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This year the blog has had over 6,830 views from 47 countries and we have you to thank! We would also like to thank our wonderful contributors who have allowed us to cover diverse topics such as prejudice in mental health, brain stimulation,  academic/creative writing, peer support, schizophrenia and the media , creative practise and many others.

We have no new content this week, but there’s plenty of fantastic posts from the last few years which we would invite you to browse through. As always we would welcome some new material so please do get in touch.

 

 

 

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Miguel Granja Espirito Santo -Does it work, or does it not? What to look for when considering ‘alternative’ therapies.

blogpicbrainTypically, my point of view on the matter of alternative medicine or treatments, is pretty simple. If it has a prefix before medicine, it is not medicine. Medicine, is a science, and as a science it should be susceptible to intense scrutiny and review, open to change, and open for criticism. Many of the prefixed ‘Medicines’ do not pass this standard.

Many people with mental health issues are looking for new treatments, therapies or drugs, and during this search may come across things like hemp oil, colour therapy, aromatherapy, acupuncture and magnetotherapy (not to be confused with magnetic stimulation).

Sadly, not everyone has had the benefit of learning about empiricism, control groups, and placebo effects; nor is everyone aware of pseudo-science ‘wooisms’ that are aimed at tricking you into thinking that it is scientific.

So, when considering some form of alternative treatment ask yourself, and/or the other person trying to sell it to you (yes, they will try to sell it to you) these things:

1:  Ask how it works

This is probably the best question. Ask how it works, and if you get an arm-wavy, exoteric, angelic answer, it is probably something you should avoid. Also be aware of the ‘bait and switch’, where something may work for one tiny aspect, and practitioners will try to extended to everything. One interesting example is Yoga. Many practitioners make claim about the benefits for mind and body, and suggest that doing specific routines can heal your anxiety, or cure your depression.  However, any of the benefits that people have from doing yoga are exercise related and not yoga specific. This rose in a field of daisies  effect can also be seen in media coverage surrounding the Medicine Nobel Prize in 2015, where Artemisinin a traditional Chinese Medicine, was scientifically tested and found to be an effective anti-malaria compound. Despite the original compound being marketed quite differently and not originally considered to have anti-malarial properties, the finding of some effectiveness gave way to a barrage of vindication articles about alternative medicine.

Here’s a list of ‘alternative’ therapies and how they work. Notice that many of the explanations given are either based on some esoteric, mystical explanation, or on pseudo-science that defies logic:

  • Homeopathy: giving patients medicines that contain no medicine whatsoever. You fight the illness with a diluted version of a substance that can cause your ailment. This is because water retains ‘shape memory’ of previous substances that were diluted in it will act as some form of inoculation. By this logic, we are all drinking poop water.
  • Reiki: Literal arm waving above someone’s body whereby you transfer some form of energy (or remove it?) and you cure someone of their pain or condition.
  • Angelic Reiki: as above, but angels power you up, like a videogame bonus.
  • Aromatherapy: smelling certain smells will treat specific things, and make you feel better.
  • Colour therapy: as above but with colours, possibly auras have something to do with this too, the website is not very clear. You can also buy a colour making machine for a reasonable price at the end of the page.
  • Acupuncture:  So this one is a controversial issue, because there are some good studies that show that it may work for back pain. However, there are no biological mechanisms offered to explain the effects and the studies are rarely double blind. But the original explanation for this treatment is that all sorts of pain, psychological or physical, lead to Qi blockages (life force -you know what it is if you ever watched any Japanese Anime). By placing needles in these specific blockages you break them down and restore the life force flow, thereby feeling better.

2: Are the [insert treatment/therapy] results’ published in any reputable medical/psychological journal?

Many times alternative therapies only refer to old books, or in-house conducted studies. This is highly dubious because they are not peer-reviewed. Peer review is, perhaps, the most important ‘bullshit’ detector that there is in science; if the study or idea does not hold up to the scrutiny of academic peers then it is no good. Peer-review usually works by having experts in the field carefully read the contents of a report and identify any flaws in the experimental design, statistics and interpretation of results. The author will receive numerous comments on their manuscript to which they have to answer to the satisfaction of the reviewers.  This creates an exchange between the author and reviewers which aims to raise the scientific quality of the report. The author of said report may disagree with the comments of the reviewer and reply with added evidence in the manuscript. Or, they could simply just directly address the reviewer’s concerns by doing an extra experiment, or doing the data analysis a different way. A little caveat to this is, if you send a study about colour therapy to Journal of Alternative and Complementary Medicine, the peers reviewing it may have a vested interest in publishing the report, even if it does not survive the highest scientific standards. Therefore, extra care should be taken when reading about the results and interpretations.

3: Is the study for the [insert treatment/therapy] double blinded?

This is important! Having a controlled, double blind study, where both the researcher and/or subject are unaware of the experimental condition, is the gold standard of good science. If you cannot find research for the treatment, or the ‘expert’ cannot answer it is probably best just to ‘#forgetaboutit’.

An excellent example of the importance of the double blind design was highlighted in a study [1] published in the journal Nature. In this study it was found that white blood cells release histamine (which is very important for the immune system) when exposed to a very diluted solution of specific antibodies (1X10129 dilution factor, which technically it is not a solution because at this factor there would be no actual molecules of compound left ). This release was observed via microscopy and with staining techniques which change the colour of the cells, and allowed researchers to count those which had reacted to the solution. Sir John Maddox, then editor of the journal, published this article on the condition that Dr. Jacques Benveniste, open their lab for a close examination and allowed the study to be replicated [2]. Part of the team, and surprising everyone, was James Randi a professional magician, and master of all tricks, who was invited to detect any subterfuge. The team sent by Maddox accurately pointed out that, when counting the number of blood cells that supposedly reacted to the homeopathic solution, the experimenters were not appropriately blind to which condition they were counting for [2,3]. In the end of the counting, when they saw that the control group did not have an appropriate count, the experimenter thought ‘this is not right’ and would recount. This lead to an obvious experimental bias where the results that fit with the experimenters’ expectations were more likely to be accepted. Having found this, the investigating team asked the experimenters to repeat the study, using a stricter blind procedure:

One person codes the samples, these are given to another who is unaware of the initial coding and re-codes them again, then another experimenter does the counting.

The above procedure was the one mentioned in the study, but typically one person codes the samples or conditions, and gives to another experimenter who does not know code and s/he does the analysis. After repeating the statistics, no significant differences were found between blood cells which has been exposed to homeopathic solutions and those which had not.  This highlights the importance of the double blind procedure. Human brains are easily tricked into bias, and perceiving  patterns where they do not exist, therefore make sure you look for the double blind design.

Deciphering the science based treatments from those which are not can be tricky, particularly with the continuous arrival of new alternative therapies. However, these 3 questions are probably sufficient for you to start developing your own bullshit detector, and focus on those treatments that actually improve your well-being.

Miguel is a PhD student in Cognitive Neuroscience, and currently is working on Brain responses to body abnormalities. lpxmg4@nottingham.ac.uk

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References: 

[1] Davenas, E., Beauvais, F., Amara, J., Oberbaum, M., Robinzon, B., Miadonnai, A., … & Sainte-Laudy, J. (1988). Human basophil degranulation triggered by very dilute antiserum against IgE. Nature, 333(6176), 816-818.

[2] Maddox, J. (1988). Waves caused by extreme dilution. Nature, 335, 760-763.

[3]Maddox, J., Randi, J., & Stewart, W. W. (1988). ” High-dilution” experiments a delusion. Nature, 334, 287-290.

 

 

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10,000 signatures needed, a selfie post card campaign and a one day conference…… Josephine NwaAmaka Bardi responds to the question, why mental health in higher education?

‘The challenge facing individuals with experiences of mental ill-health is to retain, or rebuild, a meaningful and valued life and like everyone else, to grow and develop within and beyond the limits imposed by their cognitive and emotional difficulties’ [1].

My passion to Raise Awareness of Mental Health in Higher Education began from my interaction with students who had experiences of mental ill-health. It broke my heart to watch, listen and hear them cry. They cried and I cried because there was very little that I could do at the time. Following this experience I was motivated to write a blog piece discussing the importance of mental health awareness in higher education.

Soon after, I started the Raising Awareness of Mental Health in Higher Education campaign, after receiving a successful ESRC PGR grant to host an event. Nothing was more important than to host an event on mental health in higher education. An event that will bring a diverse group of people together to dialogue on the issue of mental health in higher education. Therefore, the Raising Awareness of Mental Health in Higher Education (RAMHHE) conference will be on the 10th October 2016 at the University of Nottingham. The conference is open to staff and student at the University of Nottingham, Warwick and Birmingham. It is also open to service providers and speakers from all over the UK.

The objective of the RAMHHE conference is to promote an anti-stigma and inclusive day, where people can express their views and perceptions of mental health and recovery through collective dialogue. In order to meet this objective, RAMHHE aims to provide a social learning space.

‘Recovery is about building a meaningful and satisfying life, as defined by the person themselves, whether or not there are ongoing or recurring symptoms or problems’ [2].

‘Recovery is not about ‘getting rid’ of problems, it is about seeing the individual beyond their mental ill-health experiences, their abilities, possibilities, interests and dreams’ [1].

There will be inspirational and motivational speakers with lived experiences of mental ill-health and recovery, mental health service providers with information on mental health and wellbeing and mental health practitioners to answer any questions that attendees may have. Information from the conference will provide an interdisciplinary insight into how to raise awareness of mental health in higher education.

I have also developed the RAMHHE16 selfie post card, so that people can handwrite or print, snap and tweet to #RAMHHE16.

blogI believe in the power of many, so in addition to the conference and RAMHHE selfie post card campaign, a petition had been submitted and we require 10,000 signatures before the government will respond to the call to debate the issue of mental ill-health in higher education. Please click the link or scan the QR Code to sign the petition. Please remember to check your email and click the link from the house of parliament to sign the petition.blog2.tif

Thank you to all of the people who have shown tremendous support by signing the petition and tweeting their selfie post cards to #RAMHHE16. It is my hope that with the combination of the three campaign strategies and other supporting efforts, we will collectively make enough noise to sensitise the government about the prevalence and incidence of mental ill-health in higher education.

 Josephine NwaAmaka Bardi is a Registered Mental Health Nurse, and an Economic and Social Research Council PhD student on the mental health and wellbeing pathway.  Contact: josephine.bardi@nottingham.ac.uk

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For more information and sources of support:

StudentMinds

UoN Counselling Services

NightLine

UMHAN

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References

[1]  Repper, J. and Carter, T. (2011) ‘A review of the literature on peer support in mental health services’, Journal of Mental Health, 20(4), pp. 392-411.

[2] Shepherd, G., Boardman, J. and Slade, M. (2008) Making recovery a reality. Citeseer.

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Call for content

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Dear reader,

Do you have something to say about mental health, integrated health care or wellbeing? Are there any issues that you feel passionately about and would like to communicate to a wider audience?

Well good news….we are looking for content and would love your input! We would welcome any content broadly related to mental health and health care. This could be anything from personal accounts to discussions about recent research, current affairs or interesting books (and everything else in between!).

The blog really does depend on your kind contributions and support and we would really love to hear from you, so please don’t hesitate to get in touch with any ideas you may have.

Kat Dyke, PhD Student, Psychology (lpxksd@nottingham.ac.uk)

Charlotte Horn, Medical School (msxceh@nottingham.ac.uk)

 

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Josephine NwaAmaka Bardi -Giving higher education students a voice about their mental health

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Recent research I carried out has brought home to me how difficult it is for students to be honest about their mental health. I am a mental health nurse currently doing a PhD in mental health and wellbeing. A couple of months ago, I decided to conduct participatory action research on mental health, to give students a voice and opportunity to participate in a mental health research project. However most of the students that I invited refused to participate.

But who can blame this student? With the stigma, shame and social isolation associated with mental health, it is no wonder that higher education students want to be seen as “normal”.

As a mental health nurse, I am very aware of what the Nursing and Midwifery Council (NMC) Code of Conduct says about my responsibility and accountability to patients. However, there is no code on my responsibilities to vulnerable students who do not have a diagnosis of mental illness, neither is there a code for the ones with a diagnosis who refuse to disclose.

The question is why mental health education is not a significant part of university student inductions, health promotion campaigns and mental health awareness initiatives? It is not enough to put up A4 posters, leaflets and sign with messages like “confidential counselling team”, “feeling stressed about your exams, want to talk it?”  Stigma, shame and social isolation seems to ring through the information leaflets.

Experiences of mental health among higher education students are not limited to the student alone, but friends and family members may also have a diagnosis of mental health. This is huge mental responsibility for any student, in addition to studying to achieve academically.

Higher education authorities must recognise the importance of the student voice in facilitating help-seeking behaviour among higher education students with experiences of mental ill-health. The time has come to prioritise the voice, opinions and experiences of mental health among higher education students, so as to provide a platform for students to express their views on their mental health without the fear of stigma, shame and social isolation.

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Josephine NwaAmaka Bardi is a Registered Mental Health Nurse and an Economic and Social Research Council PhD student on the mental health and wellbeing pathway. Contact: llxjnb@nottingham.ac.uk

 

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For more information and sources of support:

Graduate School advice about mental health

Mind

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Christina Ralph-Nearman -A consideration of the ‘Thin ideal’

1930249_43290628272_1883_nEliminating eating disorders and investigating the roots of these issues is a passion of mine. While I have never struggled with an eating disorder myself, I have personally experienced dear friends both die from and overcome these disorders.  It is a serious issue that impacts many.  As a scientist investigating eating disorders, I hesitate to share that I am also a former fashion professional.  However, being a part of these two unique worlds of science and fashion, hopefully gives me experience and insight.

Eating disorders take more lives than all the other mental illnesses [1], and is a growing epidemic in children through to adults, effecting both males and females.  Recently, in the United Kingdom alone, the hospitalisations in one year (2012/13) for eating disorders rose 8% overall, and these types of hospitalisations often result in longer periods of hospitalisation than for all other admissions [2].  Sadly, eating disorders take the lives of females ages 15-24 years, 12 times more than all other causes of death [3].  The underlying roots which propel these disordered eating behaviours forward into dangerous and life-taking habits and illness are still unclear, including the role and impact of body image.

Much of the main focus regarding eating disorders seems to be on anorexia nervosa and the ideals of attaining an emaciated body, which is often blamed on the influence of the fashion and entertainment industry.  Interestingly, the most suffered eating disorder for women and men combined is currently binge eating disorder (BED), which affects nearly half of all eating disorder sufferers[1].  BED is characterised by overeating several times a week for over three months with distress. Whilst eating disorders continue taking the lives of people of all shapes and sizes, genders and ethnicities, and both malnutrition and obesity put an incredible strain on the body and lives, the main message has been to understandably eliminate “thin-ideal” and also to embrace the “real” larger body-types, for women in particular.

Within the fashion industry body-size is also a delicate subject, and many who enter the fashion model profession have naturally slimmer frames.  Whilst it is necessary to develop some type of guidelines and laws to protect fashion models (in many aspects of their profession), a Body Mass Index limit to avoid unhealthily thin models from gaining employment may also strip the means of earning a living for those who are not able to gain weight easily (in their natural state).  Just as some people naturally have a more overweight tendency and body shape, there are others who naturally have the opposite issue.

I will never forget a female fashion model from South America in tears sharing with me the frequent rude comments made about her body size face-to-face, and under her social media photos.  Perhaps many felt justified to tear down what they assumed was her goal and the “thin-ideal”, not realising that not everyone is trying to lose weight or desires the “thin-ideal”.  This particular model shared that she always struggled to gain more weight, as she came from a culture where curvy is the ideal body type for women, and was brutally bullied growing up as a very slim person.  Now this bullying continued, even in a new country, again, for not having a curvier, more voluptuous body type, and it was painful.  Seeing many struggle in many ways, brought personal awareness of the importance to consider all different shapes and sizes, in our attitudes, comments, and in how to protect anyone from being bullied for their size.  A larger, curvier body, as well as a very slim body does not make someone more or less a “real” woman.  Also, women of all shapes and sizes suffer from eating disorders.  Assumptions, rude comments, and bullying, should not acceptable whether someone is underweight or overweight or average weight.  There is a danger when working with those struggling with an eating disorder to demonise those with body size closer to the unhealthy goals the person may hold. While this may be done with the hope that these goals will be dropped, bringing health and healing, we may be more effective if we each contribute to reducing a spirit of competitiveness, and the “us” and “them” messages, even pertaining to outer appearance.  Messages that someone is not “enough”, “real”, or “worthy” because of their size and shape – should never be acceptable.  It may be that instead of labeling the “thin-ideal” as the evil to avoid, we all may work to develop an embracing society, which cheers on others beauty (of all sizes), gifts and talents, while also cheering on our own.

It is also important to research the facts behind these issues, so that we may develop the most effective safeguards.  My current research focus is investigating these underlying roots.  My hope is to help develop more effective prevention and treatments with the goal of saving more lives, whilst supporting more inclusive body messages which reduce victimisation and stigmatisation for all people.

Christina Ralph-Nearman is a former fashion professional, who has an MSc in Neuroimaging and Neuro-Clinical Psychology, and is currently completing a PhD using neuroimaging techniques to research the implicit underlying mechanisms of eating disorders.  Contact: LPXCR4@Nottingham.ac.uk Twitter: @CRalphNearman

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For more information and sources of support:

 Mind

B-eat

Eating Disorder Support Service

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References

[1] NICE (National Institute for Clinical Excellence) (2004) Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders, Great Britain: The British Psychological Society and Gaskell.

[2] Health & Social Care Information Centre (HSCIC). (2014). Eating disorders: Hospital admissions up 8 per cent in a year.  Retrieved on May 1st, 2014, at: http://www.hscic.gov.uk/article/3880/Eating-disorders-Hospital-admissions-up-by-8-per-cent-in-a-year

[3] Sullivan, F., 1995, Mortality in anorexia nervosa.  American Journal of Psychiatry, 152(7), 1073-4.

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Kat Dyke -Relationship dynamics and depression

 

The 16-22th May 2016 has not been like any other week. It has been Mental Health Awareness Week; a much needed occasion designed to raise awareness and tackle the stigma still attached to mental health. This is something I’ve always been passionate about, but in all honesty I am not always as open about my own struggles as I could be. The thing is that as much as I encourage others to share their experiences, I still have apprehensions about discussing things so openly, and I’m not alone.

We live in a time where an estimated one in five of us will experience depression at some point in our lives, but despite this we are still not particularly good at talking about it. Understandably, talking about mental health with a friend or family member who is unwell can be difficult and it can be hard to know what to say, but this doesn’t mean that silence is the answer.

The focus of this week’s campaign is relationships; the wonderful connections that we all make (and all too often take for granted) which are so important in maintaining good health and well-being.  Relationships are fluid and during times of illness these dynamics can change. I’m hoping that by sharing a few of my own experiences I can shed some light onto how depression can impact relationships, and how they can also be key to recovery.

My personal experiences have taught me two key things. Firstly, that even good strong relationships can be strained by issues like depression. Caring for someone who is ill can be difficult at the best of times, and when this illness has invisible causes it can be particularly challenging. Secondly, and most importantly, good relationships are invaluable to recovery and to maintaining good mental health.

I’ll start with the first more gloomy point. One of the things I discovered during the depths of a depressive episode was that I was unable to fully appreciate the kindness of my friends and family. During that period my thinking and self-esteem were disorganized and negative and as a result there were many instances when I felt that I deserved to be isolated and alone. I’ve come to think that this is one of the most cunning tricks of depression and also one of the reasons that small acts of kindness are so important in supporting someone who is unwell. Although at times I felt undeserving, I also felt various other emotions (albeit slightly muted). During this time things like receiving post, borrowing lecture notes or being cooked for were invaluable. These small things gave me the chance to feel valued and normal, and although these feelings didn’t always last long, they provided glimmers of light in what was otherwise a dark place.

Another cruel trick of depression was to make me exhausted and apathetic, which meant that the things I would usually do to repay kind favours went out the window. This put a strain on my close relationships as things became very one-sided, and eventually led to unhelpful but understandable comments from those around me. In a moment of exacerbation someone incredibly close to me once said ‘I just don’t understand why you can’t be happy’. This was heart breaking as I really didn’t know. I knew the answers to many questions, but that one was, and remains out of my grasp. Although everyone’s experiences of depression will be different, it’s important to remember that no one chooses this and given the option we would all surely chose health and happiness.

Fortunately, in spite of all the challenges my wonderful friends and family stuck around to help me crawl slowly back to health and happiness and as my thinking became clearer I was increasingly grateful to those around me. I also came to realise that sometimes we need to refocus and really appreciate what we have. It’s clichéd, but when it comes down to it the most valuable thing you will ever have is the love and support of others. Be kind to yourself, give yourself time and above all value those close to you. And if you ever notice a friend who seems down, don’t be afraid to ask ‘are you ok?’ and then to listen patiently for an honest answer.

Kat Dyke (@kat_s_dyke) is a PhD student within the School of Psychology. (lpxksd@nottingham.ac.uk)

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If you need someone to talk to Samaritans are available round-the-clock (and free to contact) on 116 123 (UK & ROI)

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