. Obesity rates for adults aged over 18 years have increased year on year and now stand at 26% of the population, with 64% estimated to be overweight.

Depression is caused by a combination of genetic, biological, environmental and psychological factors. Emotional distress and depression have been identified as new risk factors for coronary heart disease and those people with a known heart disease are at risk of suffering from depression. The two conditions often coexist. The risk factors for both conditions are similar, sedentary lifestyle, obesity, smoking, poor diet, overeating and excessive alcohol consumption.

Statistics show that anxiety disorders are the most common and can affect your body as well as your mind and can be different in each case.  The trend in the number of cases with mental health disorders reported has risen with self-harm and people having suicidal thoughts increasing the most.

  • Heart issues and other health conditions can lead to feelings of anxiety, depression and fear.
  • More than 15 million people (30%) of the UK population live with one or more long-term mental health conditions.
  • 1 in 4 people will experience a mental health problem of some kind each year in England. 1 in 6 people report experiencing a common mental health problem in any given week in England.
  • Antidepressant prescriptions have almost doubled in the last 10 years, with 85.6 million being issued in 2022.
  • 1.75 million people were in contact with NHS mental health services at the end of June 2023, the majority of these were with adult services.

The groups of people more at risk from mental health disorders are those facing social inequality and disadvantage, discrimination and social exclusion, and those going through traumatic experiences and differences in physical health. These include LGBTQIA+, black people, young women 16-24 years, the homeless, those taking illegal substances and those in contact with the criminal justice system. These groups face more traumas than most and it is their traumas that need to be addressed and understood to alleviate the situation.

It was estimated that in 2023 half of UK workers have ‘burnout’, mental ill health or work-related stress, costing the economy £28 billion annually. Signs of burnout are: feeling tired or drained most of the time. Feeling helpless, trapped or defeated. Feeling detached and alone in the world. Being cynical with a negative outlook. Having self-doubt and taking longer to complete tasks. Feeling overwhelmed.

Perimenopause and menopause in women affect performance. A survey of 2 thousand women instigated by the House of Commons Women and Equalities Committee found that 75% reported problems with memory and concentration with 69% reported feeling anxious or depressed.

The Covid pandemic caused many people to suffer from stress and the current cost of living crisis is having a large impact on coping with basic needs. The increase in people working from home has mixed results. For those not having the stress of travelling and being with family all day, it can be positive. For those working at home on their own, the lack of contact with other people can have a detrimental effect.

Much research has been done on the causes of anxiety and the current consensus is to have a healthy lifestyle. Of course, this has benefits for the whole of the body’s functions, especially those suffering from heart disease, the number one killer of people in the UK. The chemicals that are required for cognitive brain function come from the food we eat so, logically, we should consume food that will make our gut biome thrive.

The statistics point to a situation that is worsening and there are probably many contributing factors for this. Whether we like it or not the NHS provides a GP service that is governed by throughput of patients with 10 to 20 minutes allocated for a possible mental condition that requires more investigation. The prescription of drugs may be appropriate but in many cases just provides a short term fix which masks the underlying real problem. However, we should take the initiative to do as much we can to look after ourselves in order to try and prevent such conditions overtaking our lives, be curious of our self, take responsibility of interacting with others and being compassionate. Physical and mental health should be looked at as one because it is our biology that determines who we are and how we feel. A daily practice of looking towards the sun, breathing techniques, exercise, quality time with people, proper sleeping patterns in full darkness, proper nutrition, challenging your thoughts, keeping a diary of when you feel down, and connecting with nature will improve your mental well-being.

Trauma – Healing the Shame

28/12/2023 / / 0 Comments

When I remember my informative years there were two major issues I faced, both of which I could not, dare not, talk to anyone about. These issues have stayed with me throughout my life and I now recognise them as traumas. I found a conversation between Dr Paul Conti and Dr Peter Attia in my trawl of podcasts on this subject.

Paul Conti, MD, is a Psychiatrist who completed his training at Stanford and at Harvard, where he served as Chief Resident. He wrote ‘Trauma the Invisible Epidemic’ and was hosted on Dr Peter Attia’s podcast, The Drive. He described trauma as a sense of angst or frustration. A sense that something isn’t right, anger and resentment. Here are my favourite moments and I would urge anyone to watch any of the podcasts Paul Conti has been involved in. https://drpaulconti.com/  https://peterattiamd.com/paulconti/

Trauma can be carried within us forever if not addressed – the burden of shame, inadequacy, and self-blame. This can lead to frustration and anger, even bitterness and lead us away from being a good person in the world, being more isolated from care and concern for others and that is a very small step before the use of abusive substances because of the injustice of feeling awful. This is a self-seduction that leads to a path of short-term healing at the expense of a long-term solution. 

We face traumas all the time in our lives and this can lead to seeing those traumas through the lens of shame, “it was their fault”, “they are not a worthwhile person”, “they can’t make their way in the world”, “they cannot feel safe”, “no one will like them”, “no one will care for them”, “they’re not good enough”. Many feel persecuted internally from the trauma and this internal dialogue is played over again, blinding their true potential. Some feel the negative narrative in their head is a justifiable self-punishment for the trauma which is self-reflexive as other people hurt them.  Once they start talking about the event that led to the trauma and unpacking it then they realise there is no shame to feel but the logic doesn’t matter if the emotion is telling them something different.  When you are aware of the cause and reconstruct the narrative, the emotions do not have to control you. 

Memories only have meaning through the emotions attached to them, so if a trauma introduces an emotion of shame, the previous memories are also altered, so you don’t remember how good things were before the trauma.

Pillars of Mental Health
The Pillars of Mental HealthDownload

Living in Harmony – Ancient Daoist Philosophy – Yin Yang

22/12/2023 / / 0 Comments

I have included ancient medicine philosophy because modern thinking now recognises that nature, exercise, breathwork, meditation, acupuncture and the gut biome, have an important part to play in our physical and mental health.

Daoist philosophy dates back to 500 BC and was founded in China. The Daoists followed their observations of nature and believed the world was made up of opposites and without these opposites, the world would not function. They viewed human existence as being no more important than any other living organism and for harmonious living there had to be a balance with nature. Life was seen as a journey similar to a river flowing, with a general idea that without any intervention most outcomes would be positive ones, therefore there was no need to overly worry about problems on the way. Qi (pronounced Chee) was the life force energy and had three centres or Dantian. The lower Dantian probably seen as the most important was in the centre of the body approximately 4 fingers width below the tummy button. The other two centres were in the chest near the heart and in the middle of the forehead between the eyebrows.

The Daoist symbol of Yin Yang has become a common icon of harmony and balance. The idea behind yin and yang is paradoxical. The black and white stands for two opposing forces that are also complimentary. This constant mutual attraction and repulsion causes contestant change, that manifests in what we call the universe. Phenomena like life and death, winter and summer, matter and emptiness are all physical manifestations of Yin and Yang. 

In the ancient masterpiece written by Lauzi called the Dao De Jing, he talks about the great mother, being the mysterious, receptive and passive force represented by the black part of the symbol, and the active force that is most visible and prominent, represented by the white part. The symbol has a black dot in the white area and a white dot in the black area, representing the idea that both parts carry the seed of one another. Day carries the seed of dawn and night carries the seed of dusk. 

There are no absolutes when considering what is Yin or Yang, it depends on the situation. This is what Lauzi wrote in Chapter 2 of the Dao De Jing:

  • Being and non-being produce each other
  • Difficult and easy complement each other
  • Long and short define each other
  • High and low oppose each other
  • Fore and aft follow each other

Yin represents a series of characteristics that are – generally – passive, empty, low, cold and dark in nature. Things like passivity and emptiness seem of little value, but they harbour an immense power. Yang can be described as the active element, that’s generally found in things like light, warmth, height, fullness, aggression and speed. One cannot exist without the other, and whether one is Yin or Yang depends on the relationship between the two. An example is the functionality of a mug. Yang is the material the mug is made of while the emptiness in it is the Yin element. The mug cannot function without both parts. Without the space in our universe, the solar system would not function. 

Society’s Yin passivity is essential for every form of accomplishment e.g. After a hard gym session, muscles are built in bed when the body can rebuild the muscle tissue. Yin is receptive to flowers waiting to be pollinated. Lauzi described Yin as soft comparing it to water in relation to hard Yang rock but water can shape rock over time through erosion. An atom has a positively charged core surrounded by negatively charged electrons and the Yin Yang pattern is the essence of binary code, which solely consists of ones and zeros. Lauzi wrote that no movement is possible if an opposite movement has not occurred:

  • If you want something to return to the source
  • You must first allow it to spread out
  • If you want something to weaken
  • You must first allow it to become strong
  • If you want something to be removed
  • You must first allow it to flourish
  • If you want to possess something
  • You must first give it away

Yin and Yang complement each other, create each other, support each other, regulate each other and transform each other. Non-doing or effortless action, also called Wu Wei by the Daoists, is a practice that harvests the power of both Yin and Yang—knowing when to act and when not to, so our actions won’t be strenuous but more in a flow state. By embracing Yin we become more receptive to the natural course of the universe and in many cases, there is no need to act, many problems solve themselves and taking action can worsen a situation. By backing off we enter a Yin state but the key is knowing when to act or not. Too much passivity can be as bad as too little. No matter what you do there will always be a dark and light side to everything. Without opposites, there is nothing to support yourself in the hierarchy of things.

Qigong

Most forms of Qigong (pronounced chee gung) originated from Daoist practices focused on cultivating and maintaining personal health. Included in those practices were exercises made up of postures, breathwork, and intention setting. The exercises initially mimicked the movements of animals and then evolved as people gained a deeper understanding of human anatomy and physiology. 

Qigong follows traditional Chinese medicine principles, which claim that Qi flows through our bodies. Accordingly, people tend to feel their best when Qi travels freely, but health problems can crop up if the energy becomes stagnant or blocked in certain areas of the body. Through simple poses and patterned breathwork, Qigong can remove obstacles to promote a healthy flow of Qi. Physical movements are coordinated with breath through the repeated practice of exercises. Once proper form is achieved, work on turning those exercises into moving meditation or finding the change in energy within the postures, movements, breathing patterns, and transitions can be practised.

The slow, gentle movements are believed to warm up your tendons, ligaments, and muscles; mobilise the joints; and promote the circulation of body fluids (like blood, synovial, and lymph). Meanwhile, deep breathing, which plays a central role in Qigong, calms the sympathetic (fight-or-flight) nervous system and activates the parasympathetic (rest-and-digest) side of your autonomic nervous system, which regulates involuntary processes like breathing, heartbeat, and digestion. By tapping into the parasympathetic nervous system, Qigong can help reduce stress and anxiety, which has many health implications. From the traditional Chinese medicine perspective, Qigong optimises the flow of energy in your body to help mitigate or attend to any number of conditions.

Acupuncture

The practice of acupuncture grew out of ancient Chinese phylosophy’s dualistic cosmic theory of the Yin and the Yang. The first documentation of acupuncture that described it as an organised system of diagnosis and treatment is in The Yellow Emperor’s Classic of Internal Medicine. Acupuncture points are believed to stimulate the central nervous system. This, in turn, releases chemicals into the muscles, spinal cord, and brain. These biochemical changes stimulate the body’s natural healing abilities and promote physical and emotional well-being.

The forces of Yin and Yang act in the human body as they do throughout the natural universe as a whole. Disease or physical disharmony is caused by an imbalance or undue preponderance of these two forces in the body, and the goal of Chinese medicine is to bring the Yin and the Yang back into balance, thus restoring the person to health.

An imbalance of Yin and Yang results in an obstruction of the life force, or Qi, in the body. Qi flows through 12 meridians, or pathways, in the body, each in turn associated with a major visceral organ (liver, kidney, etc.) and with a functional body system. Acupuncture is designed to affect the distribution of Yin and Yang in these channels so that the Qi will be enabled to flow freely and harmoniously.

Living in Harmony – Ancient Buddhist and Hindu Philosophy

15/12/2023 / / 0 Comments

Another set of practices based on Eastern philosophy that have gained popularity and acceptance in the West are Mindfulness, Yoga and Transcendental Meditation.

Mindfulness in Buddhist Psychology

Buddhist psychology is an in-depth examination of the self that aims to lead humans to a flourishing life, while mindfulness meditation is a central factor in helping one to live such a life. Buddhist psychology affirms that there is no such thing as a permanent, unchanging self and further contends that suffering pervades human existence and is chiefly caused by one’s greed, hatred, and delusion concerning what is felt and seen, as well as an illusory belief in the notion that there is an independent, permanent self. According to the Buddha, the only way to eradicate human anguish or suffering is to remove the attachment or craving of our mind toward various things or concepts to which we are attached. Mindfulness meditation is one of the most important elements of the Buddha’s “noble eightfold path” to end suffering and instil wisdom. Principally, mindfulness in Buddhist teaching is viewed as a fundamental pathway through which to become aware of the causes and sources of suffering and to attain enlightenment or awakening, thereby enabling the individual to be less egotistical and obtain insight into the state of “no self.” According to Buddhism and its Chan School, when an individual has truly acquired complete enlightenment or insight into the “non-self,” they will have achieved full freedom of the mind.

In the West, it is understood either as a process of self-observation, as a disposition or kind of cognitive ability as a set of skills for self-regulation or as a disposition or kind of cognitive ability. Although there is some confusion regarding the differing definitions of mindfulness in terms of awareness, attention, and attitude a widely adopted description is that it is a particular way of paying attention, a process of non-judgmental awareness, and an attitude of openness and acceptance. As an essential agent of functioning mindfulness, mindfulness meditation is a way of looking deeply into oneself in a spirit of self-inquiry and self-understanding by a process of dis-identification or de-centring concerning the contents of the mind, and an experiential movement into a broader domain of consciousness which can make us aware of what we are beneath the image of the ego. This detached awareness reduces an individual’s clinging to the contents of their mind that are associated with the person as themselves. Such a shift in perspective is called “re-perceiving” who found that this is predominantly how mindfulness works in therapy. Ultimately, the mindfulness of both Buddhism and psychology is viewed as an important way to understand the nature of the self and to obtain spiritual well-being.

Extensive evidence exists to suggest that cultivating a mindful or meditative attitude toward oneself and others, which we have conceptualised as the MS, is of great benefit to one’s health and well-being. As a theoretical prediction based on a review of empirical research, we posit that MS can also be an important intermediary between mindfulness intervention and mental health problems, and in promoting well-being. More generally, we propose that the MS is an applicable concept with which to describe and predict the higher level of self-development of those who grow up in a Buddhist culture and those who engage in a long-term practice of mindfulness meditation. However, further empirical study is required.

Indian Traditional Medicine – Ayurveda, Yoga and Transcendental Meditation

Ayurveda is considered one of the oldest of the traditional systems of medicine accepted worldwide. Ayurveda believes that the entire universe is composed of five elements: Vayu (Air), Jala (Water), Aakash (Space or ether), Prithvi (Earth) and Teja (Fire). These five elements are believed to form the three basic humors of the human body in varying combinations. Three humors; Vata dosha, Pitta dosha and Kapha dosha control the basic physiological functions of the body. Considering the bodily constitution, pathological history, the Dosha characteristics, lifestyle and environmental conditions in an individual’s routine lifestyle, Ayurveda has many treatment strategies for promoting well-being to individuals. 

Ayurveda employs five karmas (actions) that are used for the removal of toxins from the body tissues, rejuvenation of the body, cleansing and enhancing longevity. Ayurveda has eight disciplines for the treatment of internal medicine, psychological disorders, paediatrics, the study of geriatrics, surgical treatment, ophthalmological treatment and toxicological treatment.

Yoga originated in India in ancient times. Through its therapies and diagnosis based on pulse and analysis of the state of an individual, it suggests meditative exercises and lifestyle management to obtain tranquillity and improve health. The Asanas (postures) of Yoga are applied in various clinical and nonclinical conditions for curing various physical and emotional conditions.

The origins of Transcendental Meditation (TM) have been lost. Still, it is believed to have been delivered to man about 5,000 years ago by the Hindu god Krishna, then repeatedly lost and restored as outlined in the Bhagavad Gita and the teachings of Buddha and Shankara. It is thought to be a lost form of meditation that traces back to the Yoga Sutras and was derived from an old Hindu technique.

This knowledge of transcendence (traditionally known as yoga), which means the mind settling effortlessly into silence, is a powerful key for unlocking your inner potential for self-healing and personal growth because it is simple and natural and therefore works for everyone. Frequently, those who have learned, or even taught, other forms of meditation, are astonished when they learn TM that the simplicity and effectiveness of their new knowledge produce results that may have eluded them for years.

TM is not concentration or visualisation, nor is it control or even mindfulness. Using a mantra (or sound) upon which to gently and innocently rest our attention, we simply allow the mind the freedom to follow its natural tendency towards happiness, and it will settle spontaneously into silence. This unique approach, passed on during personal instruction by a teacher trained as directed by Maharishi Mahesh Yogi, comes from the ancient Vedic tradition of India.

The resulting peace (sometimes, and increasingly, blissful) allows the body also to gain very deep rest (much deeper than sleep), in which it can dissolve even its deepest stresses accumulated as a result of life’s worst traumas. As we emerge refreshed and revitalised from the silence of meditation, this has the potential to produce sometimes dramatic improvements in any area of our life, as indicated by a vast and ever-increasing body of research over the last 45 years. However, for most people, the biggest results come gradually and comfortably over time.

The content on this website is not intended to constitute or be a substitute for professional medical advice, diagnosis, or treatment. Always seek advice from a qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on this website.

rachel@have-harmony.uk +44 7300 202290

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