Category: science

Mental Health vs The Sun

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So you’re sat outside in the sun, hanging out in the park. It’s 33c and you are wearing weather appropriate clothing. The next thing you know your anxiety is through the roof and you have to go home. Sound familiar?

Those of you in the UK will know, it’s a bit warm and it’s set to get warmer.

For many it is a time to get to the beach, hang out at the pub or go on an adventure.

Not for all of us.

Hot weather can be tough for a lot of people and for those with mental and physical illnesses it can feel impossible. I saw a few people in the Twitter community who cancelled their plans or cut plans short due to the heat affecting their mental health.

But why is this?

The Science

On a hot day, our body is fighting hard to keep our body temperature within a normal range. In order to cool down, we tend to sweat more and our capillaries dilate to increase the rate of heat loss.

Good stuff.

However, our heart rate also increases and blood pressure rises.
Studies show that hot weather has been linked to higher levels of irritability and lower concentration and mood.

All this combined with a poor quality of sleep due to humidity and heat, is a bad mixture for those with mental health issues.

My Experience

Tiredness, irritability and high heart rate is an unfortunate combination which can culminate in a panic attack. For me feeling hot with an increased heart rate is a sign that I’m panicking. So when I’m too hot, the physical reaction tells my brain I am panicking, when in reality, I’m not. But the thought that I might be panicking, causes me to panic.
I love the human brain sometimes.
So logical.

Increased irritability also makes me less tolerant of people. In a busy place, instead of being calm and working through it, it’s just so easy to get overwhelmed. Again. Panic.

How to help yourself

You may be tempted to just stay inside and avoid making any plans during the hot weather, but do you really want to miss out on a nice day?

While it will take some perseverance, having fun during a heatwave is possible.

Plan accordingly. If you are out in the sun all day you want water and sun cream. Dehydration increases the risk of heat related illnesses and suncream is always important. Dress in a way that makes you feel comfortable, but will also prevent you from overheating. Cotton and linen are good materials as they are light and airy.

Choose your destination. Maybe avoid sitting inside when eating at a restaurant or avoid using the oven when at home. Avoid staying in confined spaces for an extended period of time. Anything that is going to make you feel warmer just be careful. Why not go to the beach, to the park or go swimming?
If you are going to be somewhere where it will be warmer, keep drinking water and maybe splash your face from time to time to stay cool.

Helpful purchase. A small handheld electric fan can be a lifesaver, especially if you find yourself on public transport or a busy place. Make sure you pack some spare batteries!

Working? Again wearing light clothing, ensuring that you have access to a fan and eating cooler foods such as a salad can make a big difference. Take frequent breaks and If you do feel like the heat is affecting your health make sure you let your boss know. Employees have a right to a safe working environment.

Remind yourself that if you are feeling hot, you are not panicking. It’s just hot. Then maybe take some time inside or in the shade to cool down.

These things all sound relatively basic, but taking extra care in the heat can really help you face a hot day.

Last but certainly not least, be kind to yourself.
Being too hot isn’t a pleasant experience for anyone and it can be daunting to make plans in the midst of a heatwave. If you need to head home for a shower or need a couple of minutes in front of a fan, that’s okay. Don’t make yourself ill.

Also as a side note, make sure you check on elderly or vulnerable neighbours and family during the heat to make sure they have the means to stay cool.

Stay safe and look out for each other my dudes and dudettes!

5 Little Signs Of Depression

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Now I want to make this very clear. This is not a diagnosis. There are many other things these symptoms could indicate. If you are worried about any changes you have noticed or feel something is not quite right, please speak to a GP.

I want to make a blog post around this topic as depression is often spoken about as sadness and not getting out of bed. If you find yourself struggling in your day to day life, it might be good to speak to a professional.

Aches and pains

While researching for this post, I came across this symptom that I wasn’t aware of.
Muscle aches can be an indicator of psychological distress. While research in this area is limited, there have been some recent studies suggesting a direct link between muscle ache and depression. Click here, here and here for more information. Obviously muscle aches can be the result of a number of different ailments, but keep an eye on any other symptoms that may present.

Can’t make up your mind

Having trouble making the simplest of decisions? It could be fear of making the wrong one, it could be low self-esteem. It could be depression. Depression can cause cognitive impairments such as an effect on decision making and memory. There has been a lot of research looking into this, I feel like I have linked a lot of articles in this blog, so I would really encourage you to go out and do some more research.

You find yourself up at night

You often here tales of people that stay in bed all day with the curtains closed, which can happen. However, insomnia and trouble getting to sleep/staying asleep can be a sign of depression. Bad quality sleep can lead to lack of concentration, irritability and lower cognitive functioning.

Your toilet habits have suddenly changed

Believe it or not, there is a well documented connection between mental health issues and digestive issues. See here, here and here. When it comes to depression, research suggests that constipation and abdominal pain are symptoms to be aware of.
Change in diet, medication, lifestyle change or stress can be factors that contribute to changes in the way your digestive system functions. Again, just keep an eye on it and if it persists, see your GP. Depression or not, it maybe an indicator of other health issues.

You find yourself getting irritated over the little things

Do you find yourself getting angry at the smallest inconvenience? Are you becoming noticeably more irritable? Irritability and anger are commonly overlooked when it comes to depression. There are documented cases of people going years without getting a diagnosis, discussed here. One idea is based on Freud’s theory that depression is anger turned inwards, however other believe that this is a simplistic approach.
There are other conditions that cause people to be quick to anger, however if you find yourself in this position, I would advise speaking with someone. Unresolved maladaptive anger can develop into further issues.

So if you find yourself with any of these symptoms, it may be worth looking into. Depression or not, it might indicate underlying issues, so don’t tell yourself it’s nothing or make an excuse. You might find that a trip to the doctor can make everyday that little easier.

What Is Agoraphobia?

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Many believe that agoraphobia is a fear of open spaces, the reality is, it’s a lot more complex than that…


Photo by Denisse Leon on Unsplash

Lets Start at the beginning
The term agoraphobia was coined in 1981 by German Psychiatrist Carl Westphal, when he noted his patients would get anxious when out in social places. The term deriving from the Greek ‘agora’ meaning marketplace and ‘phobia’ meaning fear.

Research bringing about therapies and medication development for panic disorders in general was built upon through the decades, with notable contributions from Henri Legrand Du Saulle in 1878.

Modern day statistics and definitions
Agoraphobia is a complex disorder that manifests in a number of ways. It is usually characterised by fear and usually avoidance of being in a situation you perceive as being difficult to escape from, or unsafe. You may also find it difficult to be away from home or travel beyond a certain distance from home.

Examples of situations Agoraphobics may find stressful are eating with friends at a restaurant, riding on public transport, being alone or even standing in line.

In the UK, is is thought that 2 in 100 people will develop a panic disorder at some point in their life, with 1/3 of those going on to develop agoraphobia. Onset usually occurs between ages of 18-35 and is most prevalent in women. However, many people around the world of all ages, genders and ethnicity’s can develop agoraphobia.

You can find some more information here

Causes

I won’t give an in-depth look into causes as there are many.
It could be the result of another disorder such as depression, it could be the result of a traumatic event such as abuse or bereavement or it could be a number of other environmental/biological factors.
It could develop after having a panic attack in a certain situation or place leading to avoidance.
I could seriously write a whole book about this, so I’ll leave it at that.

Symptoms

There are both physical symptoms and cognitions that lead to changes in behaviour. Not all people experience every one of the following. Some people experience different symptoms depending on the severity of their disorder and their triggers; however these are some examples:

Physical

Sweating
Heart Palpitations
Increased heart-rate
Dizziness
Nausea
Hyperventilating
Feeling faint
Feeling of needing the toilet
Dry Mouth/Difficulty swallowing
Dissociation
Tiredness
Shaking
Tingling in arms and legs

Cognitive

Fear of embarrassment
Fear of incontinence
Fear of drawing attention to yourself
Fear of dying
Fear of having a panic attack
Fear that escape is difficult/impossible
Fear of being alone in social situations
Fear of vomiting
“I need to leave now”

Behaviour

Avoiding certain situations or places such as busy streets, public transport or restaurants.
Cutting contact with friends
Becoming housebound
Leaving the house only with a trusted person. i.e. family member or partner
Safety behaviours (see my post on this topic)

Please note, this is in no way meant to diagnose anyone with a panic disorder, if you feel that any of this relates to you, I would recommend that you speak to your GP.

Treatments

Again, this is a subject I could talk about all day, so I will limit this section to popular treatments and ones I have personally tried.

Therapy

Therapy is a great way to discover techniques and tools you can use to combat anxiety in your everyday life. Below are a couple of avenues you could take, however there are many options available to you so make sure to do some research and find something that works best for you.

CBT
Cognitive Behavioural Therapy is a form of short-course therapy which can usually be accessed via the NHS for those living in the UK.
The premise is basically that the way you think about a certain situation can influence the way you feel and behave.
E.g. What if I have a panic attack? (thought) = stress and anxiety (feeling) + avoidance (behaviour)
The idea is to work with your therapist to help identify these negative thoughts and with weekly sessions/homework, aim to challenge these thoughts.
CBT is one of the most common and effective ways to treat anxiety and agoraphobia.
I did an 8 week course of CBT and it really did help, I will talk about it in a later post.

Exposure Therapy
The idea of exposure therapy is that you face the situation or stimuli that you are afraid of, whether it be in real life, visualisation or VR. Within this therapy, there are a couple of types, but I will mainly focus on graded exposure.
I’ll use the idea of arachnophobia (fear of spiders) as an example as it may be easier for many of you to relate to.
Graded exposure is is where you create a fear hierarchy. For example at the bottom would be visualising a spider and at the top would be holding a spider. You slowly work your way up the hierarchy over a period of time until you eventually are able to tackle the top.

Medication

There are many different types of medication that are available to you. I will just name three types that I have personally experienced and tend to be most common. Please note that I am not a medical professional and that you will need to speak with your doctor to discuss the best option for you. Medication is often used alongside therapy for the best results for anxiety and panic-disorders.

SSRIs
SSRI stands for Selective Serotonin Reuptake inhibitors. Serotonin is a neurotransmitter, which amongst other things, is thought to regulate mood. Low serotonin can cause issues such as depression, anxiety and insomnia. By taking SSRIs, you limit the re-absorption and increase the levels of available serotonin.
Examples of SSRIs are Sertraline (Zoloft) or Fluoxetine (Prozac)

Beta-blockers
Panic attacks and feelings of anxiety release the hormone adrenaline. This increases your heart-rate, produces feelings of nausea, causes your body to shake and other common side-effects of panic and agoraphobia. A beta-blocker basically is used to block hormones such as adrenaline as well as improving blood-flow therefore reducing the effects of anxiety.
An examples of a beta-blocker is Propranolol, which can also be used for a range of issues, such cardiac problems and migraines.

Benzodiazepines
Benzos are a sedative and work by increasing the levels of GABA in your brain. GABA is a neurotransmitter responsible for reducing the activity of neurons in certain areas of the brain. The decrease in brain activity causes you to become calmer and also helps to relax muscles and aid sleep. These are a short term course of medication.
Examples of Benzos are Diazepam (Valium), Alprazolam (Xanax) and Clonazepam (Klonopin)

Many people choose medication as a treatment for anxiety and depression, which are more common than ever in today’s society. Not every medication works the same for each person and you may have to try a couple of different avenues before you find the right one for you. It is also important to remember medication is not a sign of weakness. I can’t stress that enough.

Relaxation

This is something that can be practiced anywhere at any time. Relaxation techniques are a great way to learn how to control your body and mind to be more prepared to tackle feelings of anxiety.
Some examples of techniques and practices include:
Breathing techniques – There are several techniques you can use to learn to control your breathing. During a panic attack or feelings of anxiety can create short, shallow breaths that can make you feel light-headed and increase your heart rate. Steady controlled breathing can prevent panic from taking over and slow your heart rate. This again can be practised any time, some people choose to do this when in bed to reinforce the idea of calm to help them fall asleep.
Visualisation – Visualising a place where you can feel calm and safe can help to release tension and reduce levels of anxiety. Engaging all your senses in a positive manner can help you reduce your heart-rate and blood pressure and help you to re-centre before panic takes over. Avoid visualising places such as home or bed as the aim is to change your idea of home being a ‘safe space’.
Yoga – This may or may not be for you, however I feel that yoga is a good way to help practice breathing, focusing and deal with stress. Research at Harvard medical school found that yoga is a good way to self-sooth, reducing the impact of an exaggerated stress response.

These are just some of the techniques I have tried throughout the years and overall, I have found most of them to be really useful. Although, it is important to remember that everyone is different, so if something doesn’t work for you, don’t be upset. Just try different things, speak with professionals and do some research to find what works for you.

So yeah, that is Agoraphobia. Don’t hesitate to get in touch if you have any questions or are looking for some support.
Always happy to help.

All publications and websites used are linked in this article.