I first came across the idea, rather than the name, when my father announced that he hated the Autumn as it was the precursor to him feeling down over the winter months. It was only in my 30s that I started to experience the same thing. So, what exactly is SAD?

Seasonal Affective Disorder (SAD) is a type of depression. It generally happens at a specific time of year, usually during the Autumn and winter months when daylight hours are shorter and we tend to spend more time indoors. It makes sense doesn’t it. We have less exposure to natural light at this time. This can disrupt the body’s internal clock and even prevent hormones like melatonin being released at the right time. Melatonin affects our sleep and lack of sleep can impact all aspects of our life.  It is most commonly associated with the winter months, but some people may experience a form of SAD during the summer, especially if they find themselves housebound or working in a basement, for instance.

Common symptoms of SAD are:

1. Persistent sadness or low mood.
2. Loss of interest or pleasure in usual activities. You withdraw and also loose the structure and connection those activities used to bring to your life.
3. Increased fatigue and a desire to sleep more.
4. Finding it harder to get going in the morning.
5. Difficulty concentrating and making decisions, perhaps even brain fog.
6. Changes in appetite and weight, often with a craving for carbohydrates, or “stodge.”
7. Social withdrawal and irritability.
8. Feelings of hopelessness or worthlessness.
9. Physical symptoms like aches and pains.

Even if symptoms are small, such as feeling more tired than usual, they can have a knock-on effect on your life. You end up being less productive, for instance, and this impacts your self-esteem.

How to help SAD

For many people, it’s surprisingly simple and easy to feel better. Here are some ideas:

Light Therapy (Phototherapy)

Light therapy involves exposure to a bright light box that mimics natural sunlight. It can be a highly effective treatment for SAD.  I bought a simple lightbox from Amazon for under £30 and it’s been a faithful part of my office every winter for five years now. You only need a short time every morning, and it doubles as a great light for zoom calls!

Lifestyle Changes

It may sound pretty obvious but sometimes not so easy to do if you are working – get out into the daylight early in the morning. Perhaps you can adjust your working hours to start a bit later after a walk, or get off public transport or park further away and bring a walk into your daily routine. See what you can fit in lunch time too.

See people

Do not withdraw as this makes things worse. If you’re not feeling that sociable, do something where you can be around people, but perhaps not relying on talking so much, like an activity. Or, still see people, but in shorter bursts.

Vitamin D

Some people with SAD may benefit from vitamin D supplements, as they can be deficient during the darker months.

Look at your stress levels

Stress can make things worse, and winter brings its own worries. Concerns over paying energy bills, affording Christmas or even relationship issues as we spend more time together can feel hard at this time of year. Building up a menu of stress-reduction techniques like mindfulness, meditation, and deep breathing can help. Talk to a friend and build in more exercise.

Support Groups

Not for everyone, but joining a SAD support group can provide emotional support and a sense of community with others who are experiencing similar challenges. This can be useful if you are feeling isolated and lonely already.

Your GP

If you’ve tried these natural ideas, then it could be an idea to talk to your GP. In some cases, antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs), may be prescribed to alleviate symptoms.

Counselling or Psychotherapy

Working with someone like myself can help you develop coping strategies for managing SAD symptoms. If the depressed mood is bringing other things to the surface, we can work with these.

Hope

It’s important to remember that SAD is a real and treatable condition. If you’d like to talk about how I could help you, contact me here, or book in a chat here. I offer counselling in Folkestone and Hythe, as well as online therapy.

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You might think that HRT, if it can help, would be a good thing.

As a therapist, and not a doctor, it’s not something I can advise upon. There’s a lot of evidence for the arguments of both sides of the coin. So much so that it can get downright confusing. Even many GPs aren’t as informed on the subject as we would hope them to be.

Talking about Menopause

It’s great that the subject of menopause has become much more acceptable to talk about. In my mother’s day it was whispered about (“oh, she’s going through the change”). Today, it’s openly discussed on everything from in the workplace to LinkedIn. This is good. Menopause can have a huge impact on so many aspects of a woman’s life. Once confident women report suddenly asking themselves, “where did she go?” as the ballsy woman they once were fades away.

High profile celebrities like Davina McColl and Carol Vorderman have been vociferous in coming out in favour of HRT. Waterstones’ shelves heave under new titles and it’s now no longer taboo. The downside of this, however, is that there is a lot of information out there to sift through.

For those with family or personal histories of breast cancer or deep vein thrombosis, the decision whether to use HRT can be agonising. They are literally adding up risks in their heads. Read something that says it will double your risk, will naturally send alarm bells off. Fear can take over.

The decision whether to use HRT is a very personal one. Then, once you’ve committed to that road, there could be a number of iterations of different treatments to find the one that is right for you.

Deciding whether to use HRT

What I can tell you from working with clients is:

• You need to find a GP who will take you seriously and is open to HRT. Some are not
• Reading about this yourself is the only way to understand what it means for you. Take responsibility and get yourself as educated as possible
• You can still listen to friends, but think for yourself
• HRT is not an excuse to eat badly, forget to exercise or look after yourself. You need to help your HRT do the work
• This is not a decision that is set in stone. If you go on HRT, you can come off it, if you wish. Likewise, you can swap medications, increase and decrease doses, or go private and get a more bespoke service if you have the cash

Resources to help you decide whether to use HRT

Here are some sites that I have found to be excellent resources on HRT.

Balance

An excellent look at the risks and benefits in a way that is easy to understand

Liz Earle Well-Being

A beautiful site that covers not only menopause but beauty and lifestyle features for any woman at this time of life.

Menopause Matters

A friendly forum that is supportive and often knowledgeable. Don’t make any changes to your dose or make decisions on this alone. Always consult your GP or private menopause consultant first.

Physicians Committee for Responsible Medicine

Very informative if you have decided to stick with the natural route.

The NICE Guidelines

UK guidelines for GPs.

Menopausal not Mad

A pro-menopause group on Facebook. This would be more useful if you do decide to go this way, and want ideas and support approaching your GP, rather than help making a decision.

Therapy for menopause?

Many of the symptoms can also be helped through therapy, too, especially anxiety and sleep. If you’d like a no-cost chat to see if you’d like to work on them with me, contact me here

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• Parents who come home and moan about their workplace all evening but do nothing to get a new job or take action to make things better
• Those who spend too many hours working, or on their phone
• Not looking after their physical health by eating rubbish food and taking no exercise
• Losing their temper with children because they take no time out for themselves to calm down and lower their own stress and emotional arousal
• Smoking when they know it’s a bad habit they wouldn’t want their children to take up

How can we role model good mental health habits?

One useful thing that we can do for the generation/s below us, whatever our age, is to try and role model good mental health habits. When we sit in that therapy room it can be both empowering, and a little scary, to realise that everything we do impacts those around us. This is especially so if we have children or are working with younger people. Taking responsibilty for ourselves can empower others too.

What powerful things have we learned in our own lives can we share with younger people?  One way to illustrate this is by telling stories, offering advice or starting a discussion. Alternatively, we could just model these things through our own behaviour.

Examples that will positively impact our own mental health and help young people learn to do the same might be:

Setting Boundaries

These could include being firm about deadlines, when you are and are not working, things you will and will not do in your role, and what you will talk about. Explanations are the key here. Setting a hard deadline of Tuesday for a piece of work will have much more impact if you explain why it needs to be done by then – if someone else is waiting for the piece for instance. Likewise, explaining that you don’t work on weekends so that you keep that time free to wind down will help them to gain the confidence that it’s okay to value your own time and energy.

Taking time to wind down

I often hear my therapy clients tell me they know they “should be” taking exercise, meditating, walking or doing any one of a number of powerful things we all know are helpful in calming anxiety and stress levels. They often report feeling guilty and not having time. However, these things, deceptively simple as they are, are the key to managing our anger and irritability.

Why not show those around you that you care enough for them to look after yourself, and put yourself in a good place for them? They will grow up with the knowledge that looking after themsleves is okay, and that they too can take some control over their own feelings and emotions.

Being kind

Gossip is an underestimated factor in mental health. This includes both gossiping about others, as well as worrying if others are talking about you. Setting a no gossip tone helps people feel safer and more comfortable.

If someone else is struggling, a conversation about how we can all be kind to them, even thinking in practical terms, helps everyone emerge feeling much happier.

Finally, don’t forget about being kind to yourself. This includes taking time out for self-care, as well as refusing to let that inner critic take over.

Looking after yourself

You don’t have to nag about eating greens and drinking water. If young people see you eating rubbish, it’s not unlikely that they will take that as the norm. Set the bar higher, ask them how they look after themselves, and start the conversations that show them that health should be a priority. Get to bed at a decent hour, or see a therapist about your insomnia, and let them see how important sleep is.

If you’re having a hard time cutting down your smoking, talk to them about it. Let them see that stopping struggle can be a struggle…but in the end it is worth it. What story does that tell them about overcoming hard challenges? You never know, one day they may be thinking, “if mum/dad can stop smoking, then I can do this.”

Get off the phone

If we are on the phone, our attention is turned away to some virtual person or website. It is not with the people we are with. Apart from showing respect, this models good manners and highlights that you don’t need to be glued to your phone to get on. No phone rules at the diner table are a great place to start with this, as well as when you’re all sat down watching TV together.

Learn from them

Older people are not the experts in everything. I learn so much from young people, from how Bitcoin works, to why they are turning off the news for their mental health. Listening and learning from them reminds them that they too have the ability to influence others, and how powerful is that?

My one hour seminar on creating 7 habits for your mental health is ideal for young people. Please contact me here or book in a chat to discuss this for your organisation.

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Here are the reasons why you should be journalling:

• Journaling helps with anxiety. It can help you get spiralling thoughts out onto the page where you can see patterns, solutions or are just able to dismiss them.
• It helps with sleep and depression. Your mind works overtime whilst you’re asleep, using REM sleep to help dissipate any unresolved worries or emotions from the previous day. Too many of these and you will wake up tired, or ealy, or both, as your REM sleep just can’t cope. Getting those thoughts out helps you consciously process them, rather than leaving them all to be dealt with in your sleep. Waking up tired and unmotivated is one of the stages of the depression cycle, so journalling is actively helping you step out of that cycle.
• You build the habit of working on your worries. Putting things down on paper may help you see solutions you just can’t when everything is in your head. Also, you’ll inevitably get bored of wriring about the same topics every day and you’ll force yourself to do something about them
• It is especially good if you are suffering from brain fog, like many of my menopausal or long-Covid clients. Journaling helps them get their head in order, they say.
• If you fancy yourself as creative, getting everything out of your head (a brain dump!), can help make way for something more creative to start happening. In this way it’s a perfect tool to help you out of writer’s block.
• Finally, it can help you perform better in your work, as this study explains.

How to Journal Properly

Step One: decide on when

Writer Julia Cameron calls journalling Morning Pages,  suggesting that mornings are a good time to do this. It can be easier to build a twenty minute habit at the beginning of the day rather than the end when it is easier to let it slip. The truth is, you need to do it when it suits you. I probably have one or two longer journalling sessions each week, often at a local coffee shop, and I talk about how helpful it is here. Some of my clients like to do it after work to “close down the work files.” Others can literally only find time on a Saturday morning when they have dropped the kids off at football. Work out what will work for you and commit to it.

Step two: decide on how

I like writing in a notebook, partly because I like notebooks. Some of my clients prefer to type their journal on their laptop and a small number talk into their phones and record their sessions. Physically writing is good as there is something about that eye to hand coordination which adds a cathartic quality. However, once do what suits you, and you know you will be able to keep to.

Step three: write

That’s it, just write. Whatever comes into your mind. At the beginning you might find yourself reviewing your to-do list, or a conversation with a friend. Soon, however, you’ll dig deeper and you’ll be surprised what comes out. Don’t edit yourself or worry about spelling, grammar or handwriting. This is just for you and you can dispose of or delete it afterwards if you wish.

Step four: give yourself a limit

Know exactly how much you need to write before you start. You can set a certain amount of time (ten minutes) or a certain number of pages. This is where you will build the discipline to make this a habit. Of course, you can go over if you’re in the middle of wrestling with a weighty problem. This is a tool that you may find yourself wanting to use more than you imagined!

Book an introductory session with Paula here, or find out more about her writing here.

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How Anxiety Works

Anxiety is a normal response to stress. It’s a hangover from our ancient history when we might suddenly hear the sound of rustling in the bushes whilst out foraging, or hunting. Our innate instinct at that moment is to freeze for a microsecond, while our body uses all its senses to determine whether to run (flight) or look for the nearest weapon (fight) in case it is a leopard hiding there. In that moment, our heart starts to beat faster, and our blood rushes to our muscles, and our breathing may become fast and shallow. In short, we are getting ready for action.

A moment later a face peeks out from the bushes and we realise it’s our friend, playing a trick on us, and the shock is over. This is the body’s fight or flight response and it’s designed to help us stay alive.

We may not have to contend with leopards nowadays, but our bodies still get bombarded with a huge amounts of stressors that can trigger this response. These stressors include:

• Conversations at work about the rising interest rates and their impact on mortgages
• News headlines about inflation and energy bills
• Social media posts about the price of Lurpack, and whatever is the shocker of the moment
• Emails from providers saying they are putting prices up
• Worried chats with loved ones asking how can we afford this?

I don’t know about you but I felt slightly stressed just reading that list. All these stressors, and more, that are happening every day, are putting our body into fight or flight mode over and over again. The issue is that we can neither fight nor take flight, which would at least help us burn off the chemicals. The result can be long-term or chronic anxiety.

Sleep

Worries may spill out into your sleep. Your REM sleep (the sleep that helps us dissipate emotional arousal over worry) will be tasked with trying to deal with it. If your levels are very high, or this goes on too long, you may find that you need more and more REM sleep, which leads to less refreshing deep sleep. The end result is that you will wake up feeling tired and unmotivated and just want to withdraw and worry even more. These are the prefect circumstances for depression. This is why it’s so important to address our anxiety.

What To Do About Cost of Living Anxiety

Cut down on the stressors

While you want to stay in touch with what’s going on, you don’t need to overstimulate yourself with bad news. Think about just checking in on the news once a day, leading the conversation to something more positive when it gets a bit much, or even telling people about how much it is making you worry. You can also curb your social media time, or make a rule that the first time you see an anxiety provoking money related post that becomes your trigger to close up the app and leave.

Dealing with the anxiety itself

Cutting down some stressors should help, but there may well be moments when you feel overwhelmed to the point of panicking. I teach a very effective way to help with this, called 7/11 breathing. Breathe in for a count of seven, into your tummy, slow and deep, and then out to a count of 11. If you can’t make 7/11, then 5/8 is fine. The main point is that the outbreath is longer than the inbreath. This will help reset your nervous system and push you into using your parasympathetic nervous system, which helps you relax. You can do this every time you feel wobbly, but it’s important that you use it many times during the day, to help you feel less stressed in general.

The best way to do this is to think of triggers to remind you to do a round of three or five 7/11 breaths. Clients of mine have used switching on the kettle, getting into the car or a bus, even going into the bathroom as their triggers, and it does work. Over time, you will taking the arousal out of your nervous system.

Switch off

It’s also important that you switch off from worrying. Distraction is a good way to do this. Think about what distracts you. Perhaps it’s runing, DIY, or painting? Active relaxation is always better for us than passively slumping in front of the TV. Walking with a friend is another good option, as it gives us that sense of connection, as does joining a yoga class or book group.

Working at bringing more of what relaxes you into your life, should leave you calmer and more able to deal with what comes up, including…

Face the fear

Many of us bumble along without actually knowing how much we have coming in, and what’s going out. It can be scary to actually work this out, but it’s vital to do for a number of reasons. First, we will be getting an idea of where we are now. Perhaps we don’t have to worry, just yet. Next, it’s a practical task that is moving us from our right hand side of the brain, where a lot of our worrying takes place, into the left hand side, a great problem solving machine.

First, note down everything that comes in, from your pay packet to any freelance earnings, investments or passive income returns. Calculate this on a monthly basis

Next, make a list of all your regular outgoings. Energy bills and food are obvious ones, but also think about insurances, gym subscriptions, Playstation subsriptions, Prime and Netflix, Pet plans, funeral plans, pocket money, and even contact lens subscriptions.

Spending money is less easy, and it may work out best to note what you spend over a typical week. Include lunches, newspapers, travel, ice-creams and coffees. In short, whatever comes out of your pocket over a week.

Finally add in the luxury items such as holidays, weekends away and also birthday and Christmas presents for the year. When you have come up with your total, divide it by twelve so that you have a monthly figure. Don’t forget tax and national insurance if you are self-employed or have side hustle.

These are your monthly outgoings. You should now have an idea of where you are.

Make a plan

Even if things are looking wobbly, many people are inspired into action by this. You can look at ways to bring in extra income – from taking in a lodger to just bringing in one more client. One of my clients takes in foreign language students to earn extra cash. She feeds them breakfast and dinner, gives them a packed lunch, and away they go. Don’t forget that you can earn a nice chunk of money tax free if you have a room to rent. Here’s a nice article for more ideas.

Money Saving Expert, is often a really useful site to follow. It can help you make informed decisions and keep you up to date without scaring the living daylights out of you.

You can also look at where to cut down. Perhaps you can forego the gym and start running, or make coffee shop visits a weekly rather than daily treat. It may be that you move to a different part of town, or, if you have savings that may well get eroded by inflation, use them to pay off your mortgage and bring down your monthly outgoings (check with an expert for advice on this.)

If things get too much, talk

Talk to someone. It could be a therapist (you can book a chat with me here) who can help you come up with a plan as well as work on your anxious feelings, your citizens advice office, or a trusted and calm friend who is good with money. If you are struggling, talk to your energy provider, or bank. See what they can do to help. Double check benefits you may be entitled to here.

Choose people who are supportive, or can offer practical help and ideas, rather than anyone who will, even unwittingly, make you feel worse.

If you’re in Folkestone, then this article on ways to access help in Folkestone, may give you some useful links.

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Therapy for Sleep: Sleep Clinic in Kent

Sleep is vital to not only our physical functioning, but also our emotional and mental wellbeing. Without sleep (or even with too much sleep), we can feel unbalanced. Sleep plays a pivotol part in both anxiety and depression, as well influencing our ability to cope when things get difficult. Insomnia can be debilitating, and what works for someone else may bring you no relief. This is why I devote a large part of my practice to sleep, and discuss it during many of our sessions.

Someone who is depressed often sleeps longer than they need to, and can’t understand why they still feel so lethargic and lacking in energy or motivation when they wake up. This can increase depression as you are less likely to do the things that can help lift you out of it. Worries, anxiousness and rumination can spill over into sleep, making your brain work harder to refresh itself, and often creating even more anxiety and worry (perhaps about sleep now too) the next day.

Waking up in the middle of the night is tiring, and can impact your life in so many ways.

From a physical point of view, overnight, the synaptic fluid in your spine rises up the spinal column and flushes out your brain, taking away all the toxins and accumulated gunk of the day.However, your body can only do this if you have a long enough asleep to go through the sleep cycles. This means that you need at least seven to eight hours of sleep, something so many of us just don’t get.

Sleep Clinic

I primarily work with clients on:

• Getting to sleep
• Staying asleep
• Early morning waking
• Using sleep to enhance work or sports performance
• Quality of sleep
• Waking up feeling tired and unmotivated despite having what seems like enough sleep
• Nightmares
• Feeling sleepy during the day
• The impact of shift-work

I see clients both in person and online, you don’t need to be in Kent.

Committing to sleep may be the most self-respecting thing you can do for your body. We all know what it’s like to have a really short night of sleep, that time when you have to catch an early flight, or when you’ve been drinking and wake up in the early hours of the morning, but so many of us don’t get enough sleep on a regular basis. Many studies say that we need seven to eight hours a night. Less or more than this has been linked to a shorter lifespan , chronic illness and dementia. Yes, sleep can literally save your life.

Some sleep tips

Nevertheless, if you are finding it hard to nod off, or stay asleep, here are some tips that you can start to put into practice straight away, before an appointment. Here are some steps that can help:

1. Decide what time is best for you, regardless of the other people in the house
2. Set a routine that suits your own body clock and force yourself to keep to it, even if it feels weird at the beginning. Head for bed at the same time every night and get up at the same time every morning, at least until you are in a routine and it is working for you
3. If it doesn’t happen straight away for any reason, don’t give up. You are training your body
4. Find something that can trigger your body into thinking it’s time to sleep. It could be a spray of lavender mist on your pillow before you get between the sheets, a milky drink. I have an eye mask that signals to me it’s time to drop off. I may be like one of Pavlov’s dogs but it works beautifully
5. Don’t check your phone, tablet or even TV after a certain time each night to give your brain some down-time, and ask your partner to at least do so out of your sight. I, personally, wouldn’t even read my Kindle last thing before bed
6. Go back to an old fashioned alarm clock so you don’t need to rely on your phone. You can also buy lamps/alarm clocks that recreate the sunrise over 15 minutes that provide a gentle awakening
7. Play around with sleep inducing bath salts, body oil and toiletries
8. Some people, me included, love drifting off to Audible books. It takes me back to being read to as a child
9. Make sure that you give your bed love and attention. Invest in a new mattress if you need one; certainly get some bed linen that will be a joy to snuggle in. I have a lovely lilac cashmere blanket that I can pull over me if it gets a little chilly and feel like it’s a real luxury.

What happens in a sleep clinic appointment?

We will look at your sleep in more detail, including the routines around it. We will also take a thorough inventory of aspects of your life, emotional and physical, that may be impacting your sleep, and work on addressing them. You won’t be wired up to anything, or be prescribed any medication.

Please do book a chat here to discuss working on your sleep, or email me here.

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