Being mindful of your mental health

Stress, depression, anxiety can affect anyone. One in three of us regularly feel stressed. One in four of us feel anxious One in five of us feel depressed.* 

Sabina, Dave and Berni all recognised they were struggling to control their stress. Signs of stress can vary by person but common signs include feeling on edge, angry, unable to switch off, tearful, having poor concentration. 

Each of them reached out to Leeds IAPT, either through their GP or by referring themselves by calling 0113 843 4388. To help manage their stress, anxiety or depression, it was recommended they attended the 'Stress Control' course. This runs for six weeks  at venues across Leeds, at times in the day or evening. Each session has a different focus, from learning to control your thoughts to controlling your body to helping you get a good night's sleep.

In these short films, they have described how the course has helped them:

If you feel like you need help with managing stress, you can get in touch with our Leeds IAPT team on 0113 843 4388. Find out more about Leeds IAPT - www.leedscommunityhealthcare.nhs.uk/our_services_az/leeds_iapt/

*Mental Health Foundation

The Stress Umbrella

'Change the way you think'

After my anxiety stepped up to a new notch of feeling shaky every day and wanting to avoid going to work I knew I needed a little bit more help. I went to the GP and told her how bad I was feeling. She referred me to a service in my area run by Leeds Community Healthcare Trust. Completely free on the NHS, the service offers an indispensable six week course which focuses on the stress umbrella. This features depression, anxiety, overcoming fears, sleep, medication, coping mechanisms and more. I was a little sceptical I have to say – an avid reader with two science degrees and a lot of self help books, I wondered what this course could give me that was new information.

However I cannot praise the course enough. It is divided into different modules and each come with fantastic booklets full of advice and activities to last a life time, and useful homework to apply what you have learned to your week. Every week you complete a questionnaire on how your feeling, confidentially, and this is used to assess the improvements or changes in your mood so that you can get further help where necessary and monitor yourself. This course ended with many people hanging round at the end just to sing and shout their praises. I did not know things like this existed on the NHS, but it motivated me to take hold of life by the horns again. Not only am I feeling over the moon now, but the useful pack and CD are for life, I feel I can refer back to it whenever I need!

Here I break down the course with some of my opinions about it and try to answer your potential questions as a service user.

But when could I even attend?

Leading a very busy work and life schedule I was sceptical about when I would even be able to attend. The course organisers are understanding and exceptionally flexible. There are day-time or evening sessions. When I couldn’t attend one of my Thursday night sessions due to work, they easily swapped me on to a Wednesday session who were up to the module I was up to, and there were a variety of convenient locations in Leeds, including the Cosmopolitan hotel in the heart of the city centre and West Yorkshire Playhouse, opposite the bus station with abundant transport options. If you did miss a session there was opportunity to swap, or catch up via the course booklets. However, it is best you do attend all the sessions for your own benefit. As I said, the course was invaluable to me; it gave me a magnificent boost!

Who else was going, will I have to talk?

The course is not like going to group therapy. In fact, I’d liken it most to attending a lecture or classroom lesson. Each session is around 90 minutes to two hours and always features a brain/drink/toilet/chat break of five minutes or so in the middle. There are usually two speakers so as to engage your listening further (we all know focus is near impossible for two hours of just listening!). You can further prepare for each session with the booklets given out in advance of that session, so you can get a good over-view before you attend. But you absolutely do not have to talk at any point if you don’t want to. The shy and anxious among you, please be reassured, there are barely any verbal questions asked that aren’t rhetorical, and no one has any pressure to answer anything. What you do find however is some members start to recognise each other and even make friends through the course. You also have the opportunity at any time to talk to the speakers in private about further questions. There is absolutely nothing intimidating in turning up and you are always greeted to sign in and grab a drink and weekly questionnaire then sit wherever is most comfortable by very friendly experienced faces.

Now I have to be honest, I thought in the original state I was in, “right, I need CBT, I need one-on-one therapy, it’ll cost loads, and I’ll probably need it for the rest of my life, I’m such a mess”. And so I was sceptical about attending a ‘group session’. I realise now, one of the biggest boosts was attending a group session. For a start, it shows that actually there are so many in the same boat. In fact, I could not believe how helpful that was to me or how many people kept attending. The age range was phenomenal, a perfect cross section of age, race and gender in fact. And there were no qualms in me bringing along my partner or a friend (subject to space on the week’s course). This was most helpful in fact, when I couldn’t relax at 3 am in the morning and my boyfriend would wake up and talk me through the relaxation techniques leant like a prize yoga teacher!

I must say, my problems were quite specific, relating to a couple of things that happened to me in my work life that had made me very anxious in work. I was convinced the course would be far too generic to help. How wrong I was! And, it is a tribute ironically to that old proverb ‘your problems are no worse than anyone else’s. Because while I was thinking my problems were worse, or too specific – actually the thinking cycles involved in depression, stress and anxiety are highly generic. By breaking the way I perceived past situations and upcoming problems I have successfully overcome the pessimistic and over-paranoid thinking patterns.

Course Breakdown

As I mentioned, the course is split across six weeks, and each week also comes with a matching booklet in advance with more information and activities. I have taken here the official module descriptions outlined in the invitation letter and added footnotes about my experiences from the course:

Week One: Information about stress

You will find out what stress is and what it is not, the main signs, the vicious circles that keep it alive and how Stress Control works. We will show you a video of people talking about how stress affects them. We will give you a pack to keep future course materials in and encourage you to start to apply the learning between classes.
An introduction to the stress cycle. Here you will realise how low self esteem, depression, anxiety, panic, poor sleep, anger, addictions and phobias can all be linked and feed each other in a powerful cycle. You will learn how to assess your own personal stress cycle and where the points are you can cut it! I left this class feeling so proud of myself for taking a step myself to self-recovery and also feeling so normal surrounded by so many others. You will see the cold hard facts about how many people are suffering, as well as the full room around you. You will also realise, therefore, it is not you, and you are not stuck like this, and you will learn to remove yourself from the stress so it cannot feed itself.

Week Two: Controlling your body

We get down to tackling stress in this session. You will learn how your body signs feed stress. We look at why we get stressed and how the body reacts to it. You will learn three skills – breathing, retraining, exercise and progressive relaxation and look at caffeine. There is a relaxation CD to take away and we would like you to try to start to use this regularly.

I really enjoyed this session; we learnt not only breathing strategies but physical muscle exercises for instant relaxation. We had a go at doing them as a class and also received the invaluable relaxation CD which takes about 30 minutes to complete. The tracks from the CD are also available to download as MP3 online for those who would rather play through their phones or tablets. The strategies to controlling caffeine were very useful to me as it made me aware of my intake, I’m a bit of a coca-cola and tea addict but working out what time to drink it and how to count it is beyond helpful if your prone to sleep issues, nervousness or palpitations. 

Week Three: Controlling your thoughts

You will learn how your thinking feeds stress. We will teach you ways to ‘think your way out of stress’ – first of all by ‘building the foundation– ‘Wait a minute’. Then you will learn ‘The Big 5 Challenges’ and, finally, you will learn a way to nip stress in the bud – ‘Breaking stress up’.

This is quite possible the best feature of the course. Learning to challenge thoughts. You will learn to be able to strip back nervous and sad impulses and begin to think in a clear, logical way. This will vastly improve your ability to make effective decisions, think with a clear head, and remove “tunnel vision”. The key is not to avoid difficult thoughts, but rather to acknowledge them, and challenge them with the cold hard facts. Thus you will overcome self destruction and insecurity. This aids much more than your happiness, it aids your self-esteem and self-belief. 

Week Four: Controlling your actions

This session looks at how the way we act feeds stress. You’ll learn ways to face your fears and a great skill called ‘Problem Solving’. Also we will look at why some people, who seem to be doing all the right things, still don’t get over their stress. We will then teach you how to overcome this (‘Getting out of the Safety Zone’). These skills are really useful for building up self-confidence. You might start to see the big picture in this session – seeing how all the skills you have learned so far fit together.

Again, a great thing about this session is it actually builds on your confidence to go for things. It teaches you behaviours such as avoidance, why it happens, and how to avoid it. Realising this is natural and part of the ‘fight or flight’ response will help you to realise that you are actually well evolved to avoid things. You will realise therefore the behaviour is not strange but instead how to remove yourself from it – you can overcome these feelings. You will also learn about when you’re avoiding things without realising and thus how to combat oncoming factors. This means you can nip a bout of depression in the bud before it spirals out of control.

 Week Five: Controlling your panic, using your breathing to control stress, prevention skills and Medication

Panicky feelings are part and parcel of stress. This session teaches you ways to control them. We will teach you about using your breathing to calm your body and, hence, your mind. We will also look at some great ways to prevent stress. We will look at tablets used for stress and, if you feel these may help you, how to get the best out of them.

Some really useful information here about panic attacks, how to prevent them through both breathing and productive thinking. Various medications are discussed for anxiety and depression, as well as a review of the famous herbal remedy ‘St John’s Wart’, and you can discuss what drugs are incompatible with each other or suit your other problems best.

 Week Six: Controlling your sleep, Wellbeing and Controlling your future

Poor sleep is often a result of stress. It also keeps stress going as you don’t recharge your batteries. So, in this session, we will look at skills to help you get a good night’s sleep. Wellbeing starts the final set of skills as we look at ways of staying on top of stress.

Learning to completely re-set your sleep patterns is invaluable. I used to have every issue; bad dreams, waking at all hours, restlessness, oversleeping, messed up patterns. When I went into shift work this was even more compounded by my ongoing anxiety. The most useful tips in this session are those that teach you how to make your bed a haven for sleep and how to re-set your cycle so you can get back on track. However by this point, you may have found your problems significantly diffused! And to finish there is an overall summary of everything covered, further advice for moving forwards and a plan for further actions with the service and beyond. 

What happens after?

So what happens to you after you complete this course? Well, there is absolutely the option to re-attend any session if you need. But further to that there is the option to go on to one-to –one help if required, and you will have built up a collection of useful information, numbers and websites through the course. If your questionnaires still rate you as at any risk to yourself or your scores are still quite high for depression or your life is being affected you will be automatically rung for a further discussion.

How do I get on to this service?

This service is run by Leeds IAPT. The service is part of the national Improving Access to Psychological Therapies (IAPT) programme – see www.iapt.nhs.uk for more details.

You will need to initially give your details over the phone (number at the end of this blog). You will then be emailed your initial questionnaire. Complete this in your own time and then you ring the service and go through it with them in a bit of detail. This initial screening can take up to an hour but there is an option to visit face to face if you would prefer. This will assess if the course is suitable and fully register you to the service. You can then discuss which sessions you can attend. The service also sends you useful text messages before each session to remind you of the time and location.

Summary

An absolutely fantastic course which is perhaps deserves more promotion. I hope it will successfully undergo re-tender and grow. I wish that people were more aware this time of thing existed. When I first went to my GP I thought I was going to be fighting on my own for a very long time. The course as successfully inspired me to continue to pursue my goals of becoming a teacher, beating past bad experiences and difficulties. I know where ever I go in my life or career this course is invaluable and in fact I would teach it to my staff/ students/ pupils if I was ever in the position to do so. I think if you’ve ever been stressed, you could benefit ten-fold from this course.

References

http://www.leedscommunityhealthcare.nhs.uk/our_services_az/leeds_iapt/

Please visit the official Leeds IAPT site for more information. Or call directly to self-refer:0113 843 4388

I encourage you if you are not from Leeds to discuss with your GP for equivalent services.

Change The Way You Think

Recently I went along to one of our Improving Access to Psychological Therapies (IAPT) service’s stress management classes to see for myself what they were about and see if I could change the way I think. After all, we have pre-conceived ideas about things especially if it is something unknown. The service said to me that people have misconceptions about the classes; that people will expect you to speak as though you’re at an Alcoholics Anonymous class i.e. ‘Hello my name is Andrew and I’m stressed’ – you don’t.  And nor do you have get on a sofa and talk about your childhood.

The session I went to took place during the evening at Leeds college of music. On arriving, there was a discrete sign by the front desk and a friendly receptionist directed me to the first floor room where the session was held.

The start of the class felt like any training I have been to in my professional life. The two facilitators, who led the session, greeted people as they arrived, checked them in and passed on an evaluation form. There was some nice gentle guitar music playing and jugs of water were available if you wanted to grab a drink.

With the session being the sixth course in the series there was a brief re-cap of what had been covered so far by Jake, one of the facilitators. The main theme for this session was sleep, and how to get a better night. There were lots of practical tips like not using laptops and phones just before bed to help you drop off (something I maybe need to remember).  We were also given advice on the things like the temperature of the bedroom and having blackout blinds. One of the interesting tips that the other facilitator, Alice, gave was setting aside worry time. This is the idea that if you are a worrier you stop yourself from doing it all the time and set aside 30 minutes to reflect on your problems and stop worry from dominating other things.

There are more details of who’d benefit from the courses and how to access them online at LeedsIAPT.com. The courses run on a regular basis so new ones are starting all the time.

Andrew Carver, Communications officer, Leeds Community Healthcare NHS Trust

Desperately seeking patients...the NHS, really?

The idea of 'marketing' services and seeking out patients for some in the NHS is seen as a bit of a taboo, even for experienced communicators, like myself, who have worked in NHS communications and public relations for over 11 years (and for over 18 years in total).

'Change the way you think' campaign poster

Very often we have great service and staff stories to tell and this can be done very easily through local media and increasingly, through social media.  Sometimes we have an even bigger message that we must tell as many people as possible and we need to turn to marketing tactics to help spread the word.

However when spreading that word is also about a subject such as mental health, it gets trickier again.  For some this is a taboo, something we can't even chat about with mates at the pub.  In fact it's just those people our current mental health campaign is aiming to reach.

Improving Access to Psychological Therapies (IAPT for short in the NHS filled world of jargon and acronyms) exist to help people find ways to cope with emotional stresses and strains, depression and anxiety that just won't go away and the overwhelming feelings some of us can be faced with at one point or another in our lives.

Across the country these services get a poor reputation as they're really hard to access due to waiting times being up to a year in some places. We have great commissioners who have ensured these services have good resources so anyone who needs to can get help the same day - you can even join one of our stress management seminars the following week.

But we just don't think enough people know about this service. So we have enlisted the help of the creative types at DS.Emotion and we've been working together on ideas for a campaign to make people think again about mental health services and to think if they could actually benefit from the help and support of our skilled team.

Put simply ,our campaign says to people with emotional problems, those feeling stressed or anxious, "Time to change the way you think" - and for those who access our service, that's just what we aim to do.

It's been no mean feat; in just around a month we've discussed ideas and concepts to really try and help to change the way people think, reviewed and tested messages, designed and tweaked creative visuals and launched the campaign.  In about a month! We're really proud of the work we've created with DS.Emotion and the support we've had from the experts at Boutique Media and from our colleagues in the IAPT team and others across our organisation.  

As you read this, our really important messages are on local radio in Leeds, on buses around the city, at railway stations and on social media - they'll be dropping through thousands of letter boxes around Leeds in the next couple of weeks too.

Awareness of mental health issues has changed radically in recent years, we have a great service in Leeds to help you or someone you may know, so let's all change the way we think about mental health.  

www.iaptleeds.com

Gillian Neild, Communications, PR and Marketing Manager, Leeds Community Healthcare NHS Trust

@GillianNeild

5 Tips to manage stress

Sally Poyser is a Psychological Wellbeing Practitioner at Touchstone one of the partner organisations in the Leeds IAPT service. To mark stress awareness day Sally gives five easy tips to help manage stress.

Stress affects everybody, but high levels of stress can affect our ability to cope with the demands that come up in life.

So, it’s important that we try to look after ourselves by taking steps to manage our stress levels.

1) It can be easy to feel overwhelmed if we have a lot of things happening in our lives. We naturally focus on the negative things in life such as the things we can't do. Try to focus on the things that you can do something about. This will help you feel more in control.

2) It can be easy to only do the things that we need to do in life and we forget about the pleasurable things. Don't let stress get in the way of the things that you enjoy, arrange to see that friend that you have not seen for a while; pick that hobby back up that you have neglected or do something that you have always wanted to do.

3) We all need help from time to time, talk to a friend about what you are going through so you can get some support from others. 

4) It is a natural human response to avoid things that are uncomfortable, but we know that avoidance makes stress worse in the long term so look at the things in your life that you are avoiding and start to tackle them by facing your fears.

5) Exercise is a natural ‘antidepressant’, try to make small changes to be more active such as taking the stairs rather than the lift or go for a brisk walk.

If you feel that you need further help in managing stress our Leeds IAPT Partnership offers courses which run once a week over a six week period. These courses help learn coping strategies and techniques to help manage stress more effectively. You can call 0113 843 4388 to have an assessment the same day or see our service webpage for more details.

Sally Poyser. Psychological Wellbeing Practitioner. Touchstone.