MHAP Dartford 19 06

Darent Valley HOSPITAL 2019

MENTAL HEALTH

Awareness

The magazine raising awareness of mental health issues

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A-Z contact list for help & advice

Focus on Addiction, Dementia & Depression

How to get help for mental health issues

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Welcome A very warm welcome to the Darent Valley Hospital 2019 edition of Mental Health Awareness, an independent magazine which brings the issue of Mental Health directly to the general public.

Our objective is to provide educational and informative content which will raise the profile of Mental Health issues across the local community.

There are many different types of Mental Health disorders that can affect anybody at any stage in their lives. If you or a family member or friend have been diagnosed with a mental health problem you might be looking for information on your diagnosis, treatment options and where to go for support. We provide an important list of useful first point contact information which can be used to get help for varying mental health issues (pages 22 - 25).

In addition, our magazines give a vital platform to various local mental health organisations and volunteer groups to highlight the wide range of support services that are available to those who may need them.

In this edition we highlight ‘Centrepieces’ (pages 32 and 33), a registered charity which helps adults in their mental health recovery through art. The organisation’s work centres on an effort to improve the confidence, wellbeing and self-esteem of people suffering with mental illness, while offering an opportunity to build a social community and promote a better understanding of mental health to the wider public.

We also feature MIND in North Kent (pages 36 – 39), who work to ensure that no-one faces a mental health problem alone. They aim to equip people with the tools they need to work towards positive wellbeing.

Our publication also provides helpful and informative articles on the following specific Mental Health issues:

• • • • • • • • • • • • • • • • •

General Addiction (page 2) Alcohol (pages 4 & 5) Drugs (page 6) Gambling (pages 8 & 9) Smoking (page 29) Dementia (pages 10 & 11) Depression (pages 14 & 15) Post Natal Depression (page 16) Eating Disorders (page 18) Anxiety / Panic Attacks (page 20) Phobias (page 26) Post Traumatic Stress Disorder (page 34) Obsessive Compulsive Disorder (page 35) Counselling (page 38) Help for Suicidal thoughts (page 39) Difficult Conversations (pages 42 & 43) Insomnia (page 44)

A big thank you goes out to all the local businesses that have advertised and supported the East Kent Mental Health Awareness publication.

If you would like to be included in the 2020 issue of Mental Health Awareness or wish to provide any feedback, please send an email to Ricky at: sales@mhap.co.uk.

Mental Health Awareness Publications Ltd Publisher Email: sales@mhap.co.uk www.mhap.co.uk

Sales - Ricky Edwards 01375 402546

Mental Health Publications Limited do not make any recommendations as to the fitness of the advertisers appearing in this publication to carry out their services and no recommendations should be deemed to have been made.

All rights reserved. No part of Mental Health Publications Limited publications may be reproduced or used in any form or by any means either wholly or in part without prior permission of the publisher.

This magazine is published by Mental Health Publications Limited. © Mental Health Publications Limited 2019

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General Addiction: What is it?

If you have an addiction, you’re not alone. According to the charity Action on Addiction, one in three of us are addicted to something.

Addiction is defined as not having control over doing, taking or using something to the point where it could be harmful to you. Addiction is most commonly associated with gambling, drugs, alcohol & nicotine, but it’s possible to be addicted to just about anything, including: work – workaholics are obsessed with their work to the extent that they suffer physical exhaustion. If your relationship, family & social life are suffering & you never take holidays, you may be a work addict. internet – as computer & mobile phone use has increased, so too have computer & internet addictions. People may spend hours each day & night surfing the internet or gaming while neglecting other aspects of their lives. solvents – volatile substance abuse is when you inhale substances such as glue, aerosols, petrol or lighter fuel to give you a feeling of intoxication.

Solvent abuse can be fatal. shopping – shopping becomes an addiction when you buy things you don’t need or want to achieve a buzz. This is quickly followed by feelings of guilt, shame or despair.

What causes addictions?

There are lots of reasons why addictions begin.

In the case of drugs, alcohol & nicotine, these substances affect the way you feel, both physically & mentally. These feelings can be enjoyable & create a powerful urge to use the substances again.

Gambling may result in a similar mental “high” after a win, followed by a strong urge to try again & recreate that feeling. This can develop into a habit that becomes very hard to stop.

Being addicted to something means that not having it causes withdrawal symptoms, or a “come down”. Because this can be unpleasant, it’s easier to carry on having or doing what you crave, & so the cycle continues.

Often, an addiction gets out of control because you need more & more to satisfy a craving & achieve the “high”.

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How addictions can affect you: The strain of managing an addiction can seriously damage your work life & relationships. In the case of substance abuse (for example, drugs & alcohol), an addiction can have serious psychological & physical effects.

Some studies suggest addiction is genetic, but environmental factors, such as being around other people with addictions, are also thought to increase the risk.

An addiction can be a way of blocking out difficult issues. Unemployment & poverty can trigger addiction, along with stress & emotional or professional pressure.

Getting help for addictions: Addiction is a treatable condition. Whatever the addiction, there are lots of ways you can seek help.

You could see your GP for advice or contact an organisation that specialises in helping people with addictions.

Alcohol addiction services - Alcoholics Anonymous 0845 769 7555 www.alcoholics-anonymous.org.uk Drug addiction services - Narcotics Anonymous 0300 999 1212 www.ukna.org.uk Gambling addiction services - Gamblers Anonymous UK www.gamblersanonymous.org.uk Stop smoking services - SmokeFree 0300 1231044 Rehab 4 Addiction - free helpline dedicated to assisting those suffering from drug, alcohol and mental health problems. Tel: 0800 140 4690 www.rehab4addiction.co.uk To speak to someone anonymously about any kind of addiction, you can also call the Samaritans on 116 123 – 24 hour helpline. Other helpful contacts can be found on our Mental Health Glossary on pages 22-25.

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Alcohol Addiction Alcohol misuse means drinking excessively. If someone loses control over their drinking and has an excessive desire to drink, it’s known as dependent drinking (alcoholism).

Alcohol consumption is measured in units.

A unit of alcohol is 10ml of pure alcohol, which is about: half a pint of lower to normal-strength lager/ beer/cider (ABV 3.6%) a single small shot measure (25ml) of spirits (25ml, ABV 40%) • a small glass (125ml) of wine contains about 1.5 units of alcohol.

Lower-risk limits To keep your risk of alcohol-related harm low, the NHS recommends not regularly drinking more than 14 units of alcohol a week. If you drink as much as 14 units a week, it’s best to spread this evenly over 3 or more days.

If you’re trying to reduce the amount of alcohol you drink, it’s a good idea to have several alcohol-free days each week Regular or frequent drinking means drinking alcohol most weeks. The risk to your health is increased by drinking any amount of alcohol on a regular basis.

Risks of alcohol misuse Alcohol misuse increases your long term risk of serious health problems such as heart disease, stroke, liver disease, pancreatitis and various forms of cancer. It can also lead to social problems, such as unemployment, divorce, domestic abuse and homelessness.

Short-term The short-term risks of alcohol misuse include: accidents and injuries requiring hospital treatment, such as a head injury violent behaviour and being a victim of violence

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unprotected sex that could potentially lead to unplanned pregnancy or sexually transmitted infections (STIs) loss of personal possessions, such as wallets, keys or mobile phones alcohol poisoning – this may lead to vomiting, seizures (fits) and falling unconscious People who binge drink (drink heavily over a short period of time) are more likely to behave recklessly and are at greater risk of being in an accident.

Long-term Persistent alcohol misuse increases your risk of serious health conditions, including: heart disease stroke liver disease liver cancer bowel cancer mouth cancer breast cancer pancreatitis If someone loses control over their drinking and has an excessive desire to drink, it’s known as dependent drinking (alcoholism). Dependent drinking usually affects a person’s quality of life and relationships, but they may not always find it easy to see or accept this.

Severely dependent drinkers are often able to tolerate very high levels of alcohol in amounts that

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would dangerously affect or even kill some people.

A dependent drinker usually experiences physical and psychological withdrawal symptoms if they suddenly cut down or stop drinking, including: hand tremors – “the shakes” sweating seeing things that aren’t real (visual hallucinations) depression anxiety difficulty sleeping (insomnia) This often leads to “relief drinking” to avoid withdrawal symptoms.

Realising you have a problem with alcohol This is the first big step to getting help. You may need help if: you feel you should cut down on your drinking you often feel the need to have a drink you need a drink first thing in the morning to steady your nerves or get rid of a hangover other people have been criticising or warning you about how much you’re drinking you get into trouble because of your drinking you think your drinking is causing you problems you feel guilty or bad about your drinking

Someone you know may be misusing alcohol if: they regularly exceed the lower-risk daily limit for alcohol they’re sometimes unable to remember what happened the night before because of their drinking they fail to do what was expected of them as a result of their drinking – for example, missing an appointment or work because of being drunk or hungover

Getting help with treating alcohol misuse If you’re concerned about your drinking or someone else’s, a good place to start is with your GP. Try to be accurate and honest about how much you drink and any problems it may be causing you.

Your level of alcohol intake may be assessed using

various tests and this will determine your type of treatment. They’ll be able to discuss the services and treatments available. Initially your alcohol intake may be assessed using tests, such as the: Alcohol Use Disorders Identification Test – a widely used screening test that can help determine whether you need to change your drinking habits Fast Alcohol Screening Test – a simpler test to check whether your drinking has reached dangerous levels

Treating alcohol misuse Treatment options include counselling, medication and detoxification. Detoxification involves a nurse or doctor supporting you to safely stop drinking; this can be done by helping you slowly cut down over time or by giving you medicines to prevent withdrawal symptoms.

A dependent drinker usually experiences physical and psychological withdrawal symptoms if they suddenly cut down or stop drinking, including anxiety after waking, sweating, nausea and vomiting, hallucinations, seizures or fits, hand tremors, depression and insomnia. This often leads to “relief drinking” to avoid withdrawal symptoms.

To stop drinking instantly could be harmful and you should take advice from your GP to do this safely.

Cutting down or stopping drinking is usually just the beginning, & most people will need some degree of help or some long term plan to stay in control or to stay completely alcohol-free. Getting the right support can be crucial to maintaining control in the future. Only relying on family, friends or carers for this is often not enough.

Some people with medium or high levels of alcohol dependence may need intensive rehabilitation & recovery support for a period after they stop drinking completely; either through a programme of intensive support in their local community or by a residential rehabilitation service. This may be in an NHS inpatient unit, or in a medically-supported residential service, depending on your situation and the assessed medical need.

Further help for alcohol abuse As well as the NHS, there are a number of charities and support groups across the UK that provide support and advice for people with an alcohol misuse problem. Helpful contacts for Alcohol Addiction can be found on our Mental Health Glossary on pages 22-25. www.mhap.co.uk

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Drug Addiction If you need treatment for drug addiction, you’re entitled to NHS care in the same way as anyone else who has a health problem. With the right help and support, it’s possible for you to get drug free and stay that way.

Where to get help for drugs: Your GP is a good place to start. They can discuss your problems with you and get you into treatment. They may offer you treatment at the practice or refer you to your local drug service.

If you’re not comfortable talking to your GP, you can approach your local drug treatment service yourself. Visit the Frank website to find local drug treatment services or call the Frank drugs helpline on 0300 123 6600. They can talk you through all your options.

Charity and private drugs treatment - as well as the NHS, there are charities and private drug and alcohol treatment organisations that can help you. Visit the Adfam website to see a list of useful organisations. Private drug treatment can be very expensive but sometimes people get referrals through their local NHS.

Your first appointment: At your first appointment for drug treatment, staff will ask you about your drug use. They will also ask about your work, family and housing situation. You may be asked to provide a sample of urine or saliva.

Staff will talk you through all of your treatment options and agree a treatment plan with you.

They can tell you about local support groups for drug users and their families or carers. You’ll also be given a keyworker who will support you throughout your treatment.

What drug treatment involves: This depends on your personal circumstances and also what you’re addicted to. Your keyworker will work with you to plan the right treatment for you. Your treatment may include: Talking therapies – talking therapies, such as cognitive behavioural therapy (CBT), help you

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to see how your thoughts and feelings affect your behaviour.

Treatment with medicines – if you are dependent on heroin or another opioid drug, you may be offered a substitute drug, such as methadone. This means you can get on with your treatment without having to worry about withdrawing or buying street drugs.

Detoxification (detox) – this is for people who want to stop taking opioid drugs like heroin completely. It helps you to cope with the withdrawal symptoms.

Self-help – some people find support groups like Narcotics Anonymous helpful.

Your keyworker can tell you where your nearest group is.

Reducing harm – your drugs workers will help you reduce the risks associated with your drug-taking. You may be offered testing and treatment for hepatitis or HIV, for example.

Where will you have your treatment?

You may have your treatment while living at home or as a hospital inpatient. If your drugrelated problems are severe or complicated you may be referred to a residential rehab. For more information about residential rehab, or to find a rehab near you, visit rehabonline.

Other contacts for help with Drug Addiction can be found on our Mental Health Glossary on pages 22-25.

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Gambling Addiction Being a compulsive gambler can harm your health and relationships, and leave you in serious debt. If you have a problem with gambling and you’d like to stop, support and treatment is available.

Are you a problem gambler?

Try this questionnaire: Do you bet more than you can afford to lose?

Do you need to gamble with larger amounts of money to get the same feeling?

Have you tried to win back money you have lost (chasing losses)?

Have you borrowed money or sold anything to get money to gamble?

Have you wondered whether you have a problem with gambling?

Has your gambling caused you any health problems, including feelings of stress or anxiety?

Have other people criticised your betting or told you that you had a gambling problem?

Has your gambling caused any financial problems for you or your household?

Have you ever felt guilty about the way you gamble or what happens when you gamble?

For each time you answer Score 0 “never” Score 1 “sometimes” Score 2 “most of the time” Score 3 “almost always” If your total score is 8 or higher, you may be a problem gambler.

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Help for problem gamblers and their families’ There’s evidence that gambling can be successfully treated in the same way as other addictions. Cognitive behavioural therapy usually has the best results. Treatment and support groups are available for people who want to stop gambling: Gamcare - offers free information, support and counselling for problem gamblers in the UK and also for partners, friends and family of people who gamble compulsively. It runs the National Gambling Helpline (0808 8020 133) and also offers face-to-face counselling.

If you’re having problems because of another person’s gambling, it’s best to be honest with them about it. They need to know how their behaviour is affecting you.

National Problem Gambling Clinic - If you live in England or Wales, are aged 16 or over and have complex problems related to gambling, you can refer yourself to this specialist NHS clinic for problem gamblers.

Gamblers Anonymous UK - Gamblers Anonymous UK runs local support groups that use the same 12-step approach to recovery

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from addiction as Alcoholics Anonymous.

There are also GamAnon support groups for friends and family affected by someone else’s gambling problem.

Self-help tips for problem gamblers Do: pay important bills, such as your mortgage, on payday before you gamble spend more time with family and friends who don’t gamble

deal with your debts rather than ignoring them – visit the National Debtline for tips Don’t: view gambling as a way to make money – try to see it as entertainment instead bottle up your worries about your gambling – talk to someone take credit cards with you when you go gambling Other contacts for help with Gambling Addiction can be found on our Mental Health Glossary on pages 22-25.

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About Dementia As you get older, you may find that memory loss becomes a problem. It’s normal for your memory to be affected by stress, tiredness, or certain illnesses and medications. This can be annoying if it happens occasionally, but if you’re becoming increasingly forgetful, particularly if you’re over the age of 65 and it’s affecting your daily life or is worrying you or someone you know, it may be a good idea to talk to your GP about the early signs of dementia.

What is dementia?

Dementia isn’t a single disease, but is a syndrome (a group of related symptoms) associated with an ongoing decline of brain functioning. Several different diseases can cause dementia.

Alzheimer’s disease is the most common type of dementia and, together with vascular dementia, makes up the vast majority of cases. Because both vascular dementia and Alzheimer’s disease are common – especially in older people – they may be present together.

This is often called mixed dementia because a mix of these two conditions is thought to be the cause of the dementia.

Many of these diseases are associated with an abnormal build-up of proteins in the brain. This build-up causes nerve cells to function less well and ultimately die. As the nerve cells die, different areas of the brain shrink.

Vascular dementia is caused by reduced blood flow to the brain. Nerve cells in the brain need oxygen and nutrients from blood to survive. When the blood supply to the brain is reduced, the nerve cells function less well and eventually die.

There are many rarer diseases and conditions that can lead to dementia, or dementia-like symptoms. These conditions account for only 5% of dementia cases in the UK. Mild Cognitive Impairment (MCI) isn’t a cause of dementia. It refers to a condition in which someone has minor problems with cognition, or their memory and thinking, such as memory loss, difficulty concentrating and problems with planning and reasoning. These symptoms aren’t severe enough to cause problems in everyday life, so aren’t defined as dementia.

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How common is dementia?

According to the Alzheimer’s Society there are around 850,000 people in the UK with dementia.

One in 14 people over 65 will develop dementia, and the condition affects 1 in 6 people over 80.

The number of people with dementia is increasing because people are living longer. It is estimated that by 2025, the number of people with dementia in the UK will have increased to around 1 million.

Symptoms of Dementia Dementia is not a natural part of the ageing process and you need to be aware of the symptoms of dementia, which tend to worsen with time and can affect the way you speak, think, feel and behave.

People with dementia can become apathetic or uninterested in their usual activities, or may have problems controlling their emotions. They may also find social situations challenging and lose interest in socialising. Aspects of their personality may change. A person with dementia may lose empathy (understanding and compassion), they may see or hear things that other people do not (hallucinations).

Because people with dementia may lose the ability to remember events or fully understand their environment or situations, it can seem as if they’re not telling the truth, or are wilfully ignoring problems.

As dementia affects a person’s mental abilities, they may find planning and organising difficult.

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Maintaining their independence may also become a problem. A person with dementia will therefore usually need help from friends or relatives, including help with decision making.

Although dementia isn’t just about memory loss, it’s one of the key symptoms. Others include: increasing difficulty with daily tasks and activities that require concentration and planning changes in personality and mood understanding - periods of mental confusion language - difficulty finding the right words or not being able to understand conversations as easily memory loss, thinking speed and mental sharpness judgement movement

Why is it important to get a diagnosis?

Although there is no cure for dementia at present, if it’s diagnosed in the early stages, there are ways you can slow it down and maintain mental function.

A diagnosis can help people with dementia get the right treatment and support, and help those close to them to prepare and plan for the future.

With treatment and support, many people are able to lead active, fulfilled lives.

Dementia is diagnosed by doctors ruling out other conditions that could cause the symptoms, as well as completing a thorough assessment.

A GP, or a doctor specialising in memory problems, will run a series of tests and assessments to see if there is an alternative explanation for the problems. The doctor will also want to discuss how the problems being experienced have developed over time.

How to talk to someone you think has signs of dementia Raising the issue of memory loss and the possibility of dementia can be a difficult thing to do. Someone who is experiencing these symptoms may be confused, unaware they have any problems, worried or in denial.

Before starting a conversation with someone you’re concerned about, the Alzheimer’s Society suggests that you ask yourself the following questions: have they noticed the symptoms? do they think their problems are just a natural part of ageing? are they scared about what the changes could mean? are you the best person to talk to them about memory problems? do they think there won’t be any point in seeking help?

When you do talk to them, choose a place that is familiar and non-threatening. And allow plenty of time so the conversation isn’t rushed.

You may like to suggest that you accompany your friend or relative to the GP so you can support them. This also means that after the appointment, you can help your friend or relative recall what has been discussed.

If the diagnosis is dementia A dementia diagnosis can come as a shock, but over time some people come to view it in a positive way. This is because a diagnosis is the first step towards getting the information, help and support needed to manage the symptoms.

A diagnosis of dementia can help people with these symptoms, and their families and friends, take control, make plans and prepare for the future.

Further help and information Other contacts for help with Dementia can be found on our Mental Health Glossary on pages 22-25.

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Depression Overview Depression is more than simply feeling unhappy or fed up for a few days. Most people go through periods of feeling down, but when you’re depressed you feel persistently sad for weeks or months, rather than just a few days.

Some people think depression is trivial and not a genuine health condition. They’re wrong – it is a real illness with real symptoms. Depression isn’t a sign of weakness or something you can “snap out of” by “pulling yourself together”. The good news is that with the right treatment and support, most people with depression can make a full recovery.

Symptoms Depression affects people in different ways and can cause a wide variety of symptoms. But as a general rule, if you’re depressed, you feel sad, hopeless, anxious, tearful and lose interest in things you used to enjoy. There can be physical symptoms too, such as feeling constantly tired, sleeping badly, having no appetite or sex drive, and various aches and pains. The symptoms of depression may persist for weeks or months and are bad enough to interfere with your work, social life and family life. There are many other symptoms of depression and you’re unlikely to have all of those listed below.

Psychological symptoms: continuous low mood or sadness / feeling hopeless and helpless / having low self-esteem feeling tearful / feeling anxious or worried feeling irritable and intolerant of others / feeling guilt-ridden having no motivation or interest in things / not getting any enjoyment out of life finding it difficult to make decisions having suicidal thoughts or thoughts of harming yourself Physical symptoms: moving or speaking more slowly than usual changes in appetite or weight (usually decreased, but sometimes increased) / constipation unexplained aches and pains

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lack of energy / low sex drive (loss of libido) / changes to your menstrual cycle disturbed sleep / finding it difficult to fall asleep at night / waking up very early in the morning Social symptoms: not doing well at work avoiding contact with friends and taking part in fewer social activities neglecting your hobbies and interests having difficulties in your home and family life

Severities of depression Doctors categorize the symptoms of depression from mild to severe: mild depression – has some impact on your daily life and you may simply feel persistently low in spirit moderate depression – has a significant impact on your daily life severe depression – makes it almost impossible to get through daily life; a few people with severe depression may have psychotic symptoms and it can make you feel suicidal and that life is no longer worth living.

How to tell if you have depression and when to see a doctor Most people experience feelings of stress, unhappiness or anxiety during difficult times.

A low mood may improve after a short period of time, rather than being a sign of depression.

However, it’s important to seek help from your

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of depression, with talking therapies and antidepressant medicines.

Bipolar Disorder (also known as manic depression) - there are spells of both depression and excessively high mood (mania); the depression symptoms are similar to clinical depression, but the bouts of mania can include harmful behaviour, such as gambling, going on spending sprees and having unsafe sex.

Seasonal Affective Disorder (SAD) – also known as “winter depression”, SAD is a type of depression with a seasonal pattern usually related to winter.

Treating depression GP if you think you may be depressed. Don’t wait before seeking help for depression, the sooner you see a doctor, the sooner you can be on the way to recovery.

Depression can often come on gradually, so it can be difficult to notice something is wrong.

Many people try to cope with their symptoms without realising they’re unwell. It can sometimes take a friend or family member to suggest something is wrong.

What causes depression?

Depression is fairly common, affecting about 1 in 10 people at some point during their life. It affects men and women, young and old. Studies have shown that about 4% of children aged five to 16 in the UK are anxious or depressed.

Sometimes there’s a trigger for depression. Lifechanging events, such as bereavement, losing your job or even having a baby, can bring it on. People with a family history of depression are more likely to experience it themselves. But you can also become depressed for no obvious reason.

Grief - it can be difficult to distinguish between grief and depression. They share many of the same characteristics, but there are important differences between them. Grief is an entirely natural response to a loss, while depression is an illness. People who are grieving find their feelings of sadness and loss come and go, but they’re still able to enjoy things and look forward to the future. In contrast, people who are depressed constantly feel sad. They don’t enjoy anything and find it difficult to be positive about the future.

Postnatal Depression – some women develop depression after they have a baby and it’s treated in a similar way to other types

Treatment for depression can involve a combination of lifestyle changes, talking therapies and medication. Your recommended treatment will be based on whether you have mild, moderate or severe depression.

If you have mild depression, your doctor may suggest waiting to see whether it improves on its own, while monitoring your progress. This is known as “watchful waiting”. They may also suggest lifestyle measures such as exercise and self-help groups. Talking therapies, such as cognitive behavioural therapy (CBT), are often used for mild depression that isn’t improving or moderate depression. Antidepressants are also sometimes prescribed.

For moderate to severe depression, a combination of talking therapy and antidepressants is often recommended. If you have severe depression, you may be referred to a specialist mental health team for intensive specialist talking treatments and prescribed medication.

Living with depression Many people with depression benefit by making lifestyle changes, such as getting more exercise, cutting down on alcohol, giving up smoking and eating healthily. Reading a self-help book or joining a support group are also worthwhile. They can help you gain a better understanding about what causes you to feel depressed. Sharing your experiences with others in a similar situation can also be very supportive.

Further Help and Information Other contacts for help with Depression can be found on our Mental Health Glossary on pages 22-25. www.mhap.co.uk

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Post Natal Depression Postnatal depression is a type of depression that many parents experience after having a baby.

It’s a common problem, affecting more than 1 in every 10 women and up to 1 in 25 new fathers within a year of giving birth.

Many women feel a bit down, tearful or anxious in the first week after giving birth. Having a baby is a life-changing event and it often takes time to adapt to becoming a new parent. Looking after a small baby can be stressful and exhausting. This is often called the “baby blues” and is so common that it’s considered normal.

Unlike the “baby blues”, which generally do not last more than 2 weeks after giving birth, postnatal depression can start any time in the first year after giving birth. It’s important to seek help as soon as possible if you think you might be depressed, as your symptoms could last months or get worse and have a significant impact on you, your baby and your family. With the right support most women make a full recovery.

Symptoms There is no evidence that there’s anything specific you can do to prevent the condition developing, apart from maintaining a healthy lifestyle. However, if you or your family have a history of depression or mental health problems earlier in life or during and after pregnancy, tell your GP if you’re pregnant or thinking of having a baby. If you have had a mental health problem while pregnant, your doctor should arrange for you to be seen regularly in the first few weeks after birth. Signs that you or someone you know might be depressed include: a persistent feeling of sadness and low mood / lack of enjoyment and loss of interest in the wider world lack of energy and feeling tired all the time / trouble sleeping at night and feeling sleepy during the day difficulty bonding with your baby withdrawing from contact with other people problems concentrating and making decisions frightening thoughts – for example, about hurting your baby

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Getting help for postnatal depression Speak to your GP or health visitor if you think you may be depressed. Many health visitors have been trained to recognise postnatal depression and have techniques that can help. If they can’t help, they’ll know someone in your area who can. Don’t struggle alone hoping that the problem will go away. Remember that: a range of help and support is available, including therapy depression is an illness like any other / it’s not your fault you’re depressed – it can happen to anyone being depressed doesn’t mean you’re a bad parent / it doesn’t mean you’re going mad your baby won’t be taken away from you – babies are only taken into care in very exceptional circumstances

Treatments Postnatal depression can be lonely, distressing and frightening, but support and effective treatments are available. These include self-help such as talking to your family and friends about your feelings and what they can do to help; making time for yourself to do things you enjoy; resting whenever you get the chance and getting as much sleep as you can at night; exercising regularly; eating a healthy diet. Psychological therapy and antidepressants may also be prescribed..

Local and national organisations, such as the Association for Post Natal Illness (APNI) and Pre and Postnatal Depression Advice and Support (PANDAS), can also be useful sources of help and advice – see pages 22-25.

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Eating Disorders An eating disorder is when a person’s relationship with food becomes abnormal, forcing them to change their eating habits and behaviours. It can involve eating too much or too little, or becoming obsessed with your weight and body shape. It can take over your life and make you ill. Men and women of any age can get an eating disorder, but they most commonly affect young women aged 13 to 17 years old.

Eating problems can disrupt how a person eats food and absorbs nutrients, which affects physical health, but can also be detrimental both emotionally and socially. Eating disorders often occur alongside other mental health conditions, such as anxiety, depression, panic disorder, obsessive-compulsive disorder and substance misuse disorders.

Types of eating disorders Anorexia Nervosa – keeping your weight as low as possible by restricted food intake and/or excessive exercise Bulimia Nervosa – binge eating followed by deliberate purging (deliberately sick, use laxatives) to restrict what you eat, or do too much exercise to try to stop yourself gaining weight Binge Eating Disorder (BED) – episodes of overeating in a short space of time until you feel uncomfortably full, and are then often upset or guilty Other Specified Feeding or Eating Disorder (OSFED) - when your symptoms don’t exactly match those of anorexia, bulimia or binge eating disorder.

Symptoms of eating disorders include: dramatic weight loss /spending a lot of time worrying about your weight and body shape avoiding socialising when you think food will be involved eating very little food / eating a lot of food very fast / cutting food into small pieces or eating very slowly deliberately making yourself sick or taking laxatives after you eat wearing loose or baggy clothes to hide weight loss exercising excessively or obsessively exercising lying about how much and when they’ve eaten, or how much they weigh

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having very strict habits or routines around food changes in your mood You may also notice physical signs including feeling cold, tired or dizzy, problems with your digestion, your weight being very high or very low for someone of your age and height and not getting your period for women and girls.

What causes eating disorders?

There is no single reason why someone may develop an eating disorder - it can be the result of a combination of genetic, psychological, environmental, social and biological factors.

Getting help for an eating disorder If you think you may have an eating disorder, even if you aren’t sure, see your GP as soon as you can.

They’ll ask you questions about your eating habits and how you’re feeling, and will check your overall health and weight. If they think you may have an eating disorder, they should refer you to an eating disorder specialist or team of specialists.

You can also talk in confidence to an adviser from eating disorders charity Beat by calling their adult helpline on 0808 801 0677 or youth helpline on 0808 801 0711.

Treatment for eating disorders While they can be very serious mental health conditions they are also treatable and, although it may take a long time, full recovery is possible.

Treatment normally consists of monitoring a person’s physical health while addressing the underlying psychological problems with psychological therapy such as cognitive behavioural therapy (CBT) or family therapy. Medication such as a type of antidepressant may also be used.

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Anxiety / Panic Attacks Anxiety is a normal emotion that we all experience, such as in the run up to exams or a job interview. But when anxiety becomes much more severe this feeling can take over and begin to interfere with everyday life. Conditions under the anxiety disorder umbrella include: social anxiety, generalised anxiety disorder (GAD), panic disorder, obsessive-compulsive disorder (OCD), phobias, and post-traumatic stress disorder (PTSD).

For people with an anxiety disorder, feelings like stress, panic and worry are longer lasting, more extreme and far harder to control. Anxiety can stop people living the life they want – whether that means not being able to work, see friends or, in the most severe cases, even leave the house.

As with many mental health conditions, the exact cause of panic disorder isn’t fully understood.

But it’s thought the condition is probably linked to a combination of things, including a traumatic or very stressful life experience, such as bereavement, having a close family member with the disorder or an imbalance of neurotransmitters (chemical messengers) in the brain.

Symptoms Everyone experiences feelings of anxiety and panic at certain times. It’s a natural response to stressful or dangerous situations. But for someone with panic disorder, feelings of anxiety, stress, panic or fear occur regularly and at any time, often for no apparent reason. You may start to avoid certain situations because you fear that they will trigger another attack. This can create a cycle of living “in fear of fear”. It can add to your sense of panic and may cause you to have more attacks.

A panic attack is when your body experiences a rush of intense mental and physical symptoms.

It can come on very quickly and for no apparent reason and can be very frightening and distressing. Symptoms may include a racing heartbeat, feeling faint, sweating, nausea, chest pain, shortness of breath, trembling, hot flushes, chills, shaky limbs and, a choking sensation.

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Most panic attacks last for between 5 and 20 minutes, but may last up to an hour. The number of attacks you have will depend on how severe your condition is, sometimes once or twice a month, while others have them several times a week. Although panic attacks are frightening, they’re not dangerous. An attack won’t cause you any physical harm, and it’s unlikely that you’ll be admitted to hospital if you have one.

Treatments for panic disorder Panic disorder is treatable and you can make a full recovery. If you’ve been experiencing symptoms of panic disorder visit your GP. They’ll ask you to describe your symptoms, how often they occur and how long you’ve had them. They may also carry out a physical examination to rule out other conditions that could be causing your symptoms. If you don’t get medical help, panic disorder can escalate and become very difficult to cope with. You’re more at risk of developing other mental health conditions, such as agoraphobia or other phobias, or an alcohol or drug problem.

Treatment aims to reduce the number of panic attacks you have and ease your symptoms, using one or a combination of Psychological therapy (based on cognitive behavioural therapy) and medication. If your symptoms don’t improve after CBT, medication and connecting with a support group, your GP may refer you to a mental health specialist such as a psychiatrist or clinical psychologist.

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A Summary of Contact Numbers and Information for Selected Mental Health Disorders Specialised Area

Contact Details SANE - emotional support, information & guidance for people affected by mental illness, their families & carers.

SANEline: 0300 304 7000 www.sane.org.uk/support Mind - 0300 123 3393 (Mon-Fri, 9am-6pm) www.mind.org.uk Rethink Mental Illness - support and advice for people living with mental illness.

Phone: 0300 5000 927 (Mon-Fri, 9.30am-4pm) www.rethink.org Mental Health Foundation - provides information & support for anyone with mental health problems or learning disabilities. www.mentalhealth.org.uk

Mental Health

Young Minds - information on child & adolescent mental health.

Parents helpline 0808 802 5544 www.youngminds.org.uk (Mon-Fri, 9.30am-4pm) The Samaritans - confidential support for people experiencing feelings of distress or despair.

Phone: 116 123 (free 24-hour helpline). www.samaritans.org.uk NHS Choices – www.nhs.uk/conditions/online-mental-health-services Information on online mental health services.

British Association for Counselling & Psychotherapy – 01455 883 300 www.itsgoodtotalk.org.uk Adfam - a national charity working with families affected by drugs & alcohol. Has a database of local support groups. www.adfam.org.uk

General Addictions

Rehab 4 Addiction - free helpline dedicated to assisting those suffering from drug, alcohol and mental health problems.

Tel: 0800 140 4690 www.rehab4addiction.co.uk Addaction - a UK-wide treatment agency that helps individuals, families & communities manage the effects of drug and alcohol misuse. www.addaction.org.uk

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to advertise in the next issue of Mental Health Awareness call: 01375 402 546

Drinkline - the national alcohol helpline. Free & confidential 0300 123 1110 Alcoholics Anonymous - 0845 769 7555 (24 hr) www.alcoholics-anonymous.org.uk

Alcohol Misuse

Al-Anon Family Groups - offers support to the families & friends of problem drinkers. Helpline 0207 403 0888 www.al-anonuk.org.uk The National Association for Children of Alcoholics for children of alcohol-dependent parents and others concerned about their welfare. Free confidential helpline 0800 358 3456. www.nacoa.org.uk

Drugs / Substance Abuse

FRANK drugs helpline 0300 123 6600 Narcotics Anonymous - 0300 999 1212 (daily until midnight) www.ukna.org GamCare – the National Gambling Helpline 0808 8020 133 offers free information, support and counselling for problem gamblers in the UK.

Gambling

Gamblers Anonymous - runs local support groups www.gamblersanonymous.org.uk GamAnon - support groups for friends and family. www.gamanon.org.uk NHS Smokefree - helpline on 0300 123 1044

Smoking Dependency

There is also support available from your local stop smoking service. www.nhs.uk/Service-Search/Stop-smoking-services/ LocationSearch/1846 National Dementia - helpline 0300 222 1122 Alzheimer's Society - helpline 0300 222 1122 www.alzheimers.org.uk

Dementia

Alzheimer's Research UK 0300 111 5 111 www.alzheimersresearchuk.org Dementia UK - to talk to an Admiral Nurse, who are registered nurses & experts in dementia care, call 0800 888 6678 www.dementiauk.org The Carers Trust - if you are looking after someone with dementia, get help & support & even a break from caring. www.carers.org www.mhap.co.uk

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A Summary of Contact Numbers - continued Anxiety Disorders & Social Anxiety Disorder

Anxiety UK - Phone: 03444 775 774 (Mon-Fri, 9.30am-5.30pm) www.anxietyuk.org.uk Anxiety Care UK – www.anxietycare.org.uk No More Panic – www.nomorepanic.co.uk

Panic Disorder

No Panic – www.nopanic.org.uk / helpline: 08449 674848 (10.00am – 10.00pm)

Phobias

Triumph Over Phobia – www.topuk.org

Depression

Depression Alliance - for sufferers of depression. www.depressionalliance.org

Bipolar Disorder

Bipolar UK - www.bipolaruk.org.uk

Postnatal Depression

The Association for Post Natal Illness 0207 386 0868 www.apni.org Pre and Postnatal Depression Advice and Support 0843 2898401 www.pandasfoundation.org.uk

Psychotic Depression Episodes / Confusion (Sudden Delirium)

If you think the person's symptoms are placing them or others at possible risk of harm you can take them to your nearest A&E department, call their GP or local out-of-hours GP or call 999 to ask for an ambulance.

Seasonal Affective Disorder

SAD Association - www.sada.org.uk

Eating Disorders

Body Dysmorphic Disorder

Beat - Phone: 0808 801 0677 (adults) or 0808 801 0711 (for under-18s) Website: www.b-eat.co.uk (Anorexia Nervosa, Binge Eating Disorder & Bulimia).

Body Dysmorphic Disorder Foundation – www.bddfoundation.org Respect – 0808 802 4040 www.respect.uk.net

Anger

National Domestic Abuse - helpline – 0808 2000 247 Refuge – www.refuge.org.uk

Autism Spectrum Disorder 24

The National Autistic Society Autism Helpline 0808 800 4104 www.autism.org.uk

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Dissociative Disorders

MIND - www.mind.org.uk has a list if useful contacts

Grief / Bereavement

Cruse Bereavement Care - Phone: 0844 477 9400 (Mon-Fri, 9am-5pm) www.crusebereavementcare.org.uk

Hoarding Disorder

www.ocduk.org – 0845 120 3778

Obsessive Compulsive Disorder

OCD Action - support for people with OCD related disorders.

Phone: 0845 390 6232 Website: www.ocdaction.org.uk (Mon-Fri, 9.30am-5pm)

Paranoia

National Paranoia Network – 0114 271 8210 www.nationalparanoianetwork.org

Post-Traumatic Stress Disorder

ASSIST trauma care – helpline 0178 856 0800 www.assisttraumacare.org.uk Combat Stress – helpline 0800 1381 619 www.combatstress.org.uk PTSD Resolution – 0300 302 0551 www.ptsdresolution.org

Premenstrual Dysphoric Disorder

National Association for Premenstrual Syndrome – www.pms.org.uk The National Association for People Abused in Childhood (NAPAC)

Sexual Abuse

0808 801 0331 (freephone, Monday–Thursday 10am–9pm and Friday 10am–6pm) www.napac.org.uk HAVOCA (Help for Adult Victims of Child Abuse) www.havoca.org Lifecentre - helpline: 0808 802 0808 www.lifecentre.uk.com

Self-Harm

Harmless – email info@harmless.org.uk

Stress

Men's Health Forum - 24/7 stress support for men by text, chat and email. Website: www.menshealthforum.org.uk PAPYRUS - Young suicide prevention society.

HOPElineUK 0800 068 4141 (Mon-Fri,10am-5pm & 7-10pm. Weekends 2-5pm) www.papyrus-uk.org

Suicide / Suicidal Feelings

Childline – for children and young people under 19 Call 0800 1111 – the number won’t show up on your phone bill CALM - the Campaign Against Living Miserably, for men aged 15-35. www.thecalmzone.net The Silver Line – for older people Call 0800 4 70 80 90 www.mhap.co.uk

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Phobias A phobia is an overwhelming and debilitating fear of an object, place, situation, feeling or animal and they are the most common type of anxiety disorder. They can affect anyone, regardless of age, sex and social background. Phobias are more pronounced than fears. They develop when a person has an exaggerated or unrealistic sense of danger about a situation or object. If a phobia becomes very severe, a person may organise their life around avoiding the thing that’s causing them anxiety. As well as restricting their day-to-day life, it can also cause a lot of distress..

Symptoms A phobia is a type of anxiety disorder. You may not experience any symptoms until you come into contact with the source of your phobia. However, in some cases, even thinking about the source of a phobia can make a person feel anxious or panicky. This is known as anticipatory anxiety.

Symptoms may include: unsteadiness, dizziness and light-headedness, nausea, sweating, increased heart rate or palpitations, shortness of breath, trembling or shaking an upset stomach.

Types of phobia There are a wide variety of objects or situations that someone could develop a phobia about.

However, phobias can be divided into two main categories: Specific or simple phobias - centre around a particular object, animal, situation or activity. They often develop during childhood or adolescence and may become less severe as you get older.

Common examples of simple phobias include: animal phobias – such as dogs, spiders, snakes or rodents environmental phobias – such as heights, deep water and germs situational phobias – such as visiting the dentist or flying bodily phobias – such as blood, vomit or having injections

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sexual phobias – such as performance anxiety or the fear of getting a sexually transmitted infection

Complex phobias - tend to be more disabling than simple phobias. They tend to develop during adulthood and are often associated with a deeprooted fear or anxiety about a particular situation or circumstance. The two most common complex phobias are: Agoraphobia – a sufferer will feel anxious about being in a place or situation where escaping may be difficult if they have a panic attack.

Social phobia (also known as social anxiety disorder) - centres around feeling anxious in social situations.

Causes Phobias don’t have a single cause, but there are a number of associated factors. For example: it may be associated with a particular incident or trauma, it may be a response that a person develops early in life from another family member or genetics may play a role – there’s evidence to suggest that some people are born with a tendency to be more anxious than others.

Treating phobias Almost all phobias can be successfully treated and cured. If you have a phobia, you should seek help from your GP. Simple phobias can be treated through gradual exposure to the object, animal, place or situation that causes fear and anxiety ( known as desensitisation or self-exposure therapy). Other contacts for help with Phobias can be found on our Mental Health Glossary on pages 22-25.

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Local Community Focus

Alzheimer’s Society in Kent and Medway Alzheimer’s Society North Kent Alzheimer’s Society Bexley, Local Service Office, Wolsley House, Wolsley Close, Dartford, Kent DA1 4BE Telephone 01322 524950

Alzheimer’s Society West Kent West Kent Local Office, 1-7 Commercial Road, Paddock Wood, Tonbridge, Kent TN12 6YT Email christine.russell@alzheimers.org.uk Telephone 01892 835498

At Alzheimer’s Society, we believe passionately that life doesn’t end when dementia begins. We are here for anyone affected by dementia, and we do everything we can to keep people with dementia connected to their lives and the people who matter most.

If you or someone you know are worried about or affected by dementia, we are here for you. We have information to help you understand dementia, what to expect, and practical advice and support to help you live as well as possible with the condition.

Alzheimer’s Society, Kent and Medway provide support, information and practical guidance to anyone affected by dementia.

Our three offices cover most of Kent and Medway’.

Alzheimer’s Society Maidstone Maidstone & Rural Communities Local Office, Unit 1 Dairy Court, Fair View Farm, Linton Road, Loose, Maidstone, Kent ME15 0AL Email maidstone@alzheimers.org.uk Telephone 01622 747181

Alzheimer’s Society East Kent Ashford & Shepway Local Office, Lemanis House, Stone Street, Lympne, Hythe, Kent CT21 4JN Email ashford-shepway@alzheimers.org.uk Telephone 01303 260674

For local support and advice please contact: 28

to advertise in the next issue of Mental Health Awareness call: 01375 402 546

Smoking Self-help tips to stop smoking.

Get some stop smoking support - If friends or family members want to give up too, suggest to them that you give up together.

Think positive - You might have tried to quit smoking before and not managed it, but don’t let that put you off. Look back at the things your experience has taught you and think about how you’re really going to do it this time.

Make a plan to quit smoking - Make a promise, set a date and stick to it. Sticking to the “not a drag” rule can really help. Whenever you find yourself in difficulty say to yourself, “I will not have even a single drag” and stick with this until the cravings pass. Think ahead to times where it might be difficult – a party for instance – and plan your actions and escape routes in advance.

Make a list of reasons to quit - Keep reminding yourself why you made the decision to give up.

Make a list of the reasons and read it when you need support.

Identify when you crave cigarettes - A craving can last five minutes. Before you give up, make a list of five-minute strategies. For example, you could leave the party for a minute, dance or go to the bar. And think about this: the combination of smoking and drinking raises your risk of mouth cancer by 38 times.

If you want to stop smoking, you can make small changes to your lifestyle that may help you resist the temptation to light up.

Consider your diet - Is your after-dinner cigarette your favourite? A US study revealed that some foods, including meat, make cigarettes more satisfying. Others, including cheese, fruit and vegetables, make cigarettes taste terrible. So swap your usual steak or burger for a veggie pizza instead. You may also want to change your routine at or after mealtimes. Getting up and doing the dishes straight away or settling down in a room where you don’t smoke may help.

Change your drink - The same study as above also looked at drinks. Fizzy drinks, alcohol, cola, tea and coffee all make cigarettes taste better.

So when you’re out, drink more water and juice.

Some people find simply changing their drink (for example, switching from wine to a vodka and tomato juice) affects their need to reach for a cigarette.

Get moving - A review of scientific studies has proved exercise – even a five-minute walk or stretch – cuts cravings and may help your brain produce anti-craving chemicals.

Make non-smoking friends - When you’re at a party, stick with the non-smokers.

Keep your hands and mouth busy - Nicotine replacement therapy (NRT) can double your chances of success. As well as patches, there are tablets, lozenges, gum and a nasal spray.

And if you like holding a cigarette, there are handheld products like the inhalator. There are also e-cigarettes. When you’re out, try putting your drink in the hand that usually holds a cigarette, or drink from a straw to keep your mouth busy.

There is also support available from your local stop smoking service. Did you know that you’re up to four times more likely to quit successfully with their expert help and advice? www.nhs. uk/Service-Search/Stop-smoking-services/ LocationSearch/1846 You can also call the NHS Smokefree Helpline on 0300 123 1044 open Monday to Friday 9am to 8pm, and Saturday to Sunday 11am to 4pm. www.mhap.co.uk

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Mental Health and Wellbeing Mental health problems are a very common part of life, one in four people will experience a mental health problem at some point in their lives and at any given time one in six people will be experiencing a mental health problem which may affect their daily life, relationships or physical health.

Mental health is important to everyone, there are times when everyone feels down, stressed or frightened but most of the time these feelings will pass. However, sometimes these feelings can develop into more serious problems.

Help and support For information on the local support available to help improve your mental health and wellbeing visit the Kent County Council website.

If you are in emotional distress and need urgent support ring the Mental Health Matters helpline (24/7) on 0300 330 5486 (free for mobiles) or 0800 107 0160 (free for landlines).

Six ways to wellbeing The Six Ways to Wellbeing. Simple enjoyable things that make a big difference to how you feel, now and in the weeks and months to come.

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The Six Ways to Wellbeing can be quick things, like giving way to another driver (“give”) or noticing something unusual on the way to the shops (“take notice”). Or they can be longer-term projects, like starting a new hobby (“keep learning”) or becoming a volunteer (“give” and “care”).

The Six Ways – connect, be active, keep learning, give, take notice and care - over a range of actions and activities. More and more research shows that they help to improve our moods, strengthen relationships, keep us healthy and even add seven years to our lives.

Here are some examples of different Ways to Wellbeing. Please add your own!

Connect Sit with the family to eat a meal together.

Say hello to a neighbour.

to advertise in the next issue of Mental Health Awareness call: 01375 402 546

Ask what is selling well when you buy

something in the local shop.

Be Active Do a good spring clean.

Put on your favourite song and dance to it.

Organise an informal sports session for

work colleagues or neighbours.

Take Notice Savour the taste of your meals.

Think about your day when you

brush your teeth; recognise what you did well.

Notice three unusual things on a journey you make often.

Keep Learning Browse in a charity shop and look at the

sections you don’t usually look at – CDs, DVDs, books, shoes...

Watch an interesting documentary on TV. Ask a friend to teach you a practical skill,

like sewing on a button.

Give Contact a charity or community group

about volunteering opportunities.

Offer your seat to someone who needs

it more.

Tell someone ‘Well done’.

Care: Grow your Planet Switch off phone chargers when you’re

not using them.

Freecycle unwanted belongings.

Get a “bag for life” and put it by the front

door, ready for when you shop.

Share your wellbeing stories. Inspire others on their way to wellbeing.

Small changes to your lifestyles can improve your health and cut your risk of illness.

In partnership with Kent County Council, Dartford Borough Council is able to deliver a wide range of initiatives and projects to help improve your health and wellbeing.

More information about the wide range of initiatives and projects available to help you start a healthier lifestyle and how you can sign up can be found below.

If you have any questions or queries concerning anything on the health and wellbeing pages please contact the Healthy Living Team on 01322 343067 or online: Contact the Healthy Living Team.

You don’t have to go it alone - One You Kent is here to help. We’ve got loads of support on offer to help you take the first step towards a better you. Our One You Advisors can support you to make the small changes that can make a big difference. An Advisor provides you with free one-to-one support to help you to: Lose weight Get fitter Quit smoking Improve your mental wellbeing Get more involved in your community Get housing, debt and employment advice

If you would like a One You Advisor to contact you to chat about the service or to book an appointment, complete the One You self-referral form or you can contact the team online: One You Team or telephone 0300 0200636. www.mhap.co.uk

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Mental Health Arts Project Registered Charity 1160300

Patron: Isabel Losada

Welcome to Centrepieces!

Founded in 1999, Centrepieces is a registered charity which helps adults in their mental health recovery through art.

The organisation’s work centres on an effort to improve the confidence, wellbeing and self-esteem of people suffering with mental illness, while offering an opportunity to build a social community and promote a better understanding of mental health to the wider public.

Centrepieces provides the resources for people to participate in art workshops and activities, and to exhibit and sell their artwork. Running regular workshops, which encompass art practices from sculpture and painting to mask making and photography, we are committed to providing our artists with the tools and the environment for creative expression.

About Us Centrepieces exists to promote mental health recovery through the arts, providing opportunities for people to participate in art activities and to exhibit and sell their work. It also tries to promote a better understanding of mental health to the wider public.

Our mission statement is: “To help adults within the local community who have mental health issues to improve their well-being and achieve better social inclusion through art.”

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Centrepieces was founded in 1999 after an explosion of enthusiasm and creativity amongst a group of artists, all of whom were experiencing mental health problems and living in the London Borough of Bexley and surrounding areas. After successfully applying for a £5,000 National Lottery Millennium Award, Centrepieces was for many years based at and supported by the Crayford Centre, a local authority and NHS mental health service.

In June 2014 Centrepieces moved to new premises at The Lodge in the tranquil grounds of Hall Place Historic House, with financial assistance from Oxleas NHS Foundation Trust.

Centrepieces is now a Charitable Incorporated Organisation (CIO), registered with the Charity Commission. You can read our Constitution here.

Centrepieces’ board of Trustees makes decisions about strategies and the development of the project, and also helps

to advertise in the next issue of Mental Health Awareness call: 01375 402 546

with fundraising. Many Trustees also lend a hand in a practical way with the activities of the organisation.

Centrepieces is currently run by a team of over 20 committed volunteers, who help provide art activities as well as admin, financial and other support.

The Co-ordinator is Geoff Norris, who is responsible for the day to day running of the charity. Geoff is a trained Social Worker and Counsellor, who for many years worked in the fields of mental health and substance abuse. He helped nurture and oversee the development of Centrepieces from its beginnings in 1999 up until the present time at The Lodge.

We work closely with other local organisations, including: Oxleas NHS Foundation Trust Hall Place House and Gardens London Borough of Bexley MIND Bexley Voluntary Service Council Reinstate

Workshop Galleries Centrepieces Mental Health Arts Project offers a constantly evolving programme of workshops and the opportunities for our artists to participate in sculpture, creative writing, mosaic and watercolour classes and many more!

Workshops This is our current programme of workshops.

Monday Drop in Sculpture session 10.30 - 1.00

Tuesday Workshops & Taster sessions

10.00 – 12.30

Wednesday Photography Group

10.00 – 12.00

Thursday Mixed Media sessions

10.30 – 1.00

Friday Sculpture workshop

10.30 – 1.00

Open Studio

10.00 – 1.00

Creative Writing

1.00 – 3.00

Saturday Photography Field Trip

Fortnightly

Various workshops

10.00 – 1.00

Contact Us Tel: 01322 554589 Email: info@centrepieces.org Address: Centrepieces, The Lodge, Hall Place, Bourne Road Bexley, Kent DA5 1PQ The Lodge is normally open on: Monday, Tuesday, Thursday and Friday 10am- 4pm; Saturday 10am- 3pm. The Lodge closes for a seasonal break over the Christmas holiday period. www.mhap.co.uk

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Post-Traumatic Stress Disorder (PTSD) Post-traumatic stress disorder (PTSD) is an anxiety disorder caused by very stressful, frightening or distressing events.

Someone with PTSD often relives the traumatic event through nightmares and flashbacks, and may experience feelings of isolation, irritability and guilt. They may also have problems sleeping, such as insomnia, and find concentrating difficult.

These symptoms are often severe and persistent enough to have a significant impact on the person’s day-to-day life.

Causes of PTSD Any situation that a person finds traumatic can cause PTSD. These can include: serious road accidents violent personal assaults, such as sexual assault, mugging or robbery a traumatic birth PTSD can develop immediately after someone experiences a disturbing event or it can occur weeks, months or even years later. PTSD is estimated to affect about 1 in every 3 people who have a traumatic experience, but it’s not clear exactly why some people develop the condition and others don’t.

Complex PTSD People who repeatedly experience traumatic situations such as severe neglect, abuse or violence may be diagnosed with complex PTSD. Complex PTSD can cause similar symptoms to PTSD and may not develop until years after the event. It’s often more severe if the trauma was experienced early in life as this can affect a child’s development.

When to seek medical advice It’s normal to experience upsetting and confusing thoughts after a traumatic event, but most people improve naturally over a

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few weeks. You should visit your GP if you or your child are still having problems about 4 weeks after the traumatic experience, or if the symptoms are particularly troublesome.

If necessary, your GP can refer you to mental health specialists for further assessment and treatment.

How PTSD is treated PTSD can be successfully treated, even when it develops many years after a traumatic event.

Any treatment depends on the severity of symptoms and how soon they occur after the traumatic event. Any of the following treatment options may be recommended: watchful waiting – monitoring your symptoms to see whether they improve or get worse without treatment antidepressants – such as paroxetine or mirtazapine psychological therapies – such as traumafocused cognitive behavioural therapy (CBT) or eye movement desensitisation and reprocessing (EMDR); you can refer yourself directly to a psychological therapies service

Further Help and Information Other contacts for help with PTSD can be found on our Mental Health Glossary on pages 22-25.

to advertise in the next issue of Mental Health Awareness call: 01375 402 546

Obsessive Compulsive Disorder (OCD) Obsessive compulsive disorder (OCD) is a common mental health condition in which a person has obsessive thoughts and compulsive behaviours.

It affects men, women and children, and can develop at any age. OCD can be distressing and significantly interfere with your life, but treatment can help you keep it under control.

An obsession is an unwanted and unpleasant

thought, image or urge that repeatedly enters your mind, causing feelings of anxiety, disgust or unease.

A compulsion is a repetitive behaviour or mental act that you feel you need to carry out to try to temporarily relieve the unpleasant feelings brought on by the obsessive thought. e.g. For example, someone with an obsessive fear of their house being burgled may feel they need to check all the windows and doors are locked several times before they can leave the house.

Getting help for OCD People with OCD are often reluctant to seek help because they feel ashamed or embarrassed. But there’s nothing to feel ashamed or embarrassed about. It’s a health condition like any other. If you think a friend or family member may have OCD, try talking to them about your concerns and suggest they seek help. OCD is unlikely to get better without proper treatment and support. You can either refer yourself directly to a psychological therapies service or visit your GP who can refer you to a local psychological therapies service if necessary.

Treatments for OCD There are some effective treatments for OCD that can help reduce the impact the condition has on your life. The main treatments are:

psychological therapy – usually a special

type of cognitive behavioural therapy (CBT) that helps you face your fears and obsessive thoughts without “putting them right” with compulsions

medication – usually a type of antidepressant

medication called selective serotonin reuptake inhibitors (SSRIs) that can help by altering the balance of chemicals in your brain

Causes of OCD It’s not clear exactly what causes OCD. A number of different factors may play a role in the condition. These include family history, differences in the brain and personality (neat, meticulous, methodical people with high personal standards may be more likely to develop OCD, as may those who are generally quite anxious).

OCD may also occur after important life events such as childbirth or a bereavement.

Further Help and Information Living with OCD can be difficult. In addition to getting medical help, you might find it helps to contact a support group or other people with OCD for information and advice. The following sites may be useful sources of support:

OCD Action – www.ocdaction.org.uk. The national OCD charity, run by people with experience of OCD TOP UK – www.topuk.org The OCD and Phobia charity.

Health sUnlocked OCD forum

Other contacts for help with OCD can be found on our Mental Health Glossary on pages 22-25. www.mhap.co.uk

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Local Community Focus

Mind in North Kent North Kent North Kent Mind The Almshouses, 20 West Hill, Dartford, Kent DA1 2EP General Office: 01322 291380 www.northkentmind.co.uk North Kent Mind (formerly Dartford, Gravesham and Swanley Mind) is an independent mental health charity operating in North Kent. We provide a wide range of services for people who experience mental health problems, whether these are described as anxiety, depression, bipolar, schizophrenia, OCD (Obsessive Compulsive Disorder), Personality Disorder, or otherwise.

We work with people individually or in small or large groups.

Our services include supported housing, low cost counselling, agoraphobic support, activity sessions, springboard, social groups, person centred planning, self-management courses, peer-led activities and open sessions. We work closely with other local organisations, where this is the best way of achieving our aims, and are supported in our work by paid staff, trained volunteers, and student social workers and trainee mental health nurses on placement.

In North Kent Mind we are committed to continuously improve our services through quality review and services users feedback.

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An Overview of Our Services We are proud of the range of services we deliver, which have been created in the knowledge that different people require different forms of support through their journey to recovery, and that there is no “one size fits all” in the world of mental health and emotional distress.

The four main strands of our work are: 1 Talking Therapies on the NHS 2 Supported Housing 3 Fee-Paying Services Low–cost Counselling Service.

Anger Management Course.

4 Wellbeing Services Open Sessions/Activity Sessions Springboard Services Short Courses Coping With Life Courses Mindfulness Course Drama Course Support Groups Time for Change Group Recovery Group Stand-Alone Activities Computer Group Agoraphobia Service Other Services

to advertise in the next issue of Mental Health Awareness call: 01375 402 546

Local Community Focus

North Kent

Aims and Objectives Our Vision: We won’t give up until everyone experiencing a mental health problem gets both support and respect.

Our Mission: To work in partnership with people on their journey to recovery.

We try to help people to: Stay Well Increase their self-confidence and self-esteem Move through their mental health issues on the road to recovery Be empowered to make informed choices about how they live and recover Develop their skills for self-help and mutual support Increase their awareness and understanding of mental health Participate fully in society Influence the way mental health services are planned and delivered.

Campaign in response to local and

national concerns

Provide mental health education Develop our work in response to

changing needs.

Our values: As part of the Mind network we have the following values: Open: We reach out to anyone who needs us Together: We’re stronger in partnerships Responsive: We listen, we act Independent: We speak out fearlessly Unstoppable: We never give up.

To do this we: Provide direct services including supported housing, a wide range of community services (in groups or individually), low-cost counselling and other fee-paying services, and talking therapies on the NHS www.mhap.co.uk

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Counselling Counselling is a talking therapy that involves a trained therapist listening to you and helping you find ways to deal with emotional issues.

Sometimes the term “counselling” is used to refer to talking therapies in general, but counselling is also a type of therapy in its own right.

What can counselling help with?

Counselling can help you cope with:

a mental health condition, such as depression, anxiety or an eating disorder

an upsetting physical health condition, such as infertility

a difficult life event, such as a bereavement, a

relationship breakdown or work-related stress

difficult emotions – for example, low self-esteem or anger

other issues, such as sexual identity

What to expect from counselling Counselling can take place either face to face, in a group, over the phone, by email or online through live chat services During your appointment, you’ll be encouraged to talk about your feelings and emotions with a trained therapist, who’ll listen and support you without judging or criticising. The therapist can help you gain a better understanding of your feelings and thought processes, and find your own solutions to problems.

You may be offered a single session of counselling, a short course of sessions over a few weeks or months, or a longer course that lasts for several months or years. It can take a number of sessions before you start to see progress, but you should gradually start to feel better with the help and support of your therapist.

Where to source Counselling You can get free psychological therapies, including counselling for depression, on the NHS.

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You don’t need a referral from your GP and you can refer yourself directly to a psychological therapies service.

If you decide to pay to see a private therapist, make sure they’re professionally qualified and you feel comfortable with them. Many private therapists offer an initial free session and lower rates for students, job seekers and those on low wages. You should ask about charges and agree a price before starting a course of counselling.

Some charities and voluntary organisations also offer counselling. You don’t need a referral from your GP for an appointment for these services, but you may have to pay a fee to cover the cost of your sessions.

Charities that may offer counselling include:

Cruse Bereavement Care – for bereavement advice and support

Rape Crisis England and Wales –

for women and girls who have been raped or sexually abused Relate – for relationship advice and counselling Samaritans – for people to talk about whatever’s troubling them at any time

Victim Support – for victims and

witnesses of crime You may also be able to access support groups through your local community, church or social services.

to advertise in the next issue of Mental Health Awareness call: 01375 402 546

Help for Suicidal Thoughts Suicide is when someone purposely ends their own life. This section looks at why someone might think about suicide and how you can help them. People might think about suicide for different reasons. There’s no right or wrong way to talk about suicidal feelings – starting the conversation is what’s important.

If you are worried that someone may be thinking about suicide, talk to them. Ask them about how they are feeling and offer to help.

Talking to someone about their suicidal thoughts does not make them more likely to end their life.

You can help someone who is feeling suicidal by listening to them without judging them and trying to help them think about other options.

Helping someone with suicidal thoughts is likely to have a big impact on you. Find out what support is available to you. If someone does try to end their life, this is not your fault.

If you’re feeling like you want to die, it’s important to tell someone Help is available right now if you need it. You don’t have to struggle with difficult feelings alone. Talk to someone you trust. Let family or friends know what’s going on. They may be able to offer support and help keep you safe.

Alternatively, you could call your GP and ask for an emergency appointment or call 111 out of hours – they will help you find the support and help you need. You could also contact your mental health crisis team.

Important is your life in danger?

If you have seriously harmed yourself – for example, by taking a drug overdose – call 999 for an ambulance or go straight to A&E or ask someone else to call 999 or take you to A&E.

Phone a helpline These free helplines are there to help when you’re feeling down or desperate. Unless it says otherwise, they’re open 24 hours a day, every day.

Samaritans – for everyone Call 116 123 Email jo@samaritans.org

Campaign Against Living Miserably (CALM) – for men Call 0800 58 58 58 – 5pm to midnight every day Visit the webchat page

Papyrus – for people under 35 Call 0800 068 41 41 – Mon to Friday 10am to 10pm, weekends 2pm to 10pm Text 07786 209697 Email pat@papyrus-uk.org

Childline – for children and young people under 19 Call 0800 1111 – the number won’t show up on your phone bill

The Silver Line – for older people Call 0800 470 80 90 www.mhap.co.uk

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Local Community Focus

Kent and Medway

NHS and Social Care Partnership Trust Dartford Gravesham and Swanley Community Mental Health Team Dartford Gravesham and Swanley (DGS) Community Mental Health team provides support and treatment in the community to those between the ages of 18-65 who are experiencing a mental illness.

We provide assessment of their current need and treatment for service users with moderate to severe mental health needs.

The team includes psychiatrists, community mental health nurses, occupational therapists, psychological

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services and support staff. We also work in partnership with social care.

Social workers provide assessment under the Care Act 2014 and work with service users who have social care eligibility.

Contact Information Arndale House, 18-20 Spital Street Dartford, Kent DA1 2DL Tel: 01322 622230

Opening Times Monday-Friday from 9am-5pm

Key Contacts Sarah Rodger-Smith - Service Manager Prof. Soliman - Consultant Dr Osoba - Consultant Dr Muthurveeran - Consultant

Referrals We accept referrals from: Your GP Healthcare professionals

to advertise in the next issue of Mental Health Awareness call: 01375 402 546

Live it Library One in four adults will be affected by mental ill health in their lifetime and one in 10 young people will be affected in theirs.

Statistically, this means you or someone you know will experience a mental health condition at some point in life.

While mental health conditions are widespread, severe cases are generally concentrated among a relatively small proportion of people and some of these will experience more than one condition at a time.

Most people feel uncomfortable talking about their mental health condition and this isn’t surprising, considering nine out of 10 people affected by mental ill health still experience stigma and discrimination.

The most commonly diagnosed mental health conditions in the UK are Depression, anxiety, Obsessive compulsive disorder (OCD), Bipolar disorder, Schizophrenia, Personality disorders and Eating disorders.

The Live It Library is an online resource containing a number of stories from people who have lived experience of mental ill health, carers, friends or relatives and mental health professionals. Join us and speak honestly about your experience.

You can also share the stories in the library to help others while challenging stigma, promoting understanding, and offering hope.

The Live it Library stories will become part of a Kent and Medway wide resource that allows individuals, professionals and groups to easily access the ‘stories’ and it is hoped that our story tellers can become involved in training and events to talk about their stories and experiences.

If you have already shared your story, why not consider volunteering at a future event.

If you are interested, register to become a trust volunteer by contacting us. https://www.kmpt.nhs.uk/informationand-advice/live-it-library/

Proud to support Mental Health Awareness

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www.introland.co.uk access@introland.co.uk

01322 339595

This could be you please call Ricky on 01375 402546 www.mhap.co.uk

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Advice on how to start a difficult conversation if you’re worried about someone else.

If you’re worried about someone try to get them to talk to you: Often people want to talk, but wait until someone asks how they are. Try asking open questions, like ‘What happened about...’, ‘Tell me about...’, ‘How do you feel about...’

Don’t worry about having the answers.

Just listening to what someone has to say and taking it seriously can be more helpful.

Repeat back what they say to show you understand, and ask more questions.

Focus on your friend’s feelings instead of trying to solve the problem - it can be of more help and shows you care.

Respect what they tell you. Sometimes it’s easy to want to try and fix a person’s problems, or give them advice. Let them make their own decisions.

How do I start a conversation with someone I’m concerned about?

You might feel that you don’t know how to help someone, because you don’t know what to tell them or how to solve their problems. You don’t need to be an expert. In fact, sometimes people who think they have the answers to a problem are less helpful. Don’t forget that every person is different, so that what worked for one will not always work for another.

Find a good time and place Think about where and when to have the conversation before you start. Choose somewhere where the other person feels comfortable and has time to talk.

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Ask gentle questions and listen with care You might feel that you don’t know how to help someone, because you don’t know what to tell them. But you shouldn’t tell them anything.

Telling doesn’t help.

The best way to help is to ask questions.

That way you leave the other person in control.

By asking questions, the person you are talking with finds his or her own answers.

The more open the question the better Questions that help someone talk through their problems instead of saying ‘yes’ or ‘no’ are the most useful. Questions like:

When – ‘When did you realise?’

Where – ‘Where did that happen?’

What – ‘What else happened?’

How – ‘How did that feel?’

Why – be careful with this one as it can make someone defensive. ‘What made you choose that’ or ‘What were you thinking about at the time’ are more effective.

Find out how they feel Don’t forget to ask how this person is feeling.

Sometimes people will talk you through all the facts of what happened, why it happened and what actions they are thinking of taking, but never say how they actually feel.

to advertise in the next issue of Mental Health Awareness call: 01375 402 546

Revealing your innermost emotions - anger, sadness, fear, hope, jealously, despair and so on – can be a huge relief. It sometimes also gives clues about what the person is really most worried about.

Check they know where to get help If someone has been feeling low for some time it is probably a good idea that they get some support, whether it is through talking to someone like a counsellor or getting some practical help.

Useful questions you might ask them include: ‘Have you talked to anyone else about this?’

‘Would you like to get some help?’

‘Would you like me to come with you?’

Or, for someone who is reluctant to get help:

‘Do you have someone you trust you can go to?’

‘If it helps, you can talk to me any time.’

You can also suggest to your friend that the following sources of help may be useful: Samaritans (by phone on 116 123 or email jo@samaritans.org.

Befrienders Worldwide includes a directory of emotional support helplines around the world.

NHS 111 offers health advice in the UK and is free from landlines and mobiles.

Respect what they tell you, don’t pressure them If they don’t want help, don’t push them.

Sometimes it’s easy to want to try and fix a person’s problems, or give them advice.

It’s usually better for people to make their own decisions. Help them think of all the options, but leave the choice to them. Being there for them in other ways, like through socialising or helping with practical things, can also be a great source of support.

If you say the wrong thing, don’t panic There is no perfect way to handle a difficult conversation, so don’t be too hard on yourself if it didn’t go as well as you had hoped. If you feel able to, put things right: “Last week I said … and I realise now that was insensitive so I’m sorry. What I meant to say was …”

Show you understand Ask follow-up questions and repeat back the key things your friend has told you, using phrases like ‘So you’re saying…’, ‘So you think…’.

Look after yourself, and talk to someone too Hearing someone else’s worries or problems can affect you too. Take time for yourself to do the things you enjoy, and if you need to talk, find somebody you trust to confide in.

Be careful not to make promises to people you may not be able to keep; this could relate to someone telling you they are experiencing abuse.

Don’t take on so much of other peoples’ problems that you yourself start feeling depressed.

www.mhap.co.uk

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Insomnia Most people experience problems with sleep at some time in their life, but Insomnia means you regularly have problems sleeping. In fact, it’s thought that a third of Brits will have episodes of insomnia at some point. Symptoms can last for months, sometimes years.

How much sleep you need Everyone needs different amounts of sleep.

On average we need: Adults – 7 to 9 hours Children – 9 to 13 hours Toddlers & babies – 12 to 17 hours

Symptoms of Insomnia You have insomnia if you regularly:

find it hard to go to sleep wake up several times during the night lie awake at night wake up early and can’t go back to sleep still feel tired after waking up find it hard to nap during the day even though you’re tired feel tired and irritable during the day find it difficult to concentrate during the day because you’re tired

What causes insomnia?

The causes can include physical conditions, psychological conditions (such as depression or anxiety) or a combination of both. The most common causes are: stress, anxiety or depression noise, a room that’s too hot or cold, uncomfortable beds, alcohol, caffeine or nicotine, recreational drugs like cocaine or ecstasy, jet lag, shift work illnesses.

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Treating Insomnia yourself Insomnia usually gets better by changing your sleeping habits.

Do go to bed and wake up at the same time every day – only go to bed when you feel tired relax at least 1 hour before bed make sure your bedroom is dark & quiet – use thick curtains, an eye mask or ear plugs exercise regularly during the day make sure your mattress, pillows and covers are comfortable Don’t smoke, or drink alcohol, tea or coffee at least 6 hours before going to bed eat a big meal late at night exercise at least 4 hours before bed watch television or use devices right before going to bed nap during the day sleep in after a bad night’s sleep – stick to your regular sleeping hours instead

to advertise in the next issue of Mental Health Awareness call: 01375 402 546

UNISON DARTFORD & GRAVESHAM NHS BRANCH OFFICERS

MARCIA MING (NEE WEST) BRANCH SECRETARY, STEWARD SENIOR PHARMACY TECHNICIAN, PHARMACY Phone: 01322 42 8522 Email: marcia.west@nhs.net

MICHELLE PALMER ASSISTANT BRANCH SECRETARY, HEALTH & SAFETY OFFICER, STEWARD RECEPTIONIST, DAY CARE UNIT Phone: 01322 428266 Email:michelle.palmer9@nhs.net

GARY MEARS BRANCH CHAIR, HEALTH & SAFETY OFFICER, STEWARD HOSPITAL PORTERS, SERCO Phone: 07939957806 Email: g.meares9566@btinternet.com