Your Mental Health - Sarah Buttle
Your Mental Health - Sarah Buttle
December 1, 2016
An insight into psychotherapy and understanding antidepressants.
I’m 21 years old, and just over 18 months ago I was diagnosed with Borderline Personality Disorder (BPD), Obsessive Compulsive Disorder (OCD) and Body Dysmorphia Disorder (BDD). These disorders do not define who I am, but rather explain why I act, react and respond the way I do. I want to break down the many barriers and stigmas still attached to mental health disorders and illnesses, particularly among young people.
After taking some time out from college to look after my mental health, I am now back studying Journalism and Visual Media in Griffith College, Dublin. After having my fair share of ups and downs with medication, counselling/therapy and inpatient treatment (St. John of God), I feel that I have learned so much about mental health and the reasons for my diagnosis. I want to educate other people who are feeling lost and need direction in terms of finding professional help. There is a reason for how we are feeling, but unfortunately as children and teenagers, we are not exposed to any education on mental health, so it is no wonder that there are so many young people in crisis today.
There has been a lot of misinformation in the general media regarding the efficiency of antidepressants. It is not a secret that medication such as antidepressants, are being prescribed too freely and seem to be concentrated among people with less severe, poorly defined, mental health conditions.
It is estimated there are up to 1.5 million people in Britain on long-term prescriptions and up to 4 million in the US. The psychopharmacology experts criticise that this increase of longterm prescription medications is as a result of lack of action by doctors, health authorities and governments.
(Photo by Sarah Buttle)
There are many other ways to treat mental health disorders, such as psychotherapy, which is the treatment of mental disorder by psychological rather than medical means. In fact, unless your depression is severe, the National Institute for Health and Care Excellence (NICE) guidelines recommend that antidepressants should not be your main treatment. NICE suggests that before prescribing you medication, your doctor should recommend partaking in exercise or a talking treatment, such as Cognitive Behavioural Therapy (CBT).You might also find it helpful to investigate an alternative therapy, such as complementary therapies, mindfulness and arts therapies.
I had the chance to talk to Dr. Susan Byrne, a cognitive and behavioural therapist in Dublin. Dr. Byrne is a qualified counsellor with the Addiction Counsellors of Ireland. She has a degree in Psychology and Philosophy, a doctorate in Embodied Cognition; Cognitive Psychology and Philosophy, a certificate in Counselling Skills, advanced certificate in CBT and a diploma in Addiction Counselling.
Pioneered by Dr. Aaron T. Beck in the 1960s, CBT combines basic theories about how people learn (behaviourism) with theories about the way people think about and interpret events in their lives (cognition). The therapy is now firmly established as the leading psychological treatment for many mental health conditions. Dr. Byrne described CBT as a talking therapy that refers to how our thoughts, feelings and behaviours and how they are all interlinked and are directly related.
“For example, the thoughts we are having about a particular situation can influence our feelings about the situation and therefore how we act, react, respond or behave.”, Dr. Byrne
Dr. Byrne explains how this therapy helps clients to address negative thoughts and thought patterns which are contributing to maladaptive or unhealthy behaviours- behaviours can only be understood when thoughts can be clearly explored along with various stressors. Also, the history of why a client has these particular thoughts, their origin and how long they have had the same patterns of thinking. She provides homework for her CBT clients such as worksheets and journalling, which has proven extremely helpful for clients to record and breakdown their thoughts, emotions and behaviours.
(Edit: Gas photo of bears because why not. Conko x)
Although Dr. Byrne does not practice mindfulness based cognitive therapy or mindfulness based stress reduction, only because she is not sufficiently trained in these areas, she always advises her clients “how being mindful and present is, in itself, a useful tool to use in any situation”. She says that where possible, it should become a part of everyday life. She recommends particular apps to clients such as Headspace. The feedback from clients on this particular app has been clearly positive. There are of course limitations to CBT as there are limitations to most interventions.
“CBT, as a therapeutic tool, is simple not suitable for some clients. No one ‘therapy’ will be appropriate for all clients. A client may respond well to a technique such as CBT but could also be receptive to another. Medication can also help a client, both short & long term, depending on this issues.”, Dr. Byrne
Finding a therapy that suits you is the first step in seeking professional help. Dr. Byrne explains that the link between the client and the therapist is vitally important. When finding the right therapist it is important that clients aren’t afraid to ask questions such as: What are your qualifications? Have you worked with this particular issue before? What interventions do you practice? Are you in supervision?”
“Your therapist literally comes your best friend, albeit with boundaries”, Dr. Byrne
Unfortunately people still feel uncomfortable talking about how they are feeling. Recent NCHS survey data found that rates of antidepressant use rose as self-reported severity of depressive symptoms increased. There is a fundamental problem that antidepressants are over prescribed by General Practitioners (GP). Psychiatrists are routinely cautioned against medical conclusions without actually examining the patient. I discussed this issue with Dr. Byrne and she agreed there is a problem.
“In my experience a huge majority of my clients would have been offered medication for mental health issues such as depression, anxiety, OCD and even bereavement. Talking therapies are particularly effective for depression, anxiety, OCD and addiction, where there is an emphasis on patterns of behaviour and stressors/triggers.”, Dr. Byrne
However, Dr. Byrne explains how it is important to understand that sometimes a client, for example, may present with depressive-anxiety disorder and may need medication initially, in order that they are more receptive to therapy. She continues explaining how it is challenging for both the client and therapist to work together in therapy when a client has such a bleak and narrow view of the world. This makes it difficult to make progress;
“An antidepressant gives the client the opportunity to interpret their mood level and have a more optimistic outlook. Therefore they can engage more in the therapeutic process. It is vital that the therapist monitors the clients progress and possible resistance to the intervention and revises treatment plans as necessary.”, Dr. Byrne
It is evident that there is not one solution that will work for every person with regard to mental health. Every person is different, both physically and mentally. What works for your friend may not work for you. It is important to take the time needed for finding the right help. After talking to Dr. Byrne it is clear that there is not one solution to mental health problems. It is important to know that if one therapy or if one medication did not work for you, there are always other options.
If we continue to educate ourselves about mental health disorders, together we can fight against the on going stigma attached to mental health, especially here in Ireland. Mental health disorders are constantly being used incorrectly in society today. This lack of understanding and the incorrect use of these disorders such as depression; depressive disorders, such as bipolar; obsessive compulsive disorder (OCD); anxiety disorders and many more, are as a result of the neglect that mental health education as endured in this country.
Year after year we hear of more setbacks and funding cuts from our government, who should have peoples health and well being as their main priority. Unfortunately this has not been the reality here in Ireland, and it is safe to say that the mental health sector has had more than its fair share of constant funding cuts and neglect in recent years. Budget 2017 was announced on the 11th of October 2016, where we saw the Government’s decision to invest just €15 million into services for 2017, instead of the agreed €35 million.
For a country that priorities children’s physical health enough to have attention devoted to it weekly on a nationally scale, personally I think it is time that equal amount of time is allocated to mental health education. I asked Dr. Byrne would she agree that it is time that the Department of Health and Education took the same approach towards mental health in Ireland;
“We are seeing an alarming increase in young people presenting with mental health issues such as depression and anxiety. We also have an increase recently in addiction particularly in substance misuse, eating disorders, deliberate self harm and suicidal ideations. It is imperative that these issues are openly discussed with young people and that services (free) are made available and accessible.”, Dr. Byrne
When addressing your problems or when you are wanting to get help, it can be sometimes difficult to know where and who to go to. The first step in getting treatment will normally be to visit your GP practice. If you are attending your first appointment to discuss your mental health you may feel quite anxious or nervous, this is normal. A tip is to write down what you have been experiencing before you go in to see your doctor, or make a note of any questions or worries you might want to ask. Your GP can suggest or direct you to a specialist such as a mental health nurse, psychiatrist or psychologist if needed. This is not unusual so do not become alarmed if he suggest you see a specialist.
Sharing how you feel to a close friend or family member is also another support you can have in your life. Breaking down the barriers can be one of the harder parts in taking care of your mental health. It is by no means an easy or comfortable topic to discuss originally with anybody, but once the initial stone is dropped, you will gradually feel more confident, comfortable and able in terms of dealing with your mental health.
To find your nearest hospital health centre, GP and more, you can head over to the Health Service Executive (HSE) website at www.hse.ie/eng/services. The HSE website also provides information about your rights, how to access personal information, and how to make a comment or complaint about services you have used.
For more information on the issues discussed you can read more about CBT at www.psychcentral.com or www.mentalhealthireland.ie, which is a great source for all information and resources on your mental health.
Author: Sarah Buttle, 2016
(first image is an original photo by Sarah Buttle)
(others images Stephen Considine nabbed off the internet, ok thanks)
Check out Sarahs other insightful and interesting blogposts here https://rebuttalmedia.wordpress.com/