Takings steps to beat depression - York Press Column March 2015

This is the *extended Wellbeing column from York Press on Monday, March 9th.

http://www.yorkpress.co.uk/features/health/11843396.Taking_steps_to_beat_depression/

Last Monday morning and before I settled down to put the final touches to this column, I read The Press, giving special attention to my fellow columnist, Dr Andy Field. I agreed with him about antibiotics, but then winced as I read on. He’d written about what I had written about. Bother! Did I have to start again? I decided to build on his sensible advice.

Dr Field wrote about this time of year and low mood. I didn’t expect to have first-hand experience last month. It is often thought that people who have an optimistic, outward-looking, positive attitude to life, as I generally do, don’t have low moods and depressive thinking. They do. I thought JK Rowling must have experienced depression when she created the Dementors in Harry Potter. “Get near a Dementor and every good feeling, every happy memory, will be sucked out of you…” 

*This from Harry Potter and the Prisoner of Azkaban. In workshops, I have used the full, descriptive passage, without mentioning JK Rowling and Harry Potter, to describe depression. Then I inform people, what it's actually describing. Later on Harry is given the antidote - something described as a Patronus charm. But unpack the description of a Patronus Charm and Cognitive Behavioural Therapy can be indentified in another form.

In the past, I have felt as if I was under duvet made of lead, pressing down, making movements impossible. That’s where, in the past, I have wanted to stay, in bed, not confronting problems, just introspecting and misusing my imagination. But nothing gets solved lying in bed. 

*A client said to me, "As I lay in bed, I suddenly realised that nothing was going to change in my life if I stayed there, so I got up." I recall a morning many years ago, where the Dementors were forcing the duvet down, while I struggled to get out of bed. The force seemed so strong and I wanted to give in to it, but I didn't. From the actions I took that morning, my life changed.

I had a brush with that duvet last month. There wasn’t one trigger, but a variety of all sorts, topped off by a book, which I found demoralising. 

* Someone suggested that I could just live an easy life and I wondered why I didn't make life easier for myself. That led to guilt from not helping those less fortunate. I developed a cold. I read a book called Bad Pharma by Ben Goldacre, which confirmed what I already knew, but despaired about.  I was left questioning my actions, as in, "What's the point of trying to make a difference?" and it unsettled me.

The Dementors were nagging away in one ear, while Pollyanna was attempting to be heard in the other.  Age, experience and knowledge has its benefits and I now know how to fight these Dementors. The highly emotional state needed to be broken and only I had the power to challenge and change my thoughts, attitudes, beliefs and actions. (See Patronus Charm above.)

Step by step, I waded through the treacle that my mind and body had become stuck in and the demented thoughts slowly faded away.

These were some of my steps:

1. Get up, showered and dressed. Tough, but crucial. 

*Little can be achieved otherwise and sometimes beating the demons and winning a challenge feels good. Thus releasing the 'feel good' hormones. 

2. Ate healthily. The mind and body need the correct fuel to work properly. I fought the urge to self-medicate with my choice of chocolate and alcohol. 

*I didn't abstain, but didn't overdo it.

3. Fresh Air. I unearthed an old pedometer and set a target of 10,000 steps a day. Gardening.  Helps sleep too. 

*If I managed 10,000 steps by 2/3pm, I knew I would be tired.

4. Enjoyed the simple pleasures in life. Signs of spring and hope. In York I looked at The Minster and wondered at its magnificence.  Another day I sat overlooking the sea, marvelling at the always changing scene. 

*Watching the waves coming in and going out can be relaxing as it slows down the breathing.

5. Spent five pounds on a bunch of flowers. 

*Just putting them in a jug on the table lifted my spirits. Worth every penny.

6. Telephoned two friends and talked about their lives and problems. Counted blessings. 

*In fact, I rang one long-time friend for a long chat and the very next day another long-time friend rang me, out of the blue. Then I exchanged long emails too. Both have challenges in their lives with family members, so it was good to listen.

7. Booked a neck and shoulder massage. 

*A massage, manicure, pedicure etc: can all help aid relaxation for a period of time. Touch is good too.  I believe that these treatments should be offered in all mental health units and elderly care homes. Far more effective than medication. 

9. Restricted TV watching. A demotivating, energy sapping activity.

* Dark days, multi-channels, a comfortable sofa and the remote control makes this activity so easy to get sucked into. 

10. Stopped worrying about what I can’t do in a troubled world and concentrated on what I can do, which is to help a few people, not thousands. 

*It upsets me to see good people having their lives ruined unnecessarily and scandalously.

I also recognised the truth in ‘This too will pass.’ It has. 

*The memory is useful here, as it can act as a reminder of how a change of thinking and behaviour made life better in the past.

©AlisonRRussell2015

Medication - why do I feel so strongly on this subject?

At the beginning of this blog, I will state that anti-biotics have probably saved my life twice and certainly saved my husband's life.

On Tuesday, January 27th,  the first item on the news was about some medication and dementia.
http://www.bbc.co.uk/news/health-30988643

I also heard on a newscast this week, that GPs will be paid to prescribe statins. What?

I felt as I did when writing this blog last June:
http://alisonrussell275.blogspot.co.uk/2014/06/i-could-weep.html

I need to write from my own experience. I wanted to express my views on the pharmaceutical industry in the book, but the editor thought that my comments would look like a rant and decrease the efficacy of the content. Begrudgingly, I took her advice. I wrote the book to help people and left much out. Hopefully, I can include something in the new book in progress. Something suggesting that they question and research the medication that they and their relatives have been prescribed and it helps just one family, then the job is done. The ripple effect can be powerful. 

When did I start to question medical matters?
Seriously, in 1978. Though in 1968, I had experienced unpleasant side-effects from some medication I was taking for period pain. But then it was a given and you didn't question doctors. I'm only too grateful that Attention Deficit Hyperactivity Disorder (ADHD) was not known in my childhood, as I feel that Ritalin would have been prescribed. Too scary to contemplate.

In 1978, I underwent a small gynae op. On the follow-up appointment, I mentioned that I was still in extreme discomfort on occasions. I told the surgeon that it seemed to be every month and around the time of ovulation. He thought it was nonsense and memorably said, " If you don't buck your ideas up young lady, you will lose your husband." You don't believe me? It's true. 

So I carried on, in extreme discomfort every month, until one day in the library, chance (?) led me to a book on a condition I had never heard of before, called Pre-Menstrual Syndrome, (PMS) or Pre-Menstrual Tension (PMT), as it became known. A book that changed my life for the better. The contents made sense and the recommendation was for taking extra Vitamin B6.  In our small town was a small grocer's shop and he had a comprehensive sideline in vitamins and nutritional supplements. He was helpful and I was soon feeling better, though he mentioned that GPs didn't like what he was selling. I mentioned my Vitamin B6 purchase to  my GP, he laughed and said, "You're flakey." Some years later he offered me large bottles of Vitamin B6 on prescription.

In 1981, I was getting fed-up of diets and thought I would try some slimming-pills. I didn't go to my own GP, knowing he wouldn't give me any medication. But the grapevine worked well and everyone knew of the GP who would give you anything you asked for. He did. I was prescribed slimming pills, though cannot recall what they were, except I went as high as a kite when taking them. Life and soul of the party. Until the day I had a road accident on my way to work. The Ford Transit van hit a bend, mounted the pavement, knocked over a wall and I was fortunate to be alive, when the vehicle stopped, with my head having smashed through the side window. I didn't tell anyone what I was taking, but I knew the pills had made me more reckless than usual. I stopped taking them.

It was around this time that the TV presenter, Esther Ranzen, ran a campaign on her programme, 'That's Life' about the addictiveness of some anti-depressants called Valium and Librium. That made sense of what some of my friends were experiencing. The pharmaceutical industry created another type of medication. One in daily use today. Selective Serotonin Re-uptake Inhibitor (SSRIs), claiming they were not addictive. No? Fifty million prescriptions for anti-depressants alone, last year?! The majority of these drugs are unsuitable, if not damaging for the under 18s. Does that stop them being prescribed? No. It's scandalous. 

At least ten years ago, I heard a radio programme where some British medics were attempting to make the World Health Organisation (WHO), recognise that while Big Pharma was saying that some medication wasn't addictive anymore, the withdrawal effects from SSRIs could be so bad, that people didn't want to come off the medication, thus creating a dependence. Not so different from an addiction?  The WHO didn't listen.

In late 1990s, I thought I would research the menopause, before it occurred. Hormone Replacement Therapy (HRT) was beginning to get wider publicity and I started to read up on the subject. This was also timed with another TV personality, Dr Miriam Stoppard, visiting the local town extolling the virtues of HRT and promoting her new book on the subject. It was a powerful presentation and I doubt there were many women in the room who did not feel motivated to "find the HRT that suits you and stay on it for life."

I heard this presentation before learning about how the brain works, trance states of learning and how emotional hijacks occur. Twenty-four hours later, with my emotional enthusiasm calming down and therefore beginning to think logically, I started to look at the consequenses. One question loomed large in my head. If every woman over 50 took HRT for the rest of their lives, who would really benefit? Only one answer. The Pharmaceutical industry. I researched Dr Miriam Stoppard. She sat on the board of a Pharmaceutical Company and they had sponsored the luncheon we'd all enjoyed. The scales fell from my eyes. 

I have never believed anything I've been told since then. Not without researching and becoming informed. It is no coincidence that when I found the following quote on a drinks coaster, I  adopted it for my readers too.

"Believe nothing, no matter where you read it or who has said it, not even if I have said it, unless it agrees with your own reason and your own common sense. " Attributed to Buddha

So, a couple of years later, when the GP told me that for a variety of reasons, I should take HRT, I told him that I was making an informed decision (and by that time I was very informed) and declined it. He told me that I was foolish and "not to rubbish HRT." This is the same GP, who a few years later, asked me why I needed a bone density scan. When I said it was due to family history and my refusal to take HRT, he told me that I was correct in not taking it. Gobsmacked, I reminded him of what he'd previously said. He slid his hand across the desk, placed it on top of my hand and said, " Things change, my dear." When the scan showed the I had stopped the bone density deterioration with nutrition and exercise, this was excused by, "it must have been a faulty machine." My bone density is still okay.

Around this time I had been working for a number of years on a psychiatric unit. My views haven't changed in nearly twenty years, except the situation is far worse. 

In 2015, I could replace HRT with Statins. 

I was at a post-play conversation with an actor last month. The actor was recovering remarkably well from a severe stroke. Also present was a consultant from the local stroke unit. At one point the subject of statins arose. The consultant said that, "everyone over 60 should be taking them." There was a slight murmur in the room, but no-one said anything. I couldn't keep quiet, so just said strongly, "No". At the same time a woman at the next table, also made a negative comment. The consultant looked daggers at both of us.

Afterwards I went up to the woman. She said, " Statins nearly killed my husband. My daughter is a doctor and wants me to take them, but I have refused." She then turned to her companion and asked her if she was taking them. The companion uttered these words, " I don't know. I just take what he gives me." *knocks head against wall*

That's the attitude of the majority of patients. Doctor knows best. They don't. As one said to me, "we can only guesstimate." But if HRT was originally sold to be taken by all women over 50, what about the profits from everyone over 60 taking statins?

Doctors are also exposed to an onslaught of advertising and sponsorship. Have a look around the surgery next time, let alone the names sponsoring medical training, hospital units etc:

Back in the nineties, we visited Centre Parcs. It was Friday afternoon and walking through a cafe, I bumped into the practice nurse for the GP surgery I attended then. (The HRT one). She looked very happy and told me that she had been attending a course on diabetes. The course had finished, but as Centre Parcs couldn't sell the accommodation for the weekend only, they were being allowed to stay on. I jokingly asked (I guessed the answer), whether she was paying or the Pharmaceutical Company? Her reply was, "Oh, it all free, the Pharmaceutical Company are paying, but it doesn't influence our prescribing." No of course it doesn't, advertising never works does it?

A Surgery Manager attended a seminar on the psychology course I was taking. It was held in a large, draughty, faded ballroom in a faded hotel. "I wish my doctors could hear this, but last week they were guests at Blenheim Palace, why would they come here and pay?" Fortunately, some did and still do.


I was asked to give two workshops to the staff of a day centre for adults with mental health problems. After I had spoken, the consultant asked the staff to stay behind for a talk by someone from a Pharmaceutical Company about a new anti-psychotic medicine. I was furious and naive. That's how my fee was being paid. I refused to take it, though people said I should have taken it and given it to charity. Emotional arousal had shut off logical thought. 

I have stated that my life was saved by anti-biotics. Twice. On two occasions I had pneumonia and ended up in A&E. The first time was on Millennium Eve, so I definitely remember how I celebrated - not! Except I was diagnosed with kidney problems and sent to the urology ward. Atypical symptoms and one mistake. Okay, but two? Eight years later, the same thing happened, but this time after I had told the doctor about the first time and was pretty sure the atypical symptoms were the same. On the second visit to hospital, I was given oral morphine. It should have been bliss, but the pain didn't go away, so I was given another dose. The pain was indescribable and I thought I was going to die. I should have been given a stomach liner beforehand, but wasn't. The same thing happened to my 90 year-old father with a pre-chemotherapy drug he was given. That's my father who was given no more than six months to live at the most, due to the 'off the scale' reading he had on a test. He lived for forty-four months, all them lucid, but frail in the end.

Common-sense takes me back to my chemistry lessons. I wasn't very good at the subject, but I do recall the layout in the workbook. We had to draw a diagram and write, Method, Result, Conclusion.

Medication is full of chemicals. One chemical interacts with another. In turn, they interact with the chemicals in our brains and bodies. A great deal of research has been done about the side-effects from each medication. There is sizable research about taking two medications together. There is little or no research about more than two medications taken together, but how many people do you know who are taking more than two medications every day?

Another question came to me, when working on the psychiatric unit in the 90s. It can still be asked. Anti-depressants are taken to reduce depression and anxiety conditions, that's why they use the word, 'anti'. So, why do so many people say, without thinking it through properly, "I'm depressed and taking anti-depressants."? Having spoken to several paramedics in the UK and Australia, they inform me that most of the people who have committed suicide or attempted suicide are taking anti-depressants. Not working then are they?  Ah, people will say, but they were depressed. 

An acquaintance died by suicide. He was having some bad symptoms, physically and emotionally. He was taking medication. Except that it turned out that he wasn't taking it regularly. He didn't realise that he was going cold turkey on a regular basis, with distressing consequenses. It must have been awful for him. So awful, he hung himself. Not that the Coroner knew that's what he'd been doing, because he didn't ask and wasn't told.

Just withdrawing from caffeine is bad enough, let alone strong medication with harmful withdrawal effects. 
http://alisonrussell275.blogspot.co.uk/2014/02/its-cold-turkey-stupid.html

The information about side-effects is out there, researched and written about by qualified people. But Big Pharma shout louder or rather, have the bigger advertising budgets.

Okay, I'll stop. You have the idea. I could write an entire book on my observations and experience alone. At present I do not take any medication, something that made a hospital doctor recently ask, "How did you manage that?" If I took everything I've been told to take, I would rattle, be severely overweight and exist rather than live. I'm not negligent, but have made informed choices. 

Far more accomplished people have wrriten about the subject. An excellent start is Ben Goldacre http://www.badscience.net/

NB: From Thursday, February 2015
innereye.eu/obhiblog/wp-content/uploads/2015/02/Letter_Wollaston_Feb_2015.pdf 

©AlisonRRussell2015