Wednesday 28 October 2009

This is Panic 13.1 - Therapy in the news

Well folks this is a bit of an update from the last post. Whilst on BBC News earlier I stumbled across this@

Link to "'Talk therapy for the depressed"

The National Institute for Health and Clinical Excellence (aka NICE) have come out saying that antidepressants shouldn't be used to treat depression in adults with chronic health problems but rather they should be directed towards structured physical acitvity and Cognitive Behavoiral Therapy for help.

MIND, the mental health focussed charity have responded saying that shifting too much of a focus towards CBT and computerised CBT and away from counselling could be seen as an excuse by some health providers to cut funding to other talk based therapies.

Reading the advice from NICE, I can see where they come from to an extent but it seems very much like they are trying to pick one therapy that "works" best and then tar all people with the same brush somewhat.

Depression (and anxiety as they are linked) relating to chronic health problems or even chronic health anxiety is very much a different thing for different people and to push one form of talk therapy over other kinds seems irresponsible to me. It's not scientific to assume that all people will benefit from one kind of therapy to a mental illness.

Take the drugs from the statin family, used for blood pressure conditions. There are a variety of different statins used for different people and you tailor to the patient. Essentially what this advice from NICE seems to be is totally disregarding that individual patients and thrust one kind of therapy upon people which doesn't sit well with me.

I'd hope that NICE will listen to constructive criticisms from the mental health professional community and be prepared to alter that advice in the future.

As ever, this is just the ramblings of myself so please do read the article and the advice from NICE at their website; click here for that.

Saturday 24 October 2009

Panic Buys - Understanding Anxiety and Panic Attacks

Title: Understanding Anxiety and Panic Attacks
Author: Dr Kwame McKenzie
Publisher: Family Doctor Books in association with the British Medical Association
Click here for the publisher's website
Click here for the book on Amazon.co.uk

The back of this book proudly trumpets that over 4 million books have been sold in the Family Doctor series which makes sense if they follow a similar pattern to this one.

I bought this book a while ago and it's very good if you deal with your anxiety condition and life's problems in a similar way to myself which is to bone up on a subject, read around it and use the appropriate tactics gleamed from what you've read.

The book's format has the various chapters broken up into sections making it easy to stop and start without feeling like you particularly need to race to the end of the chapters which is useful as you don't want to rush through reading anything to better inform you about your condition.

As the book covers a range of subjects within the broader field of anxiety, the book is also useful in that to get to information you may find useful you don't have to read the whole book. The break up of the chapters helps the reader to jump about as needed to and the information is never presented in massively long lumps of text. That said, if like me you are keen on reading around the subject then knowing about other kinds of anxiety disorders can be interesting reading. If that's not your bag and you want it for additional help rather than for interesting reading, the book itself normally retails for about £3-£5 so it's usefulness is not negated by the cost

The book's author Dr Kwame McKenzie is a lecturer in psychiatry at University College London and the book obviously benefits from his expertise. The issue of course with some books written by clinicians and aimed at the lay person is that the way information is presented in certain parts can come across as a bit patronising but the book doesn't bamboozle the reader with overly technical terms and any longer terms are explained.

As well as explaining the conditions and drugs used, the book also covers the different kinds of treatments and provides a chapter on self help techniques that could be useful.

Don't be mistaken, this book is a basic overview of everything rather than an in depth study. It will give you bare bones help and good signposting towards other treatments and ideas that may be useful. I liken it to an appointment with your GP; decent and to the point but short and a bit overly clinical and sterile in parts.

If you're wanting something to hold your hand a bit or help you through a hard time or provide you with effective techniques for dealing with attacks, this is not the book for you. If your problem is a new thing and you want something to read before delving deeper or you want to give something to others to help them understand a bit better than this book will certainly do the job.

With such a low price it's certainly a handy book to have around but it's a bit like taking an aspirin for a broken arm. It'll help short term but it certainly won't cure anything.

Friday 16 October 2009

This is Panic 13 – Therapy

Well folks, it’s been a long time coming this one so I wanted to share my experiences that I’ve had with therapy. I should say now that I am throwing counselling and therapy under the same title here, basically any sort of talking related bits to help you get well as it were.

Apparently having therapy sessions regularly appears on those lists of “things to do before you die” which always struck me as odd. Before I’d really thought about it, therapy was a thing people did when they were ill. Now I’ve grown older (though not necessarily wiser) I realise that things like therapy can be very helpful and reflecting on who you are and why you do certain things with an objective observer can be very useful.

I had a smallish bout of therapy back in early 2004. Looking back I was physically not that bad but for a messy break up with someone had left my head a bit of a mess and it spiralled a bit from there to the point where I wasn’t really sure what was going on. I was having infrequent panic attacks as well which obviously wasn’t helping matters.

I got put in touch with a guy called Arthur through the church I go to. Arthur had training as a counsellor which sounded ok to me, he said he didn’t want any money from me because I was a student at the time so thought “well I feel bloody miserable and it’s costing me nothing but my time so why not?”

Arthur was actually a really nice old boy (he was nearly 80 when we met) and was also very good at what he did. Now as it was through church, yes there was a Christian element to what was going on which I know is not everybody’s bag. That said whilst we prayed at the end of every session and he occasionally pulled the odd part of the bible out to explain a point, he knew what to say. It wasn’t “your ill feelings are the work of the devil, repent sinner!” sort of thing, but carefully considered thoughtful words from a guy who shared a belief system with me.

That was a while ago now and since then my anxiety issues have come more to the fore than minor bouts of depression. I should also point out these recent visits to therapy were not through my GP so the waiting times were drastically cut down.

I actually asked to be referred to someone through occupational health at work. Work had been really stressful and I’d suffered burnout after trying to do everything for everyone. When I came back to work, I sat down with my boss and asked if there was scope to see someone. They don’t want me having time off ill, I don’t want me having time off ill and I wanted to take more of a grip on my problems. As I’ve said before, I owe it to myself and my fiancĂ© to be as healthy as I can be. It’s right that I make that effort and so my boss referred me on.

In any one year through my work you can have 7 sessions total. It seems like an odd number but I was told it was one introduction session to get to know a bit about me and my issues and then 6 actual sessions as it were. I was actually pretty grateful for the fact I got someone relatively close to home, round the corner from my other half in fact so I could go and see her afterwards.

A session was about 50 minutes, give or take a bit, which is a good amount of time to delve into stuff and develop ideas without being too long and straining your brain too much. It sounds kind of cheesy but it was always on comfy chairs in nice well lit, pastel coloured rooms, I guess to try and be as relaxing as possible. The one thing that I noticed, probably because I never sit still for more than a few minutes at a time is that the room was set up so I was nearest the door but could never see a clock in my line of sight. To be fair that’s a sensible tactic. The client feels less time pressure if they are not looking at the clock.

We covered a lot of ground actually in a few sessions. A lot of my issues (and this is not going to shock anyone who has even the most basic knowledge of psychology at all) stem from my adolescence and growing up in the home environment that I had. We dug back into some of the decisions made by me and for me, what I liked about them and what I didn’t like and had a look at some of the things that may have triggered me having anxiety issues and panic attacks.

It was actually interesting to sit there and have someone help me do nothing but reflect on my and why I do things for a sustained period of time like that. The whole process threw up a lot of issues surrounding being assertive when I need to be and why I am so passionate about things and get so wound up so easily. We also spent a lot of time looking at how I could perhaps relax better and get rid of the megaton of nervous energy that I seem to have so often. We talked about me doing things to “let things out” like singing more and how the physical act of breathing out or singing could be useful for me as I hold stuff in.

It’s odd to think when you first try some of these techniques that you’ll be using later but I realise that I am using some of them, particularly some of the assertive linguistic techniques. I did learn a decent relaxation technique that I was told to try at work. The only shame of course is I never get 15 minutes to myself to try it.

My series of sessions have ended now and I need to decide where to go from here. I either go back into the primary care route and talk to my GP again and possibly go down the route of the improved access to psychological therapies, or look for other free therapies or pay.

I think the best thing for me to do right now is ironically what I’ve been doing; sit, contemplate and think about where to go from here. I don’t need to instantly rush back into another kind of therapy or constantly need to analyse who I am or why I do things.

It was a useful process though and for us anxiety sufferers, I actually recommend it. I talked in part 9 about wondering why an individual attack happened and this is just an extension of that. This is me looking at the bigger picture of why I have all my panic attacks and it can only do good I feel.

Now…time to chill out on that couch.

Wednesday 7 October 2009

Make it write - This is Panic in Anxious Times

As I've mentioned before, This is Panic was recently featured in the magazine Anxious Times, the quarterly magazine of national charity Anxiety UK.
A bit of backstory; I emailed Anxiety UK asking to be put on their blogroll if they had one, they asked me to write about the blog. It covers a bit of ground that's been covered before here but it serves as a good introduction to me and the idea of the blog. I hope you enjoy it


Originally published in Anxious Times issue 71, September 2009

I always start with the gory details.

I’m 25 and had my first panic attack at 17. I was in the car with my dad and my sister and I saw my face in the rear view mirror of my dad’s Vauxhall Astra and thought I was about to die. The pins and needles caused by my hyperventilating were so strong that my thumbs locked into my palms and my eyes clamped half shut. Since then I have had up times and down times. During my time living in Germany, I started having stomach issues that were linked into my anxiety and to this day when I am having an anxiety attack, I will continually burp. My triggers are health related and I am continually scared of having a heart attack, a stroke or catching meningitis to the point where I will stare at my arms to see if I have a rash.

We all find ways to cope with our anxiety conditions. Some people go for runs, some play video games, I write.

Writing was a hobby that I fell into at 15 and, now that I have this chance to examine it, it’s one of the few true solaces that I had growing up and one I still have today. No matter what I do or how hectic the day has been, there is always time to jot something down. My great uncle wrote poems in the jungles of Papua New Guinea, my fiancĂ© writes on TV for a popular mens magazine, I do This is Panic.

This is Panic started out as a post on Facebook. One Friday in May of this year, I was off work due to a viral illness and stress and the anxiety that plagues me was fully in control of me. Out of nowhere I found myself writing a really long rambling mess as to how I was feeling and what it was that affected me. I actually felt a lot better for having done it, like I’d screamed every ounce of air from my lungs. I’d always told people that I had panic attacks but I’d never gone into so much detail.

I got a response from a variety of people in a variety of ways, many of them reminding me that whilst anxiety affects me, it doesn’t define who I am. I wanted to answer people whilst continuing to talk about the problems I was having. Work was stressing me out so I talked about work, my work ethic, how I don’t know when to stop and the effect that it all has on my anxiety. It helped me examine everything in a different light.

One thing people talk about with the internet is the chance of anonymity. You can divulge as much or as little about yourself as you want. You can even make it all up should you so choose. Not me, I wanted people to see what this was, who I was and how I felt so brutal honesty isn’t an editorial choice I make as a writer but a necessity. Honesty is the best way of being able to accept that you have a problem and helps others to understand it. It was from there that more ideas came for posts and more and more response came. I decided that I didn’t want it to just be me writing but This is Panic to be a sounding board for sufferers or friends of sufferers or professionals with a bit of handy advice to impart whilst at the same time continuing on with my writing/anything else I decide to do with the blog (I am experimenting with the idea of video posts).

I don’t expect This is Panic to be a cure all for anyone, least of all me but I know that the blog has helped me take on an objective and rational examination of myself and my condition. It’s not a replacement for professional help (and hopefully by the time this is published I will have started mine) but it’s me taking as much of a personal hand in my own care as I can.

Anything I write for This is Panic is all my own garbled thoughts and I use examples from my own life to illustrate my point. Somethings won’t work for everyone just like they don’t all work for me. If they do or don’t, I will say. I’m not trying to play at doctor or therapist but as a lot of us are in the same boat, I just want people to know that we’re not crazy and there’s tuff we can do to minimize the impact this has on us.

If asked what my plans are for the site, I’d say that I want to keep writing it and think of new ways to try and give a real person’s perspective on panic and anxiety whilst hopefully being able to publish articles from other people who want to do the same thing.

The dream is people reading it and feeling they’re not alone. For a very long time I felt very isolated with this problem. I was even once told by a doctor to “pull myself together”. I was lucky that people took the time to understand what was with me and by nature I am so social that I went looking for help. Some people are not so lucky or so social. My biggest hope is that This is Panic makes one person feel less alone and more like a human being. If that happens, it’ll be worth it.

When I am writing a blog post I try and sign off in a semi humorous way that is appropriate to what I’ve been talking about. Now whilst I inject humour into my writing, this subject isn’t a joke to me. I do not know when and if my anxiety problems will stop as I can’t see the future. I still gave minor episodes and the odd full blown attack where I am convinced that I am about to die. I am a massive dentalphobe and don’t like water on my face as I nearly drowned twice at age 4. I am scared that my children will be susceptible to this because I do.

I just want to react in the best way I can with every skill I have and I want to help end some of the preconceptions surrounding something that a lot of British people suffer from. I may not make it better but I want to make it right.