On Friday 1st December 20 lovely ladies joined me for breakfast at the Ivy Chelsea Garden. There has been a lot of recent press about mental health conditions, but there is still a huge stigma associated.

MENTAL HEALTH

There is a mental wellness crisis in the UK – we are mocked for our inability to talk about our emotions – but it is time for us to start talking! Around 25% of the population are affected by mental health conditions every year, yet only around 6% of NHS funding goes towards all mental health conditions.

Have you ever noticed that people will talk so openly about physical injuries in a social situation? I have witnessed people as they share stories of skiing injuries almost competing with one another about who broke their arm in the worst way. Far fewer people talk this frankly about mental health, and this is why we have come to live in a world where almost a quarter of our friends and family are suffering, and we don’t even realise it. We feel alone, and we might even feel like we are failing, worthless, irrelevant. But we are in this together, and it’s important to share experiences, share advice, and educate ourselves properly about mental health.

These conditions affect women more than men so it is important that we support one another, and empower other women to look after their mental health. I personally believe healthy well-being is as much about mental health as it is physical health.

It seems as though people receive sympathy when they have a physical injury, like a broken leg, but there is never the same response for people suffering for months with chronic anxiety and addiction.

 

“People will run towards someone to sign a cast, and away from them if they feel depressed and suicidal”

 

I don’t think it is because we don’t care. I think it is because after years of prejudice and stigma, as a society we just don’t know that much about mental health.

Is there still a stigma associated with mental health conditions?  I will give you a few scenarios to think about:

Would you feel more comfortable telling your boss you can’t make work today because you have back pain, or that you are feeling depressed and suicidal?

Would you rather tell your friend you couldn’t make coffee because you have food poising or you are having panic attacks?

Would you rather tell your date you can’t find a babysitter, or you feel too anxious to leave the house?

I think for most people it might be easier to give a physical excuse, and that suggests we still have work to do to silence the stigma. Thank you to all the ladies who joined the breakfast, and have taken a positive step to raise awareness about mental health conditions. It is important that we keep the conversation going to #silencethestigma

 

Stress

Mental health covers a vast array of conditions, with stress and anxiety disorders being the most common. Stress is a silent killer. It has become normal for us to experience stress on a daily basis, but sustained low levels of stress increases our risk of diabetes, heart disease, cancer and a number of other health conditions.

When we feel stressed or anxious our brain can make a lot of noise. Ultimately we have control over what we choose to listen to, and when we want to turn it off. When we feel stressed or anxious our breathing and heart rate increases, and blood stops going towards reproductive, rest and digest processes. One quick way we can switch off this stress response, and switch on our parasympathetic relaxation nervous system is through guided meditation and diaphragm breathing exercises.

 

Pain

I treat patients with physical conditions, so why am I bothered about mental health conditions?

Most of the people I see are in pain. Pain is extremely complicated.

Pain does not reflect the true state of the tissues of the body.

What I mean by this is that if you take two people – one with severe pain and one with no pain at all – you might find that the scans of their body do not correlate to the pain level. People with no pain at all can have severe disc prolapses, even fractures go unnoticed, and very often people with chronic pain have no physical findings when they undergo scans. Their pain is very real, but it is no longer due to injury of the body, but has become ‘centrally sensitised’ in the brain.

It can be incredibly frustrating for people who are in severe pain and told ‘nothing can be found’, ‘there’s nothing more that can be done’, ‘pain is in your mind’.

As I said earlier – pain does not reflect the true state of the tissues in the body.

If I took a bow and fired an arrow at your leg, before your brain even produced the sensation of pain, it would have gone through some incredibly complicated pathways and processes. Our brain takes information from 3 main categories before deciding on how much pain to give us. These are:

1.     Physical – what’s going on in our body physically – do we have a strained muscle? A torn ligament? A broken bone? This also includes chemicals such as hormone balances, inflammatory markers and stress hormones like cortisol.

2.     Environmental factors – what is our mood like today? Are we happy/sad/indifferent? Our emotions, amount of sleep, relationships and satisfaction at work are all considered before we feel pain.

3.     Historical/Memories – have we had a previous injury like this? Do we know someone who has? Maybe your friend had an arrow in their leg and had to have it amputated, so what does that mean for you?

After your brain has collated all of this information if will give off an appropriate pain signal.  As you can see, this is far more complicated than just the injury. This is exactly why I believe in a holistic approach, and why one persons low back pain is never the same as another persons back pain.

When we have been in pain for a while our physical state changes as our muscles tense and we try to protect the area that hurts, our emotional state might change too as our life, and possibly work, are affected by the pain. This feeds back in to the brain and continues the pain cycle. This is why an amputee can still feel pain in a limb that doesn’t exist.

Pain does not reflect the true state of the tissues in the body.

Pain is far more complicated than that.

This is why I find both mental and physical health so important, even though I treat patients with ‘physical injuries’. Our brains cannot differentiate emotional and physical pain – stubbing your toe and missing a mortgage payment register identically in the brain.

One of the reasons an osteopathic consultation is so long is because we take a detailed case history to build up a big picture – an overview of how you the patient came to be who you are today. You can do this yourself by writing down your personal emotional and physical journey. This includes childhood injuries, illness, possibly playground comments that have stuck with you, relationship breakdowns, change in work or home etc. As you write everything down you might realise certain things you haven’t properly processed yet, that might be contributing to your pain. This almost serves as a detox for your brain. Understanding the true meaning and cause of your pain will allow you to move forwards.

 

DR MARWAH ON WOMENS MENTAL HEALTH

“Our mental health, and our way of thinking and behaving, begins to take shape from the moment we are born. Our external surroundings and relationships of those around us form the way we think over years. Negative behavioural patterns and negative thoughts are addictive. Just as a smoker or drinker becomes addicted to substances, so does a negative thinker to their negative thoughts. Negative thinking leads to a low mood and anxiety.

This can be changed!

These habits are formed over decades and therefore take a while to break these thought processes. The key is to share your feelings, and make each other aware.

 When thinking about women’s mental health and what I could share to help raise awareness, I thought about what we have as women, that our male counterparts do not. The menstrual cycle! How many women reading this were told in their early teens that when you start your periods, not only will you experience bleeding, but you will also have mood swings and emotional changes? Did anyone’s mother, teacher or friend tell them about the emotional downs, the irritability, the snappy behaviours and the lack of energy a lot of us experience during our periods? Following the temporary cessation of ones period, hormonal changes persist – does anyone warn us about those?

Some of my close friends have recently had children and they have told me they feel very low and isolated because their life has changed so dramatically. Although a new bundle of joy is the most incredible gift in the world, the change in life can make women feel very low at times. So many patients have shared stories like this with me, but feel ashamed to tell their husbands, parents and friends as they feel like a failure. Their mums didn’t feel like this… their friends seem fine… what will their spouses think? The truth is that these feelings are completely normal, and actually very common.

After periods comes the menopause – your hormones are all over the place again! Some patients report feeling tired all the time, decreased sex drive, low mood, irritable and snappy; some have their symptoms years after their last periods and don’t know that taking HRT 3, 4 or 5 years later can help the hormonal symptoms caused by menopausal changes. The point is that it’s normal to have emotional ups and downs, so lets talk and share with each other.”


OUR TOP 3 TIPS

We asked our lovely guests to share their top 3 tips for managing stress and anxiety on a daily basis:

@sunshineandwaffles

1.     Breathing exercises

2.     Sleep

3.     Writing a list of priorities

@goodnessguru

1.     Walking without purpose

2.     Podcasts

3.     Baking

@Rhitrition

1.     Reduce stimulants in diet

2.     Engage in mindfulness

3.     Surround yourself with positive people

@kate_harrison

1.     Being with the people you love

2.     Movement and fresh air

3.     Good food

@hipandhealthy

1.     Getting into the outdoors

2.     Finding some quiet time with a cup of tea

3.     Chatting about what’s on your mind

@drsimimarwah

1.     Practising mindfulness

2.     Taking time for yourself

3.     Movement