Category Archives: Depression

22Jan/18
loneliness is embedded in society

Politics of loneliness

loneliness is embedded in society

loneliness by Alice Popkorn (https://flic.kr/p/a6RWak)

We have a new ministerial post in Britain: theĀ minister of loneliness. Tracey Crouch was recently appointed to continue the work of Jo Cox and following the recommendations of a cross-party report. This is a positive move to address a problem that is embedded within a society that has championed individualism at others’ cost, a rat-race, and a ‘me-first’ model of economics (The Guardian editorial, 20th Jan, 2018). Happiness does not emerge from such a context, instead isolation for many, with very real effects upon health.

Of course this approach is not just evident in the marketplace and the workplace. It has been encouraged in schools where grades are the measure of success, and being better than everybody else is a driver. The reality is that no-one is better than anyone else, and on continually feeling that they must look a certain way, be on a certain social media channel, have certain material things and strive to be better than the others, the pressure builds. This is one of the main reasons for the ever-growing issue of childhood and teen ill-health. Loneliness is almost certainly in the mix. How lonely must it be to always be thinking about oneself?

“You are no better than anyone else and no one is better than you

~ John Wooden

Yet this is a society of our making. We must all wake up to this and build structures that promote collectivism and connection in line with our design to co-operate. It will not be enough to try and minimise suffering downstream by picking up the pieces. We need top down change in attitudes and beliefs, because what we are doing at the moment is not working. The next generation needs this desperately. They need to be prepared for the modern world: creativity, critical thinking, communication and collaboration — the 4Cs.

Suffering is part of life. How we address our suffering and support others who suffer determine what it is actually like. Suffering affords opportunities to learn and transform experiences. To try and wrap people up in cotton wool will not work. Giving them practical tools to roll with life’s ups and downs together with know-how, creating opportunities to pursue a purpose, to master chosen skills and feel a sense of autonomy are all part of a healthy, evolving society.

Those who are familiar with the scientific literature on loneliness know about the biological effects. There are several key points to consider. Firstly, it is the perception of loneliness that is the governing factor. Secondly, in the case of perceived loneliness, we switch at a gene level to being inflammatory. This makes sense because being isolated means that if we are bitten by the sabre-tooth tiger, our healing responses are ready to go. That’s basic biology at play. If we perceive ourselves to be part of a community and connected, we are pro-viral because we are more likely to pass viruses to on another. Great system, but being pro-inflammatory for a prolonged period has health consequences: e.g./ chronic pain, depression–the two largest global health burdens.

Tracey Crouch has a job of huge importance. This is not just about people who live alone. This is about how society functions to enable people to connect with purpose, to support and trust each other and to share a planet. Now that’s a job worth doing well!


A brief note on loneliness and pain

Chronic pain is often described to me as being a cause of loneliness for several reasons. Firstly because of the limits that the pain can seem to impose until the person learns skills and has tools to change his or her experience, and secondly because no-one else can actually feel that pain.

Pain is a shared experience however. Each person will suffer their own pain of course, and for different reasons, yet it is a conscious phenomena that most will feel. Being that it is unavoidable, it becomes essential that people understand pain so that they can address their needs with effect.

One of many actions that can be chosen and committed to, is that of making connections and ensuring meaningful interactions as often as possible. These practices and others can easily be interwoven into life as a means to address the effects of loneliness.

07Jun/16

Depression and inflammation

Depression and inflammationFor some years there has been thinking about depression and inflammation being related in as much as when we are in the throes of inflammation, our mood changes. Think about when you feel unwell and how your mood drops, which is part of the well known sickness response. In some people, probably a large number, these sickness responses are the norm. In other words, they endure a level of this sickness response consistently that is underpinned to an extent by on-going inflammation.

Reports today about a study at Kings College London describe how inflammatory markers in the blood could identify a ‘type’ that would benefit from a certain antidepressant drug — read here. This would make the prescription specific for the person, so rather than trialing a drug, we would know which would be most likely to be effective for that person by identifying the blood markers.

Many people I see with persistent pain are low in mood and some have been diagnosed as being depressed. In my mind, it is entirely understandable why someone suffering on-going pain, who cannot see a way out, would be in such a state. In simple terms, the person with chronic pain may well be chronically inflamed. We know that people who perceive themselves to be under chronic stress will be inflamed as the body continues to protect itself via the immune system and other systems that have such a role. Typically and understandably, someone in a chronic pain state is stressed by their very circumstance and hence can be inflamed.

It is very common to suffer an enduring pain state and generally feel unwell; a sickness response. We all know what a sickness response feels like — we don’t feel ourselves, aches and pains, loss of appetite, irritability, emotional, sleepy, tiredness, poor concentration etc. This is underpinned by inflammation and how this drives a range of experiences and behaviours, all designed to create the conditions for recovery. In the short term this is adaptive but if prolonged, the symptoms are enormously impacting and potentially maintaining a cycle of stress and anxiety.

Like any problem, understanding its nature is the start point so that problem solving can be effective; i.e. think about it in the right way and take the right action, congruent with recovery and the desired outcome. Realising the links between health state, depression and inflammation helps to distance oneself from the lived experience, being less embroiled with that particular ‘film’, instead focusing on what needs to be done to overcome the problem.

A loss of the senses of self is often a part of a persisting condition such as chronic pain or dystonia. The overarching aim of a followed programme is for the individual to resume living their life with a sense of self worth which they can identify: I feel myself again. This self feels normal to that person, and only that person knows how that experience is lived. As best they can, I ask them to describe that experience, and this forms the desired outcome. The sense of self is at least a unification of body sense, interoception, exteroception, the inner dialogue and our past experiences. Improving body sense with exercises, some general and some specific, is a simple way of stepping towards that outcome. And of course there are all the other benefits of exercise to consider.

It will undoubtedly be very useful to identify who will benefit from which antidepressant drug, yet we must still consider each (whole) person. A comprehensive programme of treatment for pain for example, includes developing working knowledge of pain so that the person can independently make effective choices as well as eradicate fears, specific training, general activities, gradual progression of activity, and mindfulness to name but a few. However, it is not just the exercises that are important. The person also needs to be motivated, resilient and focused, all strengths that they have likely used before in other arenas but now need to employ here and now with their health — this is the strengths based coaching aspect of the Pain Coach Programme. In cases of depression, the chosen drug maybe more specific and hence more efficacious, yet there are other actions that are also important such as understanding the links as explained and consistent physical activity. Great work in the aforementioned study; it will be interesting to watch how this progresses.

Pain Coach Programme | t. 07518 445493