Eco-Anxiety, Like Climate Change, is on the Rise

If the prospect of climate change makes you stressed, anxious or depressed, you are not alone.

With reports of some children becoming terrified by climate change and the protest group Extinction Rebellion holding ‘grief-tending workshops’, there is an increasing awareness of so-called eco-anxiety.

A UK Council for Psychotherapy conference met in London on 19 October 2019 to discuss how best to manage such anxiety.

While there is little quantitative evidence about eco-anxiety yet, here are eight approaches that commentators suggest may help.

1. Live More in Alignment with your Values

  • The effect of individual actions can be very small, but changing how you live to be more compatible with your ideals can help with eco-anxiety.
  • You could eat less meat and dairy, drive less and stop buying and disposing of so many items, for example.

2. Give your Hone an Energy Health Check

  • Household energy use accounts for 14% cent of total UK greenhouse gas emissions.
  • Reducing your home’s energy use can help you take some ownership of your consumption.
  • Make sure you have good insulation and draught-proof windows and doors, and try putting on an extra layer of clothing rather than turning up your heating.

3. Cut Back on Flying

  • The Swedish concept of flygskam (“flight shame”) has recently gained wider attention, but a minority is responsible for the lion’s share of emissions from flights.
  • A 2014 analysis found that 15% of adults in the UK account for 70% of flights taken, so it is those who take three or more flights a year who will make the most difference by cutting back.
  • If taking fewer flights could put your job at risk, try switching from business class to standard, as this uses a plane’s capacity more efficiently.

4. Do not Feel Ashamed

  • In relation to flygskam, billions of people fly.
  • Your individual actions are not actually capable of solving climate change.
  • While altering how you live and travel may help you by letting your life be more aligned with your values, you
  • should not feel ashamed for not being able to fully comply with these.
  • The systems in which we are all enmeshed essentially force us to harm the planet, and yet we (can) put all that shame on our own shoulders.

5. Focus on Changing Systems, Not Yourself

  • Accepting that we cannot get where we want to be through individual action can have therapeutic benefits.
  • A complete narcissistic focus on the self is not healthy.
  • Instead, you can have a much more meaningful impact by working with others to lobby governments.
  • For example by:
    • Letting your MP, local councillors, and and mayor know that you think action on climate change is important; and
    • Writing to your bank or pension provider to ask if you can opt out of funds that invest in fossil fuels.

6. Find Like-Minded People

  • Find a community of like-minded individuals so you can express and share your feelings of eco-anxiety.
  • Saying that you can not solve climate change alone and joining a group of some kind will help you to make friends.
  • Socialisation is an important aspect in mental health.

7. Protect and Nurture Local Green Spaces

  • Getting involved in community environment projects may help your mental health, as well as being good for the planet.
  • Green spaces absorb carbon dioxide, cool down urban areas in hot weather, reduce flood risk, and provide habitats for wildlife.
  • Additionally, a recent study found that spending 2 hours a week outdoors in nature is linked to better health and well-being.
  • Make an excuse to find some time outside every day.

8. Bring Others with You

  • Consider the importance of talking about your experiences – the challenges as well as the positives – and bringing other people along with you.
  • Talking about the practical things people can do in their day-to-day lives can give them some sense of control back, which can really improve people’s well-being.

Owning & Managing a Business Can be Hazardous to your Mental Health

1.0 Introduction

Owning and Managing a Business Can be Hazardous to your Mental Health.

This article provides an overview of business ownership in the context of mental health.

If you are one of the millions of small and medium business owners around the globe, you probably have a good idea of how tough (and sometimes lonely) it can be at the top of the business – and how owning and managing your own business can be hazardous to your mental health.

It is well-known that our mental health can deteriorate, for a variety of reasons, and, if left unchecked, can lead to mental health problems.

Although depression and anxiety are likely to be the most common issues an owner faces, it is important to remember that mental health symptoms and conditions come in many forms.

2.0 Why Be a Business Owner?

Many of us are drawn to small business because working for others provides its own stresses, for example, the feeling of lost control as others make decisions we may feel unable to influence.

Being a business owner offers a level of freedom and control that we may be unable to achieve as an employee.

3.0 Factors Affecting Mental Health in Owners

Although the symptoms of mental health conditions can be similar between people, the triggers can be very different.

There are a number of factors that could lead to a deterioration in a business owner’s mental health, including:

  • Excessive stress;
  • A toxic work environment;
  • Poor leadership;
  • Uncertainty;
  • Long hours;
  • A lack of sleep; and
  • So on.

These can lead to burnout which, in turn, can lead to mental health conditions such as anxiety and depression.

Increased competition in your particular market or industry means added pressure to perform and stand out from the crowd, as well as potentially making it more difficult to be financially successful. Business costs may also be rising, possibly faster than your ability to increase sales and revenue – meaning the bottom line is impacted, aka less profit.

Using a contemporaneous example, the business uncertainty surrounding Brexit, especially for export-orientated businesses, can have a profound impact on business planning and sales generation.

4.0 A Blur between Personal, Family & Work

Small business ownership, especially, can be tough because there are few support structures for owners.

As an owner, you are responsible for everything and the lines between personal and family pressures and work are blurred or even non-existent.

Finally, the financial pressures are very real, as it is the owner’s money at stake not a large company’s money.

5.0 I’m In Control!

Business owners may be reluctant to seek, ask or talk about any mental health issues they may be facing due to the need to be perceived as having everything under control.

This means that business owners can, effectively, end up in rather stressful jobs.

With this in mind, most employees will be unaware of the stress attached to owning a business and how challenging cashflow, for example, can be. When margins are tight, paying wages can be extremely stressful. There are real life examples where owners have paid staff wages through their credit cards or overdrafts to ensure their employees get paid – mainly due to a feeling of guilt and not wanting to let them down. It can be stressful knowing that your employee’s family relies on the wage you are paying their loved one.

There is also the stress on marriages, especially if a couple is in business together.

6.0 The Value of Mentors

Other business owners understand what you, as a business owner, are going through. They understand the impact that long hours, for example, can have on the owner’s well-being and their families.

A business mentor can assist by helping the owner find ways of being more effective with their time, among other things.

7.0 Addressing Mental Health Issues

It is imperative that you do not do nothing.

There are a number of things owners can do, at both at an individual and organisational level:

  • Know the risks to mental health and well-being in your business.
    • What are the triggers?
  • Talk about mental health and well-being.
    • This helps to normalise it.
  • Leaders in your business need to be on board.
    • They must send the message to all staff that the business takes mental health seriously.
    • Role model what good mental health looks like and what we do when someone needs our help.
  • Get some education around mental health.
    • The reason that myths and fear exist is because of lack of awareness and knowledge.
    • There are workshops, coaches and even online courses now which help plug this knowledge gap.
  • Have the conversation with your people.
    • Not saying anything to someone who is struggling is not the way to go.
    • Simply asking “Are you OK?” is a really good start and shows the person that you have noticed and do care.
  • Sleep, nutrition, relationships and exercise all correlate with mental health, so check in on your people to see how they are going with these areas.
    • For example, if someone tells you that they have not been sleeping for two months, that is going to take its toll and something needs to be done.
  • Know who to go to.
    • Have an accessible list of contacts that you can call on for a range of different mental health and well-being matters.

It is important to seek support from someone who:

  • Has received appropriate training;
  • Is a registered practitioner; and
  • Has frequent supervision.

8.0 Pursing Good Mental Health

In the pursuit of good mental health, it is important to:

  • Understand our stressors;
  • Name our stressors;
  • Admit they exist; and
  • Aim to avoid them.

If our stressors cannot be avoided, we should attempt to better manage them.

Finally, when possible, it is important as a business owner to make time and take personal care of yourself.

Can Mushrooms be the New Cannabis?

In the attached article, from The Economist, investors are hoping that medical psychedelics will be the new cannabis.

It briefly looks at how Ketamine and psilocybin (which gives mushrooms their magic) are being researched for their potential effects on psychiatric conditions such as depression, anxiety, and addiction.

Reference

The Economist. (2019) Medical Psychedelics: Shroom to Grow. The Economist. 16 October 2019.

Inflammatory Response & Treatment-Resistant Mental Disorders

Research Paper Title

Inflammatory Response and Treatment-Resistant Mental Disorders: Should Immunotherapy Be Added to Pharmacotherapy?

Abstract

Treatment resistance continues to challenge and frustrate mental health clinicians and provoke psychiatric researchers to seek additional explanatory theories for psychopathology.

Because the inflammatory process activates symptoms of depression, anxiety, and psychosis, it is a reasonable route to follow for primary and/or indirect contribution to mental disorders.

The current article reviews the research literature regarding the role the inflammatory process and immune system play in mental disorders as well as novel treatments under investigation for resistant depression, anxiety, substance use, and psychotic disorders.

Reference

Limandri, B.J. (2020) Inflammatory Response and Treatment-Resistant Mental Disorders: Should Immunotherapy Be Added to Pharmacotherapy? Journal of Psychosocial Nursing and Mental Health Services. 58(1), pp.11-16. doi: 10.3928/02793695-20191218-03.

What are the Comorbidity Rates of Depression & Anxiety in First Episode Psychosis?

Research Paper Title

Comorbidity rates of depression and anxiety in first episode psychosis: A systematic review and meta-analysis.

Background

Anxiety and depression symptoms are frequently experienced by individuals with psychosis, although prevalence rates have not been reviewed in first-episode psychosis (FEP).

The aim of this systematic review was to focus on the prevalence rates for both anxiety and depression, comparing the rates within the same study population.

Methods

A systematic review and meta-analysis was completed for all studies measuring both anxiety and depression in FEP at baseline.

The search identified 6040 citations, of which n = 10 met inclusion criteria.

These reported 1265 patients (age 28.3 ± 9.1, females: 39.9%) with diagnosed FEP.

Studies which used diagnosis to define comorbidity count were included in separate meta-analyses for anxiety and depression, although the heterogeneity was high limiting interpretation of separate prevalence rates.

A random-effects meta-analysis also compared the mean difference between anxiety and depression within the same studies.

Results

The researchers show that anxiety and depression co-occur at a similar rate within FEP, although the exact rates are not reliable due to the heterogeneity between the small number of studies.

Conclusions

Future research in FEP should consider routinely measuring anxiety and depression using continuous self-report measures of symptoms.

Clinically, the researchers recommend that both anxiety and depression are equally targeted during psychological intervention in FEP, together with the psychotic symptoms.

Reference

Wilson, R.S., Yung, A.R. & Morrison, A.P. (2019) Comorbidity rates of depression and anxiety in first episode psychosis: A systematic review and meta-analysis. Schizophrenia Research. pii: S0920-9964(19)30542-0. doi: 10.1016/j.schres.2019.11.035. [Epub ahead of print].

Overview of Trauma- & Stress-Related Disorders

Trauma- and stress-related disorders result from exposure to a traumatic or stressful event.

Specific disorders include acute stress disorder (ASD) and post-traumatic stress disorder (PTSD). These disorders cause similar symptoms but differ in how long they last.

  • ASD:
    • Typically begins immediately after the event.
    • Lasts from 3 days to 1 month.
  • PTSD:
    • Lasts for more than 1 month.
    • It may develop as a continuation of acute stress disorder or develop separately up to 6 months after the event.

Although depression and anxiety are often prominent, individuals with trauma-related disorders often have a wide variety of symptoms that may not obviously seem related to the traumatic event.

For example, individuals may:

  • Act aggressively;
  • Be unable to experience pleasure; and/or
  • Feel restless, discontented, angry, numb, or disconnected from themselves and others.

Treatment of Anxiety Disorders

When treating anxiety disorders, there are a number of things to consider:

  • Treatment of the cause if appropriate;
  • Psychotherapy;
  • Drug therapy; and/or
  • Treatment of other active disorders.

Accurate diagnosis is important because treatment varies from one anxiety disorder to another.

Additionally, anxiety disorders must be distinguished from anxiety that occurs in many other mental health disorders, which involve different treatment approaches.

If the cause is another medical disorder or a drug, medical professionals aim to correct the cause rather than treat the symptoms of anxiety.

Anxiety should subside after the physical disorder is treated or the drug has been stopped long enough for any withdrawal symptoms to abate.

If anxiety remains, anti-anxiety drugs or psychotherapy (such as behavioural therapy) is used.

For individuals who are dying, certain strong pain relievers, such as morphine, may relieve both pain and anxiety.

If an anxiety disorder is diagnosed, drug therapy or psychotherapy (such as behavioral therapy), alone or in combination, can significantly relieve the distress and dysfunction for most individuals.

Benzodiazepines (such as diazepam) are commonly prescribed for acute anxiety.

For many individuals, antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), work as well for anxiety disorders as they do for depression.

Specific treatments depend on which anxiety disorder is diagnosed.

All of the anxiety disorders can occur along with other psychiatric conditions.

For example, anxiety disorders often occur along with an alcohol use disorder.

It is important to treat all of these conditions as soon as possible.

Treating the alcohol use disorder without treating the anxiety is unlikely to be effective since the individual may be using alcohol to treat the anxiety.

On the other hand, treating the anxiety without addressing the alcohol disorder may be unsuccessful because daily changes in the amount of alcohol in the blood can cause levels of anxiety to fluctuate.

Diagnosis of Anxiety Disorders

A diagnosis of anxiety disorder is via a medical professional’s evaluation, based on specific criteria.

Deciding when anxiety is severe enough to be considered a disorder can be complicated.

Individual ability to tolerate anxiety varies, and determining what constitutes abnormal anxiety can be difficult.

Medical professionals usually use the following specific established criteria:

  • Anxiety is very distressing.
  • Anxiety interferes with functioning.
  • Anxiety is long-lasting or keeps coming back

Medical professionals look for other disorders that may be causing anxiety, such as depression or a sleep disturbance.

They may also ask whether relatives have had similar symptoms, because anxiety disorders tend to run in families.

Medical professionals also do a physical examination. Blood and other tests may be done to check for other medical disorders that can cause anxiety.

Symptoms of Anxiety Disorders

Anxiety can arise suddenly, as in panic, or gradually over minutes, hours, or days.

Anxiety can last for any length of time, from a few seconds to years.

It ranges in intensity from barely noticeable qualms to a full-blown panic attack, which may cause shortness of breath, dizziness, an increased heart rate, and trembling (tremor).

Anxiety disorders can be so distressing and interfere so much with an individual’s life that they can lead to depression.

Individuals may develop a substance use disorder.

Individuals who have an anxiety disorder (except for certain very specific phobias, such as fear of spiders) are at least twice as likely to have depression as those without an anxiety disorder.

Sometimes individuals with depression develop an anxiety disorder.

Causes of Anxiety Disorders (Physical Disorder or Drug)

Anxiety can also be caused by a general medical disorder or the use or discontinuation (withdrawal) of a drug.

General medical disorders that can cause anxiety include the following:

  • Heart disorders, such as:
    • Heart failure; and
    • Abnormal heart rhythms (arrhythmias)
  • Hormonal (endocrine) disorders, such as:
    • An overactive adrenal gland (hyperadrenocorticism); or
    • Thyroid gland (hyperthyroidism); or
    • A hormone-secreting tumour called a pheochromocytoma.
  • Lung (respiratory) disorders, such as:
    • Asthma; and
    • Chronic obstructive pulmonary disease (COPD).

Even fever can cause anxiety.

Anxiety may occur in dying people as a result of fear of death, pain, and difficulty breathing.

Drugs that can trigger anxiety include the following:

  • Alcohol;
  • Stimulants (such as amphetamines);
  • Caffeine;
  • Cocaine;
  • Many prescription drugs, such as corticosteroids; and
  • Some over-the-counter weight-loss products, such as those containing:
    • The herbal product guarana;
    • Caffeine; or
    • Both.

Withdrawal from alcohol or sedatives, such as benzodiazepines (used to treat anxiety disorders), can cause anxiety and other symptoms, such as insomnia and restlessness.