Carlie Tufnell Exhibition 22 June 2022 Dr James Arkell Consultant Psychiatrist My Qualifications FRCPsych MA Hons Cantab Diploma in CBT Certificate for systemic practice with family and couples ID: 1036262
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1. MANAGING YOUR MENTAL HEALTHCarlie Tufnell Exhibition22 June 2022
2. Dr James Arkell, Consultant Psychiatrist. My Qualifications:FRCPsych MA Hons (Cantab) Diploma in CBT Certificate for systemic practice with family and couples My Professional Experience:I studied medicine at Cambridge University and University College London. I trained in psychiatry at The Maudsley and Royal Free Hospitals and have worked in Sydney, Hong Kong and London. I worked as an NHS consultant psychiatrist in Kensington and Chelsea until 2014. I have worked both in general psychiatry and in eating disorders. I see patients at the Nightingale Hospital. I also hold an honorary contract at the Royal College of Art where I support the student counselling service. I am an honorary lecturer at Imperial College Medical School. I teach psychologists and medical students, supervise therapists and have mentored consultants. I am lead for psychiatry at The Cleveland Clinic London. My Personal Statement:Through working in both the private sector and NHS I have experience in treating the full range of mental health problems from mild stress through to severe and enduring mental illness. I endeavour to combine an informal style with rigorous diagnostics and use an integrated approach addressing the biological, psychological and social aspects of illness. I work with both pharmacological and psychotherapeutic approaches using my background in CBT and mindfulness.I take an interest in the interface between mental health and the arts. I sit on the Almeida Theatre development board.
3. What do I do?Diagnosis; why this problem for this person at this timeBiologicalPsychologicalSocialMPs Airline Pilots Actors & Failure to Launch
4. OverviewPressures specific to young adultsMedicationResilienceMeditationSleepVagus NerveNutrition
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7. Five markers of adulthood millennials Gen Z have had to give up onLack of disposable income and rocketing living costs are forcing young adults to miss out on key milestones (Guardian)De-ChronologizeHome ownershipPermanent jobLife partnerChildrenSaving money
8. The Mental Health Foundation 20% of young people in Britain will experience some sort of mental health problem in any given year, and 10% at any one time.COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide
9. STIGMA160 times more spent on cancer than MH researchEvery Govt £1 spent on MH public contribute 3pEvery Govt £1 Spent on Cancer public contribute £1.27Yet 40% 14-25 year old women have diagnosable emotional disorder – only 35% under active treatment
10. Social Isolation; 15 cigarettes/day3.4 times depression risk1.9 times dementia in 15 years3 times more likely to be inactive physicallyONS April 2020 : 5% pop 2.6m adults lonely ‘often’ or ‘always’“We all have adversity but it only becomes trauma when experienced alone”.
11. 2022 Student Academic Experience SurveySurvey 100,000 studentsNearly one-in-four feeling lonely ‘all’ or ‘most’ of the time.ONS April 2020 : 5% pop 2.6m adults lonely ‘often’ or ‘always’
12. STAMMTISCHDescriptionA Stammtisch is an informal group meeting held on a regular basis, and also the usually large, often round table around which the group meets. A Stammtisch is not a structured meeting, but rather a friendly get-together. Wikipedia
13. DiagnosesADHDASDGAD/Panic/AgoraphobiaPTSDDepressionAvoidant/ Emotionally Unstable PD
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16. Selective Serotonin Reuptake Inhibitors - SSRIs
17. SSRIsCitalopram (Cipramil) – Dep, PanicEscitalopram (Lexapro) – Dep, GAD, Panic, SocFluoxetine (Prozac) – Bulimia, OCD, Dep AnxParoxetine (Seroxat) – PTSDSertraline (Lustral) – Dep Anx PTSD (Most common px in USA)
18. Side EffectsGI – nausea, diarrhoeaSexual - decreased libido, anorgasmia, impotence (up to 40%)Changes in weight/appetiteSweatingExacerbation of anxietyDrowsinessRisk mania in BPADAkathesia
19. ResilienceResilience is a key factor in protecting and promoting good mental health. It is the quality of being able to deal with the ups and downs of life, and is based on self-esteem. Fonagy defines resilience as “normal development under difficult circumstances.” “We all have adversity but it only becomes trauma when experienced alone”.(Fonagy,P. et al (1994) The theory and practice of resilience. Journal of Child Psychology and Psychiatry. 35,2.231-257)
20. Protective Factors Good school experience One supportive adult Special help with behavioural problems Community networks Leisure activitiesTalents and interests
21. Michigan Study Adolescent & Adult Life Transitionshttp://garp.education.uci.edu/msalt.html3248 adolescents 1986-2017 for 30 years (11-42 years old)‘It takes a village’Coherent nuclear family important early on but extended community networks later more predictive of wellbeing – either biological or social
22. Suicides are preventable: https://www.zerosuicidealliance.com/training
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24. ResilienceMindfulnessSleep optimization – managing ITAerobic exercise – PT - ADHDBroad Spectrum Micronutrients - ADHDCommunity Networks – sport / craft / drama / family / music /mentors / old school networks /religious groups
25. MINDFUL MEDITATIONJon Kabat –Zinn – ‘Paying attention in a particular way: on purpose, in the present moment and non judgementally.’Waking up from being on automatic pilot.
26. PracticeBody Scan – moving attention sequentially through the bodyBreathing Exercises: being aware of the breath as an anchor - when the mind wanders drawing it back to the breath. Two Feet on The Ground; Tadasana Mountain Pose
27. Mindful Resources The London Mindfulness Centrehttps://www.londonmindful.com/Headspace.com and Calm.com AppsFinding Peace in a Frantic World Williams & Penmanwww.Franticworld.comFull Catastrophe Living Jon Kabat Zinn
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29. GlymphaticsGlial cells clear toxins - Amyloid plaquesSleep Hygeine: cool, dark room. Just for sleep, No devicesRoutine
30. SLEEP SupplementsL-Tryptophan 500mgMagnesium Chloride – salts or oil BETTERYOU SALTSLavender Oil 80mg capsules KALMSCircadin 2mg MR – OTC in USASedating Antihistamines
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36. Sleep DevicesDodow – light metronomeSAD Beurer TL30UK 10,000 Lux within 10cmMysleepbutton App Timeshifter App
37. Mind & Body
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39. Gut-Brain AxisLactobacillus reduces depression and anxietyKefir https://happykombucha.co.uk/Prebiotic Inulin Probiotics Symprove Alflorex