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Pressures on doctors undermine the NHS | Letters

Sep 2nd, 2016 by

The shocking account of the suicide of GP Dr Wendy Potts after her “outing” by a patient because of her bipolar disorder and subsequent suspension from work (GP died after patient’s complaint, 27 August) makes depressing reading for doctors and patients alike. What an appalling tragedy, both for her family and the patients under her care. Suspension is one of those events intended to be non-accusatory, neutral and fair-minded, but the effect on a professional’s state of mind is colossal and always highly destructive, even though the large majority of cases submitted to the General Medical Council result in complete exoneration, not formal charge. Such episodes are not only highly damaging to professional confidence, morale and clinical effectiveness, but also place extra strain on colleagues who have to patch the service gap. It is well known that many accusations of this type, though essentially groundless, prove to be the beginning of the end of an often unblemished career.

Both the government and the GMC must do more to protect doctors, so many of whom – judging by recent figures on early retirement and ever-increasing inquiries for permanent work overseas – have clearly had enough. Most suspensions don’t of course result in such a desperate outcome, but the current system, so weighted against doctors who by and large contribute so much to society, cannot continue. Dr Potts’s sad case is one avoidable tragedy too many.
Professor Jeffrey Tobias
Department of oncology, University College Hospital, London

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Sleep ‘resets’ brain connections crucial for memory and learning, study reveals

Sep 2nd, 2016 by

Discovery that sleeplessness causes neurons to become ‘muddled’ with electrical activity could help develop new treatments for mental health disorders

For Jules Verne it was the friend who keeps us waiting. For Edgar Allan Poe so many little slices of death. But though the reason we spend a third of our lives asleep has so far resisted scientific explanation, research into the impact of sleepless nights on brain function has shed fresh light on the mystery – and also offered intriguing clues to potential treatments for depression.

In a study published on Tuesday, researchers show for the first time that sleep resets the steady build-up of connectivity in the human brain which takes place in our waking hours. The process appears to be crucial for our brains to remember and learn so we can adapt to the world around us.

Related: Lack of sleep alters brain chemicals to bring on cannabis-style ‘munchies’

Related: Why do we sleep? To clean our brains, say US scientists

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More than third of teenage girls in England suffer depression and anxiety

Sep 2nd, 2016 by

Number of those reporting symptoms increases from 33% to 37% since 2005 but survey also finds teens less prone to risky behaviour or playing truant

Depression and anxiety have risen among teenage girls in England, with more than a third reporting symptoms of distress, although the rates are stable among teenage boys, according to a major survey of 14-year-olds carried out for the Department for Education.

Among the girls, 37% reported feeling unhappy, worthless or unable to concentrate, more than twice the percentage of boys reporting such feelings, a rise since a study in 2005, which was described by the researchers as “an important and significant trend”. The figure for the girls had risen by nearly four percentage points since 2005, while the figure for boys, 15%, had fallen slightly.

Related: Social media is harming the mental health of teenagers. The state has to act | June Eric Udorie

Related: Teenage girls’ mental health overlooked by parents, survey finds

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Pregnancy and mental health: the hidden pain of giving birth

Sep 2nd, 2016 by

The range of mental health problems experienced around pregnancy and childbirth is vast and often isn’t spoken about. Here, we share your stories

Magda, a 29-year-old software developer, regularly fends off questions about when she will have her first child. Coming from a close-knit family and having been with her boyfriend for a decade, the topic is brought up regularly. But Magda grimaces in response, only to be told: “Don’t leave it too late.”

For Magda, the question of when she wants to have a child is complex. There is a serious history of depression and psychosis in her family on both sides. In fact, her mother was sectioned for a long time after giving birth to her.

A lot of times my days are coping minute to minute. I don’t know if that puts me in a good position to raise a child

When it comes to having children I have two thoughts. One, genetically I don’t like the idea of gambling and seeing whether I pass it on… Second, should that child not have to deal with that, they will have to deal with me as their father and a lot of times my days are coping minute to minute. I don’t know if that puts me in a good position to raise a child in the best way.

Giving birth was much more painful and difficult than I ever imagined it would be

I have been told that I may need medication for life to treat my anxiety and depression. When I decided to have a baby, my main fear was that the drugs would be dangerous and I’d have to come off them. I was scared of falling ill, which had happened when I came off medication before – when I was at my worst I had extreme panic attacks about 10 times a day.

My dad, who is a doctor, assured me that citalopram is generally considered OK during pregnancy. But babies born to depressed mothers can have worse growth and general health.

I have borderline personality disorder and a social anxiety disorder. I stopped taking my medication (Escitalopram) when I was pregnant because I was worried about the health of my baby. Some doctors thought it was better I stay on the drug, while others disagreed, and because of this varying advice I stopped. However, coming off it caused me a lot of problems. I started self-harming, for example, and worried about everything. I ended up hiding in my house, which meant I couldn’t go back to work. With borderline personality disorder I can go very quickly from being level-headed to mentally unstable. Being pregnant made it harder to cope with this. I didn’t feel like my body was my own. I couldn’t harm myself physically to rid my mind of distressing thoughts.

I was referred to a mental health assessment team and put back on medication on a low dosage. I had one visit with the assessment team but found the nurse dismissive and unhelpful. They didn’t realise I’d had past mental health problems and were treating me as if I had just turned up with thoughts of harming myself. Once I explained to them that I presented before pregnancy I hoped they’d adjust their attitude towards me, perhaps offer more contact, but they didn’t.

I started to have horrible thoughts about my baby – thinking I had made a terrible mistake and wanted to get rid of it

I have never experienced mental health issues other than while I was pregnant. When I was around eight weeks, I started to feel upset. The baby hadn’t been planned, but I was ecstatic at first. However, depression soon took over. As the weeks went on it got worse – I hated people talking about the pregnancy and wanted to pretend it wasn’t happening. I started to have horrible thoughts about my baby – thinking I had made a terrible mistake and wanted to get rid of it. Bizarrely, I also decided that when the baby was born, I would swap it with another child in the hospital, and at least then they wouldn’t be my responsibility any more.

Fortunately by the time I was heavily pregnant, I didn’t feel negatively any more. I only felt sad that this thinking had ruined my early pregnancy for me. I now have a huge amount of sympathy for anyone who experiences depression.

I finally admitted to myself that I was seriously ill after weeks of considering throwing myself under the train

I finally admitted to myself that I was seriously ill after weeks of considering throwing myself under the train on my way to work, followed by weeks of not being able to get out of bed. I lacked the motivation to do anything: get dressed, wash my hair, let alone make any preparation for a new baby. There is a hormonal trigger to perinatal depression and the more the pregnancy progresses the greater the influence of hormones.

Looking back on it it would have been better for me to have someone to talk to [after the miscarriage] and maybe drop the stigma that men have to be strong and carry everyone around them, because something like losing a child does affect us just as much emotionally.

I’m pregnant for the second time. My husband and I lost our first child when I had a miscarriage in my first trimester. It’s not something you get over. People around you think that it’s all about getting pregnant, but the waiting for the arrival of a healthy baby now is worse than any treatment. I suffer from crippling anxiety – crying at random times, waking up from nightmares. I can’t talk about being pregnant and am still trying to hide it at almost 20 weeks.

I wish that I could be offered some counselling. My partner and I received no support whatsoever from the NHS after the D&C [a surgical procedure often performed after a first-trimester miscarriage]. Only now, from reading the Miscarriage Association’s literature am I beginning to understand that the anxiety we are going through is common.

I had my daughter a few years ago and read all the information I could get my hands on. After a difficult birth I eventually delivered my baby. I was exhausted (it took 48 hours in total) and shell-shocked. We stayed in hospital for a few days while trying to get my daughter to breastfeed. I was struggling so much with this that I refused to have any visitors as I didn’t want anyone to think I couldn’t cope. In the end I gave up so that we could all just go home. Luckily bottle feeding didn’t affect bonding with my baby.

However, my partner didn’t cope well at all. From seeing me in so much pain and out of control, he tried to take on far too much so that I could recover. His mental health spiralled as a result to the point where he couldn’t look at our baby. He couldn’t handle her crying and one day I found him crouched in a corner rocking. I got him to see a counsellor and the doctor advised that he would recover better if he moved out for a while. He went to live with his parents and we would visit, but he couldn’t cope with the guilt of leaving us.

I’d already had a baby and enjoyed being a mum, so when I fell pregnant again I never expected to experience postnatal depression.It was four months before I plucked up the courage to go and see the doctor. I kept telling myself to keep going, and that I could be a perfect mum like the ones you see plastered all over social media. Now I realise that it’s not real. To me, during the dark days that perfect picture wasn’t my life but boy did I try to achieve it. I was really struggling and I told no one. Admitting weakness was like putting my hand up and saying: “Look at me, the bad mum over here.”

The day I told my sister and my mum I was at my wits’ end. I cried the whole time. I paced the length of my house for half an hour before I finally made the call to my family. After that I went to the doctor. I thought he was going to laugh and tell me to just get on with it like every other mum, but he didn’t. He told me that this would be the last time I would feel this way and that every day, from today, I would start to feel better. Most importantly he made me realise for the first time in four months that I wasn’t a failing mother-of-two. I’d managed to keep my head above water through one of the most challenging times of my life.

I completely lost touch with reality and was convinced my phone was communicating with me in code

I started to get hyper-manic and the effect that had, in terms of behaviour, meant that I would be wide awake all night. My mind would be racing and I was really driven to do things, for example I would reorganise the kitchen cupboard at 3am to 4am in the morning. I also wrote lists compulsively and used hand gestures, which I don’t normally do … then after that I became psychotic. I completely lost touch with reality and was convinced my phone was communicating with me in code. I thought it might be my father who had died three years previously. I thought I would just will with my mind ordering a pizza and it would be delivered to the door.

My wife and I experienced the stillbirth of our first child, Andrew. It was very sudden, my wife noticed a lack of movement and we went to hospital. We saw a classic scan, but this time with no heartbeat. I carry the image with me to this day. The following days and weeks were traumatic. We were told that the chances of a future successful pregnancy were higher if my wife delivered Andrew naturally, so labour was induced gently. We then went to a dedicated maternity suite (where we were handled with exceptional care and attention by all staff). The delivery was normal, except that Andrew was not alive.

Following the stillbirth, I experienced post-traumatic stress disorder for which I have since received cognitive behavioural therapy. I had flash-backs of the traumatic delivery and the events immediately before and after, including my son’s funeral. I also suffered from an intense anxiety as we went through four more pregnancies – two ended in miscarriage and two ended inthe births of two wonderful boys. We constantly wondered about miscarriage, stillbirth and the chances of a good outcome. The mental health problems affected my work – I was constantly on high alert.

On the whole the NHS was marvellous. Their care when we lost Andrew was excellent in the circumstances

I had a traumatic first birth and my baby was in neonatal care, which left me struggling with what I know now to be PTSD and perinatal anxiety. I didn’t understand what was happening, so tried to carry on as normal. I became pregnant again 14 months later by accident and really suffered. I believed I would die, writing letters to all my family and counting down the days until I would leave this world. I had awful anxiety, flashbacks and was terrified all the time. I didn’t trust healthcare professionals, hated going to the hospital for appointments and didn’t know who I could approach for help. I became a shell, empty and full of fear.

I wish that my traumatic birth had been acknowledged and that I had been asked how I was coping in my next pregnancy. I wish that there had been counselling, more information around having a difficult birth. I wish I’d just been asked how I was, not physically but mentally. I wish there had been continuity of care so that I had someone I trusted care for me. It took me 15 years to get a correct diagnosis after the second birth and even then there was no specialist treatment support available.

I was diagnosed with OCD following the birth of my first child. I was experiencing intrusive thoughts about my son coming to harm (and that I might actually be the one to harm him). I have suffered from recurrent depressive episodes throughout my life.This and the severe anxiety I was experiencing led me to spend a lot of my maternity leave sitting at home, waiting for something terrible to happen.

My midwife noticed during my pregnancy that I was feeling anxious and referred me to a mental health clinic at the local women’s hospital. I continued to attend there after my pregnancy and, as things spiralled out of control, I was prescribed antidepressants and given a place in a group therapy session. I was admitted to hospital – in a dedicated mother and baby unit – for two months as things failed to improve.

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First ‘gold-standard’ trial of ketamine’s anti-depressant effects launched

Sep 2nd, 2016 by

Clinical trial conducted in Australia and New Zealand will compare patients’ response to multiple doses of the drug with placebo

The first “gold standard” clinical trial of ketamine for the ongoing treatment of major depression was launched in Sydney on Tuesday and will involve seven research institutions and 200 patients from across Australia and New Zealand.

Several pilot studies have examined the effectiveness of ketamine for depression but these have typically been smaller studies testing a single dose of ketamine on acutely depressed patients.

Related: Quarter of chronically ill Australians skip treatment due to medical costs

Related: Health service calls for royal commission into Indigenous suicide rates

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Books to give you hope: Wild by Cheryl Strayed

Sep 2nd, 2016 by

This memoir of an epic walk along the US’s Pacific Crest Trail, during which the author regains lost strength, offers redemptive inspiration to any reader

I came across Cheryl Strayed’s Wild during a difficult patch last year. Without going into too much detail, a perfect storm of life events left me anxious and depressed. I remember doing all the things you are supposed to do to get better: exercising, meditating – and reading, which brought me to this book. When my anxious mind refused to concentrate on TV or music, Strayed’s account of her 1,100-mile solo hike along the Pacific Crest Trail transported me out of myself, made me feel less alone, and more hopeful.

Related: Walk on the Wild side: Cheryl Strayed’s 1,000-mile hike

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UK’s ‘hidden disgrace’: mental health problems can lead to 42% pay gap

Sep 2nd, 2016 by

British workers with depression or anxiety face a life of lower earnings, according to Equality and Human Rights Commission

People suffering from mental health problems such as depression and panic attacks earn up to 42% less than their peers, prompting the government’s equalities watchdog to brand the pay gap “a disgrace”.

Evidence collected by the Equality and Human Rights Commission has exposed stark differences between the earnings of those suffering from psychological illness and those who are not. For every pound that a non-disabled man earns, men who have conditions such as phobias or panic attacks earn only 58p. Similarly, men with anxiety or depression are paid only 74p for every pound earned by their contemporaries those who have no such troubles.

Related: Have men been let down over mental health?

Related: Younger voters put social issues and environment before economy, survey shows

Related: The Guardian view on mental health: still underfunded after too many false promises | Editorial

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A digital detox sounds great. But using the internet mindfully is better | Emily Reynolds

Sep 2nd, 2016 by

Like many young people, I live much of my life online. While it can be isolating, the internet can also aid mental health

Last week, in a largely futile attempt to actually do some work, I installed a browser extension that blocked pretty much any website I could possibly distract myself with. Twitter: gone. Facebook: gone. Even my emails, which I obsessively tend to in order to feel moderately productive, were off limits for an hour.

Having found new and imaginative ways to waste my own time, what surprised me most was not how much more work I did, but the sheer frequency with which I attempted to access the internet. I’d incessantly tap “twitter.com” into the address bar, somehow immediately forgetting it was blocked. I’d click on my still-open Facebook tab to check my feed before remembering there was no point. Every time I finished a sentence I’d flit away from my work again, trying to exchange 10 seconds of productivity for 10 minutes of distraction. I knew I spent a lot of time online – but not this much.

Related: Five ways to curb your internet use and get your life back | Rhiannon Lucy Cosslett

Related: Turning off technology is about mental wellbeing – not being a hermit

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Scientists discover 17 genetic variations that raise risk of depression

Aug 2nd, 2016 by

Research involved 300,000 people of European ancestry and could lead to better understanding of the condition

Scientists have discovered 17 separate genetic variations that increase the risk of a person developing depression.

The findings, which came from analysing DNA data collected from more than 300,000 people, are the first genetics links to the disease found in people of European ancestry.

Related: Antidepressant prescriptions in England double in a decade

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Can doing fun activities cure my depression?

Aug 2nd, 2016 by

If you are feeling down, learning to tap dance or going out with friends can enhance mood, even if you don’t want to do them

Going out for dinner, learning to tap dance or seeing friends are all effective treatments for depression, according to recent research published in the Lancet. These activities even have a therapeutic name – behavioural activation. The research says it works as well as established treatments, such as cognitive behavioural therapy (CBT). But how does it work?

Related: Could Pokémon Go improve people’s health?

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