Whether it’s painting, drawing, sculpting, cooking, knitting, sewing, writing, singing, playing music, dancing, the arts play a big role in our overall mental and physical health as well as our communities.

Creativity can be seen by some, perhaps in past decades, as frivolous. But there’s evidence to show that creativity helps our mental health and our stress management.

For me, I realised in my ongoing journey of mental health recovery, that the days I didn’t create were the days I felt disconnected and more likely to experience intrusive thoughts or unhealthy coping strategies. Moreover, writing or drawing helps me see something new about my own thought process or feelings, it helps unblock something I’m struggling to communicate to myself let alone to others. Creating doesn’t need to be for the sake of showing it to others. Creating is a way of showing ourselves to ourselves. Expressing ourselves and exploring what it means to be human.

As a person who has lived with mental illness most of my life, I’ve encountered many types of therapies. Many people are aware of common therapies used to treat mental health conditions like Cognitive Behavioural Therapy, psychotherapy and group therapy. Alongside these, particularly in inpatient care, can comfortably sit more creative pursuits as therapy.

April is Stress Awareness Month so to be aware of stress, honour it and deal with it appropriately, it’s important to be clear in the distinction that stress is not a mental health condition although it can be the cause of and the symptom of one.

We perhaps in society mistake “stress” as a mental illness partly as a hangover from the time when doctors might sign people off from work with “stress” instead of “undiagnosed or untreated mental health condition”. Perhaps also partly due to the rife epidemic of Post Traumatic Stress that veterans lived with for years after various wars in the past century. We’ll come back to these vital differences between stress and mental health conditions in a few paragraphs’ time.

 

What is stress and long-term stress?

 

Stress is the body’s natural nervous system response to a threat. Our bodies become stressed to prepare itself for an attack. It could be a physical threat, an emotional threat, an imagined threat or a threat we experienced a long time ago and haven’t fully processed yet.

Occasional stress is a part of life. Problems and even illness – both physical and mental – occur when we experience long-term or chronic stress.

In today’s world, we face different kinds of stress: stress of reading the news, screen time stress, tech stress, cost of living crisis stress let alone the stresses of relationships and workloads.

Our bodies can experience these external situations as a threat to our survival in one way or another. If it is ongoing, pervasive, it can be often hard to notice the impact that these stresses are having on us until symptoms become hard to live with. And this is why it’s vital to understand stress a little bit better.

This is partly why challenging the stigma of “getting on with it” and “pulling our socks up” isn’t sustainable. If we bury, deny or ignore our body’s response to stress we can’t run away from it. Our bodies store it.

If we ignore long-term stress it can turn into a mental health condition. Many are familiar with the term Post-Traumatic Stress Disorder and many are now becoming familiar with Complex Post Traumatic Stress Disorder. These are both mental health conditions with symptoms that can disrupt every day life due to traumatic events our minds and bodies have gone through. The difference between the two was outlined to me when I was in the early stages of being diagnosed with CPTSD in the following way:

 

• PTSD occurs mostly in adults who have been through a traumatic event and can be developed by anyone, even someone who has never had a history of trauma, mental health issues or other risk factors for mental illness.
• CPTSD, as the name suggests, is more complex and can be the result of ongoing trauma, abuse or adverse childhood experiences.

 

For example, a soldier knows they’re a soldier, they know there’s a war, they know what they experience. After experiencing traumatic events, they might develop symptoms of PTSD. But if a child in its formative years, while it’s brain and sense of self is developing, goes through ongoing and pervasive traumatic events, then the trauma informs brain structure, thought patterns, beliefs and more. It is common for a person with CPTSD to be diagnosed with 10-15 different mental illnesses before finally receiving this diagnosis.

Ignoring stress can lead to mental health conditions and physical health conditions. So, stress itself is not a mental illness. But it can cause them, and it can be a symptom of them.

 

Why is stress not mental illness?

 

Stress and mental illness are two concepts that are often used interchangeably, but they are not the same thing. While stress is a normal response to challenging situations, mental illness is a serious condition that requires medical attention.

Stress is a natural response to situations, environments and relationships that challenge us. Stress can be a physical stress in our bodies, intense and pervasive cognitive load (stress on our mental capacity) and increased emotional burdens. Stress is a normal part of life because life itself is challenging and, in small amounts, can be beneficial. Stress can help us stay alert and focused. However, when stress becomes chronic or overwhelming, it can have negative effects on our physical and mental health.

Chronic Stress can even lead to developing mental health conditions and physical health conditions. Therefore it is vital we learn to manage stress to prevent other more long term conditions arising.

Mental illness is a diagnosis of one of many serious conditions that affects a person’s thoughts, feelings, and behaviours. Mental illness can be caused by a variety of factors, including genetics, environment, and life experiences.

Another difference is that mental illness is not a choice, but a medical condition that requires treatment. Stress isn’t always a choice, but sometimes we can find ourselves becoming addicted to the stress hormones and therefore start seeking stressful situations to get that familiar “high”, and a familiar response.

The differences are clear, if we take the time to pay attention to our bodies, our minds, thought patterns, behaviour patterns and feelings. Whether you are experiencing symptoms of stress or mental illness, it’s important to seek help. Neither stress nor mental illness is a character flaw, but with the right knowledge, support and guidance we can learn to manage and treat both.

 

Coping with Stress

 

Stress left unmanaged can lead us to develop coping mechanisms, often not consciously healthy ones. Our minds want us to survive and so if stress goes unmanaged it can lead to our energy reserves managing our nervous system for us: we can develop anxiety disorder or other anxiety related disorders like OCD to manage our pervasive stress levels, we can become so stressed our nervous system goes into a “freeze” response or “shut down” causing depression and alongside these responses our bodies can develop physical illnesses due to stress.

Some people might want to banish stress from our lives and profess that a stress-free life is a happier one. But a little acknowledged truth is that we all need some stress in our lives. Firstly, while it might sound lovely to lie on a beach relaxing for the rest of our life, our bodies adjust faster than we realise and our minds tend to find new sources of stress. It’s a survival instinct to perceive potential threats. So while we may relax for a short time in these quick fix scenarios, to make them the norm doesn’t adjust our ability to handle stress necessarily. It’s more sustainable if we adjust our daily routines to involve regular habits to manage stress levels.

Not only can we not all sit around in bubble baths all day or meditate all hours because our society isn’t built for us to do so. Plus our skin would get wrinkly from the suds! If we have too little stress we can experience lack of motivation and disinterest, maybe even leading to shut down. If we experience too much stress it can lead to agitation, overwhelm and burnout. There is an optimal level of stress in this bell curve and it’s where we are interested, excited, motivated, engaged in life and have purpose.

This stress awareness month we can also be mindful of positive stress and how it differs to negative stress. Negative stress is burnout, missed deadlines, arguments with loved ones, the pressures of negative self-talk, exasperation at the news, not being able to switch off, to sum up? Stress is the demands of a modern life.

Positive stress could be learning some new skill, positively stressing our bodies with exercise, positively stressing our minds with new experiences, positively stressing our interrelation skills with meeting new people, trying new things, pushing ourselves gently and with excitement, compassion and curiosity outside of our comfort zones.

Learn how to recognise and reduce stress in this article.

 

 

 

Symptoms of anxiety, depression, and substance dependence have ravaged my life for 50 years. Suicide? Sure, it’s crossed my mind, but never set up camp. It did in Zoraya ter Beek’s psyche. She’ll die next month. We need to talk about it.

Quick heads up: some may find our subject matter troubling, even triggering. If you’re one of them, please feel free to close the piece. Maybe Bringing light to our darkest days would be a good choice.

Now that medically assisted suicide for those with severe and persistent emotional and mental health challenges (“psychiatric euthanasia”) is legal in a number of countries, the end of life stories continue to pour in.

Intro

Let’s do some table setting before we get rolling…

We’ll be using the term “assisted dying” in our discussion. Medically assisted dying, physician-assisted dying, physician-assisted suicide, medical assistance in dying (MAID), and in this case, psychiatric euthanasia are also used. Just don’t lose the forest for the trees, okay?

Since we’re discussing a case taking place in the Netherlands, you may want to read the Government of Netherlands’ euthanasia information, as well as the Termination of Life on Request and Assisted Suicide (Review Procedures) Act.

Finally, there are two articles here on Chipur that address assisted dying, including ethics and opinions: Assisted dying – psychiatric euthanasia: You okay with it? and Assisted dying – psychiatric euthanasia: You okay with it? Part 2. Both are well worth reading.

The Zoraya ter Beek story

On April 1st, The Free Press published ‘I’m 28. And I’m Scheduled to Die in May.’, written by Rupa Subramanya. The piece is based upon an interview with Zoraya ter Beek.

You may notice that I didn’t include an image of her. Fact is, I don’t have the rights. But even if I did, and even though she came forward, it wouldn’t be here. It’s about discretion and respect.

Who is she?

Zoraya ter Beek, 28, lives in a small Dutch town with her boyfriend and their two cats.

There was a time that she wanted to be a psychiatrist; however, the symptoms of her major depressive disorder, autism spectrum disorder, and borderline personality disorder prevent her from finishing school – even starting a career.

Sadly, she’s tired of living.

Her psychiatrist’s shocking statement

For all we know, Ms. ter Beek would have pursued assisted suicide regardless; however, a shocking statement by her psychiatrist pushed her over the edge.

After pointing out that everything had been tried, the doc said, “…there’s nothing more we can do for you. It’s never gonna’ get any better.” (I’m still shaking my head.)

It was then that ter Beek decided to die, stating, “I was always very clear that if it doesn’t get better, I can’t do this anymore.”

”Tree of life”

Interesting: ter Beek has a tattoo of a “tree of life” on her upper left arm, but “in reverse.”

She explained, “Where the tree of life stands for growth and new beginnings, my tree is the opposite. It is losing its leaves, it is dying. And once the tree died, the bird flew out of it. I don’t see it as my soul leaving, but more as myself being freed from life.”

Death

Ter Beek has decided to die on her living room couch. She says there will be no music. She’s asked her boyfriend to be with her until the end.

Ter Beek detailed, “The doctor really takes her time. It is not that they walk in and say: lay down please! Most of the time it is first a cup of coffee to settle the nerves and create a soft atmosphere. Then she asks if I am ready. I will take my place on the couch. She will once again ask if I am sure, and she will start up the procedure and wish me a good journey. Or, in my case, a nice nap, because I hate it if people say, ‘Safe journey.’ I’m not going anywhere.”

According to ter Beek, her doctor will administer a sedative, followed by a drug that will stop her heart.

Protocol

So ter Beek provided a glimpse of the protocol for ending her life. For learning’s sake, let’s review protocol for a non-psych case in Vermont that took place earlier this year.

Five powerful medications are used, including diazepam, digoxin, morphine sulfate, amitriptyline, and phenobarbital. Death usually comes within 90 to 120 minutes, but can take longer.

When a patient is ready, they, a relative, or friend mixes the drugs with water or apple juice. It’s crucial to drink the entire mixture within two minutes for the greatest efficacy.

Within a couple of minutes, the patient loses consciousness, only the heart and lungs still working. Then comes the waiting for the end.

Postmortem

Back to Ms. ter Beek. When she’s dead, a euthanasia review committee will evaluate her death to ensure the doctor adhered to “due care criteria.” If there are no complications the Dutch government will declare that the life of Zoraya ter Beek was lawfully ended.

There won’t be a funeral, as ter Beek doesn’t have much family and she doesn’t think her friends will feel like going. Instead, her boyfriend will scatter her ashes in “a nice spot in the woods” that they have chosen together.

Ter Beek texted the interviewer: “I did not want to burden my partner with having to keep the grave tidy. We have not picked an urn yet, but that will be my new house!” She added an urn emoji after “house.”

Ter Beek wrapped things up by saying, “I’m a little afraid of dying, because it’s the ultimate unknown. We don’t really know what’s next – or is there nothing? That’s the scary part.”

What to make of it all?

Incredibly intense stuff, isn’t it. I mean, it wasn’t too long ago that I wrote about Shanti De Corte’s assisted suicide – and the complexity and emotional roller coaster ride continue.

My two cents

With a tip of my hat to cultural and spiritual realities, an adult has the right to end their life.

I’ll go out on a limb and submit that very few people would take issue with someone doing it if they’ve been diagnosed with a terminal medical condition.

But when it comes to an emotional or mental disorder – which are medical conditions – things get dicey. And that’s because they aren’t terminal. Now, I suppose one could make the case that they are; however, the only support would be, ironically, the potential for suicide.

Regarding Ms. ter Beek’s case, the symptoms and manifestations of major depressive disorder, autism spectrum disorder, and borderline personality disorder could be a will-breaking load.

Who could blame her for wanting out?

My biggest hang-ups in any psych assisted suicide case are compromised thinking (e.g., cognitive distortions), judgment, impulsivity, and negative environmental factors.

Yes, I realize ter Beek was assessed and received approval from medical and psychological professionals. But when the biggest player says, “…there’s nothing more we can do for you. It’s never gonna get any better.”, I’m not feeling good about it.

And there’s something else that has me scratching my head. I may have missed it, but I don’t recall reading anything about psychotherapy. Was she participating? Was it the right type? Did she have quality clinicians?

Well, look, regardless of my two cents, in several weeks Ms. ter Beek will fulfill the wishes of her mind and soul. No judgment here.

What are your thoughts and feelings?

I’d give anything to chat with her

So Zoraya ter Beek will die next month. Her choice, her right. And the physician facilitating her death will be protected by the law.

It saddens me. In fact, I check every day to see if she cancelled the procedure. Is that selfish?

Pure countertransference: I’d give anything to chat with her and, yes, see if I could change her mind.

Hey, if you or someone you care about are in immediate danger of any form of self-harm call 988 in the U.S. And here’s a list of international suicide hotlines.

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Here’s the article from The Free Press: ‘I’m 28. And I’m Scheduled to Die in May.’

Those Chipur inspiration and info articles: plenty of them.

Applications to become an MQ fellow are open for researchers in the United States. This is an opportunity to receive not only financial support but also practical support from the MQ team. But what is it like to apply and be selected for an MQ fellowship?

One of the first ever MQ Fellows selected was Dr Joshua Roffman from Harvard University and Massachusetts General Hospital . He tells us the inside story of the process and what being an MQ fellow is like.

 

I was thrilled and honoured to be selected as one of the first MQ Fellows in 2014.  At that point in my career, I was experienced enough to know that I needed to shift my focus to achieve greater public health impact – to the area of prevention, where there is tremendous unmet need in psychiatry.  But it was also early enough in my career that this shift would be considered too scientifically risky by large funding agencies such as NIH (National Institutes of Health) to invest in. 

 

Exciting Beginnings

 

The MQ Fellows program seemed like the perfect catalyst for me at the time, as it provided support to grow in a new area.  Much of my prior research had focused on the biology of chronic psychosis using brain imaging and genomic tools and had pointed to a promising treatment lead involving supplemental folic acid.  Indeed, clinical trials conducted by our group showed some degree of benefit, but well below the level needed to substantially improve outcomes. 

 

At the same time, other groups using different tools – population health and birth cohort studies – were finding that folic acid delivered early in prenatal life conferred substantial protective effects against autism risk.  Given known areas of overlap in risk for autism and schizophrenia, I wondered whether periconceptional folic acid might also confer protection against schizophrenia risk.

But there were daunting challenges, both from an experimental design standpoint given the two decades between prenatal life and typical schizophrenia onset and given my lack of expertise in population-level studies.

 

Ambition and Mentorship

 

MQ provided the platform not only for me to develop and test an ambitious idea, but also to receive additional mentorship from one of the world’s experts in this area (Dr. Ezra Susser). 

We decided to leverage the US population-level rollout of folic acid fortification of grain products in the late 1990s. This intervention rapidly doubled blood folate levels in women capable of pregnancy and dramatically reduced spina bifida incidence. As a “natural experiment”, we used this to study effects of increased periconceptional folic acid exposure on brain development through adolescence. 

Using existing MRI data from two large groups of adolescents, we found that those born during or just after the fortification rollout showed more favourable patterns of cortical development than those born just before and that this pattern associated with reduced risk of psychotic symptoms.

This finding pivoted my career trajectory, leading to substantial additional funding from both federal and non-federal grants. 

 

Moving Forward From Here

 

The focus of my lab has now shifted to early brain development, with the goal of discovering, developing, and implementing additional interventions that promote healthy brain development, with folic acid as the prototype. 

We continue to be focused on psychosis prevention as the primary endpoint but have also broadened to consider risk for other psychiatric disorders that may have shared biological underpinnings. 

We are studying individuals from early in pregnancy through late adolescence with a broad arsenal of approaches, from imaging and genomics to prospective cohort studies, to qualitative research meant to reach families who have been historically excluded from translational psychiatry research. 

All of this is thanks to MQ, and to their investment in me at a critical time in my early career.  I feel fortunate to be a member of the MQ community, and as someone who now trains early career scientists myself, I am that much more grateful for the opportunities that they provide. 

 

Our thanks to Dr Joshua Roffman for his story. You can read Joshua’s full paper here.

If you would like to apply for the next round of MQ Fellowships, find out more about the 2024 Fellows opportunity and how to apply here.

 

There are so many myths about what it’s like to live with bipolar disorder. People constantly make assumptions about it based on media portrayals, but life is not a movie or a news report. Living with bipolar disorder is complex and varied, and what happens for some is not necessarily common for all. So, let’s dispel some of the myths about what it’s like to live with bipolar disorder and encourage people to stop making uneducated assumptions.

Living with Bipolar Myth #1: We Experience Violent Outbursts

The media loves to mention that a person has bipolar disorder when there’s a violent incident. This convinces people that those with bipolar disorder are violent. This is rarely the case.

While people with bipolar disorder are more likely than the average person to be violent, this is primarily the case where a comorbid substance use disorder or a personality disorder is involved. For example, the NESARC study from 2001-2002 found that while 0.66% of the population without a psychiatric diagnosis exhibited aggressive behavior, those without comorbidity (i.e., an additional illness like a substance use disorder or a personality disorder) and bipolar type I had a rate of 2.52%, and those without comorbidity and bipolar type II had a rate of 5.12%. Those numbers are elevated when compared to the general population without a diagnosis, true, but are still very, very low. To say that people with bipolar disorder are violent is radically incorrect.

Living with Bipolar Myth #2: We Repeatedly Experience Radical Mood Shifts

Again, thanks to the movies and television, people are under the impression that those with bipolar disorder will flip from one mood state to another at the drop of a hat. This is not true. Most mood episodes in bipolar disorder last from weeks to months (when untreated). Additionally, most people with bipolar disorder experience fewer than four mood episodes per year. There is a minority of people who experience rapid cycling bipolar disorder (more than three episodes per year), but even those people experience mood states that typically last for days to weeks. The 12-month prevalence of rapid-cycling bipolar disorder was found to be 0.3% in a 2010 study.

Living with Bipolar Myth #3: We Are All Addicts

While it is true that substance use disorders are common in those with bipolar disorder, it is still not true for everyone. In surveys between 1990 and 2015, it was found that substance use disorders were present in more than 30% of those with bipolar disorder in the community and 40% of those in clinical settings. (For comparison, it’s about 16.5% in the American population ages 12 and over.) That certainly makes it common (even in those without bipolar disorder), but it does not make it universal. It’s unfair to assume that a person has a substance use disorder just because they have bipolar disorder when more than half of us do not.

Living with Bipolar Myth #4: We Exhibit Antisocial Behaviors Such as Deceitfulness and a Lack of Guilt and Empathy

Antisocial behaviors are not typically associated with bipolar disorder and are not listed as diagnostic symptoms. Antisocial behaviors are normally associated with antisocial personality disorder. A person can have both antisocial personality disorder and bipolar disorder, but this is only true for about 4.1% of people with bipolar disorder. This means the vast majority of us are stumbling through life like everyone else. (This means that sometimes people with bipolar disorder do things like lie — just like everyone else.)

Living with Bipolar Myth #5: We Are All the Same

I run into people constantly who have had a bad experience with a person with bipolar disorder and thus assume they would have a bad experience with everyone with bipolar disorder. This just isn’t true. While there are similarities to people with bipolar disorder — we all have a brain disorder — most of who we are is unique. Yes, we experience elevated moods like mania or hypomania and low moods like depression; those are the similarities, but other things are unique to us. Some of us like chocolate, others vanilla. Some of us would hold a door open for a little old lady; some of us wouldn’t. Some of us are assholes, some of us aren’t. Those things aren’t about our bipolar disorder; they are about us. We can’t blame everything on bipolar disorder, and neither can you. We deserve to be treated as individuals, just like you.

What It’s Like for All of Us to Live with Bipolar Disorder

When I talk about living with bipolar disorder, the fact of that matter is that it’s different for everyone — even in regard to the experience of symptoms. I am an expert in bipolar disorder; I have been writing professionally about it for 14 years, and I have been living with bipolar disorder for 26 years and even I can’t tell you what it’s like to live with bipolar disorder for any individual. Bipolar disorder is a highly varied illness. The only way to know how a person experiences living with bipolar disorder is to ask them.

Image: © Nevit Dilmen, CC BY-SA 3.0 via Wikimedia Commons

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In April 2020, the world was locked down due to Covid-19. Our lives and how we lived them changed overnight. Some of us might be feeling a lot of unexpected feelings at the times of year that remind of us difficult memories such as this, and with good reason. Whether it’s at the forefront of our minds or not, the anniversary of a traumatic event can have a psychological impact. The term ‘Traumaversary’ has crept into the mental health world in recent years. A ‘traumaversary’ is the anniversary of a traumatic event so let’s first define what this is.

 

What is a traumatic event?

 

A traumatic event is something that happens to us that causes us harm. This harm could be physical, emotional, or psychological. The causes might be another person, an event outside our control or a natural cause.

Traumatic events usually include an intense feeling of threat which affects our nervous system setting us into a physiological threat response. It might include the threat of death or actual death or serious injury, it might include threat to physical safety of yourself or others, feelings of intense fear, helplessness, or shock. As a result a person may view the world differently, feeling it to be unsafe and unpredictable.

Experiences like this may mean some people develop Post Traumatic Stress Disorder also known as PTSD or cPTSD (complex post traumatic stress disorder) symptoms. With work, we can understand these symptoms and their causes, taking time to process the events that occurred perhaps with the help of a therapist. Even then, anniversaries of traumatic events may bring specific challenges.

 

Trauma-related cues or “triggers”

 

People with traumatic experiences describe a “waxing and waning of PTSD symptoms” around the anniversary with intensifying struggles related to self-reflection, social connection and drawing a meaning from the trauma.

There may also be a lot of growth that comes around the time of an anniversary as we evolve through reflection on what happened, how it affected us and how far we’ve come since.

Thanks to social media, the term “trigger” has become a little diluted in colloquial language use. But in a clinical sense, a trigger is a trauma-related cue that induces a PTSD response. These reminders of a traumatic event could be a sight, sound, smell and indeed a date in the diary. Our physiological responses can be huge and unexpected. But there’s hope.

With self-reflection and support, trauma-related cues can be anticipated and linked to a particularly problematic moment. And in relation to traumaversaries, this may be a good way to practice working with and working through a trauma reminder.

 

Memorialising with meaning

 

Trauma anniversaries can be memorialised as a meaningful time to reflect, or they could become sources of anxiety. These times might be publicly shared trauma reminders, such as the anniversary of the Covid-related lockdowns or a natural disaster or terrorist attack. Others are personal and sometimes unknown by others, for example the death of a loved one or the date of a traumatic experience like being sectioned under the mental health act or a sexual assault.

 

Anticipated, time-linked trauma cues, whether public or personal can be a way to help us move through and let go of physiological trauma responses in a contained way, if done with compassion and patience, knowledge and support.

 

 

Danger of Resilience

 

Often people who experience trauma and survive are described as “resilient”. However refining and redefining what we mean by “resilience” is drastically needed for the good of those who’ve experienced trauma. This poses a challenge.

For example, does resilience mean tenacity or positivity? Optimism or hardiness are traits sometimes associated with those who’ve been through difficult times, but life never stays the same and neither do we. People who once might feel or be perceived as being optimistic or resilient may not always remain this way. People can change. Because these perceived traits can change, applauding vulnerable people as being resilient may leave them more susceptible to isolation when their circumstances or outlooks change.

There’s another a danger when applauding resilience that a person affected by trauma might feel “split”, meaning they feel the pressure to act differently in different settings and hide their true feelings. Whether this repression is done consciously or not, either way it can have an intense psychological impact. For example, a police officer might perform very well at work while experiencing high levels of PTSD symptoms which may not affect them at work but may very well have profound effects on their homelife or relationship to themselves.

MQ is working with researchers to help create new solutions to help emergency workers with PTSD recovery and prevent PTSD developing.

 

How to help yourself

 

If you’re experiencing distressing thoughts and feelings surrounding the anniversary of a traumatic event and the resulting experiences you might’ve had, you’re not alone and there are ways to help yourself and places to turn to get help. Here’s some suggestions on how to cope more healthily with traumaversaries such as this.

 

• Recognise and acknowledge feelings: Understand that your feelings are part of the recovery process. It may help to journal about your feelings by writing them down and taking time to reflect on what you’ve written.
• Begin a reflective ritual: much like we might remember a birthday with a party, it can help to remember difficult times with a ritual related to the anniversary. Perhaps gather friends together to talk about your real experiences or arrange a therapy session with a professional.
• Get proactive: If you feel the need to do something proactive, you could decide to volunteer your time to help a charity connected to a cause related to your traumatic experience or you could raise money for a charity.
• Stay active. Activities that allow your mind to focus on something other than these memories are a good coping strategy for some people. Taking a walk in nature, meditating, exercising may help. Maybe combine this with the previous point and fundraise with a charity event like a charity run.
• Remember and celebrate what we have lost: whether it’s grieving the loss of life or a life you wished to have, anniversaries can be a chance to remember and honour what is now no longer with us.
• Reach out to your support system. Talking to trusted friends and family in anticipation of difficult times is vital. Isolation is not good for mental well-being, so stay connected. Help is always available.

 

Mental illness can affect people differently. It can be challenging, differently, for those with the condition and those who love them. This is one son’s story. Lukas Kesslig has experience of living with someone who showed symptoms of bipolar disorder. Lukas grew up with a father who had mental health challenges. Here he kindly shares with MQ part of his experience growing up with his father.

 

My father, especially when tilted toward mania, always needed to be doing something – something important.  The mission was accomplishment and it crept into all aspects of life.  All work didn’t make him a dull boy, as the saying goes, but frivolous pursuits didn’t interest him.

He cared deeply about his work, but also family, politics, creativity, conservation, travel.  As a young man, much of his restless energy funnelled into risk-laden activism.  Later in life, he would redirect it into family, academia, teaching, writing.

When an idea or task was important to my father, he would have no peace until he fully explored or achieved it.

This task-oriented focus and singular determination kept him ploughing ahead – but not without cost, not without drawbacks.  His mind never felt like it had enough, his ambition and accomplishment never coalesced into victory.

When you think this way, you never feel fully successful no matter how much you achieve.  That insistent itch that Dad had, you can never quite alleviate it, not completely.  Any sense of resolution remains elusive, fleeting, distant.  The more you do, the more work you see ahead of you.

This mission that never ends often intensifies with mania, but it doesn’t have to.  I experience a similar unquenchable drive for fulfilment and achievement and, while a tendency toward bipolar traits is in my genetics, I have never been diagnosed with bipolar disorder.

Clinical depression, like the depressive episodes which Dad suffered as part of his bipolar disorder, does occasionally strike me.  Yet, even in the fog of depression, the drums of pent-up ideas, of unfinished creations, continue their diffused pulse.

Like Dad, for my whole adult life, I have navigated a nervous energy and a quest for contentment that hovers perpetually just out of reach. I liken this to my father’s “itch”.

The itch is a double-edged sword that I, too, have attempted to wield.  I share Dad’s impulse for doing things and his physical and mental intolerance for idleness.

This unquiet nature is a bonanza for productivity, but much of the time, it really can feel like a curse.  The next task always needs immediate attention.  The taste of victory is semi-sweet, but increasingly diluted by the tide of duties to come.  My father recognised that saccharine flavour all too well.

When the Civil Rights Movement succeeded in its major goals, when the troops came back from Vietnam, when his conservation ideas became legislation, Dad was still looking, still searching for wholeness, still running the last mile.

He remained on that treadmill his whole life, straight through his career, into retirement and on his death bed.  As every milestone passed, he always held a compulsion for more purpose – and therein lay the itch.

My feet follow the same never-ending path.  The road always continues beyond the destination. Fortunately, I’ve found other ways to rest along the way.

Our thanks to Lukas for his story. MQ is interested to work with researchers who are looking to study various aspects of bipolar disorder. If you’re a researcher interested in this area please take a look at our funding opportunities page.

I told you a new book on bipolar disorder was coming. I’ve been working on it for months, and while it’s not here yet, the title and cover art are. I hope you enjoy this Natasha Tracy bipolar book title and cover art reveal.

‘Bipolar Rules! Hacks to Live Successfully with Bipolar Disorder’

Bipolar Rules! Hacks to Live Successfully with Bipolar Disorder is my new book. Its cover looks like this:

What’s in ‘Bipolar Rules! Hacks to Live Successfully with Bipolar Disorder?’

This book is full of rules that are memorable and explained in detail. They cover everything from treatment rules to empowerment rules to coping skill rules. It even has rules around suicidality. Each section and rule is designed to give you just the information you need when you need it. A detailed table of contents will allow you to pick and choose the information that makes the most sense for you. While you can read Bipolar Rules! from cover to cover, you can also pick it up and read it a little bit at a time when you’re looking for guidance.

Bipolar Rules! offers rules regarding simple topics like mood tracking and more difficult topics, like outthinking bipolar disorder and dealing with bipolar thoughts you can’t control. It aims to help you live more successfully on a daily basis and overall.

Keep Up to Date with ‘Bipolar Rules! Hacks to Live Successfully with Bipolar Disorder’

To keep up with everything Bipolar Rules!, keep an eye on this page and subscribe below. (You won’t receive other types of emails.)

And let me know what you think of the title and art in the comments! I look forward to your thoughts.

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Applications to become an MQ fellow are open for researchers in the United States. The opportunity will mean researchers will receive not only financial support but also practical support from the MQ team. Which of our MQ researchers have previously been based in the USA and what areas of research have they been supported in developing?

 

2013

In MQ’s first year as a charity organisation, 2013, two of our first ever fellows were based in the United States.

Dr Susanne Ahmari identified brain activity related to Obsessive behaviours, the first step towards developing new treatments for OCD.Dr Ahmari investigated what happens in the brain to cause OCD (obsessive compulsive disorder) specifically, whether complications in the brain’s circuits may cause symptoms.

Susanne’s project involved a new technique named optogenetics which means researchers can isolate and study specific brain cells. This can happen by these cells being made sensitive to light, then targeted lights being used to switch those cells on and off. With this fascinating technique, Susanne progressed the understanding of OCD forwards and contribute to treatments.

 

“The MQ fellowship was transformational. This study would have been too high-risk for conventional funding. MQ has enabled research that may result in measurable impact in prevention of mental illness in young people.” Dr Joshua Roffman

 

That same initial year of 2013, another USA-based researcher Dr Joshua Roffman found that by increasing the consumption of folic acid during pregnancy, changes occur in children’s brain development, therefore reducing the occurrence of psychotic symptoms later in life.

Thanks to the MQ Fellowship, Joshua found that taking folic acid during pregnancy decreased risks of psychotic symptoms in children. MQ supported his research and as a result public health policies changed worldwide to increase levels of foods fortified with folic acid.

 

2014

In MQ’s second year, 2014, another two researchers were supported in the USA.

Dr Jeremiah Cohen used innovative techniques to explore the role that brain chemical serotonin plays in affecting mood, leading to better drugs to treat mood disorders in the future.

Serotonin is largely associated with changes in mood. Many antidepressants work by increasing the amount of serotonin in the brain due to this. However, understanding of how serotonin is involved in mental health conditions at a cellular level is still limited. So Dr Cohen used cutting-edge techniques to investigate the precise role of serotonin within the brain.

That same year, Professor Sergiu Pasca was supported to develop a method to create 3D brain circuits ‘in a dish’, providing a pioneering new way to understand how different parts of the brain develop.

 

2015

The following year, 2015, another USA-based researcher Dr Ian Maze took a novel, multidisciplinary approach to understanding how serotonin impacts major depressive disorder which could lead to improved pharmacological treatments for depression.

“Prior to MQ’s support, work [in this area] was sparse and primitive. MQ was instrumental and essential to launch what is now a major thread of research in mental health. We would not have believed how far the field, and our own work, would have come in such a short time.” Dr Zach Cohen

 

2016

Yet another pair of USA researchers joined MQ’s team in 2016. Professor Jean-Baptiste Pingault found strong evidence around the direct impact of bullying on the development of mental health problems in young people. Working since 2017, his study, Bullying and Mental Health: a Genetically Informative Approach, aimed to improve understanding of mental health and bullying would could lead to more successful support for young people.

In 2020 Jean-Baptiste concluded his study, giving clear evidence on the sources and effects of bullying. The project used a large sample of 11,108 twins from the Twins Early Development Study, siblings who shared genes and environments but have different experiences regarding victimisation.

Professor Baptiste’s study found those with pre-existing risk factors such as ADHD and depression are more likely to be bullied and to experience mental health conditions than others.

Dr Patrick Rothwell from the USA also was supported the same year as Professor Baptiste. Dr Rothwell identified the brain cells related to impulse control which could lead to the development of treatments to curb negative behaviours. Dr Patrick Rothwell and his team at the University of Minnesota used innovations in neuroscience to investigate whether conditions such as addiction and depression can be successfully treated by strengthening connections between areas of the brain.

 

2017

From the USA, Dr Zach Cohen ran the Stratified Medicine Approaches for Treatment Selection Tournament (SMART), to improve treatment selection for anxiety disorders in 2017, supported by MQ.

 

“This fellowship has been incredibly helpful for my career. It has provided funding towards improving my intervention and is also furthering my own learning as a scientist. The call itself inspired an entirely new approach to my research that has already resulted in other funded awards in pursuit of improving youth mental health.” Dr Marisa Marracini

 

2023

Skipping ahead to 2023, and three USA-based fellows were welcomed to MQ’s roster of researchers.

Thanks to MQ’s support, Dr Marisa Marracini is now co-designing a virtual reality tool to help adolescents who have been hospitalised for suicide-related crisis.

Marisa is working to promote child and adolescent mental health in school. Currently Dr Marracini is developing and testing a virtual reality intervention to accompany inpatient treatment for adolescents hospitalized for suicide-related incidents. She is also partnering with young people to develop and spread therapeutic skills through social media.

 

“Through one-on-one interviews with these clinical actors and group discussions with people living with type 1 diabetes we will have a full picture of where there are gaps in service delivery and how we can create acceptable and sustainable solutions that meet both patient and provider needs.” Dr Leslie Johnson

 

Dr Leslie Johnson, also from the USa, is adapting and testing an existing treatment for people with type 2 diabetes in order to treat patients with type 1 diabetes. This project has the potential to help the millions of people living with type 1 diabetes and symptoms of depression and anxiety by improving the choices of care available.

 

“I am deeply honoured to receive an MQ Fellows award and very excited to conduct this research. This award provides a unique opportunity to complete some important work in the field of suicide research, which I might not have had the chance to complete otherwise. I am very grateful for the support of MQ and their belief in the potential impact of this work.” Dr Alexandre Lussier

 

Finally, Dr Alexandre Lussier based in the USA and Canada, is running a longitudinal study of gene to environment interactions and epigenetic mechanisms to understand how depressive disorders influence suicide risk.

If you’re interested in applying for the next round of MQ Fellowships, find out more about the 2024 Fellows opportunity and how to apply here.

 

When I was a boy, out of necessity, I learned that active fingers and hands reduced my anxiety. Hmm, knitting works calming wonders for folks around the globe. So let’s sink our needles into the yarn and see what we can make of it.

I can count the number of times I’ve knitted on one hand. How ‘bout you? Are you a knitter?

Yes or no, lots of interesting and helpful info coming at you, so dig right in…

Intro

Let’s set the table with some choice tidbits from an article I bumped into on The Creatives Hour’s website: “15 Surprising & Interesting Knitting Statistics 2024.”

• There are 53 million knitters in the United States, 7 million in the United Kingdom
• Knitting and crocheting sales in the US in 2019 were $1.2 billion
• 51% of knitters spend 8+ hours a week on a project
• Knitting is the most relaxing hobby that everyone can take up
• To relieve stress after a long day, knitters prefer grabbing their needles over zoning out on TV or having an alcoholic beverage
• 88% of knitters feel less stress when knitting
• Knitters have a lower heart rate by an average of 19% compared to participants in other activities
• 40% of knitters use it for depression relief

How’s that for laying a solid foundation?

Knitting and mental illness: Calmness and structure

Okay, time to sink our needles into the yarn…

During an online browsing session I found this news release, dated March 15, 2024, from the University of Gothenburg (Sweden): “Knitting brings calmness and structure to the lives of people with mental illness.”

It details a study which was published in The Journal of Occupational Science. Its first author is occupational therapist and University of Gothenburg PhD candidate, Joanna Nordstrand.

As the title of the news release implies, the study shows that knitting, described as a way of bringing a sense of calm and giving life structure, is beneficial for people living with emotional and mental health issues.

A way of coping with life

From Ms. Nordstrand, who happens to be a knitter…

Knitters have a creative leisure interest that can also help them to cope with life and so improve their mental health. I’m convinced that this is part of the reason why so many people have taken up knitting these days,

What makes this study unique is that it explores what people enduring emotional and mental health problems say – in their own words – regarding what knitting means to their health.

The study team collected 600 posts from Ravelry, a free online forum for knitters, crocheters, and fiber artists. The posts were analyzed using established qualitative content analysis methods.

The benefits of knitting

The results of the study revealed three primary ways in which knitting supports improved emotional and mental health.

1. Enables people to unwind
2. As a hobby, it offers an identity as a knitter and a low-stakes social context
3. It can bring structure to people’s lives

Study participants noted improvement in their short and long-term health due to believing their knitting is a highly appreciated occupation.

Some of the knitters also noticed a change in their mental processes, saying that when they were knitting, their thinking became clearer and easier to manage.

Ms. Nordstrand…

The aim of the occupational therapist is to get people’s lives working. There’s potential in needles and yarn that the health system shouldn’t ignore!

Participant comments

See if these participant comments hit home. I think they speak well for the benefits of knitting…

Regarding meds replacement

The nurses were wanting to give me [an anti-anxiety medication] until I told them that I preferred knitting for the anxiety. She stopped, looked at me, and said, ‘That’s much healthier than drugs.’ Ya think?

Stress reduction

When my parents convinced me to go to the walk-in center at the hospital, I was knitting while I sat crying next to my mother in the waiting room. I carried on knitting all the way through the entire hour […]. I’ve now adjusted my medication but knitting is still my best tool for reducing stress.

Thought management

While my hands are busy doing something, my mind slows to a crawl, and I am actually able to think about one thing at a time… rather than having 20-30 threads all going at once.

Pretty good, huh.

Reach for some needles and yarn

As a boy, unable to fall asleep because of anxiety, I grabbed a pad and pencil and doodled in the dark. That was my first lesson in the power of active fingers and hands.

Knitting is in the same ballpark, isn’t it.

if depression, anxiety, or stress frequently knock on your door, reach for some needles and yarn. I bet they’ll help.

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Here’s the full release from the University of Gothenburg: “Knitting brings calmness and structure to the lives of people with mental illness”

Be sure to check out 15 Surprising & Interesting Knitting Statistics 2024.”

Looking for more Chipur emotional and mental health info and inspiration articles? Peruse the titles.