Alcohol dependency and families

Blue - from the Kaleidoscope Project exhibition - information below

by our guest author from North Powys

It was recently Alcohol Awareness Week and there were lots of stories and comments online about the effect alcohol dependency can have on society. This got me thinking about my own experience and I wanted to write down my thoughts and share my story to help people understand what is like for the families affected by alcohol dependency.

So, let’s start by looking at what exactly alcohol dependency is.

"Alcohol dependence, sometimes known as ‘alcoholism’, is the most serious form of drinking problem and describes a strong, often uncontrollable, desire to drink.

Drinking plays an important part in the day to day life of alcohol dependent people, which could lead to building up a physical tolerance or experiencing withdrawal symptoms if they stop."

The reason I use the above quote is because all too often nowadays people believe that alcohol dependency is a choice. No. No. No!  Alcohol withdrawal is one of the most dangerous and painful of all the addictive substance withdrawals with some awful symptoms such as hand tremors, sweating, nausea, hallucinations and seizures.

The incident that finally led to my mother’s recovery started with a seizure. She was trying to do the right thing but ended up having seizures. I didn’t live at home at this point, and I got a call from my mother’s boyfriend nonchalantly informing me she was having a seizure. I screamed down the phone whilst running home. I called an ambulance and she went into hospital. It was horrifying but she was released and went into rehab. I found out later that she had been given three months to live.

Does that sound like she had a choice?

Then you hear the other argument people often come out with.

"But when someone starts drinking then surely that’s their choice?"

What they don’t know is what happened to start that person drinking. I suffered from anorexia and self-harm. When I was severely ill would you blame me? After all it was my choice to stop eating. Or when I turned up at the A+E department needing to get stitched up, embarrassed and ashamed after self-harming, am I a waste to society because I did it to myself? Unless you have no compassion or empathy the answer is no. 

I struggled with these issues because I was abused. I believe that my mum’s guilt for not realising what was happening to me was one of the reasons she began drinking unhealthily. I was very ill with my own mental health when my mum found out she was pregnant again. My brother had his own issues which didn’t help and she had a new-born to look after. She was struggling. Who wouldn’t be? Everyday stresses, job worries, financial issues, a mentally-ill child who was stockpiling pills and running away. It was no surprise when she was diagnosed with post-natal depression and sent away with a supply of pills and an appointment with a doctor in a few weeks. A can of lager in the evening was the norm.

It’s so gradual. It’s hard to pinpoint when it became a noticeable problem. That can of lager in the evening becomes a few more, a bottle of wine a day which becomes a bottle of vodka. She was very good at hiding it. She drank to hide her anxiety. Every time she left the house she had a panic attack so she found a coping mechanism to continue to function. And it worked. For a while. We had no idea, we knew about the anxiety but she was ‘out and about’ so that was ok. However, we started to notice she was drunk more and more often and empty bottles were turning up around the house. That’s when it came to a head and we all knew she needed help.

People can forget about those who are around an alcohol dependent person because of the stigma involved. It becomes a family secret and if you do try to reach out people don’t know what to say. It can be incredibly isolating. I would dread coming home as I didn’t know what I would find there. Mum usually passed out, us having to make tea and look after my sister. If she was awake there might be a huge row between my mum and her boyfriend whilst I had to try and keep peace for the sake of the children. I felt responsible and that I had to keep it all together. I was taking time off college to help look after my baby brother whilst my mum was drinking. I would attend the parent evenings, and I was always the one who people offloaded their problems on. My mum, her boyfriend, my brother. I was there for them to vent at, but there was no-one for me to turn to. 

It was soul destroying at this time seeing my mum going to the doctors, begging for help. She was referred to the local Community Mental Health Team but was discharged after two weeks because she ‘didn’t want to help herself.’ I was missing college, and I was continually stressed and glued to my phone. I went to a GP. This was the same GP that had prescribed Diazepam for my mum for her anxiety which she was now dangerously mixing with the alcohol. I told him what was happening, and how stressed I was, and I hoped he could do something for my mum. He called the child protection services, which unsurprisingly left me unpopular with my family after that, adding to my poor mental health.

I used Google to find out about a national organisation called National Association for Children of Alcoholics (NACOA). I sent them a lot of emails and received good advice and support back from them. I saved the emails, and re-read them when I was struggling. Those emails got me through some dark times and difficult choices.

I am very lucky that my mum was finally able to get the support she needed. She made a full recovery with very little damage to her body. I am so proud of her as it is a huge achievement. Not everyone is so lucky. Some people cannot access treatment because they don’t have a permanent address, or the health professionals they are in contact with don’t understand their illness. They might not have the support or strength to recover.

A big issue is with dual diagnosis. If somebody is diagnosed with depression and alcohol dependency you need an assessment to access the service. To have the assessment you need to be sober. Do you see the issue here? It’s a vicious circle where the cause of the problem can’t be treated until the problem has been treated. But the alcohol dependency can’t be ‘cured’ until the depression is. One feeds the other and we need to understand this more as a society.

The idea that ‘they did this to themselves’ is so instilled in society that when someone tries to recover they are turned away. We need to fight the stigma and celebrate and nurture recovery.

Photographs

The photographs in this blog post feature artwork from a Project Kaleidoscope exhibition held in May 2019 in Newtown in Powys. Kaleidoscope is a charity which seeks to tackle the stigma that people with drug, alcohol and mental health issues face.

The exhibition was inspired by using forms of art in individual care plans to address drug and / or alcohol use. Service users and volunteers worked together to develop the display at the Oriel Davies Gallery, which showcased the creativity of individuals who had accessed support for substance misuse at some point in their lives. What their work has in common is how creative activities have played a significant role in exploring emotions, reducing anxiety, improving a sense of self-worth and helping to resolve other psychological conflicts.

Sources of support

Kaleidoscope Project - 01686 207111

Alcoholics Anonymous - there are regular meetings in Brecon, Newtown & Welshpool

National Association for Children of Alcoholics - 0800 358 3456

Drinkaware - 0300 123 1110

What is it???

The menopause and women's wellbeing

This week we feature a blog post by a new guest author from North Powys. The author writes about the impact of the menopause on women's daily lives.

The menopause is part of the natural ageing process for women. Commonly known as ‘the change.’

What is it? Not the physiological process, but …..what is it? Do we know? Women experience it in isolation, in silence and pretend to others around them that it is not even happening. Resulting in us all ‘going it alone’ and often thinking we are useless, incompetent, weak and always petrified someone will find out that we are not coping so well and on some days not coping at all!

So, why am I talking about this now? I am nearing the end of the process and watching other women around me going through it. All the signs are there to see - the mood swings, women being snappy, tearful or even displaying a strange vagueness when normally this is not the way they are. Then there is the loss of names of people or the names of everyday objects, general tiredness and the dreaded FLUSHES - like someone has lit a match inside you and the heat spreads and spreads until its unbearable!

And what do we do?…. we LIE!

We pretend we are OK.

We ignore it and in doing so, it becomes TABOO and not only is it hidden, we don’t support one another. Sometimes just to hear another women mentioning some silly thing that happened to them like -  “I couldn’t remember the word for hairbrush” - makes menopausal women feel better. Then they know this happens. Otherwise the silly thing becomes an enormous thing and women begin to think they have some type of dementia or a brain tumour or worse. You think I am being dramatic? I promise you I am not.

Grieving for your reproductive abilities, even if you never wanted children, or you didn’t want any more babies anyway!

And more...

• Writing endless lists because we are petrified our memory will fail us at work. 
• Dealing with all the physical things, like bleeding, sometimes for weeks, until finally your periods stop. Vaginal dryness, painful sex, hot flushes, brain fog, breast tenderness, lower sex drive, fatigue, feeling old and even urine leakage when coughing or sneezing. OH what it is to be a woman! 
• Dealing with the sadness, a depression that seems to have no cause, even when everything else in your life seems just fine. 

I have cried a lot, and still do some days. I was lucky, I had very few physical symptoms, but my memory was shot to pieces! The doctor told me it would return and you know what? It is… returning, even though I still look at someone I have known for years and think: “OH no, I can’t remember their name.”

Every woman experiences the menopause differently. Some have a terrible time, while some appear to sail through it, but what we all have in common is the "secretness". I do not even know if that is a real word but it’s how I describe society making women feel - ashamed of a natural process and trying desperately to hide it and then...  inadvertently not enabling us to help other women understand that what is happening to them is perfectly NORMAL.

The menopause needs to be regarded as a normal part of life, like pregnancy is, not a taboo subject. Little conversations about the menopause could normalise and encourage understanding of the subject and make life at work (and home) so much better.

So, celebrate your womanhood, celebrate your strength, even celebrate ‘the change’. Tell people about it. Oh, they might get embarrassed but they will have learnt something new about wonderful, amazing women and, you never know, one woman might go home thinking “Thank goodness, I am not going insane.” And one man might leave the building – thinking…

.... and here I am hiding in plain sight ANON.

“It is only in our darkest hours that we may discover the true strength of the brilliant light within ourselves that can never, ever, be dimmed.” 

– Doe Zantamata

In 2017 The Wales TUC published its new report ‘The Menopause: a workplace issue’. The report, based on a survey of almost 4000 workers, found that 88% of women workers who've experienced the menopause felt it has an effect on working life, while around 6 in 10 had witnessed the issue being treated as a joke in the workplace. The survey also showed that only a very small number of workplaces have policies in place to support women who experience difficulties during the menopause.

If you need support around the menopause, check out the charity Women's Health Concern, which is the patient arm of the British Menopause Society.

How playing Pokémon Go helps my mental health

by Mark Evans aka wildfairyboi 

As a sufferer of anxiety and depression, and suspected Post Traumatic Stress Disorder (PTSD), I spend a lot of time alone in my room. I find it extremely hard to start a conversation and when people begin to talk to me I get dizzy. My heart begins to race and I find it hard to catch a breath so I kinda shut off to the world. To some I might seem extremely ignorant. But this is not the case. I would love to be able to just walk up to someone random, introduce myself, and have a good old chat...

However, since I can remember I have always freaked out at the prospect of meeting someone new .. Some days I even find it hard to talk to people I know very well including my own family so I'm always looking for reasons to give me confidence to leave my room... 

As a 90s baby I grew up watching Pokémon and I loved it throughout my childhood…. And, not gonna lie, I still watch it to date… So when Niantic released Pokémon Go I was really excited to give it a go to the point I ordered a new contract mobile specifically to play... I was so taken in to the game catching all my favourite Pokémon I started going out all night when there was nobody around to play the game. I started to go out nearly every night. I walked around town and the lake every day for nearly a year.

Then I got ill and also had to look after one of my mates so I stopped playing so much. I actually didn't pick up the game for nearly 9 months as I was with my friend every day trying to fix her life up. Or I was really sick myself, and in and out of hospital. So I stopped my evening walks and began to spend all my time either at hers or hiding in my room again as I slowly got more sick. This made my depression and anxiety worse to the point I stopped going out again at all.

In the last 4 months I have picked up my fone and begun to get out walking again as I convinced my mate to do the same. She also got a fone to come and play Pokémon with me. So we began walking round in the evening, then we decided to start doing some of the daytime tasks on the game including meeting other players. I noticed my anxiety was still there but having Pokémon to talk about distracted me enough to get into conversations about it.

We met more people to share Pokémon info and tips with and began to get invites to X raids for a chance to catch legendary Pokémon ... So I started to go and meet random groups to play Pokémon although still feeling anxious .. Playing Pokémon Go gave me a reason to meet up with these random people and a reason to talk, so I slowly gained confidence to the point I'm now out most of my day playing... I’m either walking round town or the lake several times hatching eggs or walking Pokémon or even just chasing cool Pokémon on the near by. 

I'm even trying to get groups of people to come and meet me to help at some of the Pokémon raids and awaiting any one asking for help on the chat. If anyone asks for help I'll try to get wherever the raid is. 

So I've gone from having no confidence and staying indoors all the time to walking round the town for hours on end not wanting to go home some days. I’m meeting lots of new people and re-meeting old ones - all out playing Pokémon. I noticed there's quite a few really anxious players but all eager to come play when they can. 

S is another regular Pokémon Go player locally who has been 

struggling with her mental health. She says: 

“Playing Pokémon Go has literally changed my life.”

Big thanks to Anne Woods who is a Participation Officer in our team but also a very keen player of Pokémon Go. Anne has been playing since the day it started in the UK. She very kindly created the infographics with the Pokémon Go basics for the newbies amongst us...

I found recovery in putting pen to paper

by guest author Charlotte Underwood

My name is Charlotte Underwood. I am a 22 year old mental health advocate and writer. I have fallen into a passion of writing and raising awareness of mental health and suicide by a beautiful accident; now I wouldn’t change a thing for the world. It’s ironic that for a long time I belittled writing and those who perused it, I had no idea that one day writing would save my life.

I used to laugh at my father for writing poems but now I know why he did it.

I remember the feeling of dread when I knew I had an English lesson. Writing and reading had become a chore, a forced constraint of my time – I hated it almost as much as I hated P.E. which was an immeasurable amount. The very thought of Shakespeare would make me groan in frustration.

It wasn’t always this way. As a child of maybe seven, I spent my spare time writing these stories about tornados (I was obsessed with the film Twister at the time) and writing a very varied volume of song lyrics. I was, at one point, an avid book worm. I could read before I could spell or even ride a bike, it was second nature to me. I was always running out of books to read and found myself wiser beyond my years. I couldn’t understand why no one else liked reading, when a whole new world was at your fingertips. I loved that I could be anyone I wanted to be, see anything I desired and it didn’t cost me a thing – except my pocket money. It was a blissful escape for a life which was hard on my younger self.

I feel like a mixture of those pesky teenage hormones, and the dullness of the school that I was attending, was why I lost my love of the novel and I why no longer enjoyed writing. All my creative juices were compressed into a shape dictated to me by the teacher, where is the fun in that?

Besides, I wanted to fit in and those who enjoying reading and writing were at the bottom of the social ladder, an easy way to get bullied. I never understood the reason for this but I never wanted to argue. I had a hard time fitting in and I was often picked on, so I didn’t want to give any ammunition to my peers. So, for the remainder of my school life, I stuck to social networking and gaming as that was cool, apparently.

When I left school, I could have picked up a book again or started to write but I had no time. If I wasn’t drinking with potential partners, or trying to get noticed online, I was working, like everyone else I knew – another social pressure. My brain was much like an empty fuel tank on a rusted vintage car.

Then a blessing hit me when I turned 20. It was disguised as a very traumatic job loss but turned to be the most wonderful gift. Once I had licked my wounds and made the most of not having an alarm clock or a routine, I found myself bored. I am a very independent person and I like to keep busy. I am very compulsive and can’t sit around and do nothing, so I had to find something before I started to relapse. I did not believe that I needed to write but I was wrong, so wrong. I only wish that I never gave up my love of literature because it seems now that my love had never gone, it was just buried under the weights of life.

I don’t know why I started but I began to write. I wrote a little each day - I must have started and stopped many novels. It was hard because I was trying to drink from an empty cup, though with time found the water I needed to nourish the blank paper. Eventually I found a passion for mental health and preventing suicide, as I lost my father in 2014 this way. I wanted to create something that would support people like me as I noticed how lonely it was to be a suicide survivor and that wasn’t right. Thus, born was my first book and the romance of my two passions, writing and mental health.

Since then, I have found myself entering short story competitions and have written a second short novel, as well as a full-length novel yet to be published. However, my love was found in poetry. Poetry allows me to bend the rules of writing, to ignore perfection and focus on emotion, it is a perfect match for my mental health advocacy – even flaws can turn into roses.

For what began as something to keep me busy, writing has become my therapy and daily self-care. I may not wash myself or brush my hair on some days but I will write, like I have every day for the last 6 months – without fail.

To write is an art but it is also a way to remove negative thoughts and feelings from your mind. From there you can start to unjumble it all and start to make sense of it. It’s enlightening and has been my biggest tool in recovery.

It’s worth a mention that writing has kept me feeling productive, and moving my hands is soothing to a person like me who cannot sit still, which means I have less time to allow that black dog back in.

I think I may write every day until my last.

If you would like to find out more about Charlotte's story, you can download her free e-book, After Suicide.

Connecting at Brecon’s Bipolar UK support group

This week's post is from a regular attendee at the monthly Bipolar UK support group in Brecon.

My name is Liz and I have bipolar disorder. I first experienced mental health difficulties at aged 16, and was diagnosed with depression at 22. I continued to experience depressive episodes, which became more severe and frequent during my working life, leading to early retirement when I was 48. 

I was treated with a number of antidepressants, but these had limited efficacy and activating side effects. I was told I had Treatment Resistant Depression and things seemed pretty bleak. 

Six years ago, in my early fifties, I was sectioned and admitted to a psychiatric ward with psychosis. Following this I continued to experience mental health symptoms, despite medication and therapy. 

In April 2016 I was seen at the National Centre for Mental Health in Cardiff and given the diagnosis of Bipolar 1 Disorder. Since starting a mood stabilizer, I have been much better. 

I also attended the Bipolar Education Programme Cymru, an award winning education programme for people with bipolar developed by Cardiff University.

Following my diagnosis, I picked up a Bipolar UK flyer at the hospital. I later contacted Bipolar UK to find out what support was available in my area, and they put me in touch with the Bipolar Support group in Brecon. I have been attending the group for almost a year, travelling the 20 miles from Merthyr, and really value the sessions.

The group meets on the 4th Monday of the month between 7 and 9pm in Brecon and District Mind. The sessions are open to people with a diagnosis of bipolar disorder, family and carers, and it costs just £1 to attend. Refreshments are provided.

The meetings allow time to find out more about bipolar disorder, and to share how we are all feeling and doing. Sometimes we have outside speakers. These have included Jodine Fec, the Lead Pharmacist Mental Health for Powys Teaching Local Health Board and Support Workers from Gwalia Care and Support. We might also watch films with a bipolar theme – one was Infinitely Polar Bear – a comedy drama about a man from Boston with bipolar. Or sometimes we enjoy a bring and share meal together. 

Personally, I really value the mutual sharing and support, in a friendly and non-judgmental environment. I have my own social networks, but it’s not the same as talking to someone with bipolar disorder who has the understanding and experience.

You don’t have to speak at the meetings if you don’t want to, although everyone has the opportunity to do so. You can stay as long as you want – so leave whenever you wish. And you can come along to as many or as few meetings as you like.

The groups are aimed at people aged 18 and over, but young people aged between 16 – 18 can attend if they are accompanied by a parent or guardian. 

The next meeting is on Monday 27 November 2017. If you would like to join us at this or any future meetings you would be very welcome. You can:

• Just turn up at a meeting 
• Or find out more by phoning 0333 323 3885
• Or email: brecon@bipolarukgroups.org.uk

Stop press: We plan to screen a film about Graham Obree, the cyclist nicknamed “The Flying Scotsman” who lives with bipolar disorder, at a future meeting.

Many thanks to Liz for telling us about the Bipolar Support group at Brecon. This is currently the only such group operating in Powys, but if you would like to see a group in your area then contact Bipolar UK to express an interest. The more people who want a group in a specific area then the more viable it becomes.

All artwork by Liz.

Type 2 anorexia – my experience

This week's guest post is by a young person living in Mid Powys.

Perfectionistic, body dysmorphic, obsessive and depressive are accurate words to describe anorexia. Six months in a psychiatric hospital suffering from the disease has proved this beyond question. However, the experience also revealed to me two different manifestations of the disease - characterised by varying degrees of the traits above:

Type 1, where the sufferer has a severely distorted view of their body and therefore exercises and starves themselves in the pursuit of looking ‘normal’. This is what most people perceive anorexia to be about, but I (and others in hospital) didn’t identify fully with this and hence believe there’s a second type. 

Type 2, where an obsessive routine of eating and exercise develops in order to avoid irrational consequences despite perceiving oneself as normal (perhaps slightly overweight). Here, the consequences could revolve around any aspect of your life but mainly around weight gain where the goal is to be thin - better than normal. Hence, those who identify with the second type are likely more perfectionist, academic and hardworking. However, they’re probably more at risk (due to these underlying personality traits) as it’s probably more dangerous to act on self-perfection than on self-perception.

The obsessive, perfectionistic roots of type 2 affect many aspects of the disease making it clearly distinguishable from type 1. In type 2, food itself isn’t an issue, the calories are (hence half the hospital chose to have liquid supplements and the other half had food despite being equal in calorific intake). Exercise is also more of an issue in type 2 than type 1 as it becomes built into a rigid routine and must be done to relieve anxiety (as opposed to accelerate weight loss). Type 2 anorexics are also more likely to be deceptive and compete with other sufferers to be perfect in other people’s eyes rather than just in their own to become the ‘best’ anorexic they can be. In this respect access to online material and social media create a competitiveness which likely makes many people’s condition worse. Finally, in type 2, anorexia cannot be separated as an entity from the sufferer (hence getting to draw/name it isn’t effective despite working well for type 1 anorexics). This is because for them the disease takes advantage of their personality traits and becomes an extension of them.

We should use our understanding of each type of anorexia to personalise the otherwise universal treatment plans. Personalised medicine is a hot topic in modern medicine. Gene sequencing and editing has allowed us to choose the treatments which we know will work best on patients. Why not extend this to anorexia?

Of course, the line between the two groups is blurred, but there are many instances where placing me into one of these groups would’ve helped mine and other sufferers’ recovery. Catching it early will inevitably reduce the likelihood of the disease worsening but recognising when further intervention (from Child & Adolescent Mental Health Services to psychiatric hospitals) is necessary is just as important. Taking away the choice by involving professionals is often the only way people too far into the disease can recover and increase their weight enough to correct the depression and distorted thinking associated with anorexia. 

Also, the incentives for recovery are blocked by body image or compulsions for type 1 and 2 respectively. We could therefore target these blocks differently for each type. Classical conditioning is used to treat Obsessive Compulsive Disorder (OCD) and involves patients doing what it is that causes anxiety (or not doing it in the case of a ritual). After being in a better mentality to do so, I decided to try it. I went home over a weekend and didn’t sneak off and exercise at all. That weekend was the only time my weight dropped during my whole recovery. My anxieties were practically gone from this point onwards. 

Finally, the qualities associated with type 2 sufferers can be redirected from weight loss to something beneficial. For me, I became very academic which allowed me to preoccupy myself and give enough incentive to remain fully recovered. Incentive is the key to the cure. Access to mental health services is the key to prevention.

After sharing my thoughts on service provision I’d like to talk about what it’s like to have been a male anorexic. I imagine that you’ve pictured a female through reading this blog and hope that you’re somewhat surprised that the author, the sufferer, is male. I wasn’t at all surprised to be told I had anorexia - I knew about the disease and could tell things weren’t right especially after comments from almost everyone I knew expressing their concern. I have a female twin and understandably my mother has since admitted she was always conscious of the fact that she could become anorexic. These were probably unconscious thoughts felt by everyone around me - I wasn’t expected to become anorexic and hence I was allowed to get progressively worse without it crossing anyone’s mind. I’m sure that this allowed my mind set to change and my weight to drop enough that the anorexia had developed into something that couldn’t be solved without professional help.

Unfortunately, I was taken to the GP surgery twice and both times was told that my weight wasn’t low enough to cause major concern. I was, however, referred to CAMHS on the second occasion. To an anorexic this was like being told you’re not thin enough. Furthermore, the naivety of the doctors to accept all that I said (that I eat lunch and have snacks, only exercise every couple of days and am still sociable and happy) prevented them from assessing me on anything bar the weight-age percentile I was in.

As a boy my original motives were also different to those of girls. At 7 and a half stone, I was plump and had innocent comment from friends and family saying the same. I thought I should try and lose some weight and gain some muscle (as mentioned, the muscle gain I wanted was impossible for a 12 year old). I started with cutting out food and exercising more and liked the results so continued doing this to greater and greater extents. The weight loss and routine consumed me - I lost friends and my confidence, my work suffered, my hair began falling out, my skin flaked away, I was constantly cold and remember dreading the thought of standing or walking because of how faint they made me feel - this is certainly a mental and physical disease. 

Waiting almost a month for an appointment with CAMHS gave me the time to rapidly worsen. I was lucky to have an exceptional psychiatrist - the best of many I’ve had since. However, weekly appointments with her were of little benefit and my weight continued to drop. A paper cut in class one day caused me to faint and have a small seizure which prompted my removal from school and a two week bed rest. Another month of this saw little improvement - I didn’t want to get better. My family and I were becoming more and more depressed and with all of us finding life unbearable, I was taken to a psychiatric hospital where I was the only boy. 

By removing the choice of recovery, my weight rapidly gained and I began to see more clearly - food really is the ultimate medicine and choice is its antagonist. After six months I returned to school where everyone supported me through my last steps. It took almost a year of going at my own pace before simply wanting to be normal gave me the incentive to recover - I came off my meal plan, started socialising, working hard and enjoying life again. Once in the healthcare system being male didn’t affect anything, however - expect a man as you would a woman to develop an eating disorder and don’t shy away from talking to them about it. 

There’s a reason anorexia in males is becoming more common. Social media has recently become inundated with pictures and quotes encouraging men to love women with curves and promoting curves by redesigning children's characters (particularly Disney princesses and Barbie) to reflect more realistic figures. Unfortunately, there is no male equivalent. All I ever see are pictures of ripped and good-looking men, one even quoting “women like butts too”. This sends the message out that men must love overweight women but that men must have a knife-sharp jawline, a sculpted body and of course, a peachy bum to be considered equally attractive. Its reasons like this that Body Dysmorphic Disorder is becoming worryingly common especially in males. 

We need equality to favour all genders - encourage everyone to be happy with how they look as long it’s healthy. I’ve gained so much from my experiences and have helped many to overcome their problems but the horror of anorexia and how much of life it affects is only known by sufferers and their families. It’s not a route that social media should inadvertently encourage people to go down  - we’ve ensured this with women but I feel men are increasingly led along this path due to the lack of society expecting them to do so.

Postscript from our guest author:

On the last day of an eventful year, I need to say this. The expectation of men to be strong and brave - to be masculine - is quite literally killing people. It's this expectation that allowed me to fly under the radar when my mental health suffered and it's this expectation that has killed four silently suffering but definitely loved friends in the last month alone. We need to be so much more aware of the hurt that people around us are feeling and not hesitate to talk to them about it. It really can be just a few words, a quick check up or a smile that can break that depression and give someone reason to think about the future which is otherwise non existent in the mind of a depressive. Please, have a Happy New Year and make this your resolution so that in 2017, good people aren't hurt by their mental health.

Many thanks to our guest author for sharing his experiences of anorexia. There are several charities specialising in providing support for people with eating disorders. These include:

B-eat - the UK's eating disorder charity

Anorexia & Bulimia Care

Seed - eating disorder support service

Men get eating disorders too

If you know of others, let us know in the comments box below.

Active Monitoring - Mind working with Powys GPs

Just last month at the PAVO Conference, which focused on Prevention and Early Intervention, we found out more about a new initiative at Brecon and District Mind when Service Director Val Walker spoke at the Mental Health Conversation. Active Monitoring provides support to people who visit their GP with symptoms of common emotional health needs including stress, anxiety and depression. The service aims to increase wellbeing, self-esteem and confidence, and reduce the likelihood of needing to access further support relating to a person's emotional wellbeing.

The mental health charity Mind describes Active Monitoring as: "a psycho-educational programme designed to provide early intervention provision within the Primary Care arena. With growing demands on Therapeutic Services resulting in increasing waiting lists it is getting more difficult for people to access the help they need in time. This role involves working directly from a GP surgery delivering the Active Monitoring programme. The service complements/replaces the ‘watchful waiting function’ and proactively works with individuals on agreed pathways to support early intervention via a facilitated self-help model."

Elizabeth Bogunovic

Brecon & District Mind works closely with the GP cluster in South Powys and Red Kite Health Solutions CIC (Community Interest Company) to deliver the Active Monitoring service.

Elizabeth Bogunovic is the Mind Active Monitoring Practitioner delivering the service for Brecon & District Mind, and she tells us more about this innovative way of working:

It was when I began volunteering for Merthyr and the Valleys Mind that I became aware of a service called Active Monitoring. The more I heard about it, the more intrigued I became so I sat down with Nicola, one of their practitioners, who explained to me the ethos behind the product so to speak. From that point on I was passionate about the possibilities an early intervention, self help service could offer people and considered the time a few years ago I found myself stuck in my own ‘mental health mess’, and how it may have changed the course I took at that time. I am convinced it would have helped me to recover a lot quicker than I eventually did.

Now I am delighted to be the Wellness Practitioner delivering the service for Brecon and District Mind, based at the Haygarth Surgeries which cover the areas of Hay-on-Wye, Talgarth and rural villages around here. I have been part of the Brecon Team since August 16th where I began by getting to know the area, the people and the surgery set-up, before heading off to Oldham to have some excellent training from Mind which fully prepared me to begin working with patients on September 8th.

The Active Monitoring Service consists of an initial ‘drop-in’ session where I meet the patient referred to me by the clinical team for a brief fifteen minutes and then, a further five more sessions. During the time they spend with me, they complete the GAD7, PHQ9 and Warwick Edinburgh Wellness evaluations at the beginning, middle and end, and choose one of six workbooks or pathways to engage with. These workbooks focus on Managing Anger, Anxiety & Panic Attacks, Stress, Low Self Esteem, Depression and Feeling Alone. To complement these workbooks, I have at my disposal a selection of exercise sheets they can work with and some smaller booklets to help them. The initial feedback I am receiving is on the whole excellent and very positive.

The last few months seem to have flown by and I was surprised to notice today how many of my first patients have had their last sessions with me over recent weeks! It only seems like yesterday I sat with them, full of anticipation both for them and me, describing the service and inviting them to engage in it. I was delighted for one patient at our third session when she completed the same evaluations she did at her first drop in session to see a slight improvement, I remember feeling her pleasure almost as my own!

So far I have worked with 48 people -  all at different points of their journey through the service - many of whom tell me how much more aware of their feelings and emotions they are since starting work with me. This not only gives me some validation that Active Monitoring ‘works’ but an immense sense of achievement when someone starts to notice a change in themselves.

I have amazing support from the staff here at Haygarth, it feels almost like being part of a big extended family which makes it a pleasure to come to what is called work but what I prefer to call ‘doing something I love with financial reward’. Even more than that I am lucky to be part of the team at Brecon & District Mind who also feel passionately that Active Monitoring has the potential to offer people an alternative approach to mental health matters, one that really can make a difference in a person's life.

Brecon & District Mind believes that early Interventions are far more effective than waiting, and that prevention is better than allowing things to linger. "We want people to get help immediately rather than wait to get help, or for things to get worse". 

You can find out more about the Active Monitoring project on the Brecon and District Mind website. Contact Elizabeth by ringing 01874 611529 or email: activemonitoring@breconmind.org.uk

Thank goodness it's Friday in Knighton!

This week's guest post is by Doreen Matthews - a member of the thriving Knighton Mid Powys Mind Friday group. It was written at the height of summer 2016.

I love Fridays. So say the members of Knighton Friday Group.

We meet as friends, share stories and experiences of our lives and talk of what our week has been like. The group is so important to us. Life for most of us is not easy, events may have happened to us which cause anxiety and depression, but one of the big things in life is loneliness.

I met a friend who I have known for many years, and I was asked to have coffee. I was in a hurry, but I did stop and we talked about many things. The comment was: “My world has got smaller; I seem to have lost confidence, so find it hard to live my life, and feel rather worthless.” This person has tried to find help but does not like groups and when seeking help it has not really worked. I could not find answers, but I did listen and give gentle understanding. As we parted the remark from this friend was: “I feel so much better now that I have met you today. I always feel better when I meet you.”

The comment: “My world has gotten smaller” has stayed with me. I thought my world had gotten smaller too since my husband died. I have lost so much confidence, and if I did not make the effort to go out and meet people I would end up a very lonely person.

Friday Group has been so important and good for me, and I have been a member of Mid Powys Mind for 15 years and I have learnt so much from the activities. Doing a craft and being creative is so good for the brain. I feel more relaxed and my spirits uplifted. It takes me out of my casual domestic world.

Over the years I have seen members come and go. We have had our highs and our lows, sometimes despairing as to whether we can go on. Something always happens. A new member comes along - a new friend and we feel encouraged. I do wish people would realise how special and important they are to the group - I always like to see who is coming in through the door.

When someone comes along for the first time we know how hard it is for them to walk into the room. First impressions count and we can make or break at that first meeting, so we have to be careful how we deal with this. When people ask us “how are you?” the usual answer is to say “I am fine, very well”. The truth is in many cases they are not fine and sometimes want to talk. We must remember to give them the chance to talk, but with our own busy lives we tend to just hurry along. A nice smile can do wonders; a cheerful considerate person can make a difference. A nasty remark will put people down for hours.

Earlier this year we were told there would have to be a cutback due to lack of funding. We took on the running of the group ourselves straight away, with involvement from Mid Powys Mind. We all put a little extra money in to give us a working fund, and the Rotary Club gave us a generous donation to keep us going. We used some of the money to buy season tickets to The Whimble Nursery Garden. The tickets allow a member to visit the garden whenever they want. It is a place of beauty which is a natural therapy to make us feel better. We are using the gardens for some of our meetings and our next visit will be reading poetry and taking in the scents and colours of this lovely garden. We will have tea and cake and perhaps buy a plant. Walking through the wild flower meadow on our last visit with friends made us feel we were in another world. We had a visit to Monkland Cheese, of course we all now know how to make cheese, but we haven’t got a cow so we will leave it to the experts!

Some of our activities this year have included: chalk painted wooden spoons, making pretty boxes, woofing down homemade rhubarb and strawberry crumble, and cream gateau, and last week we made raffia mats which resembled Hobnob biscuits. Oh yes, we love our crafts. We really enjoyed “Havin’ A Laugh” with the comedians, they found us very comical; we ladies taught them a lot about life.

We felt, as a group, that we would like to reach out to others and it was decided we would make little posies for the Queen's 90th birthday. The result was breathtaking when we looked. Our work, arranged in baskets, was then taken to Cottage View Residential Home. The shades and perfumes of roses and sweet williams just gave off a feeling of joy and happiness. We had collected so many flowers and the happy “buzz” of busy bees being creative made me just stop and listen to our ladies. I thought of how happy everyone sounded, we were friends together, so contented in one another’s company. We all went up to Cottage View Residential Home and presented each resident with a dainty bouquet as we all sang Happy Birthday to the Queen. The feedback from the home let us know how glad they were to have us there, and we hope to return again.

The group has become very strong and we are getting new members. Everyone is so enthusiastic, putting in an effort to make things work. “We make our motto, we can achieve anything”. I think we can be proud of ourselves, and we are becoming noticed in Knighton.

We are now looking forward to an afternoon picnic at Aston-on-Clun on a member's lawn. Then we will be dancing with Powys Dance, we just love that! Our imagination makes us swans, sugar plum fairies, salsa dancers, fashion models or whatever we want to be.

The great thing about our group is that we are friends who care about one another, friends who laugh and have fun.

The Knighton Friday Group meets every Friday 1 - 3 pm at St Edwards Community Room, St Edwards Close, Knighton. 

If you would like to find out more about the group, which is supported by Mid Powys Mind, please ring 01597 824411, or contact Nic Williams by emailing: vo@midpowysmind.org.uk

The latest on MasterMind - computerised CBT in Powys

Powys Teaching Health Board staff at a MasterMind seminar in Odense, Denmark in October 2015.
Front row far right: Dr Wasi Mohamad, PTHB Clinical Director & Consultant Psychiatrist who is the Clinical Lead for MasterMind; next to him: Becka Williams Project Administration Assistant. Back row second from right: Harold Proctor Dementia Lead for PTHB and the MasterMind Project Executive.

Back in August 2014 our friends at Powys Teaching Health Board wrote on Introducing MasterMind - computerised CBT in Powys. 

The MasterMind project is currently being piloted across Europe, including Powys. Some individuals with a diagnosis of low to moderate depression have been able to access the computerised Cognitive Behavioural Therapy course in their own homes. We decided now was a good time for an update and Becka Williams, who works with the team overseeing this project, gives us the latest news.

MasterMind – where are we?

We have just begun the final year of the MasterMind project with the project due close in February 2017.

We went ‘live’ with the online CBT programme in March 2015 and have had 216 referrals since. We have implemented this service into the Local Primary Mental Health Support Service teams (LPMHSS), Pain Management and Occupational Health and in recent weeks have started engaging with the GP practices in Powys to encourage GP direct referrals.

A bit about the programme…

Powys staff opted for Beating the Blues as their software of choice which was developed by our service provider Ultrasis with ownership transferring to 365 Health & Wellbeing.

What does Beating the Blues consist of?

Beating the Blues consists of eight, approximately 1-2 hour sessions recommended to be completed weekly. The programme is interactive. During sessions you can watch video clips, complete exercises and learn CBT techniques that can help with depression and anxiety. Each week tasks will be given to be completed during the time between sessions.

How will it help?

Beating the Blues will help to pinpoint and change unhelpful ways of thinking that can affect how you feel, whilst teaching you more effective ways of solving problems.

How many sessions need to be completed?

It is important to complete as many sessions as possible. When completing the first couple of sessions it may be hard to see how it is relevant to your situation, however the programme is designed to build up your knowledge and skills over the weeks, if you stop too early, you will not get the full benefit of the treatment. The advice is to complete all eight sessions.

Where can the course be completed?

The course can be completed in your home or in a community site such as a library. To do it at home you need a PC or laptop with either speakers or earphones, along with access to a printer as there will also be a need to print material most weeks. Beating the Blues does not run on iPads, Tablets or Smart Phones at present. When doing it at home it is important to set aside enough time to complete your session at roughly the same time each week and ensure you have sufficient privacy to do so. You do not have to complete all sessions from the same location, you may want to complete some from home and some form one of the community sites. 

Feedback from participants

“The sessions were brilliant.”

“The programme was good in many aspects.”

“Most techniques I knew but Beating the Blues helped me put them into action.”

The Mastermind seminar in Denmark, October 2015

Collaborative Care through Videoconferencing (cCVC)

The second part of the MasterMind project is the collaboration of care through videoconferencing (VC) which we are currently implementing. In the initial stages we will be implementing this in the Crisis Resolution Home Treatment Teams (CRHTT) and the Community Mental Healthcare Teams (CMHT). In short, a member of these teams will meet with the patient and together they will have an appointment with the Consultant Psychiatrist through the use of Videoconferencing. The VC software that has been rolled out across the Health Board is Skype for Business.

Our EU Partners

Throughout the project, there have been a number of meetings and events taking place across Europe to get together with our European MasterMind partners to discuss the project, the pros and cons and generally share thoughts and ideas. The project has been a great opportunity for networking, building working relationships and shared learning. 

Many thanks to Becka for the update. Have you had experience of Beating the Blues or other computerised CBT sessions? Let us know what you think in the comments box below.

You can find out more about the MasterMind Project on the project website, and also join the debate on Twitter.