As the clocks go back and the nights are drawing in, for many this is the time of year that mood plummets and Seasonally Affected Disorder SAD raises its ugly head and is debilitating for many. In this month’s article, I look to explain some issues around depression and try to give an insight into current research and best practice in suicide prevention.
The 10th of this month saw the annual World Health Organisation Metal Health Day which focussed on the health of young people. In the UK we haven’t got a great record in meeting young people’s needs in respect of mental health with long waiting times within the NHS and a reported poor quality of care once services are provided with facilities in cities miles away from the family home. The only alternatives for care is separation which is an added risk factor in the child’s care. To be honest the UK’s record on Adult care is also found wanting. I hear as a private counsellor from clients seeking counselling help that waiting times for therapy are still around the 18 month mark. I am also underwhelmed by the Government move to create a Minister for mental health, inequalities and suicide prevention. Potentially a good move but the incumbent appointed has held a similar position for the last three years as Under Secretary of State in the Department for Health. So a little bit like the creation of a new role but no new ideas or initiatives are anticipated. Hope that I am wrong. More money seems to be promised but the NHS trusts say they have less money for Mental Health,
The biggest cause of death in men under 50 is not cancer, liver failure or heart disease, it’s suicide. The rate is falling but men are more than three times more likely to commit suicide than women although in recent years up to 2016 women’s suicidal rates have been on the increase.
The question as to why the suicidal death rate is so high is a complex question to answer. Anyone who saw the Horizon Programme on the BBC “Stopping Male Suicide” will have seen that the work of Dr Joseph Franklin is an interesting and positive development. Dr Franklin Professor of Psychology at Vanderbuilt University has developed a predictive tool which is an algorithm that looks at over 700 different factors which may contribute to a suicidal attempt. These algorithms are as powerful as those which watch your surfing behaviour on Social Media (see my article on Artificial Intelligence in Counselling – https://counselling-helps.co.uk/do-i-need-to-be-worried). The great news is that the costs are very low but the algorithm can predict whether a suicidal attempt is likely within the next five years with 90% accuracy. I did some further research on Dr Franklin’s work. The algorithm (or big data) programme needs information on all 700+ factors and so it is difficult to predict the likelihood of suicidal behaviour but the top five contributory factors are, being poor, poor physical health, a pre-existing mental health issue, number of visits to an emergency room and low frequency of visits to the Dr. This is pretty groundbreaking stuff, as previously all the research has been on a completely different set of variables and with no predictive outcome. I hope that health organisations all around the world start taking practical steps to use this technology. It has to happen doesn’t it?
In the same Horizon programme, there was a focus on a private clinic in Detroit run by Dr Frank (no relation to Professor Franklin) who runs the Henry Ford Medical Centre. She created a target of zero suicides and in some years she achieved just that. How did she do it? For EVERY patient contact in the clinic, irrespective of presenting issue, whether this be the flu, a broken hand or a heart condition i.e. for every presenting issue the patients were asked whether they had had any thoughts, at any time, of wanting to kill themselves. Such screening allowed the centre to identify risk patients quickly and to connect them to talking services, family friends and essentially adopting life-saving strategies for hundreds of patients. Impressive that this achieved a zero rate of suicide for the clinic. Again this strategy needs consideration, even for therapists. We must not forget our responsibility and must not take safety for granted, As expounded in an article by the Chair of the BACP Andrew Reeves in September’s Therapy Today “Daring to Talk About Suicide”. Counsellors should not rely on questionnaires alone as a predictive tool to determine risk of self-harm or suicide but should have an open dialogue with all their clients in the therapy room.
You can probably tell that I feel strongly about all this and I do. You might be asking if you are having thoughts of not wanting to be here, what to do about it? My top 5 recommendation would be – do not keep these feeling to yourself, make sure you exercise, eat and sleep well. If things are getting too much for you then connect with a mental health professional.
Recovering from depression is achievable. It’s important to have relationships that are emotionally supportive. You need to have someone that you can contact in times of loneliness and feelings of despair. This person will ensure that during your lowest moments, you are not alone. It’s also extremely important to engage in physical activity. Our initial feeling during low times is to isolate ourselves. However, that’s when you really need to be in the presence of others.
Secondly, Physical activity releases endorphins that assist in changing your mood. It is a natural antidepressant. Along with getting physical activity, soaking up at least 15 minutes of sunlight each day is a natural mood elevator. There seems to be a direct connection between our mood and how long the sun shines each day. For instance, in the countries where the sun barely shines, the rates of depression are higher.
The third pillar of self-care is to get enough sleep. Lack of sleep and fatigue make us more emotional and moody. Most of us need between 7 and 8 hours of sleep. If you are into mindfulness and meditation then this should help and particularly I find that the body scan (paying attention to your body from tip of your toes to the top of your head) is a great way to relax enough to ensure a good night’s sleep. My favourite Body Scan guide is by Mark Williams which you can find on Alexa and the Google equivalent or just via youtube here: https://www.youtube.com/watch?v=MHoXAn0H0b0. Last night I started the scan and fell asleep as soon as I got to my left shin! The object of meditation is all about falling awake, not to sleep, but I did have a lovely night’s slumber last night!
What you eat directly affects (impacts) your mood. Maintain a well-balanced diet. Never skip breakfast which is your most important meal of the day. It’s best to stay off high c’arb diets and eat the healthy stuff, the greens reds and yellows of fruit and vegetables. Diets high in protein also give us the energy we need to carry us through the day. Would advise against too many Burgers from fast food chains, I believe inconclusive reports that such food has a negative impact on mood and in particular – anger (clue for subject of my next article!) For veggies and fruit lovers chillies, kale and broccoli are great mood enhancers, Kiwi Fruit can help for some who have difficulty in sleeping (two kiwi fruit an hour before retiring should help you to get to sleep – tried this one myself and it worked for me!). I was also impressed with the book by Dr Lynn Rossy “The Mindfulness Based Eating Solution.” Which has some great tips and resources to change your relationship with food forever!
Last but not least, if you are struggling and friends and or family that you can trust are hard to come by, then do seek the support of a Dr and if the waiting list for a therapist is too long to see if you can find a counsellor in your area whom you can develop a trusting relationship with. Therapy doesn’t have to be costly, for instance, I retain two weekly low-cost slots for those out of work or on low wages. Do make sure though that the therapist you choose is a member of the BACP or UKCP. Both have search engines of qualified professionals the Counselling Directory also is a good source of qualified professionals @ https://www.counselling-directory.org.uk/.