Merry Christmas from all at 96 Harley Psychotherapy

Well, it's that time of year again, when we let down our hair and hang up our stockings in preparation for Christmas and the festive season. It's also an opportunity to acknowledge that we are coming to the end of another year and, as any good therapist will tell you, endings are a great time to appraise and recognise how far we've come.

This year we've added many new faces to the 96 Harley Psychotherapy team. On the administrative side, we've been delighted to welcome Tanya Boncoeur and Chloe Booth, receptionist and PA, respectively. On the therapeutic side, we have new psychologists Jacquie Hetherton and Jennie Persson and psychotherapists Avraam Karagiannis and Ron Bushyager.

The depth and breadth of the skills to be found at number 96, as anyone who has experienced our practice will tell you, are second to none. We look forward to spreading our wings even further in the new year, with new therapists and new services waiting in the pipeline.

We've also been busy establishing a formal Department of Psychological Medicine, now registered with the Care Quality Commission (CQC), a mark of the integrity and calibre of the mental health services we provide. Under the aegis of this department we plan to be included in a parliamentary review booklet, which will be circulated to colleagues in the allied healthcare professions in the coming year. This will further consolidate our reputation and standing.

Regular visitors will also be delighted to know that our wonderful, whimsical, centre-piece of an elevator (which possibly drives much more business into the practice than can be quantified - a ride in it is better than a spin on the London Eye!) is scheduled to be serviced, so you can look forward to riding between floors with nary a hitch or a bump in 2015!

Once again, our annual Christmas drinks gathering - the most coveted ticket of the Harley Street social calendar - went off with a bang last night, with colleagues from all walks of the psychological spectrum and other collaborators blending to perfection - like a deep, rich, spicy brew of heartening mulled wine!
We thank them all and wish all our readers, followers, patients and other associates a happy, safe and harmonious Christmas.

We hope you have enjoyed reading our blog during 2014 and look forward to bringing you more news, views and topical updates in 2015. Your comments, suggestions and reflections on all our posts will, as ever, be gratefully received.

Written by Jacqui Hogan

Sunlight each day keeps depression at bay

Seasonal Affective Disorder (SAD), as the name suggests, has long been linked to the time of year; namely winter, when the days are short and the rays are in short supply. It seems reasonable to propose, then, that there may be a link between SAD and vitamin D, as sunlight is a direct precursor of vitamin D.

This is exactly the hypothesis recently put forward, formally, by a research team at the University of Georgia, who report their rationale in the journal Medical Hypothesis, under the title 'Possible contributions of skin pigmentation and vitamin D in a polyfactorial model of seasonal affective disorder.'

In it, the authors note that SAD usually begins in Autumn and continues throughout the winter months, with symptoms including anxiety, depression, irritability and feelings of guilt or hopelessness. It is more common, they say, among those who live at high altitudes or in cloudy regions.

Vitamin D levels fluctuate in direct response to available sunlight, with a lead time of about eight weeks from exposure to ultraviolet (UV) radiation. This correlates with the time between peak intensity of ultraviolet (UV) radiation and the initial onset of SAD symptoms, lending credibility to the notion of a direct relationship between SAD and vitamin D.

Author, Michael Kimlin, says that vitamin D is known to play a part in the synthesis of both dopamine and serotonin, low levels of which are associated with depression. Commenting on the research, he says:

"What we know now is that there are strong indications that maintaining adequate levels of vitamin D are also important for good mental health. A few minutes of sunlight exposure each day should be enough for most people to maintain an adequate vitamin D status."

That's all well and good for those of us perched somewhere on or near the equator, but what about us poor unfortunates who languish mole-like in solar deprivation during the winter months? Well the first thing to say is, make the most of what you've got; if the sun is shining, get out there and drink it in - even a few minutes is enough to make a valuable contribution, according to the authors of this study.

Failing that, the best source of dietary vitamin D is oily fish - salmon, mackerel, tuna and the like. If you really want to make sure you're getting enough, then, just like my grandmother used to say, a tablespoon of cod liver oil now and again may be the way to go.

With the incidence of depression at such an all-time high, let's not allow any that is obviously treatable to slip through the net. During winter, always rule out SAD.

Written by Jacqui Hogan

Fun and games

Smartphones are now equipped with a dazzling array of entertainments, using state-of-the-art graphics and algorithms. A quick pan around any public square thesedays, will reliably reveal young adults glued to their mobile devices.

It’s tempting to believe they might be using the technology to further work or school objectives; probably some of them are. But research suggests they are most often using their phones for gaming and entertainment.

A new study from Kent State University (USA) aims to better understand how young adult smartphone users experience daily leisure in the context of this new social phenomenon. The researchers surveyed a random sample of 454 college students, measuring total daily smartphone use, personality type and subjective experience of daily leisure.

The students were then divided into groups, based on similar patterns of smartphone use and personality type. Each group's experience of daily leisure was then compared. Three distinct types of smartphone users emerged: low-use 'extroverts', low-use 'introverts' and a high-use group.

The high-use group averaged more than ten hours phone use per day and accounted for approximately 25% of the sample. Perhaps unsurprisingly, particpants in this group reported a diminished experience of daily leisure. They experienced significantly more ‘leisure distress’ – that is, feeling uptight, stressed and anxious during free time. Andrew Lepp, lead researcher, commenting on the findings said:

"The high-frequency cell phone user may not have the leisure skills necessary to creatively fill their free time with intrinsically rewarding activities, For such people, the ever-present smartphone may provide an easy, but less satisfying and more stressful, means of filling their time."

By contrast, the low-use extrovert group averaged about three hours of smartphone use per day and experienced lower levels of leisure distress. They were more likely to actively engage in activities during their free time.

It seems evident from this study (if not from common sense) that being constantly connected to your phone is unlikely to enhance your experience of leisure. No matter what you’re doing on your phone, you’re doing something – arguably to distract yourself from uncomfortable feelings, as the findings suggest. There’s a word that describes activities employed to distract onseself from uncomfortable feelings – addiction.

Can you go a day without your smartphone? Does it serve as a useful substitute for more meaningful activities during leisure hours? Or maybe you work with those who are struggling with addiction in this area? No matter what, we'd love to hear from you.

Written by Jacqui Hogan  

To your health and happiness

As you pop that last frond of parsley into your alfalfa and wheat grass shake, ask yourself a question: am I happy?

Hopefully, the answer is yes and you'll down that nutritional depth charge, slam the glass back down on the table and dash out for a 10km run with spring in your stride and joy in your heart!

But an interesting new piece of research challenges the assumption that eating 'healthily' (i.e. a vegetarian diet) has a positive effect on mental wellbeing.

According to Dr John Lang, who developed the Wellness Index for preventative health company Alere, a vegetarian diet appears to be associated with an increased incidence of mental disorders, rather than a decrease.

His study, based on 50,000 yearly surveys, shows that vegetarians tend towards pessimism and are almost 30% more likely to suffer from panic attacks and anxiety disorders. Furthermore, they are almost 20% more likely to suffer from depression than the general population.

Dr Lang puts this down, not to the vegetarian diet per se, but suggests that the diet is a symptom, rather than a cause of mental ill health. He says:

"The diet isn't the cause, but rather the symptom. If you think of people who are committed to being vegetarian, it's a fairly significant commitment and it picks up those at the fringe of the obsessive-compulsive spectrum."

Interesting observation. But it's not all bad news for those who enjoy their TVP (Textured Vegetable Protein) over a T-bone steak. Vegetarians were shown in the study to have the highest nutrition scores, at 105.9 points compared to 100.7 points for meat-eaters. So at least if you're miserable, you can console yourself with the thought that you're in tip-top physical condition!

I say this tongue-in-cheek, of course. I've often heard people with mental difficulties say they wish their problems were physical, rather than so seemingly intangible - that way, they could at least feel justified in their disability.

Because the truth of the matter is, if you're mentally well, then everything, even physical ill-health can be suffered, if not cheerfully, then with patience and tolerance, sometimes even with gratitude for the positives that remain.

All of which underscores our desperate need, as a society, to come to back grass-roots mental wellbeing, rather than projecting our angst onto 'grass shoots' solutions. These may simply serve to address the physical rather than the spiritual. Good diet is all important, but it isn't the answer.

What are your thoughts? How do you see the relationship between diet and mental health? Is there a link between vegetarianism and OCD? Start the conversation below.

Written by Jacqui Hogan

Women on the verge of a nervous breakdown?

A new piece of research from the Psychology Department of the University of Texas in Austin suggests that women in positions of authority in the workplace may be more likely than others to experience symptoms of depression.

Interestingly, the paper, published in the Journal of Health and Social Behaviour, entitled Gender, Job Authority and Depression concomitantly shows that similar positions of authority are associated with fewer symptoms of depression in men.

Participants were sourced from the Wisconsin Longitudinal Study (begun in 1957) and data were gathered for this study between 1993 and 2004.

Over 1500 women and 1300 men (by 1993 around 54 years old) were interviewed and their positions at work recorded. Over the course of the nine years to 2004 the relationship between their level of authority at work and symptoms of depression were monitored.

The results were unexpected. According to present understanding, women in powerful positions should have scored lower on depression symptoms, since they display what are thought to be the strongest predictors of positive mental health - higher income, better education, more prestigious occupations and higher levels of autonomy than women in positions of lower authority.

But this was not the case. Team leader, Tatyana Pudrovska, commenting on the findings, noted:

"Women with job authority - the ability to hire, fire and influence pay have significantly more symptoms of depression than women without this power."

By contrast, the researchers found that men in authoritative positions at work showed fewer symptoms of depression than men in positions of lower authority and then, fewer symptoms of depression  than women in similar positions of authority.

So what's going on here? Is it simply wild-west research, Texan-style - i.e. the patronising answer? Do women in positions of authority in the workplace experience more discrimination, and therefore depression, than men in similar positions - i.e. the politically correct answer? Or could it be that men and women have different sets of natural endowments which make them innately more suited to, and therefore more comfortable in, different  types of roles - i.e. the answer that dare not speak its name?

Maybe there are another explanations for the findings - if so, we'd love to hear your thoughts. Please leave your comments below.

Written by Jacqui Hogan

How smart are smart drugs?

You can't blame anyone for wanting to have the cognitive edge, for wanting to be that little bit smarter. Especially students, who it is claimed have been turning to so-called 'smart' drugs, like modafinil, to increase their chances of exam success, at a rate of about one in five,

But new research from the University of Nottingham suggests that modafinil may be having the opposite effect to that which they desire.

Dr Ahmed Mohammed, of the School of Psychology at Nottingham University Malaysia Campus, in a study published in the open access journal PLOS ONE, has shown that the drug, in fact, has negative effects on healthy people.

In the randomised, double-blind study, 32 subjects were given modafinil and 32 were given placebo. All were then tested using the Hayling Sentence Completion Test, in which they were asked to respond both accurately and quickly. Mohammed found that the drug increased reaction times and failed to improve task performance. Of the results he said:

"It has been argued that modafinil might improve your performance by delaying your ability to respond. It has been suggested that this 'delay dependent improvement' might improve cognitive performance by making people less impulsive. We found no evidence to support those claims."

The current study also supports the findings of a previous study, which showed that modafinil impaired subjects' ability to respond in a creative way, particularly when they were asked to think laterally. This effect was pronounced in those who had been classified as creative thinkers to begin with.

So, that's the bad news. If we want to be smarter, we cannot simply rely on a pill to do the work for us (did we really think we could get away with it?). But are there ways we can enhance our natural cognitive gifts to enable us to perform at our intellectual peak?

Our grandmothers have the answers and it ain't rocket science; enough sleep, good nutrition, moderate exercise and balancing recreation and work activities, are just a few of the common sense actions we can take to make the most of the brains we've got.

(Dr Ahmed's research interests, by the way, are now moving on to non-pharmacological interventions, which seems like a helpful trajectory.)

Have you tried so-called 'smart' drugs? What effect did they have on you? Perhaps they helped under certain conditions? Or perhaps your experience is in keeping with the findings above? If you have other suggestions for how to improve on cognitive performance and brain vitality, please share your comment below.

Written by Jacqui Hogan


.

Children and mental health in the digital age

A recent report issued by the Commons Health Committee paints a grim picture of the situation on the ground for the mental health of children in the United Kingdom.

The report notes a radical increase in the number of children seeking help for mental health problems (25% to 30% a year) and links it to a rise in the number of violent video games, sharing of indecent images on mobile phones, bullying on social media and proliferation of websites for teenagers advocating self-harm.

The cross-party group acknowledges that social media and online communications are now integral to the fabric of life for the under-18s, but recommends a government enquiry into the effects, because of the potential for harm to this and future generations.

Sarah Wollaston, Chair of the committee, commented that so-called 'sexting' (sharing of indecent photographs) could be traumatic for vulnerable young women, who are persuaded to pose for intimate pictures then find that shots are widely shared. She also expressed unease about the impact of violent videos now being watched by young people.

Mental health services are under such pressure with this growing problem that, in some parts of England, children are only seen by a Psychiatrist once they have tried to take their own lives.

A Consultant Psychiatrist with the Cornwall Partnership NHS Trust, Liz Myers, told the committee that they were receiving four thousand referrals per year, but are only funded for two thousand.

One wonders at the need for a government enquiry when pure common sense suggests that if you expose children to concepts and imagery they are too young to process, of course you will harm their mental health. Arguably, exposing anyone to the same kind of material might cause problems.

But the juggernaut of 'progress' takes no hostages - rather it seems hell-bent on destroying all those who stand in its path. Admittedly, such an issue is way more complex than can be addressed here (like what can parents do to control access to this stuff when we are literally steeped in it?) but a first step must surely be to recognise its pernicious effect.

Something tells me it's not just a matter of controlling access, but looking underneath to the states that drive our youngsters to sink so very low. It is surely a sign of deep disillusionment and despair.

Do you have experience of working with children adversely affected by social media? Maybe you think the positives outweigh the negatives? Whatever your thoughts, we'd love to hear from you.

Written by Jacqui Hogan