Eating Disorders Awareness Week 2016 #EDAW16 by Dr Hugh Herzig

Did you know that next week 22nd – 29th Feb is Eating Disorders Awareness Week? Perhaps you already feel bombarded by news bulletins about the rising incidence of EDs… or how these days younger and younger people are affected. So why the need to be made more aware of EDs?

At Student Health we have good reasons to want to raise awareness of EDs:
• Eating disorders are not rare and exotic illnesses. They are common in the UK population, particularly so in adolescence and early adult years, and particularly so in student populations.
• They have a profound effect upon mental health, eroding well being and self esteem, so that nothing the sufferer does is ever good enough.
• They have serious physical effects on pretty much every biological system of the body such as skin and dental damage, gastrointestinal and heart problems, bone marrow and liver damage, hormone suppression and hastening the onset of osteoporosis. In fact, EDs lead to greater mortality than any other group of mental illnesses.
• Living with an ED can make life very hard indeed… friendships and social activities are deprioritised, leading to people feeling more and more isolated, anxious and depressed.
• Concentration and stamina can be much affected, so the sufferer cannot perform physically and academically to her/his potential
• Family and friends often don’t know what to say, or worry they will cause upset or have their head bitten off if they express their concern
• Some of our patients at Student Health get so unwell that they need to take time out from university. For those such as medics, vets and dentists whose degrees lead on to accreditation with a national professional body, their ED may make them unfit to practice as a registered professional.

ED Awareness week may provide an opportunity to break the taboo that surrounds EDs.

You may feel able to bring up this sensitive topic with that friend you’ve been worrying about, but who seems always to want to keep herself to herself. It is likely that doing so will help her… even if she seems not to appreciate it at the time.

If you have severe eating and weight anxieties yourself, this week may be the time to tell someone a bit about it, allow a friend to support you, maybe even seek help from your doctor. All the staff at Student Health are experienced in helping people with EDs, and in Bristol we have good services to treat eating disorders, including the First Step service which offers psychological treatments in our very own Health Centre

We are here to help YOU!

Self-injury awareness day

March 1st marks ‘self-injury awareness day’, a global movement signified by the wearing of an orange ribbon, which aims to increase the awareness of self-injury and challenge many of the misconceptions surrounding this.

What is self-injury? Self-injury, also known as ‘self-harm’ or ‘cutting’, describes how someone intentionally inflicts physical injury to their own body without any suicidal intent. It can take on any form, whether it is cutting, head banging, hair pulling, burning, recreational drug or alcohol abuse, non-lethal drug overdoses or taking excessive risks to personal safety.  It affects people regardless of age, gender or ethnicity, although it is known to be particularly common in younger people.  Due to the shame and self-hatred often associated with self-harm, many sufferers will go to great lengths to hide scars, making it difficult to identify those needing help, and also to estimate how prevalent this is.  Research suggests that at least ten percent of 15-16 year olds have self-harmed at some point in their lives.

Why do people self-injure? Self-injury is recognised as a coping mechanism for overwhelming emotional distress relating to current traumas or difficulties from the past.  The distress might be grief, anger, loneliness, emptiness, anxiety or self-hatred and sufferers may describe how the ‘real pain’ of self-harm numbs their emotional turmoil, and in some cases acts as a way of avoiding attempting suicide. Over time self-injury might become a person’s ordinary response to everyday stressors, sometimes increasing the frequency and severity of injury.

What to do if you are self-harming? GPs are well placed to provide confidential advice and support, put you in touch with local and national self- injury organisations (see below) and check for any underlying depression/ anxiety or eating disorder symptoms. The Student Counselling Service is also somewhere safe and non judgmental to go to.

Is there treatment for self-harm?  Yes there can be, and the aim of treatment may be to both minimise harm from acts of self-injury and to help the sufferer find new coping mechanisms and develop problem-solving skills.  Strategies to minimise harm include recognising triggers for self-injury, learning less dangerous ways/locations for cutting, carrying dressings and understanding the dangers associated with certain medications. However, stopping the self harm is not necessarily the aim of treatment, which may be more directed towards underlying issues.

Talking therapy (e.g. cognitive behavioural therapy/ dialectical behavioural therapy), creative therapy, support networks and the promotion of the development of self-help skills all help in supporting a sufferer to learn new coping mechanisms.  If self-harm is part of an underlying mental health illness, specific treatment for that condition may be warranted.

I am worried that my friend is self-harming?  It is upsetting to discover a friend is self-harming but it is important to provide non-judgmental support and acceptance, acknowledging that they are distressed. Encouraging them to talk to health care professionals or contact a local support group will show them that you care. Asking a person to stop self-harming will not help the situation as you are asking them to take away their coping strategy.

Will I/my friend get better?  There are no quick fixes for self-harm, but by getting a person the right support and treatment, they will start to learn new ways to deal with their emotional distress.

References/ literature available:

 

  1. Life Signs Self-Injury Fact Sheet for Health Care Workers- www.lifesigns.org.uk
  2. Information resource pack- Bristol Crisis Service for Women –www.selfinjurysupport.org.uk
  3. NHS self injury fact sheet- http://www.nhs.uk/conditions/self-injury/pages/introduction.aspx
  4. MIND- ‘understanding self-harm’- http://www.mind.org.uk

 

Support Groups

Self Injury Self Help- support groups for women and men who self-injure in the Bristol area. www.sishbristol.org.uk

TESS- Bristol Crisis Support for Women, text or email support service for girls and women who self-injure- up to age 25.  www.selfinjurysupport.org.uk, or text 07800472908

MIND- for information sheets/ advice about local resources- www.mind.org.uk

 

 

Self Injury; a paradox…

It is a strange truth that people self harm to make themselves feel better.

Some people have a glass of wine after a bad experience, some eat a huge bag of crisps or a bar of chocolate. But some people cut themselves, or burn their skin, take an overdose, or punch a wall. All of these options are a human way of coping with stress, though not a healthy way.

Most days at Students’ Health Service we see male and female students who have recently harmed themselves. Our nurses are very sympathetic, brilliant at wound care and completely non judgmental. The GPs would like to help you too, and discover what’s behind the self injury and distress. We are not easily shocked and we have seen many unusual ways that students harm themselves, secondary to depression, anxiety, obsessive thoughts or psychosis.

Alcohol usually makes self harm more frequent, or the injury worse.

Nationally self harm is thought to affect about 5% of people, though this is likely to be an underestimate (Meltzer et al 2002). In a school survey 13% of young people aged 15/16 reported having self harmed at some time in their lives, and 7% in the previous year (Hawton et al 2002).

It is important to assess and treat those who self harm, as the behaviour is often related to an underlying mental health condition, which, if treated, may lead to improvement not just of the depression/ anxiety/ schizophrenia etc but also of the self injury.

If you would like help with self injury, or would like to talk about your mental health in general, please come and see us soon. Don’t forget that the Student Counselling service is also there to help, and the team is very experienced in supporting students with such issues.

 Other support in Bristol;

Contact the Self Injury Self Help Bristol organisation, who provide services for men and women with self injury issues. They run support groups, and also run workshops related to achieving good mental health in general.

Email; sishbristol@yahoo.co.uk

 Phone; 0117 927 9600

Or, Bristol Crisis Service for Women; 07788142 999

Runs a text support service for managing your self injury and emotional distress.

The Olympic Games and the Untold Legacy

This blog is a personal viewpoint from the service’s eating disorders specialist…

Will Devlin, clinical psychologist and specialist in eating disorders for the University of Bristol, looks almost sheepish as he describes his mixed feelings about the great sporting achievements we watched with pride just a few months ago:

“…Don’t get me wrong,” he says, “there’s no doubt that the Olympic Games were a proud moment in the history of the country and many of us have been inspired by the achievements of athletes like Jessica Ennis, Jonnie Peacock, and Anthony Joshua.

“But what I can’t help wondering is what effect images of these almost superhuman, super lean, super muscled athletes is having on people who are unhappy with their bodies.  Very few of us have the genetic make up, let alone the motivation, dedication, sponsorship, training and time to develop the kind of body which we’ve seen so much of during the UK’s summer of sport.

“It’s one thing to be inspired to get fit by the Olympics, even I’ve been inspired to get back to the gym.  But the fact is,” Will says with a smile, patting his tummy, “like most of the population I’ll never have the body of an Olympian however hard I try! 

His fear is that amidst the pride and positive social change inspired by the Olympics, one untold legacy will be an increase in the number of people at risk of eating disorders: “I worry that if more of us end up unhappy with our bodies, then more of us might resort to unhealthy attempts to shape up as we aspire to a rippling six-pack, tight buns or super-pert breasts.

It’s not a popular view, that inspiring a nation with acts of sporting heroism could actually be bad for some people, but as I listen to Will’s concerns I do see his point: “Condemnation is growing on all sides at the use of size zero models on the catwalk, and Kate Moss was roundly criticized for endorsing starvation when she said, ‘nothing tastes as good as skinny feels’ …but it’s not easy to say that super lean athletes might have just the same effect as emaciated supermodels on those of us who want the perfect body but simply can’t have it.  “And don’t forget,” Will says, “the athletes themselves face these same pressures, eating disorders are rife amongst sports men and women, in fact it is estimated that more than one in 10 elite athletes may have an eating disorder.”

Will’s comments get me thinking about this untold legacy, and what some of the unintended outcomes of our summer of sport might be.  There’s no doubt that the efforts of Team GB and our paralympian heroes have the power to inspire a generation, but perhaps it’s also important to recognize that the pursuit of athletic success and the body beautiful may also have its downsides.

Will works at the University’s Student Health Service.  If you think you might have an eating disorder, talking to one of the service’s GPs will ensure you get access to the specialist help you need.

 

Club Drugs; help is at hand!

My name is Dr Tim Williams and with my colleague Elaine Driver we run Bristol’s ‘Club Drug Clinic’. This is only the second such clinic nationally and is a response to changing trends of drug use in young people.

In the last 10 years there has been a steady reduction in young people using drugs such as cannabis, ecstasy, cocaine, and heroin. Increasingly young people are buying compounds directly from internet sites for delivery. More and more young people are now finding they have developed a problem with internet substances and need some help and support. Others are wanting accurate information to ensure they are not using toxic substances. Since the media storm around mephedrone there has been a diversification in the market and new compounds emerging, usually from labs inChina, in rapid succession. Some of these compounds have been harmless but others have been poorly researched and trialled, resulting in psychoactive chemicals which are highly potent and have a very narrow safety window. Consequently in Bristol we have had several young people die after taking white powders that the press erroneously labelled as MDMA or ecstasy. The Club Drug Clinic aims to provide up to date information and advice to people who are using well known compounds such as ketamine, methoxetamine, and methiopropamine or branded internet compounds such as BenzoFury or NRG.

I am part of Professor David Nutts’ Independent Scientific Committee on Drugs (ISCD). The ISCD draws together experts in the field of drug science and allows us to have the most up-to-date information on what is out there. The forensic scientists on the committee have amazing knowledge and experience of analysing and characterising new compounds that come onto the market. Part of my role in the Club Drug Clinic is to get any information from users about compounds that have caused problems or side effects, so we are always interested in hearing about your experiences. Anyone can come in and talk to us anonymously for a chat and to share information.

If someone needed more help and treatment we would start seeing people regularly and could link into our extensive treatment services which includes detox if this was necessary.

 We are open for drop-in every Wednesday between 5-7pm at Colston Fort, Montague Place, Kinsdown, BS6 5UB. Its just off St Michaels Hill, just ring the buzzer and we would love to meet you.

“Home is the nicest word there is”

Homesickness

 

Home is a place you grow up wanting to leave, and grow old wanting to get back to.  ~John Ed Pearce, American Newspaper Editor/ political speech writer

Freshers’ week is over, the excitement has been countered by your course reading list, and reality is starting to have an impact…

New surroundings, new people, new accommodation, and in many cases a new climate, sometimes all in a new language! Home can seem a very long way away. For some people feeling homesick will briefly impact on their consciousness and then they’re off again, whirling through Bristol, eyes on their next challenge. For many people however, overcoming the homesickness IS the challenge.

Maybe this is a good time to reflect on the fact that with about 4000 new people all joining the university in the same week, those who feel homesick are unlikely to be alone in feeling this way. Certainly from where we sit, here at the Students’ Health Service, and in the experience of our colleagues in Student Counselling, and the Multifaith Chaplaincy, we know you are not alone in wishing that your nearest and dearest, and the comforts of home, were a little closer. We recognise how common an emotion this is and therefore we are here to help you deal with it and move onwards to enjoying your time at Bristol as much as you can. The Counselling Service run all sorts of groups and workshops throughout the academic year, with some specifically aimed at supporting people who are homesick. Look at their website for more information, and to book a place on them. And don’t forget that the Chaplaincy is for people of any faith AND none. You wont find a friendlier team providing soup lunches and support anywhere in the university!

My message for this blog is that you are not alone, and that we are all here at the Student Support Services ready to help and listen. It is better to seek advice early than to struggle on alone, we can help.

 A final thought on leaving home;

 “Maybe you had to leave in order to really miss a place; maybe you had to travel to figure out how beloved your starting point was.”
Jodi Picoult, author Handle With Care

 

http://www.bristol.ac.uk/chaplaincy/

 http://www.bristol.ac.uk/student-counselling/

 http://www.bristol.ac.uk/students-health/