Dealing with Depression

The black clouds of depression have haunted us since humans first trod the Earth.

Thankfully, our understanding of it has increased. If it hadn’t, starvation, lunatic asylums and exorcisms might be offered as treatments on the NHS! Melancholia was the rather poetic name once given to those suffering from it. Fictional characters such as Shakespeare’s Hamlet and the eponymous French Lieutenant’s Woman were afflicted with it, while even Winston Churchill was oppressed by what he called the Black Dog as he led the nation through its darkest hour.

If the emotional cost is incalculable, the bead counters of the government have unearthed some sobering statistics. Depression costs us over £7.5 billion a year – its damaging effects impact negatively on absenteeism, productivity, mortality, and community life. This figure rather helps focus the government’s mind on helping us beat the blues!

Nowadays, depression is viewed in a more hopeful light. Its many causes and symptoms cover a wide spectrum. Its basis may be biological or situational, or related to a past trauma or current illness. Its effects often include low mood and poor concentration, sleeping and eating problems, and a sense of worthlessness amongst others. If self-harm tends to be attributed more to women, this traditional stereotype ignores how its manifestations vary across genders and individuals. For example, depressed men often resort to drink, drugs and overwork. Suicide is obviously the most extreme response to depression and now one of the leading causes of death in young and middle-aged men. But there are no hard and fast rules for how it affects any one person.

Feeling sad temporarily is a natural response to a difficult emotional event such as the death of someone close or a relationship break-up. These challenges are part of normal life. Depression is usually diagnosed when we struggle to lift ourselves out of these slumps. This can be prolonged by the corrosive effects of an unhealthy lifestyle such as drowning one’s sorrows in alcohol or resorting to the numbing consolation or artificial high of street drugs. Then these negative feelings may be amplified and slip harmfully into other areas of life – such as work and relationships. It’s a good time to seek help.

Chasing away the Black Dog

Happily, greater awareness and investment has led to professional services to help people feel heard and better understood. Counselling can help you work through deeper issues that underlie much negative thinking and address areas of your lifestyle that may be contributing to you feeling depressed.

Practical changes to our lifestyles may help us lever ourselves out of this emotional trough whether it is through exercise and better diet, or a concerted effort to find a solution to something lacking in your life. This might be a change of direction, a new job or dealing with relationship problems.

Depression may be attributed to a chemical imbalance that can be helped with medication. Such imbalances might be triggered by the confusing rushing of hormones during periods of change such as during adolescence, the menopause, or pregnancy. Or you may have inherited this disposition through the genes and behaviour of a parent. It is also an understandable response to a long-term and debilitating illness. In such cases, the cause may remain, but its effects can often be better managed. It’s such a wide-ranging state that it’s worth discussing your symptoms with a professional doctor or counsellor to pin-point the cause and treatment that best suits you.

While professional help is the best recourse for those suffering full-blown symptoms, we can all ease this burden on society by looking out for those currently struggling on the slippery slope downwards. Preaching the value of the Still Upper Lip is a ‘solution’ that is well past its sell-by date! Like a fever that needs sweating out, the roots of depression are better flushed from the system than being left undisturbed to fester.

Simply being understood and heard can make a big difference for those feeling alone even if it’s only to direct them to help. Identifying and engaging friends, families and colleagues who exhibit the signs may bring some sunshine to those lost in the gloom.

Money Issues and Mental Health

Money problems can have a toxic effect on your emotional health.

When you are struggling financially, negative feelings about your self-worth are often created or intensified which lead to behaviour that only makes the situation worse. It’s a vicious circle where your mood plunges in tandem with the growth of your overdraft.

The average UK household now has an average debt of over £15,000 – excluding mortgages. During uncertain times, many of us are increasingly feeling the financial pinch whether planning for the future or paying for a holiday. For the harder hit, putting food on the table or paying the overdue rent are more pressing concerns.

Historically, the consequences of debt were invariably dire. Dickens described the horrors of the workhouse and debtors prison for those falling on hard times. While these no longer exist, our consumer society employs battalions of debt collectors who claim their pound of flesh just as ruthlessly. When the going gets tough, it’s hard to contact the smiling faces from the glossy TV advert.

Living off an overdraft is now commonplace for many of us. We have access to easily borrowed money to buy up an endless range of luxury goods advertised by those whose job description is to sell us what we don’t need. And when these spending sprees spiral out of control, the entire world suffers a financial crisis. When we personally get it wrong, we create a recession of your own.

In this environment, those struggling with mental health issues are particularly affected. People suffering from depression or bi-polar disorder may find their behaviour sends them into financial and emotional meltdown. When feeling down, ‘retail therapy’ is often the perceived solution. Unsurprisingly, this form of treatment was coined by retailers rather than the NHS! Being comforted by more possessions offers a similar short-term consolation to that offered by alcohol or street drugs. It has its own flavour of hangover and a similar risk of addiction. Those experiencing manic symptoms often spend irrationally – it’s a destructive behaviour associated with the condition.

Solving your debt crisis

The first priority is taking full stock and responsibility for your situation so that it remains within your control. When we are cash-strapped, it’s vital to challenge habits that contribute to our financial woes. If you’re willing to shop around, the consumer society does offer competitive choice in the high street or on-line. Big savings can be made. For those uncomfortable with new technology, ask a young person – they were brought up on it! The profits of many companies are gained largely from those who don’t do their research. While supermarkets often offer great deals, butchers, grocers, and street markets may surprise you with the cornucopia of goods available for much less than the High-Street chains. And healthy eating is invariably cheaper than living off junk food and takeaways. Shops selling high-quality second-hand goods are also booming as many amongst the middle-classes downsize their possessions for a simpler life. It seems silly not to take advantage. Food banks may be a sad sign of the times, but you can either use them in times of need or contribute to their stores and help the less fortunate.

Thankfully, professional treatment of mental health issues can now ease the debt that harms your mental health. Therapists can help unearth the emotional issues causing erratic behaviour as well as helping those falling into debt due to outside factors such as redundancy or some similar economic misfortune. Counselling can also signpost you towards specialist organisations that can help you tidy up messy finances and guide you to make better decisions. More generally, it will also look at key contributors to your emotional and physical heath such as diet, sleep, and exercise. Many in debt often know their actions make no sense, but simply don’t care enough to stop making these mistakes. Boosting your self-esteem in these areas can help you overcome self-destructive habits.

Organisations exist – see the list below – that offer practical ways to reduce this double whammy to your quality of life. This includes practical advice on managing debt, reducing interest payments, choosing better deals, how to budget, and what benefits you can claim. All these services, along with trustworthy friends and family, can help you make sensible changes to ease the burden. If they encourage you to open that mounting pile of red-inked letters, it’s the first important step to sorting out your long-term financial security.

Conquering the Clutter Mountain

In our material society, the state of our homes says a lot about us.

We have more choice than ever before. Innumerable products face us down from billboards, TV commercials and window displays. Retailers create and feed addictions irrespective of our needs. Hand vacuums? DVD rewinders? Air-conditioned shoes? How did you live without them?

Goods for life have long given way to throwaway products designed to spontaneously combust the day their warranty expires. Overnight queues for iPhone upgrades or celebrity clothes ranges highlight the epidemic of shopping till you drop. With all these possessions ending up in landfill sites or the bottom of the oceans, we don’t need David Attenborough to warn us about the dangers of excess waste…

On a more local level, the ill effects of consumerism can detract from our quality of life. Many of our homes are bursting at the seams with the obsolete souvenirs of our existence. Clutter can slow us down. Not only does its sheer quantity dilute the value of things that really matter, but living in a disordered environment distracts us from a simpler more harmonious relationship with the world.

This mounting problem is reflected by the popularity of books and TV shows devoted to decluttering. In Tidying up with Marie Kondo, the eponymous star of the Netflix hit cuts swathes through the accumulated junk of the cupboards and lofts of those she saves from death by over-consumption. She asks home-owners which possessions ‘Spark Joy’. So if they Spark Apathy, Indifference or Revulsion, throw them in the trash! Simple common sense rules – such as throwing away rarely worn or forgotten clothes – help people appreciate things they once cherished. Under her twinkling eye, no object is spared from Paper Mountains spilling down over groaning shelves to dusty boxes daring to be unpacked let alone that unused rowing machine that troubles your conscience more than your waistline.

We can reduce the physical footprint by harnessing the wonders of digital storage. Books, records, and CDs can be replaced by subscription services that rival the great museums and libraries of the world. But even the digital domain with its vague databases in the ether can overload those spaces in the back of your mind. Inboxes crammed with thousands of unread emails rarely bring peace of mind. A simple but effective way to digitally detox may be to Select All and press Delete.

Clutter doesn’t always involve inanimate objects. A menagerie of animals – often living in poor conditions – reflects the dwellings of some who prefer creatures that don’t answer back. Such neglect often reflects on their keepers as much as their charges. A visit from the RSVP may help the put upon pets, but what about the bodies and minds of their owners?

Thin line between cluttering and hoarding

Many of us can recognise aspects of this behaviour in ourselves and others. The psychological benefits of a Spring Clean can free physical space and re-assess changing needs. Passing unwanted possessions onto the needier is one way of countering waste. If you don’t know someone who would benefit, our high streets are generally well provided with charity shops to help those struggling financially. Meanwhile, the growing emphasis on recycling allows us to return our waste back to its original form – mirroring the most natural cycles of life in our universe.

Some messes may need more than a broad brush to sweep them away. Hoarding is often linked with Obsessive Compulsive Disorder (OCD), but is now recognised as a specific disorder significantly impairing the quality of life of its sufferers. Hoarding is often exemplified by storage spaces swollen with inaccessible contents, dust encrusted surfaces, and stacks of dirty dishes. Bath tubs filled with strange foreign objects leave no room for the bodies for which they were designed. Unlike some mental health issues, hoarding is usually blindingly obvious. It often affects people living alone – the absence of a partner often allowing the mixed tide of stuff to flow unimpeded.

Many victims don’t recognise the problem – perhaps because the situation has worsened by degrees over the years. An outsider’s perspective may be needed to encourage and cajole them into clearing up. Letting go of a lifetime’s possessions may need to be a collaborative effort where the hoarder confronts and relinquishes the emotional ties binding them to redundant objects.

Hoarding is usually more than a material issue. Anxiety and depression is often implicated. To break this cycle, Cognitive Behavioural Therapy (CBT) is often recommended to help householders reduce clutter and reset habits to make a new start, while anti-depressants may relieve these underlying symptoms during the transition. Similarly, counselling can reveal the real reasons behind behaviour that makes some cling to objects symbolising lost parts of past lives or attachments that may be more healthily replaced in the world outside.

Decluttering is the first step towards learning that less is almost always more.

Men and Therapy

It’s said that therapy was invented by men for women. Think Sigmund Freud stroking his beard pensively while rich Viennese women freely associate from his couch. Received wisdom has it that emotional expression comes more naturally to women. Nowadays, we attribute this to culture rather than biology. But the Traditional Man is now something of a dinosaur in the modern world, while advances in neuroscience promotes our potential for change. Therapy is no longer the preserve of the female of the species…

Nonetheless, twice as many women seek therapy and not because men are better at dealing with life’s slings and arrows. Men’s emotional life is just as complex, but often shrouded in secrecy. Suicide rates for men are three times higher. Their cry for help is often silent and the inner turmoil often unknown until too late. Self-harming often occurs unnoticed, but in plain sight. Abusing alcohol, cigarettes or drugs take precedence over ‘textbook’ signs – such as eating disorders or cutting – more commonly seen in women.

Some emotions seem assigned by gender. Toxic masculinity is often expressed by anger – an all-in-one emotional response to a range of threats. Conversely, an angry woman is often rather unfairly written off as a ‘stroppy c*w’! Rising above worldly trials was often seen as the mark of a true man. In his poem If, Kipling enshrined this idea when hailing men who treated Triumph and Disaster with equal equanimity. A term even exists – Normative Male Alexithymia – to describe men struggling to express feelings.

Displays of happiness are less strictly condemned. Two football managers, Jürgen Klopp and Mauricio Pochettino, were recently praised for unbridled displays of emotion when they celebrated reaching the Champions League final with tears of joy. Both are acclaimed for boosting the self-belief of the men in their charge with warmth and encouragement. Nonetheless, those tears may have been less comfortably accepted if shed after a loss.

It’s usually more acceptable for men to stay on message. Tribal gatherings often give little space for them to talk about problems from the game of life. Sport and mickey-taking are safer ground than discussing emotional fragility. As such, friends and family – resources often well used by women – remain largely untapped. When a man’s romantic relationship ends, the unofficial Lad’s Rulebook has a favourite remedy. Make him drink so much he can neither talk, think or stand up. It’s probably due for a revision.

Masculinity has traditionally been defined by a man’s capacity to provide and protect his flock. As such, many feel that seeking therapy shows they are failing in this role. But while women’s empowerment need not diminish the value of the modern male, it does suggest the value of adapting to a changing social environment. The pressure to provide can lead to risky business ventures, refuge in drinks and drugs, and marital violence. While men seem more hard-wired to a hunting and gathering prehistorical role, they are not computers, and the brain’s capacity to rewire itself cannot be underestimated. For everyone’s sake, the potential value of collaborating with others to work out problems is immense.

Many men struggle to admit weakness and imagine it’s expected in therapy – regardless of it being ring-fenced by the safety of confidentiality. In the bear pit of manly society, their reputation is at stake, but inside the counselling room perhaps their very self-esteem is at risk. But for the sake of their own happiness – and all those around them – this is a misconception based on the lie that men can conquer the world alone – if it needs ‘conquering’ at all. No man is an island, but an outdated, insecure chunk of society believes he still is.

Emotional Rescue

Thankfully, revealing feelings is less widely seen as weakness for men in modern society. For example, parental roles are less defined. Men now change nappies and wheel prams with impunity while the delivery room – rather than the pub – is now a welcome place for expectant fathers. Women may have adapted better to shifts in working practices, but men are now increasingly enjoying the flexibility of more nuanced lifestyles. This shift in attitude is leaking through to therapy. Men from all social classes, cultures and age groups now cross the threshold.

Men often find the first steps more difficult. Attendance is often relatively erratic. Revealing our innermost thoughts can be emotionally draining and the process can seem emasculating when discussing problems is wrongly confused with inadequacy. But the reality is that counselling generally remedies pain and increases resilience. The macho instinct to appear strong and flawless is often the last defence against the fear of what honest discourse reveals. Realising this is often the first obstacle. Once cleared, work can begin in earnest. The social programming for men to be problem solvers often influences the form it takes, but therapy is flexible enough to handle different ways of communicating. It doesn’t always have to end in tears!

Many men are relieved to express their true feelings in a non-judgmental atmosphere.

While some take to therapy like ducks to water, the most satisfying and successful work often involves working with those who enter uncertainly, but grow into it by exploring and overcoming issues that have lain dormant and allowed to fester. Such intimate sharing can then be a learned habit to practice outside. Ironically, it may be the bravest men who can swim against the tide of masculinity into the unknown depths of the emotional ocean. Staying afloat afterwards is likely to be easier and more enjoyable than they ever imagined.

Keeping your head in times of trouble

We appear to be living in turbulent times. Indeed, many of my clients have reported feeling despair and frustration about the dark metaphorical clouds they see gathering about us. But I, for one, believe there is light behind the gloom…

It’s only natural to crave some certainty in world affairs – as well as our personal lives. But if our home world is challenging enough, the problems of the wider one often seem beyond our influence. The policies of our councils, governments and nations are often at odds with our beliefs whatever we voted. In recent times, political strife has brewed up a witch’s cauldron of polarising and antagonistic views. While the support of others can instil a sense of togetherness, it can make enemies of those not sharing our beliefs. Seeing things in black and white terms – as right or wrong – can be dangerously divisive.

Of late, frustration has been bursting out of our TV sets and onto the streets. While Brexit inches towards an unknown conclusion, our nation’s future allegedly hangs in the balance. Foreign news bulletins seem to carry heavier doses of death, doom, and disaster. Dictatorships, hate speech, fake news, and intolerance are growth industries. Harmless-sounding words like Europe, May, Trump, Democracy, Boris and Environment can turn gentle souls into raging monsters and split once peaceful communities. The simmering pot of troubles seems to be spilling over and the persistent drip of negativity can feel like a water torture that has worn down our defences…

Looking on the bright side

If we can’t control the external world, how can we control our happiness?

My inclination is for an optimistic take on events, but there are good arguments supporting both an optimistic and pessimistic viewpoint (see link below). For me, a better understanding of all the perspectives can be a valuable way of reducing my frustration towards those who think differently. Also by remembering that extreme views are not representative of the majority.

To say we live in interesting times sounds a bit euphemistic. Some predictable boredom might be welcome! But historically, upheaval, suffering and conflict were often the norm. The oldest members of our community faced invasion by hostile foes. Most of our ancestors lived in times of plague, war, and religious intolerance. The philosopher Thomas Hobbes described our lives as largely ‘nasty, brutish and short’.

But we now live in a country that helps the neediest – even if it struggles to do so sufficiently. Certainly, we have the technology and knowledge to enable healthier, longer existences – and more choice to pursue them. While inequality grows, our living standards have in the long-run grown across the board. Our hard-pressed health service, for example, remains the envy of the world. Our cups may not be overflowing, but they are filled higher than those of almost all our predecessors. The threats of terrorism and environmental destruction are huge problems, but politically and economically, our country remains one of the world’s most affluent and free.

One important antidote to our current social malaise may be for us to re-connect with what we have in common with those around us rather than our differences.

For me, an episode of Gogglebox reminds me that regardless of gender, religion, culture and age – most people are decent, likeable and sensible! Perhaps it’s the circumstances rather than the people that are the real problem. The most divisive issues are often separated by shades of grey.

Spreading the love in small ways has a positive psychological value as well as making the community a happier place. The power of a smile or kind gesture to those less fortunate can be wonderful therapy to both giver and receiver. Compassion and tolerance hold communities together, but political tension has undoubtedly inflamed unfair and harsh feelings about different classes and cultures. Being a builder of little bridges within your own can help heal these rifts. Strong communities are often founded on a sense of common purpose and an ability to draw on all its rich influences. Cities like London and New York are good examples of how this largely works and is exhibited by the pride its many different peoples have in belonging to it.

These existential stresses can be countered in good ways and bad. In times of strife, some seek refuge in habits bringing short-term consolation such as alcohol, drugs, or comfort eating. Others deal more directly with the issues by voicing their discontent. How we do so involves treading a fine line between easing or adding to the problem.

If you’re struggling to identify solutions to your worldly stresses, your friends and family may help you discover what you can and cannot more usefully do with your life. Local counselling services can provide a professional neutral space to helpfully review your ambitions and contributions to the world. Small changes in our home world can make a positive difference. Ultimately, following our dreams after identifying what we can control immeasurably improves our sense of well-being. Wilfully ignoring events in society, I believe, only reduces the boundaries of places in which we can flourish.

That said, pursuing our hobbies and passions is perhaps more important than ever – whatever goes on outside. It can bring personal satisfaction and help work off the frustrations of matters outside our control. The ripple effect of a happier you will benefit everyone. And for me, the darker prophesies of our future seem far less oppressive when I accept that I can only do my best and know that I have endeavoured to do so. We can choose to see the world in a rosy or gloomy light, but only one of those options tends to make it a better place for all.

Anger Management: When the Red Mist Falls

Anger may be a perfectly natural emotion, but its effects are too often damaging.

Biologically, it was valuable as a response to danger – it triggered the red light of fight or flight. This was handy 10,000 years ago when sabre-toothed tigers strayed onto our patch but is generally less useful in the modern world! Persistent out of control anger is invariably destructive. Examples of such outbursts are increasingly witnessed in our stressed society. While righteous anger can be a healthy response to the world’s problems, when it’s manifested as road rage, public meltdowns, domestic abuse, or drunken brawls, the symptoms are problems in themselves.

While my clients often report being the victims of aggressive anger, they often don’t realise how much lies within them – just beneath the surface. Displays of anger can mask underlying emotions such as shame, guilt, or fear of criticism. Anger is also manifested inwardly in the guise of self-criticism, self-harm or abuse of alcohol or drugs. Such ‘treatments’ may bring temporary relief, but in the long run they usually exacerbate the problem. Similarly, non-confrontational displays of passive-aggression are hard for others to decipher. And like the quiet rumblings of a volcano, they may eventually lead to violent unexpected eruptions of temper.

For those who habitually lose their temper, it invariably does more harm than good. Some may think it’s a show of strength, but it usually betrays a loss of control. Others see anger as ‘just a natural emotional response’ to a situation, but it can damage relationships as well as creating a toxic cloud around the perpetrator. Another myth is that angry outbursts are psychologically healthy – but it usually just increases frustration as well as alienating those burned by its fiery blast. Furthermore, chronic anger is detrimental to our health. When a body blows a fuse – it may do so with a heart-attack or a stroke.

Controlling the Dark Side…

When the sources of your frustrations are understood, anger can be healthily harnessed to actively overcome them.

Counselling can uncover these deep roots. Talking therapy helps unveil some of these difficult hidden feelings, while Cognitive Behavioural Therapy (CBT) can teach us to deal better with situations that provoke anger. CBT can identify faulty thinking that is often learned in dysfunctional upbringings or situations where we felt powerless. In some families or environments, expressing any emotion is discouraged. The stereotypical ‘stiff upper lip’ of the British reflects this unhealthy habit of bottling it up. CBT can also identify the negative thinking that often lies beneath. Such thinking is symbolised by the regular use of words like ‘always’, ‘should’, or ‘ought’ in expressions such as ‘Why does this always happen to me?’ When people think, and feel like this, they often make bad decisions. When a situation reminds them of a painful experience – separate from what is really happening – they may compensate by over-reacting. And the wrong person usually gets blamed.

Counselling can teach us more creative and positive ways to respond. Its uglier forms can be controlled by simple calming techniques – such as counting to ten or breathing more slowly and deeply. This can reverse the biological response where more oxygen is inhaled to prepare us for action. Such ploys help us choose the best strategy. The solution is usually quite different from the first instinctive reaction. The large brain we have developed over the millennia has evolved to let us reflect on all the circumstances once the immediate danger has passed. It’s what separates us from more primitive species. It seems a shame not to use it!

While the links below offer practical tips in self-control, sometimes more specialist professional help is needed in the form of anger management. For those on the other side of the fence, various organisations exist to help victims of physical or emotional abuse.

For most of us, general lifestyle choices such as exercise, good diet and healthy sleep patterns are good protections against our frustrations boiling over, while channelling negative feelings into a healthy creative activity can improve our lives exponentially.

We can always have too much of a good thing, but with thoughtful management, anger can be a force for good. Successful people often confess to having a dark side. Maybe they have just learned how to make a strength out of their very human weakness.

Useful links

For a better understanding of anger and how best to deal with its problems go to:
nhs.uk/conditions/stress-anxiety-depression/controlling-anger
helpguide.org/articles/relationships-communication/anger-management.htm
mind.org.uk/information-support/types-of-mental-health-problems/anger/#.W9xhWpP7TIU

To gauge your own susceptibility to anger, try the quizzes at
angermanage.co.uk
moodjuice.scot.nhs.uk/Anger.asp​

Organisations for victims of severe anger include:
refuge.org.uk
womensaid.org.uk
avpbritain.org.uk

Dealing with Bereavement

Bereavement counselling tackles an issue most of us avoid thinking about. The death of a loved one may be as inevitable as life itself, but few are prepared when it comes. The passing of an elderly parent can be a traumatic and life-changing event, while an unexpected or premature loss can seem too much to bear for even the strongest individuals. Even the death of a cherished pet can turn our lives upside down.

Some dismiss bereavement counselling because it can’t take away the loss. But death’s very inevitability makes it a universal issue for all of us. By confronting all its manifestations, we can better see how precious life is – and the joy brought by those who have passed on.

Some avoid bereavement counselling because they think that confronting their loss will be too painful. They may not be ready to break that connection with their loved one. Denial perhaps avoids facing the unpalatable reality of what’s gone, but it’s a natural reaction likely to prolong the heart-ache and grieving. For this reason, the bereaved are usually advised not to enter counselling until a suitable period – often six months – has elapsed. This allows some acceptance of the event, but varies between people and circumstances.

Recovery is often delayed because some mourners confuse being happy again with a disrespect or lack of love for the departed. We mostly say we wouldn’t want our loved ones to be unhappy when we are gone – but often feel society may disapprove of us getting back to our normal lives. For all these reasons, it can be hard to let go of grief. Many old customs exacerbate this – wearing black for a set period is one – particularly in societies where the death of the head of the household is given particular emphasis.

Getting Help

People often talk of stages of bereavement. In rough order, these usually involve acceptance of the loss, followed by adjusting to life without the deceased, and a subsequent easing of the mourning process. The final stage is our readiness to start living fully again.

The associated symptoms are often shock; overwhelming sadness; and apparent emotional and physical exhaustion. It’s also common to feel anger or guilt. These are human responses to what feels like an unacceptable loss. Blaming anyone or anything: yourself, the departed, the medical authorities, an illness, God… is part of a messy process before moving on.

It’s a cliché to say time heals, but also a rule of life. Each passing day is one closer to embracing life fully again. They will never be forgotten and you can honour their memory by living in a manner that would make them proud.

Mourning is best done with support. Friends and family are obvious sources of comfort – particularly those who share your memories. But sometimes they are scarce or unavailable. Few want to be a burden or risk upsetting others. Similarly, many intimates avoid discussing your loss to avoid upsetting you further. But the more you discuss it – the easier the mourning process becomes. The loss can be integrated into your normal life rather than becoming taboo.

Religious beliefs can provide comfort particularly from a supportive congregation. Some cultures embrace the end of life more positively than in the West. Whatever your beliefs, the common factor for all the bereaved is the need to adapt to this irreversible change.

Outside help is invaluable when you don’t want to lean too heavily on family and friends. Reminders such as anniversaries or significant events may be painful initially; you may find yourself neglecting yourself or others. These may be signs to ask for help.

Modern society now provides free help with specialist bereavement services – such as Cruse – or NHS counselling services. Further support is often available in groups where you can meet others in similar circumstances to help you move on. Feeling compassion for others may put your loss in perspective and awaken you from your private world of pain. It can be easier to talk with someone outside your own personal circumstances. Counselling services offer compassionate help from experienced professionals.

With their help, you can sooner see how the departed have enriched your life and appreciate how much better your life has been with them in it.

Useful contacts

Your GP and local counselling services – represented in Hounslow by Anchor Counselling – can offer 6-10 sessions of free counselling and put you in touch with further local services.

These include Cruse Bereavement Care (cruse.org.uk – tel: 0808 808 1677), whose trained volunteers offer face-to-face, group, email, telephone, and website support. Its nearest centres are found in Ealing and Purley.

You can also contact specialist organisations for specific illnesses e.g. Macmillan for cancer at macmillan.org.uk.

General information is available at nhs.uk/conditions/stress-anxiety-depression/coping-with-bereavement

The End of a Relationship

A million songs lamenting heartbreak detail how the rupture of a relationship can affect us in original and unpleasant ways. These soundtracks to pain may make great music, but rarely ease it. A cloud of gloom still descends over me when I hear songs from The Police album, Regatta de Blanc, though I have no recollection of who provoked this teenage angst. The body retains memories of pleasure and pain jealously.

Break-ups can be a massive blow to our self-esteem with the effects reverberating through every area of our life. The loss can sometimes seem unsurmountable – the mourning before feeling ready to love again can feel like a bereavement. Humans are social animals who usually work best in harmony with others. Being alone can feel devastating after intimacy is lost. The fall-out from a passionate tryst can hit some harder than a divorce ending a marriage lasting decades.

A colleague of mine once described falling in love as ‘a kind of madness.’ Falling out of love, I believe, can also seem like a temporary form of insanity. Surviving well and limiting the damage are often key to returning to normality relatively unscathed. Usually, the loss needs processing and a willingness from the sufferer to re-evaluate what happened.

Recovery is often hampered by unpleasant emotions we would rather disown. Feelings of bitterness, jealousy, and hate are initially commonplace. An isolated break-up can dredge up traumatic childhood memories buried deep in our subconscious, and a belief that such endings will be forever repeated.

How counselling can help

Understanding your role in the drama can help you avoid its future repetition and allow you to take back control of your romantic life. You may be desperate to understand the mind of a former partner, but greater knowledge of your inner self can reveal your role in its unravelling. Such inconsolable lows may one day be reviewed as significant turning points – the break-up may be the signal for positive change. Counselling lets you purge yourself of these negative emotions and allows you to develop new insights to break out of vicious cycles. Friends and family can help, but sometimes their advice is tainted by their own bad experiences. Sometimes too their bias towards you blinds them to objective truth.

Many people see themselves as unlucky in love. Therapy helped me realise some of my choices were just misguided and that I often misinterpreted breakups as personal failures. But looking back, the relationships were often less than what my romantic imagination built them up to be. Thinking a relationship will complete you is also a common but often misguided concept. You run the risk of putting your happiness in the hands of another – a responsibility that often weighs too heavily. Thinking a new relationship will paper over the cracks in your daily life may avoid confronting the real issues eating away at your self-confidence.

I often speak with clients trapped in poor relationships that are sustained by the fear of facing the unknown beyond its end. Sometimes the ‘investment’ of time in a relationship makes people hang onto it beyond its natural life – as if breaking-up is a weakness rather than an honest sensible response to its failings. The traditional view of marriage as a life-long contract supports the idea of longevity being a worthy accomplishment. But for whom is an unhappy house worth sustaining? Rarely for those living in it. Ending at the right time can preserve the good times in your memory. Great friendships often emerge from the shared trials of the past.

Modern dating culture multiplies our romantic options bewilderingly. The deceptive and unrealistic promises promoted by the Internet and multi-channel TV create enticing and unrealistic expectations. Counselling can help you find the balance between appreciating what you do have and what more you could gain.

For struggling couples, relationship counselling helps identify poor communication. Improving it can pay rich dividends. It might also clarify if a partner is not prepared to make changes. Either way, it can release you both from feeling helplessly trapped.

At least one song relates that ‘breaking up is never easy,’ but when you understand the reasons behind it, you can learn from past mistakes and make better choices the next time. When that happens, you may start noticing all those songs that celebrate love…

Available Help

Anchor Counselling offers support for relationship problems with both individual and couples counselling. Specialist support is also available from relate.org.uk, which has branches in Richmond, Ealing, Barnes, Staines, and Isleworth and provides extensive information on its website for all kinds of relationship difficulties. For information on relevant NHS services in your area go to nhs.uk.

Building self-esteem

Clients often confess to having low self-esteem. Its importance cannot be underestimated – it is key to negotiating the trials of life. While low self-esteem is not a disorder, its symptoms can undermine us and lead to anxiety and depression. We all have the power to raise it, but the solution is in our own hands rather than the prescription pad of our GP.

The foundations of low self-esteem are often found in our environment. Like building a new house, the circumstances and terrain are often instrumental to how proudly it stands. Those fortunate to have good parenting and material comfort often find it easier to make a safe happy home. For those lacking them, a more circuitous route may be needed.

Winning the lottery of life helps, but our self-esteem is not forever set in stone. Hardship can toughen us up for later trials and increase our self-belief after surviving them. Suffering can empower us when reflected on philosophically. Meanwhile, those given far more than their needs can develop a warped and entitled view. The spoiled and narcissistic are rarely happy souls for long.

Self-esteem grows by degrees, built up brick by brick and floor by floor. Even when attained, it can be blown suddenly away by a hurricane of bad events. The death of a loved one… the loss of a job… the misfortune of being born into what the Chinese proverb euphemistically describes as ‘interesting times’.

Building self-esteem can be a slow process for those punch-drunk from the slings and arrows of misfortune. Some may need more good experiences to compensate for the poor ones. But we can build it by slow incremental changes that change the trajectory of our lives towards where we want to be. The confidence of succeeding in one field can spill over into new ones. Progress in sport or work are good examples as are academic or vocational training where we have overcome our initial fears. It might be the slow painful jog around the block that one day ends in the completed marathon. It is wiser to focus on your strengths rather than obsessing over perceived weaknesses.

Keeping the dream of our small successes in our mind’s eye helps us overcome our doubts when we take our next faltering steps on the road ahead. With each new one, it becomes easier to take more. Witness the self-made entrepreneur who has won and lost, and won again. While fear holds many back, such people seize each day as if it is their last. We may see them as different, but they are made from the same flesh and blood as us.

A helping hand

If friends and family can’t provide sufficient support, counselling can offer a safe supportive environment to compensate. As with all therapy, real gains come from clients making their own decisions about their lives. Objective professional guidance enables this, while helping you avoid straying from the path and losing sight of the finish.

Talking therapies are useful when a significant experience has affected us badly. By recovering from the damage wrought, it can give us back the position of strength from which to make changes. Significant others may have undermined us with criticisms or unrealistic expectations, which more rightly reflect on their own shortcomings. Unmasking these warped views and influences can free us to be ourselves in our own image.

Cognitive Behavioural Therapy (CBT) is often recommended in building self-esteem. It can help clients improve their quality of life and give them a sense of overseeing their destiny. It can also help challenge negative thinking about abilities, luck and circumstances, while addressing the bad influences and habits that drag us down. In a Western society that often promotes us having it all – it can help reset expectations to something attainable and realistic, while exposing the tantalising promises of advertising that build false dreams for the profit of others. You are the architect of your own dreams. What you build may not match the splendours of your imagination, but the actual bricks and mortar you lay down will bring far greater meaning and contentment than your wistful daydreams.

You don’t need a magic wand to raise your self-esteem. A thoughtful positive engagement with life can soon bring dividends. All you need is the desire for a greater sense of self-worth – the belief will follow your actions.

Further information

These links offer a mine of information in understanding the importance of self-esteem along with options for treatment to help you build it up and maximise your potential.

nhs.uk/conditions/stress-anxiety-depression/raising-low-self-esteem

mind.org.uk/information-support/types-of-mental-health-problems/self-esteem

psychologytoday.com/gb/basics/self-esteem

Changing your Career

A rewarding job usually involves a lot more than the size of your paycheque. Spending a large proportion of our life doing something we often don’t enjoy can seriously undermine the quality of our lives. But it doesn’t have to be this way…

Some problems seem to be sole preserve of counselling. Career choices may seem more suitable in the hands of a careers advisor, but you can’t underestimate how much happiness is influenced by how you spend most of your unsleeping hours. Counselling can help move your working life towards a better place. Job insecurity makes many scared of moving on – particularly in uncertain times – but there is usually wiggle room to fine-tune your skills or learn new ones. Doing so can make you a more flexible, valuable worker, and even change the direction of your career completely.

Many clients complain about bullying bosses, bad working conditions, or being stuck in organisations that treat you like a dispensable cog in the wheel. Those who are signed off work are often stuck in a purgatory between employment and being jobless. Some feel hopeless because they are embroiled in endless disputes with seemingly cold and uncaring employers. For those lost in this Kafkaesque nightmare, regaining control over your existence may seem an unsurmountable problem. But there is hope…

Feeling undervalued and out of kilter with mainstream society are common symptoms of those in the wrong job. But often it’s the job that’s wrong – not you. The invigorating effects of a new environment can be life-changing. It may initially involve a pay-cut or insufficient hours, but if you are building from a happier base the benefits spread to other areas. Unexpected opportunities often materialise when your latent talents and ambitions have more fertile ground in which to flourish. Training in a new area or even taking unpaid work can later pay dividends. If it involves a field close to your heart, an initial shortfall in wages is perhaps worthwhile as it may represent a good investment for you future leading to further opportunities previously not envisaged.

Examples I’ve encountered include the part-time artist who balances its unpredictable income with book-keeping or the actor with a flourishing painting and decorating business. One client swapped her career as a theatre manager for her second love as a landscape gardener. She retains an interest in the former, but now only for the pleasure it now brings as a spectator. She has found the best of both worlds.

My current work as a therapist would not have been possible without volunteering first. Befriending a 90-year-old blind Jamaican eventually led to fully-fledged career in counselling as well as helping me understand his very different blinkered world. The free market does not make working for free very sustainable for long, but sometimes it’s necessary to step back to jump forward…

Counselling can help you discover what you really want before approaching the career professionals whose priority is filling vacancies based on your current skills. In an unfair world of economic extremes, there is always some room to improve your lot. This is largely within your own hands, but helping hands and ears can help you brainstorm the attractive alternatives and discover pathways new or dismissed as opportunities lost. Sometimes our place may seem pre-destined by the world we are born into, but the myriad possibilities our lives can follow can benefit immensely from a little guidance in the therapy room where none are ruled out. Satisfying careers often follow that brave first step into the unknown.

More information

Before researching the practical needs in terms of experience, opportunities and qualifications, counselling can help you consider all your options without considering these constraints.

This quiz at thebalancecareers.com/quiz-should-you-change-careers may clarify how you really feel about your current work.

A great source of potential new careers (or skills) is found at citylit.ac.uk with its extensive range of mainly evening courses. Alternatively, nationalcareersservice.direct.gov.uk​ offers a solid grounding of information on different types of employment.

Meanwhile, North-West London-based twiningenterprise.org.uk bridges the gap between sound emotional health through work. They can be contacted by email on info@twiningenterprise.org.uk or by calling its Hounslow branch on 079 6172 5510. Most major jobsites also offer sensible advice on different professions and how to go about finding it.

The Perils of Social Media

Social media has transformed how we interact, but also brings its demons into the realms of communication.

Stories in the traditional media abound with the dangers – particularly for the young. Cyber-bullying kills. Fake News incites hate and ignorance. Doctored images of the beautiful and famous create looks unattainable for ‘normal’ folk. Likes and retweets are vainly sought to create illusions of popularity or importance. With 91 per cent of 16-24-year-olds using social media, these issues are rife. For such ‘Digital Natives’ this addictive behaviour is perhaps understandable, but its omnipresence also affects those brought up in a simpler analogue world.

With technology moving ever faster, platforms from YouTube and MySpace to Facebook, Twitter and Instagram drop in and out of fashion with bewildering speed. On the plus side, social media can improve user’s sense of community, self-expression and self-identity. How it’s used obviously plays a major role, but it’s perhaps worth noting that a recent survey rated YouTube as the most positive – with Instagram coming bottom. The BBC described the latter as ‘the worse social media platform when it comes to young people’s mental health’.

The digital world never sleeps. Information overload is easy when you’re presented with the random thoughts, favourite TV shows, and home-cooked dinners of a 100 people you half-know. In comparison, our own lives can seem rather dull – hence the popularity of the very modern acronym: FOMO – or Fear of Missing Out. As our connections multiply – many of us feel lonely gazing through a computer window at the airbrushed lives of others.

It is hard to disappear beneath the radar or switch off from 24-hour technology. Insomnia is a common symptom of anxiety and depression and staring at your smartphone at 2am rarely soothes the mind. Many of my clients – young and old – discuss the stress induced by following social media… how ever-widening social circles are diluted rather than enriched… how Facebook friends are less reliable than real ones… how the allegedly glamorous lives of others make us question the adequacy of our own existence.

The unceasing flow of data does not increase its quality or meaning. Some follow world events obsessively, but when the news agenda is dominated by negativity, it’s a habit that can darken our perception of humankind. And while pictures can say a thousand words, the blur of images can blunt our sensitivity rather than educate and enlighten. Billions of years of evolution has given us five senses – social media discards all but two!

Social media ultimately challenges us to sell ourselves. The increasing worship of physical appearance – let alone the visual lies created by digital editing – can promote insecurity about how we look. It encourages us to be seen and heard above the noise of everyday life. Perhaps it’s best symbolised by the tourist tool of a Selfie-stick with which we become both the subject and object of our own experiences. Might we not be missing something in between?

Taking back control

Problems created by social media lack the direct and painful sting of death, heartbreak or serious illness, but using it excessively can heighten the symptoms of other issues.

The cure is not rocket science. Reducing use is an obvious antidote, but a hard medicine for many to swallow. As going on-line is now ‘normal’ behaviour, we may not realise how much it helps or hinders our everyday life. To evaluate these effects, try calculating the ratio between how often you check your social media with how often it brings new meaning and happiness to your life! From here, you can perhaps devise a happy medium – not just in the time you spend on it, but on which parts have a positive or negative influence on your life. Make the adjustments and bring some balance back.

In therapy, we encourage people to look into themselves to discover what they really want away from the distracting demands and influences of others. Detaching yourself from a billion confusing and contradictory worlds on social media may perform a similarly useful and insightful role. And once you know yourself better, you can Like yourself without having to log in for approval from others.

Further information

If you are worried about the effects of social media on yourself or someone you know, speak to your GP about how counselling may help. As a parent, you can also help by finding out more about your child’s social media consumption and its effects on them.

The report discussed in the blog was compiled by the Royal Society for Public Health (RSPH), an independent charity working to improve the health and well-being of the public. It makes recommendations for those with influence in changing our social media habits, such as schools, organisations and governments.

Briefly, it suggested pop-up warnings for excessive use; icons highlighting when photos are digitally manipulated; health information to be certified as trust-worthy; safe social media to be taught in school; for platforms to identify vulnerable users and sign-post help; for youth workers to have social media training; and more research made for the effects of social media on mental health.

For the full report, go to nhs.uk/news/food-and-diet/instagram-ranked-worst-for-mental-health-in-teen-survey.

Fighting Anxiety

Anxiety is one of the most common and debilitating symptoms reported by clients seeking therapy. It can encompass myriad problems. The disruption it causes to daily life is one of the key indicators the NHS uses to assess emotional health.

The fight, flight or freeze response that underlies anxiety is a practical biological response to a possible threat. It’s caused by the limbic system – the most primitive part of the brain. It triggers hormones such as adrenalin and cortisol – the messengers that send your body into a state of emergency and readiness – directing blood and oxygen to where it’s needed most. This can be life-saving when danger lurks around every corner, but can cause more harm than good when activated by a power-point presentation or a missed train! It obeys a rather crude process of ‘better safe than sorry’ to aid the survival of the species.

The more reflective and analytic parts of the brain have evolved to exert some control over these extreme reactions. When this fails, we can rush into fights, lose our temper, or freeze in fear. The ‘pumped-up’ athlete can positively use anxiety to enhance their performance, but too great a ‘rush of blood’ can ruin it!

General Anxiety Disorder (GAD) describes the condition of chronic and acute anxiety – the human version of a car alarm that blares obnoxiously every time a leaf harmlessly floats past. For such people – and those around them – this near constant state of emergency is understandably exhausting. Conditions such as social anxiety, panic disorder, claustrophobia or agoraphobia, and post-traumatic stress disorder (PTSD) are separate diagnoses involving high levels of discomforting but generally treatable stress.

Reducing the Rush

Most people experience some anxiety during difficult times. If our nervous system is imagined as a bucket, our life challenges can be symbolised by the water in it. When the bucket overflows with one stressor too many, the water may spill over the rim. The camel’s back is broken by one straw too many, the engorged stomach explodes due to one too many wafer-thin mints! (One for you Monty Python fans.) Reducing the level by making small holes in this metaphorical container can reduce anxiety to something more manageable.

Removing some stressors altogether is the ideal way forward. Stress unnecessarily creeps into our lives in many small ways. Habits like smoking, alcohol, drugs and bad diet may offer short-term relief, but usually just delay and exacerbate the damage. Other influential factors may be the TV you watch, the company you keep, how much coffee you drink, the responsibilities and activities that do more harm than good… Making a periodical inventory – a kind of emotional spring cleaning – can help identify which habits ease or complicate your life.

Your GP can offer medical support for conditions such as insomnia that aggravate anxiety. Unhelpful habits ingrained in early life may suggest the value of counselling to change them. Treatment tends to control rather than cure, but the mind can be trained to be less sensitive to the scaremongering of the environment. Exercise can harness nervous energy, while relaxing activities like yoga, meditation and mindfulness can teach you to operate at less stressful levels.

Deeper sources of anxiety may be more problematic such as a long-term health condition or worries about friends and family. In such cases, try dividing your concerns into two groups. Firstly, those that cannot be changed, but can perhaps be handled better by your learning to accept them. The second category can be reserved for those you can positively improve. It may be a failing relationship or an unsatisfying job. Doing nothing about the situation is liable to make it worse.

The insecurities of your childhood may no longer exist today. The recurring nightmare of physical or sexual abuse – or flight from a war zone – are examples of traumas that may ripple destructively throughout later life when the danger has passed. Similarly, the inheriting of an anxious disposition through the lessons or genes of an over-protective parent can benefit from the appropriate re-education of our nervous system to our current needs.

Short-term counselling or more extensive psychotherapy can teach you to see the wood for the trees of your emotional life. Cognitive Behavioural Therapy (CBT) can help rewire your thinking to escape the persecution of phobias that hold your life back, while specialised treatments like Eye Motion Desensitisation and Reprocessing (EMDR) are often successful in overcoming the trauma behind PTSD.

Reducing stress can give you back control of your world. We may be programmed to feel anxiety for good reasons, but you can always have too much of a good thing.

Useful links

nhs.uk/conditions/generalised-anxiety-disorder/ explains the symptoms of GAD and how to treat it along with other conditions where anxiety is prevalent.

anxietyuk.org.uk offers a wealth of information on specific disorders such as Obsessive Compulsive Disorder (OCD), Trichotillomania (compulsive hair-pulling), and Body Dismorphic Disorder that are related to anxiety, and gives details of a range of treatments.

mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks