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July 18, 2022 by BHP Leave a Comment

Why do people get the birthday blues?

Birthdays are generally depicted in the media as happy events that should be celebrated. However, for no small number of people birthdays can be complicated and evoke difficult feelings such as sadness, listlessness and even feelings of depression. Why is this?

The ‘birthday blues’ is a term used to capture the range of difficult emotions that some people experience around birthdays. They often come on in the lead up to a birthday, peaking on the actual day and then quickly dissipating, at times with a sense of relief.

There is no single clinical reason why people may feel down or depressed on their birthday and nor is it a pathology but rather a combination of association and arguably somatic memory. Let me explain.

Whilst we all have seen images heard stories or seen films depicting ‘the perfect birthday’ for children, for most of us this was not the case, but overall we enjoyed the day because we were allowed to celebrate it with those we love. However in many cases this simply is not so. For example, for children of divorced parents birthdays can be difficult as the loss of one of the parents may be highlighted on that ‘special day’. As a clinician this is something I encounter often with clients whose parents divorced acrimoniously – they wanted nothing more than to spend the day with both parents but can’t. Worse still I have encountered stories whereby my clients as children had to choose between their parents as to with whom they were going to spend their birthday. The outcome was that birthdays become something to dread rather than eagerly anticipate.

So, birthdays can represent a marker date (not dissimilar to Christmas) – a reminder – of a painful event which is compounded by the societal expectation of how a person should feel. This creates an internal conflict between the felt reality and how that person actually feels, which exacerbates the problem and can lead to symptoms of depression.

Why are birthdays so important to so many people?

Human beings are defined by time. We did not invent it as it passes whether we are aware of it or not, however, we structure our lives around time and use it not only as an important guide in terms of the passing of the seasons but also in measuring our time on this earth.

Birthdays are seen as something to celebrate as an achievement which may seem somewhat arbitrary in the modern world, however in a world in which infant mortality was rampant and few people lived beyond their forties – which constituted much of human existence – there was arguably much to celebrate in living another year.

However, I believe that there is something else that sits beneath this explanation that operates on an unconscious level and that is how birthdays represent an overcoming of death. It could be argued that becoming yet another year older is nothing to have a party about – especially once we have passed our youth. Birthdays mark the passage of time and bring us ever closer to death – something us humans have a hard time dealing with. So by marking birthdays and celebrating them, we are perhaps avoiding contemplating our mortality. They function in part as a form of
death denial.

Like the actual new year, birthdays are psychologically and thus symbolically representative of an opportunity for renewal – we can put the bad or mediocre of the past year behind us and start another year with good intentions. Sadly, like new year’s resolutions, little generally changes following birthdays as we take our old selves with us into the ‘new year’.

Is there any physical reason why people would feel differently on their birthday?

From a medical perspective, there is no reason why anyone would feel differently on their birthday, however, as noted earlier, birthdays can evoke powerful memories that may be pleasant, difficult, or a combination of both.

We know from neuroscientist and Professor of Psychiatry Steven Porges’ work on Polyvagal Theory that our neural network extends to our gut and that we receive significantly more ‘data’ from our gut to our brain via the vagal nerve than the other way around. It therefore stands to reason that where we have powerful memories associated with a significant date, that we will feel and possibly experience those memories in our body too. How may these manifest?

Some people may feel lethargic or achy and others may have headaches or migraines in lieu of experiencing the actual feelings – and this is particularly likely in cases where there is a conflict between how the person feels, and how they believe they should feel based on social or family expectations.

How can people start to think differently about their birthday?

When I was a trainee psychotherapist, one of my tutors would say ‘if you feel stuck with a client, find the feeling’. Ultimately psychotherapy is about grieving – what clients grieve will vary, but they are coming to grieve whether they know it or not.

If birthdays have in the past been difficult and remain so in the present then there is something that has not been grieved. For example, where a client began to dislike their birthday or even dread it due to a family event such as parental divorce, and that feeling repeats in their adult life, then I would suggest that there are feelings relating to that loss of the parental unit that remain unresolved. Once these have been worked through, birthdays will be ‘freed up’ so a different meaning and set of memories can be ascribed to them.

So, the first step is in grieving whatever needs to be grieved and then the second step is in recognising that a birthday is largely symbolic and that as an adult we can take control of them and take responsibility for creating of them what we wish. The latter is critically important as it may be that one person’s idea of a ‘good’ birthday is a full-on bash with friends whilst another is a quiet walk in the woods. Both are equally valid.

Are birthdays as important as people think?

Human beings are symbolic and are unique (as far as we know) in world of mammals in that we are the only creatures that inhabit a symbolic world. The majority of what we do, create and celebrate has no pragmatic purpose, however that does not mean that it is not important.

The symbolic is the basic fabric of culture and we all subscribe to a culture, as it is through culture that we gain our sense of belonging and self esteem. Culture (whichever one you happen to belong to) gives us three fundamental stories which enable us to cope with death anxiety according to psychoanalyst Otto Rank, who was one of Freud’s acolytes – culture tells us where we came from, how to behave whilst we are alive and lastly, it tells us what happens to us when we die. Without culture, we have very little.

Birthdays are symbolic and embedded in culture thus they are important in us being a part of the world in which we live. However, particularly in Western Culture where we subscribe to individualism, we are free to create of our birthday whatever we wish.

I would therefore suggest that birthdays are important as all cultural markers are important, however, that does not mean that we should be indentured to them.

Are the birthday blues real?

Anything that a person feels is real, as it is their felt experience. This does not mean, however, that that feeling or set of feelings belong in the present. Nor does it mean that the ‘birthday blues’ are a pathology but rather a term that helps us makes sense of what someone may be experiencing.

If people are habitually getting the ‘birthday blues’ which is a set of difficult feelings akin to depression, then something from the past has got ‘stuck’ and is repeating as an experience each year.

A psychotherapist would work with you to uncover what it is that brings on these ‘blues’ around the time of your birthday and to work with you to resolve the underlying grief or address what it is in your appetite for life that is being suppressed.

Can birthday blues ever be a good thing?

Whilst it may seem counter-intuitive, it can be helpful to be curious about how we really feel around our birthday and to work out whether those feelings are perhaps telling us something important.

It’s no secret that in my profession the peak time for couple’s therapy enquiries is in early January (the same is true of a family solicitor friend of mine). This I believe is in no small part to the pressures of family Christmas being combined with a new year and a desire for new beginnings.

Birthday blues can also be a sign that something in a person’s life needs addressing and perhaps changing. Birthdays are a reminder of the passage of time and can increase feelings of anxiety when deep down a person knows they are not really living the life they want to.

If we can be curious about them, birthday blues can tell us important information about what we may want or what is missing from our life. And if you can’t make sense of it, it can be really helpful to talk to a psychotherapist who can help you unpick what the blues might mean – whether that is a loss that needs to be grieved or an appetite that needs to be expressed.

 

Mark Vahrmeyer, UKCP Registered, BHP Co-founder is an integrative psychotherapist with a wide range of clinical experience from both the public and private sectors. He currently sees both individuals and couples, primarily for ongoing psychotherapy.  Mark is available at the Lewes and Brighton & Hove Practices.

 

Further reading by Mark Vahrmeyer

Are people with mental health problems violent?

Mental health problems in Brighton

The limitations of online therapy

Pornography and the Online Safety Bill

Does the sex of my counsellor or psychotherapist matter?

Filed Under: Ageing, Mark Vahrmeyer, Society Tagged With: Birthdays, Culture, society

March 7, 2022 by BHP Leave a Comment

Thinking about the menopause in energetic terms

I often have women clients who are going through the peri-menopause or who are post-menopause and I am curious about how I might better support them therapeutically. I want to share some thoughts from a recent talk by Joanna Groves where she invited us to think about the peri- and post-menopause in more practical and energetic terms. The menopause is defined by 12 months without menstruation; on average this happens at 51 years old. The peri-menopause, the period when the sex hormones are reducing, can start from the late thirties to mid-forties and the symptoms can last for 4 or more years after the menopause.

Groves asked us to pay attention to the pressure of trying to maintain ‘normal’ life during a time of physiological and psychological change and to take seriously the stress this places on women’s physical and mental health. She outlines the physiological and psychological changes that occur during the peri-and post-menopause. There are common physiological symptoms including heart palpitations, sweating, sleep problems and fatigue, these are often accompanied by other changes such as food intolerances and sensitivity to alcohol. Along with anxiety and depression there are other psychological symptoms such as memory and concentration problems, confusion and a loss of confidence and self-esteem. The pressure to maintain work, family responsibilities and a relationship and manage everyday crises can become overwhelming, like trying to stop a burst pipe with a teacup and one hand tied behind your back.

The ‘fight, flight or freeze’ response is caused by Cortisol, the stress hormone. Cortisol is produced and managed by the adrenal glands and is a survival response, an alarm reaction to threat or danger. In contemporary life we’re not at risk from predators but we need cortisol to help us deal with an emergency or carry on under pressure. Cortisol helps us keep going partly by repressing non-essential functions such as digestion and the immune and reproductive systems. When the crisis is over or the pressure reduces cortisol levels drop and the body returns to equilibrium. But what if the pressure is continuous and we are in constant crisis? Eventually the adrenals become exhausted and we become energetically depleted, this can result in anxiety, depression, headaches, difficulties sleeping, digestive problems and burn out.

If all that wasn’t enough to contend with. Groves suggests that during the peri-and post-menopause as our emotional resilience reduces; we no longer have the energy to keep difficult emotional experiences supressed. Buried feelings of grief, loss and shame can re-emerge and memories of trauma can resurface. Long established relationships are examined and sometimes break up. What felt safe and secure no longer feels so and this can feel like a kind of madness.

Groves’ advice is to acknowledge that this time is a process of transition that will eventually lead to a new stage of life, a kind of post-menopausal rebirth with renewed energy. She highlights ways to reduce stress and conserve resources during this transition.

One key message from Groves is that ‘energy follows attention’ i.e. what we focus on consumes or generates energy. She invites us to reflect on this through several different aspects:

  • The importance of getting enough rest and sleep, this might mean delegating some responsibilities, reducing working hours and includes sensory rest such as time without a phone.
  • The physical benefits of movement and keeping mobile through activities like walking, stretching, swimming and gardening; movement creates energy.
  • Gut health and nutrition are two aspects that may need adapting, for example reducing the consumption of sugar and alcohol.
  • Relationships and friendships, it helps to prioritise friendships that sustain and nourish and to limit those that are draining. Family and romantic relationships can come under scrutiny and may be revived or changed irrevocably.
  • Finally Groves emphasises (self) compassion, this might include physical and/or holistic treatments, new creative experiences, practices such as meditation and psychotherapeutic support.

At the same time as outlining these practical approaches, Groves acknowledges that in a culture driven by productivity and achievement attempts to cut down responsibilities and become less productive may feel like ‘weakness’ or ‘failure’. Women in my practice have asked – if I can’t do what I used to do what am I good for – and said – I feel worthless like there is no place for me.

On a more positive note Groves identifies a paradigm shift around the menopause. It is not just women that go through this transition but those who accompany them, friends, colleagues, parents and especially partners and children. Hopefully by welcoming a wider range of experiences including accounts from transgender women we might develop ways to support and improve life transitions for us all. Meanwhile, as therapists we can offer a conversation to help understand and contextualise what is happening to those who find themselves at the centre of this particular life transition.

 

To enquire about psychotherapy sessions with Angela Rogers, please contact her here, or to view our full clinical team, please click here.

Angela Rogers is an Integrative Psychotherapeutic counsellor working with individuals and couples in Hove.

 

Further reading by Angela Rogers –

Poetry: A space to ponder

Relax: Watching people using their hands

What is Andropause and what happens to men when their testosterone levels decline?

Am I cracking up or is it my hormones? Pre-menstrual Dysphoric and the importance of tracking symptoms

Viagra for women? Medical treatment for women’s sexual problems focuses on the brain rather than the genitals

Filed Under: Ageing, Angela Rogers, Relationships Tagged With: Ageing, anxiety, Menopause

October 18, 2021 by BHP Leave a Comment

What is the Menopause? (part two)

The historian Susan Mattern argues there is no doubt there is some value to naming menopause as a concept. It has provided women with reasons and different perspectives and interventions on what can be sometimes very distressing symptoms. However she points out that modern medicine can have a tendency to locate cause and explanation inside the body vs society and environment.

Mattern writes – “for most of human history, people have seen menopause for what, as I argue, it really is: a developmental transition to an important stage of life; not a problem, but a solution”  (2019, P. 6).

Mattern holds a space for the menopause (what she depicts as a post-reproductive period) as a significant life stage and essential for human flourishing. She argues that for much of human history menopause was not really considered a problem to be treated, and where it was considered it rarely had such negative connotations as it does today. She argues that for many this transition in life can be one of vigour and expansiveness. She uses the metaphor in the title of her book ‘The slow moon climbs’ as aligned with this phase of life.

In terms of historical and cultural meanings and understandings it does seem that our ideas around women’s experiences of menopause has definitely shifted over time. According to Mattern (2019) it is only in the modern era we have considered and discussed the menopause as a syndrome in need of medicalisation. She explores the influence of culture in the experience of menopause today and how the medicalisation of women’s menopausal experiences emerged.

Her book traces a plethora of historical aspects including evolutionary, philosophical, psychological and cultural understandings around the menopause and how meanings have changed.  She gives insight about evolutionary theories of menopause, the role it has played in human society and strategies around reproduction and more general aspects of human society. She also dives into how modernisation has altered our experiences and notions of menopause quite dramatically. In my opinion it is a book packed with fantastic information and well worth a read if you are curious.

There are many aspects in both peri-menopause and menopause that can greatly impact our lived experience. This does not always have to feel detrimental. In some of my research many women have found it a liberating sexual experience whilst also struggling with some aspects. Often there are many different factors and impacts within the menopausal experience: physical, psychological, social, sexual, political, cultural and spiritual. Frequently they can feel like they are in conflict.  Not knowing whether you should treat it medically or not can leave us at best feeling confused, at worst it can sometimes disrupt our whole lives in terms of its effect on personal relationships and work dimensions.

Whatever route you choose and whether you want to seek medical support, psychological support or just better understand the transition through your own enquiries, therapy can be a space to do this. I feel many transitional experiences can be incredibly meaningful and transformative despite the challenges they might bring. It can invite us to explore, challenge and question our beliefs and expectations and change how we feel, think and relate to ourselves and the world.

To enquire about psychotherapy sessions with Susanna, please contact her here, or to view our full clinical team, please click here.

Susanna Petitpierre, BACP Registered, is an experienced psychotherapeutic counsellor, providing long and short term counselling. Her approach is primarily grounded in existential therapy and she works with individuals.  Susanna is available at our Brighton and Hove Practice.

Further reading by Susanna Petitpierre

What is the Menopause? (part two)

What is the menopause? (part one)

Some existential musings from the sea

Nietzsche and the body

Why read Nietzsche?

Reference – 
Mattern, S. (2019 ’The Slow Moon Climbs’ The Science and History, and Meaning of Menopause. Princeton University Press: Princeton & Oxford.
 (Book tracing historical and cultural understandings of this life stage.

Filed Under: Ageing, Society, Susanna Petitpierre Tagged With: age, Ageing, female health, Menopause

October 4, 2021 by BHP Leave a Comment

What is the Menopause? (part one)

I found myself being asked ‘what is the menopause?’ by a friend’s 13 year old son a few weeks ago. All the women in the room chimed in to answer. It was not surprising to me that he asked, nor was it surprising all the women answered. Interestingly I had no idea about the menopause at his age and I had absolutely no clue about peri-menopause until I was in my mid 30s. However, I found myself wondering how much louder the conversation seemingly is right now than when I was his age.

It does seem that the terms menopause and peri-menopause have become widely discussed in the media and medical world recently. In my experience, this does not always translate to it being more understood. It can be incredibly helpful to know discussions are happening as this can normalise the experience, conversely it can leave us feeling more adrift, especially if we find we are not fitting into any standardised categories or stories.

It led to me writing two short pieces (part two will be published at a later date). Both aim to provide a little portion of food for thought about the concept and possible options for personal explorations around the menopause. In my mind, there is no right or wrong way to consider or act in terms of the menopause, it is whatever feels right for the individual.

Medically the menopause is depicted as the final menstrual period (FMP). This is confirmed after one year of menstrual period. Typically it occurs around 51 years old, however UK statistics show this can vary between 44 and 55 years. One in 100 women can experience menopause before the age of 40 (often due to medical interventions).   The peri-menopause is a term used to depict another transition stage before the menopause whereby the ovaries start to make less oestrogen. This typically starts around 40 and can last between four and eight years.

Some people assume the menopause is a medical problem and prefer to manage it with drugs. Medical interventions can be a very positive experience. However, for others this is not always possible or perhaps how they want to relate to this life stage.

Some feel it is best to be with the experience, whilst others want to use alternative routes. Some might see it as an opportunity to face up to changes in their life span and ageing processes and some might not see it as a problem all all.

Whatever your choice or position there are some brilliant options, discussions and spaces which can support women going through these transformations (see some options in the links below).

I feel it is definitely worth exploring all the options and finding out what feels right for you. Therapy might be a space to do this. For me, it is also important to consider that we cannot always place the responsibility on the individual and it is worth considering how history and culture has impacted the medicalisation of these transitions and consequently how and what we think, feel and experience in terms of this life stage. If you are interested in this then you might want to read part two.

To enquire about psychotherapy sessions with Susanna, please contact her here, or to view our full clinical team, please click here.

Susanna Petitpierre, BACP Registered, is an experienced psychotherapeutic counsellor, providing long and short term counselling. Her approach is primarily grounded in existential therapy and she works with individuals.  Susanna is available at our Brighton and Hove Practice.

 

Further reading by Susanna Petitpierre

Some existential musings from the sea

Nietzsche and the body

Why read Nietzsche?

Magnificent Monsters

Death Anxiety

Potentially useful resources:
https://balance-app.com (menopause experience tracking support app)
www.menopausematters.co.uk
www.rockmymenopause.com
The menopause charity.org
https://www.menopausedoctor.co.uk
https://www.menopausecafe.net
https://www.mamaheaven.org/menoheaven-retreats

Filed Under: Ageing, Society, Susanna Petitpierre Tagged With: Ageing, female health, Menopause

September 13, 2021 by BHP Leave a Comment

The Passage of Time

Being human means living with the knowledge that we will one day die and that those we love will die too. As mortal beings we are the children of time and none of us are spared its reckoning. Time makes playthings of us all and we are powerless in its passage. A healer it may be but ultimately we do not escape the fatal wound inflicted upon us by time’s passing hours and minutes. There is no cure for time and this is the difficult truth that we must all live with. Religion and philosophy offer sustenance in the form of faith and knowledge. Science and medicine continually develop to improve our life expectancy but time flows relentlessly on…. we may transfigure time we cannot deny or destroy it.

Me, myself and I

Our mind shapes every experience we have, it is our greatest asset and our greatest tormentor. We spend most of our time literally lost in thought and when we are lost in thought we are by implication elsewhere and not in the present moment/reality (psychosis by another measure). It has long been understood in many contemplative traditions that being distracted by thought is the fundamental source of human suffering. It is not so much that our thoughts themselves are problematic but rather the way in which we identify with them. It is hard to truly recognise just how distracted we are and how much of the time, thoughts bond with feelings and feelings reinforce thoughts, both drag us from the present moment and hold us hostage to time…time which ticks on regardless, immune to our suffering.

“There’s a crack in everything, that’s how the light gets in”

Occasionally a crack opens up in time (or at least that might be a way of putting it) in which we have an experience akin to non time or timelessness. What characterises these moments is an experience of merger, probably best expressed through paradox and poetic imagery, as in Leonard Cohen’s evocative lyric. Love is one of these experiences. Love helps us look death in the face. Beyond pleasure and pain (and it is both) love is intensity. It cannot vanquish death but it makes it an integral part of life. Love cannot protect or preserve us from the risks inherent in living, no love ultimately escapes the ravages of time, age and ill health. Wherever there is rapture there will be rupture and like all the great creations of human kind, love is twofold, both joy and sorrow, an instant and an eternity.

Doorways

In order to become less identified with the tyranny of our thoughts and the drama of our own lives we might well be advised to consider cultivating new disciplines of attention. How might we allow for a crack in our convictions and cognitions such that a light may shine through? A sure fire way of busting through the doors of perception would be to ingest a powerful dose of a psychedelic substance such as psilocybin. For better or worse in such a state we would have a different experience of time and space, and a sense of total immersion in the present moment. (It goes without saying that if such an experience were to be truly useful the set and setting would be of fundamental importance.) Such an experience might shine a powerful light on the mind’s potential, far from that which might be available during the course of normal waking consciousness. However, a Peak experience is exactly that, fleeting in its nature and as such not coincident with everyday waking life (which presumably must go on). Meditation offers another potential way of breaking the spell of identification with thought and the persistent cycle of rumination and reactivity that so many of us are caught in so much of the time. Cultivating awareness via one intentional discipline or another seems, on balance, a useful proposition. A psychotherapeutic dialogue can be of significant value in helping to ground and integrate new insights and awareness into our everyday lives.

 

To enquire about psychotherapy sessions with Gerry Gilmartin, please contact her here, or to view our full clinical team, please click here.

 

Gerry Gilmartin is an accredited, registered and experienced psychotherapeutic counsellor. She currently works with individuals (young people/adults) and couples in private practice. Gerry is available at our Brighton and Hove Practice.

 

Further reading by Gerry Gilmartin

Intimacy: pillars and obstacles

Love and Family

Understanding sexual fantasy

Fear and hope in the time of Covid

Relationships, networks and connections

Filed Under: Ageing, Gerry Gilmartin, Society Tagged With: bereavement, life changing, passage of time

October 5, 2020 by BHP Leave a Comment

What is Andropause and what happens to men when their testosterone levels decline?

Schools will soon have menopause on the curriculum. Largely due to the efforts of psychotherapist Diane Danzebrink and her #MakeMenopauseMatter campaign. In 2019 Education Secretary Damian Hinds confirmed menopause will
become part of the Sex and Relationships curriculum for teenagers in the UK in Autumn 2020 alongside periods and pregnancy.

With the recognition that menopause needs to be better understood in the broader context of sex and relationships perhaps now we can begin to talk about men’s experience of changes in their hormones. Testosterone is the main sex
hormone (androgen) in men and the symptoms that men can experience as a result of reduced testosterone are called andropause. The hormone testosterone plays a role in the production of sperm, in the drive to have sex, in building muscle and bone mass, in the way fat is deposited around the body, in the facial and body hair patterns found in males and their deeper voices.

Men will experience hormonal changes as they age, levels of testosterone will start to decline from around 30 at approximately 10% every decade. It is important to note that testosterone reduction can also be affected by other
factors such as injury, cancer treatments, medication and chronic conditions including diabetes, obesity, kidney and liver disease. Symptoms include a lower sex drive, loss of body muscle and an increase in body fat, decrease in bone
density, fatigue, insomnia and difficulty attaining and maintaining erections*.

From research by the Centre for Men’s Health Clinic in Manchester, looking at men over 50 in the UK, Dr Malcolm Carruthers says: “Of the ten thousand men surveyed actually 80 per cent had moderate or high levels of symptoms suggesting they had testosterone deficiency. This shows that its not the rare condition that some doctors claim but actually its very common and almost totally untreated.”

Symptoms described by two patients attending the clinic and suffering from low testosterone, defined as Testosterone Deficiency Syndrome, share features with women’s accounts of menopause.

“Well I was 55 or there abouts and I was getting perspiration in my shirt and was getting really wet, I’m talking serious perspiration, tiredness and I had a lot of muscle aches particularly in my legs”.

“I was a fishing skipper for 23 years and was the type of person that woke up in the morning and rolled out of bed and was on the job, something to do” …  Then when I reached the age of 55 I began to feel that I was flagging and I got all sorts of strange to me symptoms, aches, pains, horrendous sweats and uncontrollable temper.”

What about the mental and emotional aspects of andropause? We need to acknowledge and better understand andropause and the impact on men and their lives and relationships. Symptoms of andropause include mood swings,
irritability, low-self esteem, memory and concentration problems and depression. These are familiar menopausal symptoms for women, however it may be harder for men to acknowledge these symptoms and to ask for help
because they are associated with female menopause.

 

Angela Rogers is an Integrative Psychotherapeutic counsellor working with individuals and couples in Hove.

 

Further reading by Angela Rogers –

Viagra for women? Medical treatment for women’s sexual problems focuses on the brain rather than the genitals

New Year’s Resolutions – Why change might be so difficult?

Viagra: Some ups and downs of the little blue pill

The Menopause – Women of a Certain Age

 

References –
Diane Danzebrink
https://twitter.com/hashtag/makemenopause

Centre for Men’s Health Clinic
Associated Press Television 11.3.2011
https://youtu.be/33aCzR4U9l4

*See an earlier blog about men’s use of Viagra here.

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Filed Under: Ageing, Angela Rogers, Relationships, Sexuality Tagged With: men's issues, Menopause, sexuality

September 14, 2020 by BHP Leave a Comment

Am I cracking up or is it my hormones? Pre-menstrual Dysphoric Disorder and the importance of tracking symptoms

It is not comfortable being told that you are feeling the way you do because of your hormones. This kind of biological reductionism is not helpful to any gender but the extremely severe symptoms of Pre-menstrual Dysphoric Disorder are completely aligned to the menstrual cycle. They manifest during the week before menstruation and end when or shortly after the start of menstruation. Like a switch going on and off.

There are a wide range of physical symptoms some not usually recognised as linked to pre-menstruation – changes in vision, heart palpitations, numbness and easy bruising – along with those that are familiar. In this post, I am concerned with the psychological symptoms.

The ones we might expect like irritability, confusion and weeping to excessive anxiety, deep depression and suicidal thoughts and feelings. It is the severity of these psychological symptoms, far more severe than normal pre-menstrual symptoms that make PMDD so disturbing and destructive.

Women suffering with PMDD can find themselves unable to cope with everyday life in the week or so leading up to their period. Ordinary tasks at home or at work can be insurmountable. Getting out of bed to dress and wash is impossible. The ‘personality changes’ put relationships under enormous duress. The sudden change in symptoms at the onset of a period is a relief but much of the next three weeks will be spent in repairing and picking up the pieces. It is not surprising that women can feel they are cracking up.

Unfortunately, many women are undiagnosed, incorrectly diagnosed and they can feel as if they are regularly in torment for a long time until their PMDD is recognised and treated. An example of misdiagnosis is a diagnosis of bipolar disorder. This is because the cyclical nature of mood swings is a feature of both conditions but it fails to recognise the correlation between emotional lability and the menstrual cycle. The predictability of the changes in thoughts and feelings is a key feature of PMDD and this raises the importance of tracking symptoms. Tracking symptoms provide information over time that may reveal a pattern, in this case, the menstrual cycle. Informed diagnosis leads to appropriate treatment, this means a woman will be treated for a severe problem with her endocrine system rather than a psychiatric illness. Sometimes it is your hormones.

 

Angela Rogers is an Integrative Psychotherapeutic counsellor working with individuals and couples in Hove.

 

Further reading by Angela Rogers –

Viagra for women? Medical treatment for women’s sexual problems focuses on the brain rather than the genitals

New Year’s Resolutions – Why change might be so difficult?

Viagra: Some ups and downs of the little blue pill

The Menopause – Women of a Certain Age

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Ageing, Angela Rogers, Gender Tagged With: hormones, menstrual, Relationships

April 27, 2020 by Brighton and Hove Psychotherapy Leave a Comment

Coronavirus Lock-Down – Physical Health vs Mental Health

As I write this blog, we are entering into the fourth week of so-called ‘lock-down’ across the UK. Despite daily speculation, nobody has any idea how long the restrictions on life will last for. 

Everything has changed and this has been hard to cope with in a society where stability and the ordinary continuity of life has been severely disrupted and curtailed; the UK population is currently in limbo, isolated from the wider community and possibly in closer physical contact with family than ever before. 

We know why we are doing this – we are reminded multiple times per day – to ‘save lives’ and ‘protect the NHS’. 

There has been much talk of the compelling priorities of the health of the nation vs the health of the economy. Arguably initially it was the later that took precedent in this country meaning we are now facing large numbers of fatalities. However, beyond the obvious economic costs of ‘lock-down’ and social distancing, the mental health impact seems to have been largely overlooked. 

Why start now? 

Despite a strong history and legacy of psychoanalysis and psychotherapy in the UK, mental health provision has long-since slipped from the forefront of policy-makers minds. Gone is the aptitude to be curious and instead a culture of symptoms has emerged increasingly oblivious to the fact that symptoms are communicating emotional and psychic distress. Depression has ceased to be seen as an inability to mourn and is instead an illness to be medicalised – as if it can be caught from the air like Coronavirus. 

So, in the midst of the pandemic, it is not surprising that any meaningful discussion on the impacts of quarantine, lock-down and social distancing will have on mental health, not to mention the ongoing rhetoric of how the socially interactive parts of our lives will be ‘changed forever’; today the WHO suggested that wearing a face-mask in public must become the long-term norm without the being any consideration to what the psychological impacts on self and others would be from such a policy. For example, where healthy development of an infant is contingent on them constantly scanning their care-givers face for reassurance and validation, what will the effect be of masking these quite literally behind a surgical mask? 

Compelling needs 

Whilst some of us may remain in denial, there is no question that social distancing is the only real means available at present to combat this pandemic. It is the oldest method in the book for dealing with epidemics and remains all we have (at present). 

However, for relational beings (which is what humans are) the strategy is psychologically and emotionally challenging (and for many catastrophic). 

Humans understand themselves and gain a sense of meaning through relationships with others. This is not a luxury – it is essential both as we develop and throughout our lives. Not only do humans needs to be able to communicate verbally, but we also require contact that is ‘non-verbal’. 

The mortality of isolation 

Isolation may keep us safe from the Coronavirus, however isolation is linked is not the cause of many mental health problems such as depression and anxiety and is fatal, particularly for the elderly (who, it would seem, are also being most impacted by Covid-19). Indeed, some studies have shown that loneliness is, indirectly, the biggest killer of the elderly. 

Virtual connections 

We live in an age where we can make use of virtual connections and video conference software to stay in touch with each other – my profession – psychotherapy – has overnight shifted to online working to ensure the continuity of therapy sessions. This is a positive, however, it will not migrate the tsunami of mental health and relationship problems that will arrive in the wake of the health crisis. 

Meaning making propositions 

For many, our daily lives, often revolving around work, provide us with a profound and anchoring sense of meaning and purpose. Not only has the ‘treadmill’ stopped, but with it much of the sense of purpose and meaning that many of us have. These two combined can be difficult to manage contributing to anxiety and depression – a literal crisis of meaning. 

Anxiety 

In the absence of meaning and purpose, and with the distractions of ‘ordinary’ life removed, anxiety can bubble up. It can leave us with a profound sense of unease and discomfort in our own skin and the wider world. And at present, it is hard to escape from. Of course, in reality anxiety can never be escaped from – it is part of us. It can, however, be faced and used to ask difficult questions about how we live our lives. 

Depression 

We are faced with a narrative from the media and politicians that ‘things will never be the same again’. I am unsure really what this means other than that it sounds like a warning or premonition of some kind. Being alive means accepting that things cannot remain the same and that we adapt. Change is hard and it forces us to be confronted with difficult emotions that many of us would rather run from. In the current climate of Covid, running from emotions has simply become harder. 

Whilst there simply cannot be a national or state managed balance between physical and mental health needs at present, this does not mean that as individuals we cannot be staying with our discomfort and asking ourselves what we ultimately want from this precarious life. 

 

Mark Vahrmeyer, UKCP Registered, BHP Co-founder is an integrative psychotherapist with a wide range of clinical experience from both the public and private sectors. He currently sees both individuals and couples, primarily for ongoing psychotherapy.  Mark is available at the Lewes and Brighton & Hove Practices.

 

Further reading by Mark Vahrmeyer –

Why psychotherapy sessions should end on time

Coronavirus Induced Mental Health Issues

Coronavirus (Covid-19) Counselling

How being ordinary is increasingly extraordinary – On the role of narcissistic defences

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Ageing, Mark Vahrmeyer, Sleep, Society, Work Tagged With: anxiety, Covid-19, Relationships

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