Tag Archives: Ely

piglets asleep together

CALM SLEEP – How to approach Sleep Hygiene for a better nights rest

Sleep is an essential part of our wellbeing. It helps our bodies to recover and regenerate and keeps us sharp and productive. Sleep deprivation is so detrimental to wellbeing that it was utilised in the 1600’s by self styled Witch Hunter General Matthew Hopkins as a means of eliciting confessions from accused witches. Its says something for the pain and torment of sleep that a confession to witchcraft would be seen as a preferable option!

According to the NHS, the average adult human needs around 7-9 hours of sleep per night. According to one survey however, an astonishing 30% of us have had insomnia at some point. There are a myriad of potential causes that lead to insomnia such as shift work, mental health conditions, pain etc.

Acknowledging that the underlying causes can be difficult to control, a common contributor to poor sleep is sleep hygiene. Sleep hygiene is not (as was once suggested to me) how often we clean our nightclothes. Its the routines and habits leading into our bedtime that can influence how we sleep. Addressing these, even if you think that sleeping is not a big problem for you, could ring in the benefits to your mental wellness.

I spend a lot of time talking these things through with my patients so to make things easier I have created a simple mnemonic of sleep habits that could help you to streamline your bedtime. If you are struggling with sleep, or have poor energy that might be linked to quality of sleep, I recommend you try CALM SLEEP, a few simple rules and ideas that could tidy up your sleep hygiene and send you into a more blissful land of nod to help your body and mind recover from the rigours of life!

C – Comfort.
Woman lying on a comfortable bed

Going to bed should be a pleasure and making it comfortable is going to help this no end. To give a balanced view, some researcher in the 1950’s concluded that theres little difference in the amount of sleep time we get between sleeping on a board or sleeping on a sprung mattress. I’m going to be honest, I haven’t read the whole study because I am never going to recommend sleeping on a board. Perhaps the difference between a sprung mattress and a board wasn’t so great in the 1950’s. Whatever this study says, most of us would agree that being comfortable at night enhances our sleep. A decent mattress, bedding and pillows makes our bed a place we want to go to. I know it can run expensive but if we are getting the recommended amount of sleep most nights then we are spending a third of our lives in bed. This has to be worth the investment.

A – Avoid.

There are many avoids before bedtime to aid good sleep but the highlights are caffeine, alcohol and eating too late.

Theres a lot of conflicting advice about the effects of caffeine and alcohol on our general health. Barely a week goes by when I’m not picking up a news article that bestows the benefits or calamities of moderate to heavy consumption. One area of agreement however is the effect on sleep that even moderate consumption can have. With caffeine, as we know, it keeps us awake. The advice I give to maximise sleep is avoid caffeine in the afternoon completely and keep overall consumption moderate. beware also that we aren’t just talking coffee and tea. Unfortunately caffeine can also be found in other places like chocolate so be aware that your evening treat could be having an effect too.

With regard to eating, a full stomach before bed leaves our bodies with a world of work to do when we should be sleeping. You may recall from my last blog on diet the old proverb, “Eat breakfast like an emperor, lunch like a King and dinner like a pauper”. Supporting good sleep is another reason to look at this model of eating. If you can’t face switching your habits, at least make sure you give yourself a few hours between the last mouthfuls and counting the sheep!

L – Light Control.

This is a subject we are becoming moderately aware of but which I feel has a much greater part to play in our overall health. Our bodies respond to light by releasing or suppressing the release of a hormone called melatonin that aids sleep. Studies have found that blue light in particular mimicked daylight (something to do with the wavelength) and guess what? Blue light is emitted by phone, tablets and laptops. How many of us are sitting in bed on devices? This works at both ends of the day. Getting a bit of sunlight in the morning can help to switch off the melatonin and get the body moving.

One of the issues in the western world is that we don’t adapt top our natural environment. Work and school starts at 9 winter summer or fall yet the seasons change and our bodies want to change with it. I believe its a major reason behind Seasonal Affective Disorder as I detailed in an article on the subject some years ago. Regrettably the world is unlikely to change anytime soon so the best we can do in the meantime is to try an mould ourselves around it. Small investments like a natural light clock to wake up to in the morning could help as well as paying attention to getting things switched off at the other end of the day

M – Mellow.

I contemplated making this one meditate but I accept that not everyone has or is going to start this journey. What we can all do however is look at how we slow down in the evenings.

When I ask the question – “How do you relax” to my patients, the most popular answer by a country mile is watching TV. I always challenge this. When was the last time you watched something truly relaxing on TV? Its not designed for that. TV is meant to get its audience engaged, whatever your choice of programme. Documentaries get us thinking, soap operas draw us into the drama and don’t even get me started on the news. The only truly disengaging thing i can ever remember seeing on TV in the last 46 years was the test card and even that had an annoying high pitched noise accompanying it.

Our minds have got enough to do at night filing away a days worth of memories. Calming things down before we go to sleep is going to help avoid that tumultuous brain working overtime when we are trying to drop off. Try listening to relaxing music or reading if meditations not your thing but do try to avoid the Uber excitement at least an hour before lights out.

S – Schedule.

Following a routine is the first thing to look at with sleep. The body has a natural clock called the circadian rhythm which adapts according to our habits. Following a routine at night, especially with regard to the time we go to bed and the time we rise helps our body to take care of the natural functions that aid this such as releasing the sleep hormone melatonin.

L – Leave.

Woman clinging onto a large clockThis really belongs further down but then the mnemonic wouldn’t work! Leave is for those struggling to sleep and what it means is get up, remove yourself for the bedroom and go somewhere else if you cant sleep. The rationale behind this is that we start to develop negative associations with our bedroom and the insomnia cycle becomes self perpetuating. Experts advise going somewhere quiet, reading a book for a few minutes and then returning to your bed to try again.

E – Exercise.

The relationship between exercise and sleep is well made with the advice being that even moderate activity improves duration and quality of sleep. it also helps us to wake and get going.

I always understood there was a caveat to when you exercise because too vigorous too close to bed had an opposite effect. According to the sleep foundation however, recent studies suggest that this doesn’t apply to everyone so I guess its a case of what works for you.

E – Environment.

This is something I feel very strongly about. Now I’m not a Feng Shui expert by any manner or means but it makes complete sense to me that our bedrooms should reflect the peace and tranquility we would hope to associate with a good nights sleep. Lots of clutter cannot allow for a free flowing energy.

baby sleeping on someones armRemember, our bedrooms are places to sleep. They are not for watching TV, or evoking memories or anything else. I recommend tidying up, Marie Kondo the drawers and leave only a few calming objects or pictures out.

I’d also like to discuss the issue of mirrors. According to some traditional belief, our ethereal soul leaves the body at night to wander (it is further believed that if you dream about someone your ethereal souls have met!). If it sees a reflection in the mirror it becomes startled which in can cause us to have nightmares. I recommend draping something over the mirror at night or better still, just don’t have one in there.

P – Professionals.

If you’ve done all of this and you are still struggling it might be time to speak to the professionals. Sleep deprivation is linked to a number of physical and mental health disorders and we should suffer in silence.

So there you have it.  A summary of sleep in a neat little mnemonic.  Please bear in mind that as with everything, if we spend a lifetime developing bad habits, transforming to new ones and seeing the benefit won’t happen over night.  With tenacity however you will ring in the changes.

Tony is a qualified acupuncturist with clinics across east Anglia. He is also the founder and a director of Talking FreEly, an organisation campaigning to break down the stigma of mental illness through honest and open conversations.

If you are interested in learning more about how Tony could help you to achieve your well being goals please get in touch or book an appointment at one of his clinics.

Pain

alone-62253_1920Any conversation about acupuncture will usually start involve pain.  Despite the wide spectrum of holistic clinical applications for acupuncture, it is still the most common problem that presents in my clinic.  It is probably what acupuncture is best known for and indeed the most explored and explained condition scientifically.

What is Pain?

The widely accepted definition was developed by a taxonomy task force of the International Association for the Study of Pain: “An unpleasant sensory and emotional experience that is associated with actual or potential tissue damage or described in such terms.”  Importantly, this definition highlights the fact that it is a subjective sensation.  In other words expressions such as “it can’t be that bad” say more about the frustration of the person saying it than the person suffering.  One persons intolerable discomfort may be very different to the next.  Indeed it may be very different according to a number of external factors like temperature, time of day, mood etc.  In my clinic, it is whatever the patient says it is.

There are a number of ways in which to classify pain but I particularly like those described by Professor G. F. Gebhart who separates into protective and non protective of acute or chronic duration.

_DSC0099Protective pain

This could be likened to my old career as a police officer.  Nobody likes it much but actually its doing an essential job.  In this simplest form, pain is a protective response from our body to prevent more serious injury.  For example, the pain one experiences when touching something hot is a warning shot that prevents a more serious burn.  Without this we’d be in big trouble.  When we injure ourselves and it hurts to move in a particular way its usually to stop us moving and causing more damage. Basically, we need pain.

Non protective pain

By comparison this pain serves no obvious protective function, for example the ongoing discomfort experienced after a nerve injury.

Chronic and Acute

The terms chronic and acute can be ascribed to either of the above classifications and describe the duration of the pain.  The NHS consider pain to be chronic or persistent if it has been suffered for 3 months or more and has failed to respond to standard medical treatment.  This persistent condition is poorly understood. It is believed that in at least some cases, there has been a breakdown in the way in which our complex nervous system processes information.

Alarmingly its not an unusual condition.  The Chronic Pain Policy Coalition in a recent publication reported around 14 million people in the UK living with this condition, 25% of whom have lost their jobs.  This is a significant number of people.

How does acupuncture work?

Picture of acupuncture needlesScientific research for acupuncture is very complex and is much debated (a subject better covered in my talks).  A number of theories are suggested for the mechanism behind acupuncture treatment.  Some studies have found that certain hormones released by the body for anaglesia in response to pain are released in greater quantities during electro-acupucture treatment.  Another explanation is the micro trauma theory which suggests that causing a very small injury in the region of existing trauma re-activates the bodies healing mechanism, “waking it up” so to speak.  All of the current theories/explanations are interesting and plausible but it is fair to say that the exact science is not fully understood.  Never the less, in certain conditions such as migraine, the results of using even very basic acupuncture treatment is so positive that it is recommended by the National Institute for Clinical Excellence.

Traditional Acupuncture

In chronic pain I find it useful to consider the problem in the Traditional Chinese Medicine paradigm.  In basic terms this holds that the usual smooth flow of the bodies energy force, Qi, is disrupted which causes a blockage or stagnation.  This in turn causes pain.  Acupuncture at certain points on the body can get the energy moving in the right way again.

Of course moving Qi is just one part of the problem.  The is to work out why the energy is stagnating in the first place.  In a post trauma injury this may be easy to work out but in long term chronic issues any number of physical and emotional factors could be at work in isolation, or in collusion with one another.  Looking at the wider aspects of your health and wellbeing both physically and mentally helps me to get a clearer picture of your health.  Treatment is then tailored to your specific “holistic” needs.

Help with pain

If you would like more information about how acupuncture could help please contact me to discuss – Contact Details

For more information follow this link to the NHS pain management self help leaflet – Pain Toolkit

Work life balance – 3 Steps to changing your life

work-life-balance

Photo Credit: Work Life Balance, by NY – http://nyphotographic.com/. Supplied by http://www.picserver.org under Creative Commons 3 – CC BY-SA 3.0

I remember the days quite clearly. Standing on the platform at about 5am, shattered, waiting for the train into work with several other miserable people all of us slaves to the wage.

My story is probably familiar. Job in London, moved out when I had kids so I could afford a decent house, longer commute as a result. To minimise the impact I had condensed my hours so instead of working 5 days a week I worked 4 longer ones. As a result I got an extra day at home on the weekend but the trade off was leaving the house at 4.45am and getting in at 7.30pm on a good day. If there was a delay, which there frequently was, it could be 9, 10 o’clock or dossing down with my in-laws because I couldn’t get home at all.  It was a grind and although I still believe it was the right thing to do at that time, I never the less longed for a better life.

I’m not alone in challenging the status quo.  In a recent survey  60% of respondents admitted they have a hard time maintaining a good work-life balance and most of the people I speak to would prefer to have more control over their time.  But is it really what we want and if it is, whats actually standing in the way? I suspect we will all resonate with the same thoughts: Fear of the unknown, conforming to the norm, lack of appreciation of our own self worth.  Yet if we can overcome, the rewards are priceless.

These days I work for myself.  My acupuncture clinic is about a mile from my home in the shadow of Ely Cathedral and I’ve structured my days so that I can do the school run most days and see my kids both in the morning and the evening.  I preserve Mondays and Fridays to work from home, catching up with paperwork and all of the other unspoken responsibilities of a small business owner. I don’t drive a flash car or live in a flash house but I live comfortably within my means.  Most importantly the 5am train journeys to London lie firmly in my past.

What convinced me to change?  There were various epiphanies in my transformation but I think that the process of change happened broadly speaking in three steps.  Ultimately the only barrier that truly stands between us and a better work life balance are the ones we place their ourselves.  Breaking down these barriers happens by challenging your thought processes and these three steps will help you to do that.  Ultimately you may read this and decide that the sacrifice is too great.  That’s fine too, its all about choice.

Step 1 – Challenge your relationship with money
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Photo by Jeremy Shultz on Flickr and used here with Creative Commons license

Everyone needs money to get by in life but western lifestyle is driven more by desire than  by need. In my lifetime alone we have added mobile phones, broadband and cable or satellite TV to the typical household budget.  Stretch back a generation and the list wouldn’t even have included a TV.  Undoubtedly we have become more dependant on mod cons and technology but when you strip it right back, our existence doesn’t actually depend on them.  In fact we only need 2 things to survive, food and sleep (I’d accept a third absolute need of clothing if living in a variable climate like the UK)  Everything beyond this basic need is a choice.  Once we can understand this in this highly simplistic way we can start thinking more honestly about the things in our life that are important to us and why.

An why is this important?  because for most of us, work-life balance is about compromises.  A lifestyle that involves us enjoying time with the family in luxurious surroundings without the interference of our office is called a holiday or retirement.   Work life balance however is exactly that, a trade off of priorities to make the very best from your personal circumstances.  That means sacrifices and as most of life is driven by economy, financial sacrifices are likely to sit at the middle of your decision making.

I first started to think about money differently when I moved to Ely where the train station is sandwiched between a large Tesco supermarket on one side and countryside on the other amongst which is nestled the Bridge Fen allotments.

I often pondered the irony of looking out longingly at the allotments, wishing I could be out in the fresh air growing my own food for my family.  Instead I was travelling to work to earn money to spend in the supermarket on inferior quality produce.  The reason?  I was too busy earning the said money to spend any amount of meaningful time growing my own vegetables.

You may want to read that again a few times to get your head around it!

I am realistic.  Giving up work to grow vegetables was not going to even things out.  The money I earned in “veg growing time” paid for more than just groceries.  It was however a good example of one area where I was making an unpalatable compromise.  Looking even more laterally at the savings, I could have most likely cancelled out my monthly gym subscription too on the natural exercise I would get maintaining an allotment.

I haven’t changed my life by growing veg (though it still sits at the back of my mind in the “to-do” pile) but this was my first observation that set me to changing my whole way of thinking.  Once I broadened this simple perspective I started looking at how I spend all of my money and asking hard questions about want over need.   Entertainment subscription or time to get out into the fresh air and kick a ball around?  Takeaway at the weekends or time to cook something?  Do I need an expensive house?  Do I need an expensive car?  What can I get by on?  If I don’t want to get by, how much will it all cost?

This isn’t to say I live a frugal existence.  There are many “wants” amongst my expenditures, the luxuries I feel give me the right balances in life, but what I did, and what I advocate for those who want to change their lives, is to really analyse expenditure,  challenge your thought processes and in doing so set out your priorities.  Do I need it, will I use it, will it make me happy? Cant afford your mortgage? Sell your house and buy a cheaper one. Already on the first rung of the property ladder? Sell and rent, move abroad, live in a caravan.  I know it sounds drastic but you really need to get to the bottom of what drives you.  Our society is very good at telling you what you need but its important to understand that it is not need, it is choice.

I could live in a bigger house.  I chose not to because it gives me the freedom to work less hours and spend time with my kids.  The point is that financial freedom is an option for most of us once you peel away your manufactured barriers.

Step 2 – Find the right role in life
Photo by Carmela Nava on Flickr and used here with Creative Commons license

Photo by Carmela Nava on Flickr and used here with Creative Commons license

Actually this came to me last but Ive put it here in the chronology because (for reasons that become clear later) my own experience suggests that it’s a better fit sooner in the process.

For some people, the pathway to work life balance is going to be easier than for others.  Some jobs lend themselves to part-time hours or flexible working.  Others can make an easy transition to consultancy or agency work.  But what about those of us who don’t have an easy transition or who are looking for a complete change?

For many years I had longed for the freedom of working for myself.  Trouble is, I’m risk adverse.  My dad lost heavily in a business venture back in the 80s and as a result growing up was hard.  Jumping into the unknown and potentially investing speculatively on a business terrifies me and no matter how miserable I was the safety of my situation took priority over my happiness.  It didn’t stop me dreaming though and I spent days and weeks in contemplation and conversation with family and friends trying to find the perfect plan.  I got nowhere except frustrated.

My inspiration came from an unlikely source, a discarded newspaper on the train that I’d have normally ignored.  This day however I picked it up and chanced upon an article about a person who had won a slimming title after losing a phenomenal amount of weight.  I wasn’t really interested in the story and almost put it down but just at the end I saw a short sentence which read – “now works as a slimming consultant”.  The simple idea of using your own experience to coach and inspire others made complete sense and as I thought it through I realised there were other examples. Reformed drug addicts working in rehabilitation, former gang members working with inner city youth’s and many more where life experience translated to work.  From that moment I set my future career path on doing the same thing.

It was an exciting moment because I knew that this was a safe bet.  I was investing in myself and as such had as much control over the investment as its possible to have.  But what did I have that people wanted?  The answer was simpler that I’d have thought.  I’d stepped back from the world and looked at it from a different view point and when I looked around, realised that lots of other people are striving to do just that.  I was going to change my life and in doing so improve my health and then I was going to help others who were stuck! I walked down a couple of dead ends before I decided that Acupuncture would be the vehicle for delivering my aims but once I’d decided what my “purpose” was the rest became simply about getting the right tools for the job.

Now it may well be that you have a clear idea of what you want to do.  Braver people than me may chose to really go for it. If however you are like me and struggling to see what you have to offer the world my advice is to look a bit closer to home.  The answer may be a lot closer than you think.

Step 3 – Step off the merry-go-round
Photo Credit: Merry go round, The Hoppings, Newcastle upon Tyne, by Ian Britton. Supplied by FreeFoto.com under Creative Commons License

Photo Credit: Merry go round, The Hoppings, Newcastle upon Tyne, by Ian Britton. Supplied by FreeFoto.com under Creative Commons

Of course all of this insight and self realisation is just the preparation.  You can buy the best parachute, get the best training and lay out the softest landing but whichever way you sugar coat it, you will eventually have to jump and that takes either courage or an almighty shove.

My encouragement came from a good friend who used to listen with good grace to my daily moans and complaints, crazy business ideas and mad-cap plans for a future that was apparently getting no closer.  He would simply say to me, “Tony, you need to step off the merry-go-round”.  And you know what, this metaphor encapsulates the whole experience of change so beautifully I cant think of any better way to put it! I wouldn’t however recommend getting off the same way as me.  It was spinning pretty quickly and I was half jump half push .  I failed to hit the ground running and as a result fell flat and hard.  You can spare yourself some pain by slowing the merry-go-round down and having a few steps planned before you jump!  Never the less my fall became part of my toolkit.  I got up, fixed myself and here I am now sharing the experience to help others so I guess it wasn’t all that bad!

Bringing it all together

Embracing a work-life balance isn’t an easy task and there are times when it feels the world is against you.  Society embraces quantitive success where achievements are measured in pounds and pence and it takes a brave person to challenge this and live their life to qualitative values.

What I can say, from personal experience, is if you can embrace the change a happier healthier life is almost certainly awaiting .  Most people will secretly hanker after everything you have gained and actually, far from mocking will probably applaud you.

Good luck with your journey.

Tony is a former Metropolitan police sergeant now working as an acupuncturist in Ely, East Cambridgeshire and is available for private appointments and public speaking.  Details of how to contact him are given here.

Stress Free Zone - Signpost directing you to a stress free zone

Stress – 5 steps to help you manage

Stress free zone.  A signpost pointing the way

Stress Free zone – Photo by thornypup on Flickr and used here with Creative Commons license.

Stress seems to be a a 21st century epidemic and its not difficult to see why.  Everything in life moves so quickly we barely pause for breath.  Long hours at work, mortgages and bills to stay on top of, roads full of cars, trains crammed with people.  The potential for stress seems to sit round every corner.

Dissecting the finer details and complexities of stress is the basis of a deeper and more detailed story but there are some simple steps you can take to start taking a bit of control.  Becoming aware of stress levels is now part of my commitment to self care and when I feel them rising there are a few key places I look for some quick easy releases.

1. Turn the technology feeds off – Yep I’m talking all of them.  E-Mail, Social Media, News, Twitter.  Did you know that there are now more mobile devices than people in the world ?  There is increasing evidence that we are becoming addicted to technology.  People are absolutely bombarded with information and it sits right there at our fingertips, bonging away every five seconds on a smart phone.  Do you really need to instantaneously know that you mate just checked in at the gym or the Bank of England reduced the base rate by 0.25%?  Will your mates gym session go any better for you “liking” it?  No.  Thats not to say we shouldn’t enjoy our technology.  Just be more disciplined about when you use it.

2. Switch yourself off – When I ask people how they relax the most common response I get is “Watching TV”  Lets explore this.  Is TV designed to help us switch off?  No.  Switching off is the last thing the TV bosses want us to do.  What do you watch? X Factor? The News? Soap Opera’s?  Think about whats happening emotionally when you do this.  Excited? Angry? Jealous? Watching TV may be giving your body a rest but not your mind.  I recommend mindfulness as a way to regenerate the brain as its simple and accessible.  You can find a wealth of resources out there to help develop your technique but if you want to just give it a go why not try practising a breathing technique and focusing on the breath for a few minutes each day.  You will be surprised at just how busy your mind is!

3. Go for a walk – This has 2 benefits.  Firstly, you get some exercise. A lot of my patients don’t register walking as exercise because we seem to only register physical activity with going to the gym. Actually the traditional Chinese view of health would take quite a dim view of all that heaving straining and sweating.  Traditional exercises such as Tai-Chi are far more sedate but get the blood and energy flowing all the same.  The second advantage of walking is you get some natural light.   Studies of seasonal affective disorder suggest a clear link between natural light and mood so getting this into your daily routine is really important, particularly since so few of us now work outside, instead staring at manufactured light on computers all day.  Get outdoors and revel in all that fresh air!  If the suns out even better since sunlight is a natural source of vitamin D!

4.  Sit down and eat properly – This isn’t a diet lecture. There are a whole bundle of resources out there on what you should and shouldn’t eat, some good, some rubbish. I do give dietary advice but one of the most overlooked aspects about  food is how you eat it which is arguably as important as the food itself.  Buying a healthy lunch then shoving it down at your desk between meetings is a waste of good food.  Eat 3 times a day, every day, and take enough time to sit down and eat these meals properly, preferably at a table, but at least without distractions like TV, work and yes those retched smart phones again!  You will digest better and therefore feel better.  Less indigestion, more energy and who knows, you may even lose weight.  Once you’ve nailed that we can start thinking about what type of food we actually put in!

5.  Give yourself a break once in a while – One of things we struggle with in the West is this sense that one shower ruins the summer.  If we have a chocolate bar our whole diet is a failure.  Its a huge barrier to progress because rather than seeing it as a set back or a one off it becomes the end of the line.  Out comes the ice-cream, on goes the Shakira (Bridget Jones for those who missed the reference). What we miss is the massive triumph of the 1, 2, 10 days before. Life is for living and whilst having self discipline is a wonderful thing having fun is an essential part of life too.  If you fall off the wagon, remind yourself you’re human, applaud yourself for everything you’ve achieved AND for recognising your human limitations and start again tomorrow.

So there they are.  5 simple steps on a long journey.  Thank you for reading and good luck.  Do remember to check in again for more health a wellness tips.

Written by Tony Sigrist

Tony is a qualified Acupuncturist with a lot of experience in managing mental health.  He is available for talks and presentations to businesses and groups and also has a private practise in Ely Cambridgeshire where he see’s patients for individual support across a full range of physical and mental health conditions.  Contact him today to discuss your individual needs.

Mental Health – Strong for too long?

One of the things I see on social media a lot is this statement

“Depression isn’t a sign you are weak, its a sign you have been strong for too long”

Its a well intentioned way of re-framing how we perceive mental illness but what does it actually mean and is it accurate? For me the language creates some problems!

Firstly, its a bit of a sweeping statement because mental illness is completely arbitrary, affecting people from all walks of life and for any number of different reasons.

What it refers to more specifically is a commonly encountered cause of depression. The curse of modern western society. Stress!

The “strength” to which it refers describes the capacity of a person to cope with stress. In so called “strong” individuals, stress acts as a motivator, an impulse to push harder and harder to overcome the adversity and achieve. When the drive goes beyond the bodies limits there comes a point where it has to break, like any system that is overloaded. At that point depression takes hold.

If you are one of these individuals (its fine by the way, I’m a lot like that myself) you probably feel better knowing that in spite of your mental health, society views you in positive terms as a go-getter. In some cases, it may encourage the perception that mental illness is simply a consequence of normal life if you want to “get on”.

But what if you aren’t “strong”? By implication, if not in actual language, this statement suggests that the opposite, people who fold at the first sign of stress and therefore don’t push their body through the same level of trauma, are unlikely to suffer depression. Apart from this (of course) being absolute rubbish, the implication is that these types of people are “weak” (it is after all the opposite of strong), a term most of us would consider to be an insult. Society after all has little regard for this approach to life.

Am I over analysing? Well certainly if the message that we value strong over weak is not implicitly carried in this statement on mental health, it is one that is heavily implied and indeed replicated across society, particularly in the workplace where I have repeatedly encountered the attitude that “going the extra mile” is pretty much compulsory.

Of course the path you decide to follow in life is an entirely personal choice. Where it becomes problematic is when society guides these choices through negative stereotypes. When people push themselves because they feel that is what is expected, not what they want.

Can a statement intended to make people feel better about themselves really do this? I think it can. I think the stigma of mental illness is driven by thousands of stereotypes, cultural norms and poorly used language. In this example, you could as easily change strong and weak for stupid and wise and tip the entire statement on its head. Language is a powerful tool and tackling what has become accepted norm is a huge challenge. If however we ever hope to have a lasting impact on the merciless onslaught of mental illness its one we have to take on.

It all begins by talking which is why Talking FreELY invest so heavily in facilitating simple and honest conversations about mental health. Because it is these conversations that will drive change.

If you are struggling with mental health there are a number of useful links on the Talking FreELY website. If you want to know how you can help to keep the conversation, check us out on Facebook and Twitter

www.talkingfreely.org

Mental Health – Surviving or Thriving

The theme of 2017 Mental Health Awareness Week is, surviving or thriving.  When I first read this I was immediately drawn to the word thriving, a word that fills me with optimism and excitement about the potential the world has to offer. Immediately I cast aside survival as a negative message that I didn’t want to focus on.

Today I was reflecting as I often do and I realised that this is mental health awareness week, and Talking FreELY, a local mental health organisation I am involved with is about honest non judgemental conversation on metal illness.  I realised my natural instinct to try and fix things had perhaps led to me missing at least 50% of the awareness message.   Awareness is not about solutions, its about giving some insight and however hard those messages are to deliver it is surely my responsibility as a mental health ambassador to try and do so.  So I would like to talk a little about survival and what that means in terms of mental health.

The first time I heard thrive or survive was on Chanel 4’s “The Island” with Bear Grylls.  12 contestants marooned on a desert island with nothing but basic tools and the clothes on their backs.  The challenge, not just to get through, but to actually enjoy it. To eat well, to create a comfortable living environment and a happy community.  I was watching this programme last night when the tail end of a hurricane hit the island dumping inch after inch of miserable battering rain on them.  No proper shelter, no proper clothing, unable to go and hunt for food, barely able to keep a fire going and worst perhaps, inaccessible even by the rescue teams.  It was utterly miserable and in that real life moment, any thought of thriving was lost and it became a single battle to get through that bad time.  It is a great example of how life is, and how mental health can be.

My own mental health is an ever changing landscape.  There are times when I do indeed thrive.  During these times I can really rip into life and live each day to its fullest potential,  laughing, joking, getting things done, the life, soul and energy of the party.  But its not always like that.  Several times a year, every year for as long as I can remember, my mental health will slump and the cloud of depression will loom overhead.  In these times its often all I can do to get out of bed in the morning.  I retreat from the world and everything from washing my face to taking the kids to school becomes a struggle.  As I’ve grown in my awareness I find I have an increasing number of strategies that can help me to predict and manage these bouts.  I lean more heavily on relationships, try where I can to get out more, stay off social media.  These interventions help but they aren’t about thriving or “snapping” myself out of it.  Surviving in these moments isn’t a choice under my conscious control.  I don’t chose to be depressed or anxious any more than those poor people on the island chose to be battered by relentless rain.  Its what life throws at me, and I do what I need to get through until the time passes and the sun comes out again.  Some people may come out of it and never get hit by a hurricane again.  For others, who live in their shadow, its about rebuilding and trying to be better prepared for the next time.

Perhaps I can be forgiven for focusing on thriving.  The reality of survival isn’t that cheerful and who wants to be seen as the harbinger of doom?  We all want to hear the positive messages. But this is mental health AWARENESS, not mental health utopia.  In amongst the positivity we should perhaps, quietly acknowledge that a lot of people are just surviving and in fact may not need a bundle of ideas just now to get them thriving.  Lets celebrate the successes but remember that the bigger task is in supporting the ever increasing number of people who are suffering from a mental health issue.  How you survive is what empowers and enables you to thrive.

If you are suffering from mental health problems and need help, please follow this link for details of support organisations – HELP

 

A Word about Evidence

The Detective

Photo by paurian on Flickr and used here with Creative Commons license.

The issue of science and evidence based medicine has interested me since I first entered the profession of traditional acupuncture.  I am fascinated by the far reaching capabilities of science, particularly how modern thought correlates with the traditional philosophical concepts of health that still form the main foundation of traditional Chinese Medicine.  It is through this respect however that I have also learnt the limitations of what human beings can explain or understand.

The evidence base for acupuncture is a big subject in which many pitch battles are fought, usually between the relatively niche worlds of scientific skepticism and research savvy complementary therapists.  Its dominated by big brains and personalities and an arena into which I feel intimidated to even dip my toe.  However! The recent episode of BBC’s “Trust me, I’m a Doctor”, in which they tackled the question “does acupuncture work” in about 8 minutes has convinced me to offer some observations that may better equip people to make a more informed decision for themselves.

Historical context

Acupuncture has been researched since the 19th Century and appeared in the first ever issue of the world acclaimed medical journal The Lancet.  The scientific interest however gathered momentum in the 1950’s when Chairman Mao established a number of acupuncture research institutes as part of a “reinvention” of traditional medicine”.  This and an increasing interest in acupuncture from the scientifically minded west led to a substantial amount of acupuncture research.  It is now most likely the most widely researched complementary medicine in common use.

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Photo by Jeremy Shultz on Flickr and used here with Creative Commons license

The Gold Standard of Evidence

When we hear about scientific evidence in medical terms it is really defined by the Randomised Control Trial (RCT) which is considered the Gold Standard of evidenced. In order to establish how well a particular treatment or intervention works it is studied alongside one or more “control groups”. Trial subjects are randomly allocated to one of the groups or “streams” in which they will receive either a treatment or a control treatment.   In the best studies one of the control groups will be treated with a placebo i.e. designed so that the person giving and receiving it cannot differentiate from the active treatment.  In a blind trial they will have no idea which treatment they are getting.  In a double blind study the practitioner will also be blind as to which treatment they are giving.  In its simplest terms a positive outcome would see the tested treatment or intervention outperforming the controls in a statistically significant way.  Sounds simple?  Its not.  Its a complex time and resource intensive process. There are numerous quality indicators within the process and any deviation risks invalidating or at least undermining the entire study.

Difficulties of designing and RCT of Acupuncture

Firstly, there are a lot of poorly designed studies out there and I’m not decrying the ones that say acupuncture doesn’t work.  Actually the opposite.  Some of the early studies of acupuncture that consistently found it to be better than sliced bread aren’t worth the paper they are written on.

There are of course good ones too and it is in some of the larger and better quality studies of acupuncture that we hear one of the commonly cited criticisms that ‘whilst acupuncture outperforms “usual care” with statistical significance, it fails to compare so well to sham acupuncture’.  This is interpreted by many as meaning it is no better than a placebo.  I think we should consider more information before leaping to this conclusion.

Lets be clear, RCTs are designed for and lend themselves to researching drugs.  In this type of research, creating a placebo is a simple matter of handing the subject a pill or liquid without any active ingredients, usually a sugar pill.  The subject takes it as they would any other drug and in the main, this is a direct representation of how a patient would be treated with drugs.

_DSC0027For interventions using holistic therapies like acupuncture it is far more complex.  Typical clinical practise for a traditional acupuncturist involves a great deal more than just needling.  Palpation, case history, lifestyle advice, the list goes on.  And then there’s the needling, tailored individually to the patient and their unique presentation.  Many trials of acupuncture use pre-defined acupuncture points and seek to isolate it from the other parts of treatment like lifestyle advice etc.  You end up with a highly sanitised treatment that bears little if any resemblance to a typical clinical encounter.

The issue of using a placebo control is also highly controversial.  Creating a placebo for acupuncture means designing an “act” for real and false acupuncture that nobody can differentiate. The favoured methods are retractable needles that don’t penetrate the skin or normal needling on “non” acupuncture points.  The latter at least involves needling which arguably activates a bodily response making it far from inert.  The former is also far from infallible.  During a practise sessions with various types of non-penatrative placebo needles I found that in fact they frequently break the skin and this corresponds with the experience of research acupuncturists too.  If they penetrate the skin, can it be considered as a placebo or non-active intervention?

I’d suggest not so what you end up with is a placebo that may not be inert and an intervention that does not represent normal clinical practise.  Yet in spite of this, both still outperform usual care. What does this say?  My interpretation is that even bad acupuncture is better than usual care or no treatment.  Imagine the potential for proper acupuncture!

Other evidence

What really grates on me is not the never ending argument of the wether or not an RCT has proved one thing or another.  Its the hailing of an RCT as the be all and end all of evidence like nothing else in the world matters. I think this is demonstrative of a far larger cultural shift driven by advances in technology, not just our attitude to medical science.  For example, in my previous profession of law and order we used to solve crime long before CCTV and DNA evidence (I hear the cynics amongst you! Lets have that debate another time!)  Now it seems that witness testimony doesn’t really cut it.  We need concrete proof and undisputed computer audit trails.  Does this mean that without them the crime never took place, that the evidence of a witness was wrong?  No, its just that we now have a higher expectation.  The same is true of medical science.  The old evidence is still evidence and actually, if theres enough of it or the “new” evidence is poor evidence it is arguably still “best” evidence!  Thats not to knock progress, just to encourage some humility because our expectations now are so high we seem to forget that in the greater scheme of things we actually still know very little.  Anyone who has suffered a migraine will back me up here.  Drugs may work, they may not, they may work for a time then stop working.  Actually, this commonly occurring but painfully debilitating illness is very poorly understood in spite of countless studies and amazing scientific developments.

Traditional acupuncture does not rely solely on what can and can’t be proved scientifically.  It is built primarily on the collective knowledge of recorded clinical practise over 2,000 years. It is good evidence stood next to science which has only really developed in the last 60 years and still has a long way to go.  I wonder then why some people would be so quick to dismiss it.

Conclusion

Wooden justice gavel and block with brass

Photo by Tori Rector on Flickr and used here with Creative Commons license

I hope that I have been able to give a good overview of the strength and potential weaknesses of scientific evidence in the field of acupuncture.  In my opinion, whilst science has a huge part to play in our future, it still stands very much in support of the historical knowledge and philosophy that is the bed rock of traditional acupuncture.  That doesn’t mean Im not excited about what it can and will bring to my profession as we make more and more advancements .  I simply advocate tempering this with an awareness of our own limitations and the openness of possibilities beyond our own limited knowledge.

In the meantime I will continue to be guided by “all of the evidence” to treat individual health needs with traditional acupuncture for as long as it continues to help people.  I have a feeling I won’t be retiring anytime soon!

Insomnia

A video from 2 years ago of Toyah Willcox talking to the British Acupuncture Council about insomnia and how acupuncture helped her.

Seasonal Affective Disorder (SAD)

AutumnTheres a lot to be grateful for at this time of year.  Abundant freshly harvested food, a cacophony of colours as autumn takes its hold, cosy nights in front of a roaring fire as the nights close in.  For some people the joy is overshadowed by low mood that may have no tangible origin, but simply sits there, like a cloud over their head until the seasons start to tip once again and the longer days draw in.  For those who feel like that, they could well be suffering from Seasonal Affective Disorder (SAD).

SAD is a form of depression that follows a seasonal pattern with sufferers experiencing a change in mood depending on the time of year.  The usual onset is in Autumn and Winter when the daylight hours are shorter.  Less commonly this is reversed.

The problem is poorly understood but several theories exist.  From the physiological perspective hormonal anomalies in sufferers may provide some explanation.  Melatonin is a hormone that the body secretes to induce sleep.  Scientific studies, though not yet conclusive, have examined levels of melatonin in SAD sufferers and have found it to be higher during winter months.  Likewise Seratonin, the “feel good hormone” is likely to be found in lower levels.
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It is not known why some people are affected in this way but one theory is that the reduction of daylight during winter months is responsible for the altered hormonal levels.  This is supported by data.  If you live nearer the equator, where daylight hours remain more constant through the year, you are far less likely to suffer from SAD.  This theory carries weight.  In our increasingly evolving world, far less of us work outdoors these days, instead sitting in front of computers staring at false light all day before going home in the dark.  But perhaps the bigger problem is not the amount of light we work in, but the fact that we don’t adapt.  Compare us with certain other mammals who would retreat to hibernation during the winter months.  As the colder months draw in, their bodies tell them its time to slow down and recuperate so they do exactly this.  Humans however continue at the same speed and pace making no changes at all.  If anything on the approach to Christmas we speed up, desperately trying to cram everything in before the end of the year.  In this theory, the adjustment in hormones is in fact entirely normal.  The development of symptoms happens because we don’t respond, the emotional equivalent of running on an already sprained ankle.

The solution in this instance is of course simple.  Hibernate.  If only.  Unfortunately, very few of us are in a position to work less hours during the shorter days so practically speaking, SAD becomes a condition to treat rather than a change we must manage.  So what can we do.

handsWell, firstly, I still recommend getting more rest and slowing down where possible.  Holistically, the key is to treat the source of the problem.  Acupuncture is more than an answer to aches and pains and a number of people seek treatment for a range of health issues including emotional support.  It is also worth considering light therapy for which more scientific evidence is emerging.  This is a simple and relatively cost effective therapy you can control yourself and would work well in support of other treatments.  Its worth researching the subject properly however as the science is quite specific.  Medical evidence has suggested that lights need to emit 10000 lux to be effective.  The light units that conform to this are registered correctly as medical devices.

If you would like to talk to me about how acupuncture could help with your health and well being please email me info@sigristacupuncture.co.uk or call 01353 360 633.  I may be in clinic but if you leave a message I’ll get straight back to you.

If you are considering buying a light therapy box please read do your research.  The SAD.org website provides good clear guidance with appropriate links.  Alternatively, get in touch with me.  www.SAD.org.uk

For more information on SAD including a downloadable leaflet, please follow this link to the MIND website.  www.mind.org.uk

Thank you for reading

Battlefield Acupuncture

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Photo by Mr.TinDC on Flickr and used here with Creative Commons license.

Battlefield acupuncture is an auricular protocol designed in 2001 by Dr Richard Niemtzow, a US air force Colonel, as a treatment for pain relief.

The protocol uses up to 5 points in each ear, though treatment may not include all depending on the pain reduction reported.

It was first used to treat pain patients, including wounded service personnel, in 2008 and reported significant results.  Since then its popularity has grown and it is now being taught more widely to American armed forces as a cheap, easy and safe way of treating acute or chronic pain.

It has also gained in popularity further afield including the UK where this and other auricular acupuncture treatments are used as a stand alone microsystem or as an adjunct to traditional acupuncture.

Though I personally favour a treatment approach that addresses the underlying causes of illness, I am a big proponent of auricular therapy in the management of many symptoms, not just pain, and will often add it in to my standard treatment.

Reference

 

Amaro, J. (2009) Battlefield Acupuncture for the Clinical Practitioner. Acupuncture Today. 10(4)