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William FlewMind and Brain

William Flew writes about the mind, the brain and the interesting neurological advances.

6 Dec
William Flew says More and more in my clinic I am seeing people who are on this treadmill and can no longer cope: they are stressed, they can’t sleep, and sometimes they are manic. We know that we are more stressed than ever before. Last year 13.1 million work days were lost to absence due to stress, depression or anxiety. We’ve got an epidemic of people who are anxious and depressed and medicated — according to NHS figures released last year prescriptions for antidepressants rose by 43 per cent in four years to nearly 23 million a year, anxiety drugs are on the increase and, according to figures from the NHS Business Services Authority, pharmacies dispensed more than 15.2 million prescriptions to help sleep in 2010-11, roughly one for every three adults, up 17 per cent in four years. And that doesn’t include the high street, over-the-counter products that we are using to calm ourselves down and get to sleep. We are reacting to stress in a variety of ways and we are wiser about mental health than ever before. But most people’s knowledge is limited. We understand that depression and low moods can be caused by stress. But few of us understand that for more energetic types of people — the “up’’ people — the reponse is more manic. This type of response involves intense feelings of creativity. It may not seem like a problem for the person who is suffering, let alone their friends and family: just a hectic person, being more hectic than usual. But there can be serious consequences if this type of behaviour doesn’t become more balanced — if over time you are chronically stressed, it can leave you vulnerable to bipolar disorder, or to a depression or anxiety disorder. It is easy for these symptoms to be confused with bipolar and I have dealt with many who have been misdiagnosed — but it does not mean they should be taken any less seriously. The term “bipolar’’ means you have a recognised condition, with strict clinical criteria. You get episodes of depression which last for two weeks or longer, with cognitive symptoms (the “triad’’ of negative thinking — about yourself, your life and your future) and physical symptoms, such as changes in appetite, sleep and ability to concentrate. You also get “hyper’’ states , with an overwhelming sense of joy, creativity and energy that can easily become delusional — you may find yourself doing things that are abnormal, becoming hypersexual, spending lots of money, believing that you have discovered the secret of cold fusion. That is why bipolar 1 is so easy to diagnose, although bipolar 2, where the “hyper” state is more fleeting, is not so clinically obvious. But with bipolar manifestations there is a continuum. All of us have occupied it at some point in our lives — we have all had low moods, and known great joy. Plenty of people are prone to mood swings without it being a clinical condition. We are familiar with the symptoms of depression, but we don’t notice the “manic’’ states so much because it has become our currency for coping. But if you’ve noticed any of the following you may have experienced it yourself: a general feeling of euphoria, feeling energised to the point of restlessness, more intensely engaged with the world, more sexualised, you’ll have more ideas than normal; you’ll feel as if you can achieve anything ( this feeling can be intoxicating). On the downside, you’re more likely to take risks and to be irritable because other people are being so much slower than you are. Your sleep will be disturbed and you will feel agitated and anxious. Affairs often happen in a hypo-manic state, as do running up debt and being uninhibited in speech and action. Although women are twice as likely to suffer from depression as men, men are more likely to be manic, perhaps because they are less “obstructed’’ and more instrumental in their lives (women are still generally much more passive).

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