Shore Therapy

Christmas – the best time of year….or is it?

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Christmas is fast approaching this year, and while it is a brilliant time of fun & laughter, excitement & joy, family & friends – it can also be a time of stress & anxiety, Depression & sadness, and of loneliness. Most of us don’t realise that almost all of us experience a range of emotions in the lead up to the holiday period – many of them positive emotions but also many of them are those negative thoughts that nag away at us.

There are some important things to remember if you struggle through the festive season – firstly, it is ok to have negative thoughts and feelings. All of us have them – even that one person who is decked out in Christmas top to toe and has their house decorated like Santa’s Grotto. It is when these thoughts and feelings are persistent and constant that we should recognize, acknowledge, then do something about. This may be asking for help from family and friends, seeking help from a mental health professional or simply getting back into those routines (and sticking to them despite the disruption of the holiday season) that we know help our mental status i.e. exercise, meditation, proper sleep patterns etc.

Secondly, lets be mindful of what is causing these feelings – some of us are drinking more heavily and more often because of all those Christmas parties we are attending, are we stressed with the organization of gifts, and menus, are we under financial strain – there are many things that can cause these negative emotions but understanding why we are feeling that way is the first step to being able to manage those feelings.

Small things we can implement may help us manage this tricky time of year. Start getting organized now – think about what you need to buy, what you need to make, what gifts you’re giving and to whom and what events you would like to attend. By getting this preparation done early, you can concentrate on getting things done bit by bit – making the tasks, the events and the entire holiday period seem less daunting. Online shopping is a great way to do your shopping without having the stress of big crowds and busy malls – but for this to be effective it has to be done early.

Being organized early also means that the financial burden of Christmas is easier to manage. Being able to put money aside or buy gifts with each pay packet can mean that the stress and worry of affording Christmas is not as severe. Setting a budget is extremely helpful – but you have to stick to it. It is ok to be on a small budget – family and friends understand that this time of year isn’t all about gifts and they will appreciate your time and your thought. Your mental health will thank you if you set a budget which is achievable. There are a lot of tools out there that can help with budgeting if you struggle such as https://sorted.org.nz/, but sometimes it is as easy as picking the maximum you can and want to spend and sticking to it.

When it comes to Christmas parties and events – the pressure to consume alcohol can increase and can seem overwhelming – remember to always only drink what you’re comfortable with and that you don’t have to drink at these events. For more information read our recent post on how to feel included in social situations without drinking (http://www.shoretherapy.co.nz/social-drinking-and-how-to-opt-out/). Drinking in large quantities can be a depressant and often this happens at this time of year with numerous parties and events to attend. Just remember that this is likely to lower your mood. If you’re already experiencing negative thoughts and feelings then it may be helpful to lay off the alcohol. Its also important to remember that throughout the holidays many substance and alcohol abuse issues are more likely to arise. With a pressure to feel jolly and festive, it is easy to reach for those substances that help elevate your mood, and many of those substances like alcohol seem to be readily available whichever way you look. Use the resources that are available to you – AA meetings, Alcohol and substance abuse counsellors, your sponsors. It is tempting when you’re feeling low and it seems that everyone else is happy and jolly but remember partaking in these substances can result in much lower feelings – guilt, remorse, loneliness, nervousness and depression and more than likely other people are feeling exactly as you are.

Loneliness becomes increasingly obvious at this time of year – every movie you watch, every song you sing, every Christmas function you go to – all surround around family and friends. It can be difficult for those of us who don’t have a close support network, whether it be because our family and friends are far away geographically, that you’ve just moved to a new neighbourhood or because members of your family have recently passed. There are numerous reasons you can feel lonely at this time of year but get out there and get involved. Find groups you can join, places you can go. It is hard to find the motivation to put yourself out there – but you get to build your own support network and there are always people who want to be part of it. Open yourself up to these opportunities and you may find that you have a far stronger network than what you thought.

Remember that it is completely ok and normal to feel stressed, anxious, sad or lonely at times over the holiday period but if these feelings are persistent and constant then professional advice may help you to cope. Shore Therapy operates in both Northland and Auckland and can help you throughout this time period.

Mental health & Exercise – how do they interact?

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We are officially into spring and as the weather warms up it is a perfect time to be heading outside and doing some exercise – but what’s the point?

While there are a myriad of physical health benefits related to exercising, there are also many mental health benefits too. From lifting your mood to reducing symptoms and health risks, exercise is great for your entire wellbeing.

Exercise will often cause our body to release chemicals called endorphins – these are what cause us to feel good after we have been exercising. They are released into the blood stream both while we exercise and afterward and it is believed that this can enhance our mood for up to 12 hours from just 20 minutes of exercise (1). Endorphins interact with our pain receptors so when these are released our perception of pain can be diminished. Neurologically – endorphins bind to the same receptors as what several pain medications bind to. The result is experiencing less pain, which in turn can put us in a better mood. Blood supply also increases while we are exercising – that is why we sometimes notice our faces becoming rosy during activity. The same thing happens to the brain, this improves the oxygenation of the tissues which then helps our neuronal activity (2). Increasing the activity of the brain in this manner can then strengthen those positive pathways in the brain, meaning they are easier to use. Having those positive thought pathways strong could mean that they are used more frequently – perhaps regulating our mood easier.

Exercise is often a good stress-relieving technique. Many people in high stress lives will make sure that they have included exercise in their routines as it often can help them focus and become more clear headed. By focusing on exercise for short periods of time, we are having a break from the sometimes constant stresses of life. Often, exercising will give us a boost of energy so it means when we return back to our daily tasks we are more capable and ready to face our tasks head on.

It is thought that regular exercise can help to reduce the likelihood of depression, and many mental health professionals will include exercise in their treatment plans for their clients. Certain types of exercise are thought to improve our cognitive function which is believed to help prevent the onset of some neurodegenerative diseases such as Alzheimers and Dementia. These types of exercise include things like dancing which uses both sides of the brain and includes some cognitive thought as well as using the body physically (3).

Self-esteem can be improved with regular exercise – not only do we feel more positive when we exercise but we can feel better about ourselves. Naturally, when we continue to exercise we will notice that we are becoming stronger, fitter, more capable of certain activities. This all helps build self-esteem so can help with issues like anxiety and depression. In this way, exercise can also give us a sense of control over our lives. It is a perfect example of being able to see progress when work and effort is put into certain tasks. Many exercise regimes have small achievable goals to work toward but which are manageable and can be regularly met. In this way, this can teach us how to apply goal setting to other aspects of our lives.

We know that exercise helps us physically, but this in itself can help with our mental state. If we are constantly in pain or have a continuing ailment it can cause a lot of negative thoughts and feelings to arise. If exercise can help these physical issues, it then follows that our mental health can be aided just by feeling better physically.

There is a world of different forms of exercise available – not all of which have to cost a huge amount of money. Northland and Auckland have some of the best walking tracks through forests, mountains and urban settings which are easy to access and available to use when suits you and your schedule. There are plenty of outdoor parks which are great to work out in. Northland and Auckland also has a wide range of gyms, personal trainers and bootcamps that can be signed up to as well as yoga, Pilates, dance classes etc.. that you can also become involved in. Northland has a great run/walk series which includes walks/runs of varying lengths around the region spaced at intervals throughout the year – this is a great way to get not only you but your entire family involved in getting out and about and improving overall wellbeing.

It is thought that the length or type of exercise that you do is not as important as frequency. Exercising in any form several times per week and including this in your weekly routines is thought to be the most beneficial. So gather the family, get them on board and get out there. Find an exercise type that you enjoy doing and implement it into your life. Place as much importance on exercise as you would on sleep, food, social interaction and work. Use exercise not only to improve physical health but as great wellbeing and mental health techniques too.

 

1https://www.healthnavigator.org.nz/healthy-living/physical-activity/physical-activity-mental-health/

2(https://www.psychologytoday.com/us/blog/what-works-and-why/201803/why-exercise-is-so-essential-mental-health

3 https://www.sciencedaily.com/releases/2017/08/170825124902.htm

 

Dealing with a Loved Ones Cancer Diagnosis

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It is thought that as many as 1 in 3 individuals in New Zealand are affected by cancer August 31st this year is Daffodil Day in New Zealand. This is a day to help support and contribute to the Cancer Society and all of their efforts in funding research to better understand and treat cancer.

Most of us will have a personal connection with cancer whether it is ourselves, a family member, a friend or a colleague – all of us know someone who has had to battle cancer. It is thought that as many as 1 in 3 individuals in New Zealand are affected by cancer – it’s important to remember that entire families are affected when one individual is diagnosed. Psychologically, we go through a process of grief when a diagnosis is made and this can affect several individuals within a family or community. A diagnosis of cancer isn’t always terminal, but it can still have a lasting impact on both the individual diagnosed and those who are close to them. A terminal diagnosis is always difficult to come to terms with.

In this article we are going to focus on the caregivers and loved ones of an individual who has a cancer diagnosis rather than the individual themselves. It is easy to forget our own needs when a loved one is battling cancer, however, if we don’t look after ourselves then we can’t help them – you can’t pour out of an empty cup.

It’s important to acknowledge that you have a grieving process about a loved ones’ diagnosis, just like they do. It is ok to be angry, upset, emotional, stressed and any other emotion that is felt. Often as a caregiver we will hide our own emotions in an attempt to ‘be strong’ for our loved one. Chances are, they recognize these emotions in you as they are going through them themselves and sometimes – it can be just what they need to know that they are not experiencing these emotions by themselves.

Often a diagnosis with a debilitating illness can result in a change in family or marital dynamics. The ‘decision maker’ or the previous caregiver can struggle to find themselves in a more dependent role, whilst someone who isn’t used to making important family decisions can struggle to take up these responsibilities. Often a partner or spouse can become overly protective of their unwell loved one and can try to take charge of the required treatment. Often this is an attempt at gaining control over a situation in which an individual feels helpless. Communication is important in these situations to ensure that each member of a family unit is gaining the support that they need. Talking to loved ones with open and honest communication can allow responsibilities to be fulfilled without any member becoming overwhelmed. It is important that each family/community member knows that it is ok to ask for help whether it is help with something physical like washing their hair or something practical like making sure bills are paid on time. If each individual is assigned simple tasks to help make sure that everybody is supported it can make everyday issues seem easier. Assign tasks such as:

  • Medical updates – one support person attending all medical meetings, and being responsible for asking any questions of the medical staff as well as updating family and friends on any progress. This saves the medical staff time and energy repeating answers to multiple people but also streamlines the line of communication with any medical staff. This will also ensure everyone important is informed of significant information in a timely manner.
  • Finances – one support person to ensure all bills are paid on time, the family is living within their means and sticking to budgets. This person can also liase with any relevant insurance companies etc.
  • Schedule – one support person to ensure all appointments – including medical appointments are adhered to with no double bookings.

A spouse or partner often is responsible for all of these tasks however, with illnesses like cancer, things can sometimes take an unexpected turn and it can be difficult to keep on top of everything so assigning roles to those trusted family and friends who are willing to help can ease the stress.

Preparing family and friends about what may occur can be an important step. Have regular family meetings where open communication about current treatments, side effects and medications can occur. By knowing in advance that a loved one may become frail, lose their hair, be vomiting regularly etc. we can better prepare for those occurrences and can have some time to process the emotions of seeing a loved one in such situations may be beneficial. This also gives the opportunity for family and friends to organize social situations which are able to be attended by unwell loved ones. For example, if an individual has a weekly dinner at a restaurant with friends – this can be reorganized to a stay at home movie night where the loved one has access to their home comforts and required commodities which is much more manageable but allows for social interaction if desired. If family and friends are part of the organization of these events – they may be more understanding if they need to be cancelled due to the loved one being too unwell, emotionally or physically tired.

When a loved one is diagnosed with an illness such as cancer, it can have lasting effects on many members of a family or community. It is imperative to remember that communication is key. Sometimes seeking professional support for yourself and those around you can be vital. Psychological and emotional issues may be ongoing and can have a lifetime effect, therefore reaching out for professional support can be the best way forward.

Postnatal Depression and Anxiety

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Most of us have an idea of what postnatal depression is, but its important to understand the scope to which it can affect indivduals and families.Postnal Depression

Postnatal depression can include both depression and anxiety and can occur anywhere within the first year after the birth of your child. It is thought that somewhere between 10-20% of new mothers (this includes mums with baby number 2, 3, etc) may experience diagnosable postnatal depression.

There are a few widely accepted risk factors which many professionals believe may increase the probability of postnatal mental health issues forming. This includes but isn’t limited to:

  • A history of mental health issues – depression, anxiety and most other mental health conditions.
  • A lack of support before, during and after the birth – this can include issues with the relationship of the child’s parents, as well as a lack of social support such as isolation from family (e.g. Living in a different town/country from the rest of family etc.)
  • Life stresses – money issues, trouble at work, relationship problems etc.
  • Difficulties within the pregnancy itself – this can range from severe morning sickness (Hyperemesis Gravidarum), to break through bleeding, regular ED admissions or requiring extra scans etc.
  • Difficult birth – Post natal mental health issues appear to be more common in those who had tricky births and deliveries – emergency caesarean surgery, loss of blood, use of vontouse or forceps, episiotomies etc.
  • Health of the infant – if the baby is born with health issues, a lot of stress is placed on the family – particularly the parents. Often parents who have an unwell child at birth struggle with feelings of guilt, sadness and stress, which are all risk factors for depression and anxiety.
  • Lower socio-economic families – in the 2015 New Mothers Mental Health Survey (2015) it was found that mothers coming from a ‘Low Household income’ (Under $40,000) were more likely to develop post-partum mental health issues.
  • Issues with the baby after birth i.e. feeding issues, colic, sleeplessness etc

Many feelings and thought patterns associated with postnatal depression and anxiety are normal to feel as we adjust to life with a new baby so it is important to be able to recognize when help is required. Here are a few signs and symptoms to be aware of:

  • Feelings of hopelessness, confusion and sadness which linger.
  • A belief that you can’t cope. Not just one-off thoughts, but reoccurring or constant thoughts
  • Irritable and angry for no known reason
  • No pleasure in usual activities
  • Changes to sleeping and eating – above and beyond what is expected with a new baby
  • A lack of concern over appearance and self-care
  • Negative thoughts about the baby, an unwillingness to hold or care for the baby or thoughts of harming the baby
  • Being overly anxious, overwhelming uncertainty and excessive worry and fear
  • Feelings of guilt or worthlessness
  • Difficulty thinking clearly and making every day decisions.

The ‘Baby Blues’ are common in the first few weeks after baby is born which include several of the thoughts and feelings listed above. Postnatal depression and anxiety is when these issues linger for an extended period of time or become so severe that they interfere with everyday life affecting the care and health of both mum and baby.

As new parents, we often turn all of our attention to our new baby and forget to look after ourselves. It is important to remember that we need to be well in order for us to provide the best care for our children. The ‘Fourth Trimester’ or first 12 weeks after our baby is born is still a hugely important area for both mum and baby with a lot of physical and hormonal changes occurring, not to mention an adjustment to family dynamics, routines and our mental health. This period is when support systems are invaluable. Make use of family, friends, support groups, health professionals, call lines and mental health professionals. It is important to remember that a happy, healthy mum is going to immensely help your baby.

Recently there has been some media coverage about postnatal mental health and lack of help, delay of treatment and gaps within the current health system. Here in Auckland, there are several places you can reach out, detailed below. However, Shore Therapy caters to many parents dealing with different types of post-natal issues. We are baby friendly and often will have mum and dad in our offices, seeking therapy together. Babies are more than welcome to come along as we understand that separation, child care etc… is not always an option. Northland has high rates of post-natal issues, why this is, we’re not quite sure, but help is still available. If you want to visit Shore Therapy in their offices in the Whangarei area or Auckland Click Here to make a booking online or send us an email for more information.

Where to get help:

Bullying, Cyber Bullying and Mental Health

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bullyingBullying has unfortunately become more frequent in our society. Many of us associate bullying with children and youth, and while it is very prevalent in these demographics, it can also occur at any age, and in any setting. Work place bullying and cyber bullying can occur far more often than many of us realise and it can be very damaging to our mental health.

Firstly, it is important to understand what bullying actually is. The oxford dictionary defines a bully as “A person who habitually seeks to harm or intimidate those whom they perceive as vulnerable” 1.

To expand on this definition further, there are four main factors that are associated with bullying:

  • Harming another individual intentionally
  • A misuse of power within a relationship
  • Repetition – bullying is not usually a ‘one off’
  • Behavior that can cause harm

However, there are instances when someone’s aggression is not bullying, but can appear so when it feels directed at us. These often require a different approach, so it is important to be able to identify the differences, so the most appropriate action can be taken. These instances can include:

  • A one-off fight
  • A disagreement between friends where there is no difference in power
  • One off acts of meanness
  • A single act of social rejection

The important things to remember when identifying bullying is:

  • Intentional harm, power imbalance and repetitive behaviours 2

In a Victoria University of Wellington study, a survey of staff throughout schools around the country was completed. In this study, 94% of participants indicated that bullying occurred in their schools 3

A survey of 1700 participants demonstrated that one in five workers have experienced work place bullying 4.

Cyberbullying rates are on the rise, with all age groups being susceptible. It is believed that younger age groups are more likely to experience cyber bullying with approximately 46% of 18-19 year old’s experiencing some form of digital bullying 5.

Bullying has become a daily struggle for many individuals, and its impacts can be far reaching. In the Northland, Whangarei and Auckland areas, the suicide rates have increased, so much so, that the highest number of suicides was recorded in the 2016-2017 year compared to the last ten years. The highest proportion being those under 24years old 6.

There is numerous research that link bullying with a range of mental health issues, such as, lower self-esteem, higher rates of depression, stress, feelings of hopelessness and a higher probability of self-harm or suicide. For many individuals, frequent bullying can leave them feeling alone, victimized and with no options left to escape the threatening and abusive behavior. This may lead to an increase in suicidal or self-harming thoughts and tendencies 7.

In our youth, lower school performance, lower academic performance and lower school spirit has been linked to those who are bullied, both in person, or through digital media. This may lead to further social withdrawal and unwillingness to participate in social events which may continue to translate into adult life.

Many people who suffer bullying in school or high school believe that bullying had an impact on their mental health, and that this continued to impact the rest of their lives. However, with the likes of work-place bullying and cyber bullying, anyone can be vulnerable, and unfortunately, those who have been targeted in the past are more likely to be targeted by others as they seem to be “easy marks”. Low self-esteem and a history  of not standing up for oneself may contribute to this.

Along with depression, anxiety, low self-esteem and self-harming, a higher prevalence of psychosomatic problems can be evident. Psychosomatic problems are physical symptoms or ailments which are caused, aggravated or associated with mental factors. This can include many complaints ranging from skin disorders such as eczema and psoriasis, to heart issues and high blood pressure, to irritable bowel like symptoms. All of these issues can translate into lifetime problems and will continue to have an impact on a person as a whole. Unfortunately, this can cause a vicious cycle as some of these symptoms are visible or noticeable in everyday life and can cause an easy reason to be bullied (this is more obvious in children and youth). This in turn can make depressive and anxious thoughts increase which can then worsen visible symptoms. A good example of this is any skin conditions. It is easy to judge a person who has a visible rash or skin irritation, for which they are already feeling self-conscious over, however, actively criticising someone for it will only intensify these feelings and could therefore, make the rash more inflamed 8.

Being a victim of bullying of any kind can also increase the chances of substance abuse. The more common substances abused in these cases is usually alcohol and marijuana. We already know that there are implications for both our mental and physical health with bullying, however, when we add a substance abuse issue, the impact on our mental health multiplies. Along with our negative thought patterns, we now also have an addiction to battle. Often victims of bullying will turn to these substances to escape from their reality and numb or dull these thought patterns. However, the addiction itself can encourage and strengthen these patterns. This behavior is anti-social and will withdraw the individual further, causing less motivation to engage in social interactions and decrease general day to day function. This will also have an impact on any positive and supportive relationships that are in their lives, and therefore can become self-destructive 9.

Bullying is a global issue which seems to be prevalent in many different societies and cultures. As a whole, we are more aware of bullying, and more attention, time and effort is being put into creating healthier environments and relationships. On a personal level, there are some small changes that you can make to allow you to feel safer and encourage you to regain some of your power, confidence and self-esteem.

  1. Stay Safe. As soon as you are uncomfortable and don’t feel safe in a situation, leave. Engage the help of others whether that be in the form of law enforcement, help hotlines or friends and family for support. They are all there to help you.
  2. Keep your distance. Where possible don’t engage with your bully, they are not worth your time or your energy and your self-worth is not tied to their opinions of you.
  3. Communicate. Talk about your experiences with those that you trust, a hotline, therapist, colleague, friend or family member. Suffering in silence only increases those negative thoughts. If you remain quiet about the bullying you’re experiencing, it can encourage the bully to repeat and intensify the behavior. Knowing that there is no consequence to their actions can mean the bully only escalates the abusive behaviours. Talking to someone about your experiences is a great stress relief for you but can also better equip you to deal with these actions.
  4. When interaction between you and your bully does occur, keep your cool. Reactions are what bullies thrive on. Think before you react, whether it is with a clear, concise response or simply keeping your composure, bullies are thrown off balance if they don’t receive the reaction they expect. This is not to say that you allow them to do what they like to you and you give no response. You can stick up for yourself, but responding in anger or embarrassment is the reaction they expect.
  5. In workplaces, it is important to recognize when bullying is occurring. When you realise that this is happening, put some barriers in place to safe guard yourself. Where possible, have a third-party present throughout your interactions with your bully and use formal communication through written media – there is a paper trail that can always be looked back upon 10.

Of course, these points don’t apply to everyone or every situation but they can be some good starting points. If you or someone you know is struggling with bullying, then please seek help. At the bottom of this article you will find links to several different places you can turn to for help. For help with some of the mental health side effects of bullying, reach out to our Therapists at Shore Therapy for some professional help.

HelpLines & More information:

Lifeline: 0800 543 354 (available 24/7)

Kidsline: 0800 543 754 (available 24/7)

The Raid Movement: http://www.theraidmovement.co.nz/

NetSafe: https://www.netsafe.org.nz/

REFERENCES:
1 https://en.oxforddictionaries.com/definition/bully 2018
2 https://www.bullyingfree.nz/about-bullying/what-is-bullying/
3 https://www.victoria.ac.nz/education/research/current-research-activity/new-research-into-bullying/Bullying-in-NZ-Schools.pdf (Green, Harcourt, Mattioni & Prior, 2013)
4O’Driscoll, M. P.,Cooper-Thomas, H. D., Bentley, T., Catley, B. E., Gardner, D. H., & Trenberth, L. (2011). Workplace bullying in New Zealand: A survey of employee perceptions and attitudes. Asia Pacific Journal of Human Resources, 49(4), 390- 408. doi:10.1177/1038411111422140
5 Steiner-Fox, H. W., Dutt, S. J., Christiansen, S. J., Newton, H. J., Matika, C. M., Lindsay, C., Sare, M. H. , Kapeli, S. A., & Stronge, S. (2016). Rates of cyberbullying among women and men in New Zealand in 2015. NZAVS Policy Brief, 3.
6 https://www.mentalhealth.org.nz/assets/Suicide/2016-2017-annual-provisional-suicide-figures-Final-version-Embargoed-midday-28-August-2017.pdf
7 Ford, King, Priest & Kavanagh, (2017), Bullying and mental health and suicidal behavior among 14 to 15 year olds in a representative sample of Australian Children. http://journals.sagepub.com/doi/full/10.1177/0004867417700275
8 Gini & Pozzoli, (2009). Association Between Bullying and Psychosomatic Problems: A Meta-analysis. American Academy of Paediatrics, vol123:Is3
9 Radliff, Wheaton, Robinson & Morris, (2012), Illuminating the relationship between bullying and substance use among middle and high school youth. Addictive Behaviours, vol37:Is4
10 Ni, (2016), 8 Keys to Handling Adult Bullies https://www.psychologytoday.com/intl/blog/communication-success/201611/8-keys-handling-adult-bullies