Researchers from the University of Essex found that as little as five minutes of a “green activity” such as walking, gardening, cycling or farming can boost mood and self esteem.
“We believe that there would be a large potential benefit to individuals, society and to the costs of the health service if all groups of people were to self-medicate more with green exercise,” Barton said in a statement about the study, which was published in the journal Environmental Science & Technology.
Barton and Pretty looked at data from 1,252 people of different ages, genders and mental health status taken from 10 existing studies in Britain.
They analyzed activities such as walking, gardening, cycling, fishing, boating, horse-riding and farming.
They found that the greatest health changes occurred in the young and the mentally ill, although people of all ages and social groups benefited. The largest positive effect on self-esteem came from a five-minute dose of “green exercise.”
All natural environments were beneficial, including parks in towns or cities, they said, but green areas with water appeared to have a more positive effect.
Just when I think our world has moved a baby step in the right direction regarding our understanding of mental illness, I get another blow that tells me otherwise. For example, awhile back I quoted an intelligent woman who wrote an article in a popular women’s magazine about dating a bipolar guy when she was bipolar herself. She recently discovered that she had jeopardized a job prospect because the article came up — as well as all those who referenced it, like Beyond Blue — when you Googled her name. So she requested everyone who picked up that article to go back and change her real name to a pseudonym.
Because talking about bipolar disorder in the workplace is pretty much like singing about AIDS at the office a hundred years ago or maybe championing civil rights in the 60s.
I totally get why this woman created a pseudonym. Trust me, I entertained that possibility when I decided to throw out my psychiatric chart to the public. It’s risky. Extremely risky. Each person’s situation is unique, so I can’t advise a general “yes ” or “no.” As much as I would love to say corporate America will embrace the person struggling with a mood disorder and wrap him around a set of loving hands, I know the reality is more like a bipolar or depressive being spit upon, blamed, and made fun of by his boss and co-workers. Because the majority of professionals today simply don’t get it.
Not at all.
They don’t get it even though the World Health Organization predicts that by 2020, mental illness will be the second leading cause of disability worldwide, after heart disease; that major mental disorders cost the nation at least $193 billion annually in lost earnings alone, according to a new study funded by the National Institute of Mental Health; that the direct cost of depression to the United States in terms of lost time at work is estimated at 172 million days yearly.
I realize every time I publish a personal blog post — one in which I describe my severe ruminations, death thoughts, and difficulty using the rational part of my brain — I jeopardize my possibilities for gainful employment in the future. I can pretty much write off all government work because, from what I’ve been told, you have to get a gaggle of people to testify that you have no history of psychiatric illnesses (and, again, all it takes is one Google search to prove I’m crazy).
It’s totally unfair.
Do we penalize diabetics for needing insulin or tell people with disabling arthritis to get over it? Do we advise cancer victims to use a pseudonym if they write about their chemo, for fear of being labeled as weak and pathetic? That they really should be able to pull themselves up by their bootstraps and heal themselves because it’s all in their heads?
But I don’t want to hide behind a pseudonym. I use my real name because, for me, the benefit of comforting someone who thinks they are all alone outweighs the risk of unemployment in the future. Kay Redfield Jamison did it. She’s okay. So is Robin Williams. And Kitty Dukasis. And Carrie Fisher. Granted all four of those people have talent agents ready to book them as speakers for a nice fee.
In their book, Living with Someone Who’s Living with Bipolar Disorder Chelsea Lowe and Bruce M. Cohen, MD, Ph.D., list the pros and the cons of going public with a mood disorder. I’m paraphrasing a little bit, but here are the pros:
- There’s nothing disgraceful about the condition, any more than there would be about cancer or heart disease.
- Carrying a secret is an enormous burden. Sharing it lightens it.
- The more people who know and are looking out for you, the more likely you’ll be able to get help before the problems turn serious.
- Sharing the information lessons the burden on your partner.
- Lots of people have psychiatric issues; maybe your boss or family member does too.
- Taking about the diagnosis is an opportunity to educate others.
The authors suggest telling your employer under these circumstances:
- If you are taking a new medication and may need time for adjustment.
- If your schedule doesn’t allow for regular, restful sleep–which is an important factor in controlling the disorder–or if you need to request certain adjustments to your schedule, like telecommuting.
- If you need to be hospitalized or take a leave of absence.
- If the disorder is affecting your behavior or job performance.
- If you need to submit benefit claims through your employer rather than the insurance company, or if your employer requires medical forms for extended absences.
And the cons:
- Prejudice and stigma about psychiatric disorders are still common in our society. A disclosure of bipolar disorder [or any mental illness] will inevitably color your employer’s and coworkers’ perceptions of his job performance: “Did Jerry miss that meeting because the bus was late, or because he was off his meds?” Potential problems include discrimination, stigmatization, fear and actual job loss.
- You can’t un-tell a secret.
- Your chances for promotion could be hurt.
- The employer is under no obligation to keep your condition secret.
- Discrimination is illegal but difficult to prove.
- You could be written off as “crazy.”
It’s Tricky! What are your thoughts?
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The recent controversy over the still-developing DSM-5 — that compendium of mental disorders the media love to call, inappropriately, “The Bible of Psychiatry” –has gotten me thinking about loneliness. Now, thankfully, nobody has seriously proposed including loneliness in the DSM-5. Indeed, loneliness is usually thought of as simply an unpleasant part of life — one of the “slings and arrows” that pierce almost all of us from time to time. Loneliness, in some ways, remains enmeshed in a web of literary and cultural clichés, born of such works as Nathaniel West’s darkly comic novel, Miss Lonelyhearts, and the Beatles’ whimsical anthem, “Sgt. Pepper’s Lonely Hearts Club Band.”
But loneliness turns out to be a serious matter. And as psychiatry debates the diagnostic minutiae of DSM-5, all of us may need to remind ourselves that millions in this country struggle against the downward tug of loneliness. Yet even among health care professionals, few seem aware that loneliness is closely linked with numerous emotional and physical ills, particular among the elderly and infirm.
It’s easy to assume that loneliness is simply a matter of mind and mood. Yet recent evidence suggests that loneliness may injure the body in surprising ways. Researchers at the University of Pittsburgh School of Medicine studied the risk of coronary heart disease over a 19-year period, in a community sample of men and women. The study found that among women, high degrees of loneliness were associated with increased risk of heart disease, even after controlling for age, race, marital status, depression and several other confounding variables. (In an email message to me, the lead author, Dr. Rebecca C. Thurston, PhD, speculated that the male subjects might have been more reluctant to acknowledge their feelings of loneliness).
Similarly, Dr. Dara Sorkin and her colleagues at the University of California, Irvine, found that for every increase in the level of loneliness in a sample of 180 older adults, there was a threefold increase in the odds of having heart disease. Conversely, among individuals who felt they had companionship or social support, the likelihood of having heart disease decreased.
The young, of course, are far from immune to loneliness. Researchers at Aarhus University in Denmark studied loneliness in a population of adolescent boys with autism spectrum disorders (an area of great controversy in the proposed DSM-5 criteria). More than a fifth of the sample described themselves as “often or always” feeling lonely—a finding that seems to run counter to the notion that those with autism are emotionally disconnected from other people. Furthermore, the study found that the more social support these boys received, the lower their degree of loneliness. We have no cure for autism in adolescents–but the remedy for loneliness in these kids may be as close as the nearest friend.
And lest there be any doubt that loneliness has far ranging effects on the health of the body, consider the intriguing findings from Dr. S.W. Cole and colleagues, at the UCLA School of Medicine. These researchers looked at levels of gene activity in the white blood cells of individuals with either high or low levels of loneliness. Subjects with high levels of subjective social isolation—basically, loneliness — showed evidence of an over-active inflammatory response. These same lonely subjects showed reduced activity in genes that normally suppress inflammation. Such gene effects could explain reports of higher rates of inflammatory disease in those experiencing loneliness.
Could inflammatory changes, in turn, explain the correlation between loneliness and heart disease? Inflammation is known to play an important role in coronary artery disease. But loneliness by itself may be just one domino in the chain of causation. According to Dr. Heather S. Lett and colleagues at Duke University Medical Center, the perception of poor social support — in effect, loneliness — is a risk factor for development, or worsening, of clinical depression. Depression may in turn bring about inflammatory changes in the heart that lead to frank heart disease. This complicated pathway is still speculative, but plausible.
Loneliness, of course, is not synonymous with “being alone.” Many individuals who live alone do not feel “lonely.” Indeed, some seem to revel in their aloneness. Perhaps this is what theologian Paul Tillich had in mind when he observed that language “… has created the word “loneliness” to express the pain of being alone. And it has created the word “solitude” to express the glory of being alone.” Conversely, some people feel “alone” or disconnected from others, even when surrounded with people.
Let’s admit that not everybody is capable of experiencing the “glory of being alone” or of transforming loneliness into “solitude.” So what can a socially-isolated person do to avoid loneliness and its associated health problems? Joining a local support group can help decrease isolation; allow friendships to form; and give the lonely person an opportunity both to receive and to provide help. This reciprocity can bolster the lonely person’s ego and improve overall well-being. Support groups geared to particular medical conditions can also help reduce disease-related complications. Although there are always risks in going “on line” to find support, Daily Strength appears to be a legitimate and helpful website for locating support groups of all types, including those for loneliness. Psych Central also provides opportunities to exchange ideas and “connect” with many individuals who feel isolated or alone. For those who feel lonely even in the midst of friends, individual psychotherapy may be helpful, since this paradoxical feeling often stems from a fear of “getting close” to others.
No, loneliness is not a disease or disorder. It certainly shouldn’t appear in the DSM-5 — but it should be on our minds, as a serious public health problem. Fortunately, the “treatment” may be as simple as reaching out to another human being, with compassion and understanding.
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Compulsive collecting or Hoarding is a misunderstood and debilitating mental health issue. Many psychologists and counsellors never see someone with this condition as they very rarely present for help. This article from an Australian newspaper provides an excellent overview of the condition and issues underlying hoarding, and I have included links to two brilliant books co-authored by the researchers discussed in the article, who have developed a wholistic and novel approach to it’s treatment.
Credit: Kate Benson, Sydney Morning Herald April 8 2010
They may dress well or hold down a good job. But hoarders are unhappy people who suffer from a debilitating condition.
Every suburb has one. The elderly woman weaving through an overgrown backyard full of cardboard boxes, old tyres and discarded furniture. Cats perch on every surface; kittens roll about among the rusted drums and long grass.
Inside, behind closed curtains, the rooms are piled high with papers, cups, plates and bottles. Broken toys, old clothes and shopping bags spill across kitchen benches and floor, smothering the stove and filling the sink, neither of which has been used in years.
The stench of cat faeces, urine and food scraps fill the house.
To her neighbours, she is an oddity. Or a pest, bringing down house values and encouraging vermin.
But to therapists she is one of a growing band across Australia suffering from a debilitating condition known as compulsive hoarding, where people feel a need to collect and store items that seem useless to others.
Their homes become havens of insurmountable clutter and junk, often leaving them unable to sleep in their beds or use appliances. Many end up with electricity or gas supplies disconnected or their fridge and washing machines unusable because they fear their lifestyle will be revealed if they contact a tradesmen to make repairs.
This secrecy and shame make it difficult to know exactly how many people have the disorder.
Some experts think between 200,000 and 500,000 Australians compulsively hoard, but others put the figure closer to 800,000.
“It’s a sleeping giant,” Chris Mogan, a clinical psychologist and expert on hoarding, says. “There is no systematic estimate of how many hoarders there are in any Australian setting. I suspect there are many, many more out there than we are aware of.”
Louise Newman, the president of the Royal Australian and New Zealand College of Psychiatrists, agrees.
“I’ve only seen one case in my career [because] these people usually only come to light when the council steps in and orders a clean-up. Hoarders desperately want to keep hoarding. They don’t want to be stopped.”
There is little research on the condition in Australia and not much in the way of funding or treatment programs, but experts are hopeful hoarding will be included in the next (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders, the bible used by mental health experts to diagnose psychiatric conditions.
Many sufferers fall between the cracks because hoarding is not a clinical diagnosis in its own right, but is seen more as an offshoot of obsessive compulsive disorder, muddled with depression, anxiety, panic disorder and low self-esteem.
“But it is different to OCD and once we get it in the DSM-V, therapists, psychiatrists, psychologists and social workers can then be trained in the management of it [and] we can attract funding for research,” Mogan says.
Jessica Grisham, a clinical psychologist who specialises in obsessive compulsive disorder, also believes compulsive hoarding should be included in the next edition as it requires specialised treatment.
She cites recent neural imaging studies in the US that showed that different parts of the brain were activated in hoarders than in obsessive compulsive disorder patients.
Mogan and Grisham agree that cognitive behaviour therapy, where sufferers are slowly taught to change their thought patterns, is more effective than medication alone.
But hoarders responded better to a specially adapted version of the therapy, developed by the American hoarding experts Gail Steketee and Randy Frost. It had been achieving success with about 60 per cent of hoarders – far more than standard cognitive behaviour therapy.
“But it has to be a long-term project. You don’t go in to someone’s place and do a sudden excavation against their will,” Grisham says.
“That’s a violation and it’s very traumatic for them. It might make great TV, but it’s not good clinically.”
Mogan agrees. A pay TV show, Hoarders, was damaging to the public’s understanding of the illness, because it focused on forcefully cleaning houses in three days.
“Within six to 12 months that house will be recluttered because it is a compulsion … they suffer a lot of grief after things are taken away.”
Mogan makes weekly home visits to hoarders, and focuses on getting them to reduce the associated dangers by ensuring their home has two exits for safety, and working appliances and smoke alarms.
“Just as we do with drugs and alcohol, we’re into harm minimisation. Once the house is safe, we gradually set more goals. If they are comfortable with that, they will continue to stay in touch and not reject us.”
Sometimes the problem extends beyond mounds of paperwork and clothes. Mogan and Grisham know patients who hoarded urine or fingernail clippings. Some stored their own faeces or collected one particular item, such as bicycles. One sufferer was hoarding so much junk, the only access to the house was a 30-centimetre gap at the top of the front door.
But for Allie Jalbert, of the RSPCA, the most distressing hoarders are those who keep scores of cats and dogs, all battling for attention and food on a crowded suburban block.
She has been calling for years to have hoarding classified as an illness in its own right to allow more people to receive treatment and put an end to the 100 per cent recidivism rate.
“Often, we find that hoarders might be treated for peripheral symptoms such as anxiety or depression, but their core problem, the hoarding, is not addressed. So once we have cleaned out the house, they reoffend, which is very, very frustrating for everyone involved,” Jalbert says.
Some people threatened suicide and had to be removed by police when faced with the prospect of giving up their animals or clutter.
“There’s a mixed bag of emotion when you deal with hoarders. Firstly, there is the concern for your personal safety but there is also a degree of empathy because often these people are quite emotional and attached to the animals. But it’s quite frustrating to see animals living in such horrific situations,” she says.
“I’ve seen bathtubs full of faeces and rubbish, sinks that no longer work, homes with no heating or cooling. Sometimes it’s quite an overwhelming experience.”
Who develops the condition and why?
Some studies have shown that many hoarders have been brought up in households where chaos reigned. Some were neglected as children and witnessed pets being treated poorly.
Mogan accepts the aetiology is mostly unknown, but cites an Australian study that found sufferers reported failing to connect with their parents or growing up in households lacking emotional warmth.
“The lack of attachment causes them to become ambivalent about their identity and about other people. As a compensatory mechanism, they link with things, which they find more compelling, more predictable and dependable and less rejecting.”
But Grisham believes there is no real trigger, apart from children of hoarders being rewarded for saving things and getting punished for discarding. “Sometimes there is a traumatic head injury but those cases are very rare.”
The condition affects slightly more women than men but is found across all occupations, age groups and ethnicities. “And they are in relationships,” Mogan says. “Albeit strained ones.
“Some are going out to work, but they make sure no one comes to their house. They’re not agoraphobic. On the contrary, many hoarders go out a lot to escape. But their children’s lives can’t be normalised because they can never sit down for a meal or find space to do homework. It’s a real impost on the family experience.”
Mogan runs group therapy sessions in Melbourne and says that many patients do want to be cured.
“This condition is a disability and the source of quite a lot of human suffering and neglect. A lot of these people are quite relieved to get help.”