Manager insomnia harms workers and productivity

Blog Post No. 58

6th April 2018

Copyright © Renata Taylor-Byrne 2018


Renata’s Coaching Blog: Do managers/leaders realise how crucial their sleep habits are for their staff?

Your abusive boss is probably an insomniac:”- A revealing research study by a Professor of Management

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Introduction

I continue to do my research on the science of sleep, and the things I am discovering are really quite fascinating.  I have begun to structure my book on this subject as I go along with my research.

Here’s an example of the kinds of things I’m discovering:

Your abusive boss is probably an insomniac

When people are in a position of responsibility for, and control over others, their work can be very difficult and physically draining at times. (This applies to managers at every level: directors, company executives, university and college managers, social and health care managers, emergency service managers, police management, psychiatrists, supervisors, teachers, and parents; and many others). Because of this wear and tear, self-care is very important when you are managing people.  But so also is the need to take care of the people you manage.

uninterested-group

In this blog I’m going to describe a research study which shows how the physical condition of a leader (or manager) can negatively impact the behaviour of their employees, or staff.

The research was conducted by Christopher Barnes, (who is an associate professor of management at the University of Washington’s Foster School of Business), with his colleagues Lorenzo Lucianetti, Devasheesh Bhave, and Michael Christian. He summarised the research they had done in an article in the Harvard Business Review in 2014, in an article entitled: “Your abusive boss is probably an insomniac.[1]

Sleep affects productivity – your own and your team’s

Harvard-review-image

Christopher Barnes’s previous research had investigated the effect in the workplace of the sleep behaviour of the staff, and he had found that sleep was crucial for replenishing people’s ability to control their own behaviour.

He and his colleagues then went on to conduct a field study of 88 leaders and their subordinates. For two weeks, they conducted surveys of leaders at the start of each work day, about the quality of the leader’s sleep on the previous night and the amount of self-control they had over themselves at the point of completing the survey questionnaire.

And for the same period of two weeks, their subordinates completed surveys when they had finished the day’s work, and recorded any abusive supervisor behaviour of their leader (manager) on that day, as well as their own work involvement on the same day. The research was aimed at focussing on the individual leaders, rather than assessing leaders in relation to each other.

Researchers tracked the amount of sleep that the leaders had (their sleep patterns) over a number of weeks. During that time, the reactions and observations of their subordinates to their leader’s performance was carefully recorded. (There was no knowledge, on the part of the workers, of the amount of sleep that their boss was getting, during the course of this research exercise).

Angry-boss

Sleep quality and quantity affects leadership ability

The research revealed that, if the supervisor had experienced a poor night’s sleep, this resulted in a more derogatory and disrespectful attitude towards the supervisees the following day.

Lack of restful sleep also led to a reduction in the leader’s ability to self-regulate – (to manage their responses to others constructively). This was described by the employees in their reports of their leader’s behaviour.

Another quite alarming result also occurred: On the days after the leader had a disturbed night’s sleep, the employees – (even if they had nourishing sleep themselves) – were less interested in their work during that day, as a result of the leader’s insomnia, with a consequent lack of productivity.  As Matthew Walker commented:

” …it was a chain reaction effect, one in which the lack of sleep in that one superordinate person in a business structure was transmitting on, like a virus, infecting even the well-rested employees with work disengagement and reduced productivity.” (Page 302, Walker. 2017)[2].

Conclusion

Sleeping-pair

Leading, managing and working with others needs energy and stamina, and this research is clear evidence of the vital importance of making sure that people working in management roles get a good night’s sleep (of at least seven to nine hours per night). This will have a really beneficial effect, not only on the manager’s own health, but also on the morale and work performance of the people they are in charge of during the working day, which can only be a very good thing for the organisation as a whole.

But changing habits and altering behaviour isn’t easy, especially when there is strong, social pressure to conform to the patterns of sleep of the people around you. Many managers feel under pressure to over-work and avoid self-care strategies, because of the macho cultures in some organizations. And these macho cultures actually work against the productivity of the organization!

Sorting out your priorities, as a working manager, can be difficult on your own; and being coached within your own organization can simply reinforce the pre-existing macho and self-neglectful culture.

The Lifestyle Counselling Book
The Lifestyle Counselling Book

In my chapter on sleep, in Lifestyle Counselling and Coaching for the Whole Person, I mentioned some former leaders who harmed their brains (and now we know, also their teams!) through lack of adequate sleep – Thatcher and Reagan being the most notable examples. The current President of the United States boasts that he only takes 5 hours sleep per night.  So don’t make the mistake of working for him, folks!

Clearly, you could often benefit from coaching outside your organization on the subject of managing your health and leadership ability by managing your sleep, and other lifestyle factors. This could be one of the best investments of your precious time that you ever make.

 

SLEEP-QUOTE-CALLOUTThe crux of leaderships is this: “Example, example, example!”  What kind of example are you currently setting, at home and in work, in terms of self-care, including adequate sleep?

Contact me if you want to be coached on how to manage your energy and increase the quality and quantity of your sleep, so that your working life and home life can be enriched.

Have a good night’s sleep!

Best wishes,

Renata

Renata Taylor-Byrne

Lifestyle Coach-Counsellor

The Coaching/Counselling Division

Email: renata@abc-counselling.org

Telephone: 01422 843 629

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References:

[1] Harvard Business Review: https://hbr.org/2014/11/research-your-abusive-boss-is-probably-an-insomniac

[2] Why We Sleep, by Matthew Walker (2017), Allen Lane Publishers.

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Coaching and counselling in hebden bridge

Blog Post No. 165

By Dr Jim Byrne

30th March 2018

Dr Jim’s Counselling Blog:

What is coaching, counselling or psychotherapy, and why might you benefit from it?

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Copyright (c) Jim Byrne, 2018

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Introduction

natajim-coaching-counsellingCoaching, counselling and psychotherapy can be life-changing experiences.  Renata and I certainly have had lots of such experiences ourselves, through various processes; and we have each helped lots of individuals to change their lives for the better.

But many people have no idea what these kinds of help involve.  So here is what Renata says about her work:

About Renata Taylor-Byrne’s coaching/counselling work

“My main function is life is to be a ‘people grower’, and a healer of the body-brain mind.

“If you’re struggling with problems to do with…

* handling unexpected or demanding changes in your life circumstances

* changing one of your habits, or starting a new one

* reducing your feelings of being under pressure and stress

* clarifying your thinking or feelings

* achieving important goals; or:

* working to change a difficult emotional or relationship problem…

…then I can help you with these and similar challenges.

Counselling-room1001“I offer a safe space in which to talk about your problems, to get advice and guidance, to learn some new knowledge, techniques or models, and generally to work out a way forward that suits you.

You can contact me by email at renata@abc-counselling.org, or you can find out more about my services here: https://abc-counselling.org/life-coaching-hebden-bridge/

~~~

But how, exactly, would Renata help you?  This is what she writes:

“I practice a form of coaching/counselling called Lifestyle Coaching and Holistic Counselling.

nature-and-health31“This overlaps all other forms of talk-therapy and coaching guidance, but it also significantly includes the latest research on the connection between the brain and the guts, and the role that gut health plays in sound emotional wellbeing (which some people call good ‘mental health’). It also includes insights from research on diet, physical exercise, sleep patterns, and stress.  It is often said that an army ‘marches on its stomach’, and it is true that successful individuals, in every walk of life, manage their lifestyle in such a way as to maintain healthy diet, guts, muscles, sleep patterns, and so on.  And when they don’t, they don’t have much staying power, and they under-perform in an unhappy life-space!”

Why not give Renata a chance to help you with your apparently intractable problems?  Telephone: 01422 843 629

~~~

About Dr Jim Byrne’s Counselling and Psychotherapy Division

And now, here is what Jim say’s about his own service:

DrJimCounselling002“I have helped more than one thousand individuals to overcome distressing problems of anger, anxiety, depression, stress, panic, traumatic experience, couple conflict, insecure attachment, and so on.

I do that work via conversation, which is warm and friendly, and helpful, and insightful, and exploratory, and designed to help you to straighten out your story in your head, and to straighten out your feelings in your heart and your guts.

I also give advice on how to manage your body-brain-mind, and your environment, for optimum functioning.

As indicated on the main homepage, we at ABC Coaching, practice the most up to the minute form of emotive-cognitive therapy and coaching.  It’s called Emotive-Cognitive Embodied Narrative Therapy (E-CENT), and it integrates the best elements of all the pre-existing systems of counselling and therapy.  And it includes a strong focus upon lifestyle factors, like diet, exercise and sleep patterns.”

And if you want to find out what individuals gained from consulting Jim in the past, then please take a look at the Unsolicited Client Testimonials page.*** Here: https://abc-counselling.org/counselling-client-testimonials/

Or take a look at Dr Jim’s Counselling Division.***

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Coaching, counselling and/or psychotherapy, with Renata or Jim, could transform your current life into a happier, healthier more enjoyable life-space!

That’s all for today!

Best wishes,

Jim

 

Jim & Renata's logo
ABC Coaching and Counselling Services

Dr Jim Byrne

Doctor of Counselling

ABC Coaching and Counselling Services

01422 843 629

drjwbyrne@gmail.com

~~~

Build resilience with Chinese exercise

Blog Post No. 56

2nd March 2018

Copyright © Renata Taylor-Byrne 2018

Renata’s Coaching and counselling Blog:

Millions of Chinese people can’t be wrong! Why practising Chi Kung will keep you away from the doctor’s surgery

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Introduction

Keeping fit by doing lots of exercise is good for you, isn’t it?  There is lots of talk these days about the importance of keeping fit, and of avoiding a sedentary lifestyle.

However, there are certain drawbacks with some types of exercise, which I want to tell you about, because you may not be aware of them.

Not all exercise is automatically good for your body. A lot  depends on the type of exercise you do.  A good deal of injury to muscles and joints is common in the most widely practised systems of exercise in the West.

In this blog I’m going to outline some of the differences between Eastern and Western types of exercise – and describe the benefits of Eastern exercise, and some of the disadvantages of Western exercise, which are not widely known.

It’s important that you know the effects of different types of exercise, so that you can make an informed choice, if you decide that you want to improve your health by exercising.

Why is this important?  Firstly, because you will want a good return on the investment of your valuable time and money. And secondly, because you will want to avoid physical damage to your body.

‘Hard’ and ‘Soft’ exercise

In his book, ‘The Tao of Detox’, by Daniel Reid (2003), Reid makes a distinction between ‘Hard’ exercise and ‘Soft’ exercise, and he explains the different effects these two types of exercise have on the body.

Here’s what ‘Hard’ exercise includes:

hard-exercise-picture

And now for some ‘Soft’ exercise systems:

Soft-exercise

The effects of ‘hard ‘exercise on the body

 There are lots of benefits from active sports, but there is also a downside to them. Here are some of the effects on the body of hard systems of exercise:

Infographic-on-hard-exercise.JPG

As you can see, the effects on the body aren’t all beneficial, and if there is also a competitive element to the sport, then this can act as a source of stress throughout the body-brain-mind.

The effects of ‘soft’ exercise on the body

 

The Eastern approach to exercise (which we’ve called a ‘soft’ approach) is that the exercise must be therapeutic for the body. So let us look at some evidence of the value of soft exercise.   And this will help us to understand why millions of Chinese have practised it continuously for thousands of years.

Here are some of the benefits:

# One of the top rewards of doing this type of exercise is that it switches your body into the ‘rest and digest’ (or healing) mode of functioning.  When you do ‘Soft’ exercise (which involves slow, rhythmic movements, combined with deep breathing), this shifts the autonomic (or automatic) nervous system into the calming, healing branch of your nervous system and keeps it there throughout the exercise.

This enhances the immune system and stimulates the production of red and white blood cells in the bone marrow.

# It also stimulates the thymus (the immune system’s master gland) and other glands, to release the full range of immune system protection factors; and at the same time it stops the release of the stress hormones which are part of the ‘Fight or flight’ response – (which  have powerful immune-system inhibiting effects).

# “Chi-gong also stimulates the increase in secretions of natural steroids”, states Daniel Reid (2003) “thereby relieving arthritis without the need to resort to the toxic synthetic steroids which most doctors prescribe for this condition.” (Page 114)

group-chi-gong

# Furthermore, apparently when we stretch our muscles, this squeezes stagnant blood from our body tissues and then the relaxation part allows fresh arterial blood to flow in. And stretching also stimulates lymphatic drainage, which we need to stimulate through body movement each day, so that wastes (e.g. toxic waste products, infectious microorganisms, etc), can be destroyed by our white blood cells, as they pass through the lymph nodes.

Because these soft exercises are always done in a relaxed, smooth and slow manner, with the smallest amount of effort, this means that no lactic acid is produced in the body tissues, which is a side effect of ‘hard’ exercise.

The benefits to the body (continued)…

Benefits-of-soft-exercise-chart.JPG

# Doing these soft exercises slowly ensures that the heart doesn’t race, and the breath isn’t reduced.

# Apparently twenty minutes of Chi Kung practice slows down the pulse by an average of 15%, while increasing the overall amount of blood circulating in the body, and this effect lasts for several hours afterwards.

This increase in the flow of blood around the body results from the way soft exercise alters the workload of circulation from the heart, over to the diaphragm.

And one of the implications is this: High blood pressure, which is a life-threatening condition all over the world, can be controlled without effort by doing daily Chi Kung practice, without the need for drugs.

Research findings on how Chi Kung reduces blood pressure

At the Shanghai Research Institute for Hypertension, one hundred people who were suffering from chronic high blood pressure and hypertension, took part in a research project to test whether Chi Kung exercise could help them.

What the researchers found was that after only five minutes of Chi Kung practice, blood pressure levels in all of the participants began to drop dramatically. And after twenty minutes their blood pressure reached the level it normally would have reached after three hours as a result of taking the kinds of blood-pressure drugs normally prescribed by Western medical practitioners.

Ninety-seven of the participants stayed free of high blood pressure and didn’t have to use the drugs any more, just by continuing to practice Chi Kung at home every day.

And the three patients who decided not to continue their Chi Kung practice quickly relapsed and had to go back on drug therapy.

Older-people-chi-gong-practitioners

The benefits of Chi Kung for the brain

# Electroencephalographic (EEG) scans of elderly people in China – who practice Chi Kung daily – show signs of rejuvenation.  That is to say, a pattern and frequency of brain waves has been found that are usually found in the brains of young children.  This is interpreted as showing that those who regularly practise this type of exercise can bring back the mental skills and abilities they had when they were young.

# Also, Chi Kung infuses the brain with energy, and activates the release of neurotransmitters such as dopamine, serotonin and enkephalins. The effect of this is that brain functions are balanced.  Mental alertness is increased, and pain reduced.  And communication is enhanced between the brain and the peripheral nervous system.

Chi Kung benefits for the digestion process

# Indigestion, and acid reflux, are very common for people who are following a Western diet.  According to studies in China, the practice of Chi Kung affects the stomach in a beneficial way.  For example, fifteen minutes of practise of Chi Kung produces a big increase in the enzymes which are released by the stomach to digest food: pepsin, and other digestive enzymes; plus lysozyme, which is secreted by the salivary glands. Apparently this system of exercise balances the pH level in the stomach (the level of acid and alkalinity) and this helps prevent acid indigestion.

Conclusion

We are socialized in the UK, Europe and America to see sports as a necessarily competitive process, either between different teams (for example the recent Winter Olympics) or competing against one’s own previous performance at a particular sport. But competition causes stress, as nobody wants to lose the race, or to let their team down!  And even after your team has won, there is always the anxiety about next time!  Next time we might lose!  And then who would we be?!

And inevitably there are vast audiences for these competitive sports.  And this has become a major form of involvement in sport: A passive, consumerist approach.

But what about the health of the people who are watching these events? Clearly, their health doesn’t get better by watching other people exercising. In fact, we now know that sedentary lifestyle is killing people! (Spectator sport does however make large fortunes for sports-related businesses and TV companies.)

The Eastern approach is very different: The benefits to the body of Chi Kung, (which is one of several Eastern forms of exercise), are many and varied. It’s like a type of medical therapy as well as an exercise system.

I was very fortunate in the 1980s to stumble across Chi Kung, when I joined Penny Ramsden’s Chi Kung class in Hebden Bridge. I found it so helpful, and health-giving, that I am still doing the exercises almost every morning, for over thirty years later!

Illustrating Chi Kung in action

Further down this page, you will see a video clip which illustrates the calming and relaxing movements of Chi Kung exercise, which gently gives the body a full workout – and practitioners feel great afterwards!

The exercise costs nothing, after you’ve learned how to do it.  It’s safe and effective and you can practice it anywhere at any time (indoors if the weather is bad. But exercising outside is better, because of all the fresh oxygen [chi] you get into your lungs and bloodstream).

You don’t need special equipment and, if you do it in the morning, it sets you up for the day to deal with the many hassles of life which you will inevitably face.

Here is a video clip of a group practising Chi Kung techniques:

My tutor (Penny Ramsden) told our group that, before she tried Chi Kung, she had been bed-ridden for a significant amount of time with chronic fatigue syndrome (CFS). Now she was fully recovered, after being taught by Michael Tse (pronounced Shay!), who teaches Chi Kung all over the world.

There are many classes where you can learn the movements, which you can then use for your physical and mental benefit for the rest of your life!

This form of exercise is great for developing resilience and managing the stresses of daily life, and if you practice it every day, it will slowly transform and strengthen you and enrich your life.

For many years I have recommended these exercises to students in college, and to my coaching/counselling clients.

Front cover, 8In the book on diet and exercise which I co-authored with Jim Byrne, I quoted a student of Chi Kung who improved his own mental health using this system.  Towards the end of his blog he wrote this:  “(Chi Kung) is a powerful tool for overcoming mild to moderate depression, for overcoming anxiety, worry and fear. It is a potent way to raise self-esteem and increase your resistance to the stresses and strains of modern living.”

From: How to Control Your Anger, Anxiety and Depression, Using nutrition and physical activity, by Renata Taylor-Byrne and Jim Byrne.***

So, I would recommend this system of exercise for whole body-brain-mind health.

I hope you investigate this system of exercise, and experiment with it. It’s incredible value for money. And it builds up your most precious asset: your physical and mental health.

It feels good right away, once you start to do it!  And when you set out to face your day, you can feel the energy flowing through your body!  You will also feel resilient in the face of the inevitable hassles of your day!

Best wishes,

Renata

Renata Taylor-Byrne

Lifestyle Coach-Counsellor

The Coaching/Counselling Division

Email: renata@abc-counselling.org

Telephone: 01422 843 629

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Reference

‘The Tao of Detox’, by Daniel Reid (2003). London, Simon and Shuster UK Ltd.

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Hype about antidepressants

Blog Post No. 163

By Dr Jim Byrne

27th February 2018

Dr Jim’s Counselling Blog:

Regarding some announcements about depression and medication

Some research results that should be known by all counsellors and psychotherapists, as well as their clients

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Copyright (c) Jim Byrne, 2018

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Context

Moncrieff on antidepressants.JPGWe wanted to post a blog about the new hype about antidepressants, which has been generated by a new report, which will be mentioned below; and which has been wildly hyped in the British newspapers over the past few days.

Then the magazine, What Doctors Don’t Tell You, produced an article which we liked, and we posted a link to that article, on Facebook, as follows:

“Antidepressants are a family of drugs that are bad and dangerous to know – and now researchers have named Effexor (venlafaxine) as the baddest of the bad. Patients are much more likely to attempt suicide while taking Effexor than any of the other antidepressants, a new study has found.

“The news comes as no surprise to those who’ve already been exposed to the drug. It’s considered to be one of the most powerful antidepressants, and one of the hardest to tolerate. In fact, around 19 per cent of patients stop taking the drug early because they can’t stand the side effects, which include anxiety, sexual dysfunction, weight gain, high blood pressure and thyroid depression. One patient even reported a sudden change of hair colour.

“They are the lucky ones. Once over the initial hurdles of life-destroying side effects, withdrawal symptoms are so severe that it’s almost impossible to stop taking the drug.

Antidepressants are a family of drugs that are bad and dangerous to know – and now researchers have named Effexor (venlafaxine) as the baddest of the bad…
WDDTY.COM

~~~

Some time later, there was a response.

A statement in defence of antidepressants!

A contact on a major social media platform posted this piece:

Unnamed Person: “…”  (The statement made by Unnamed Person has been removed, at their request, and is now replaced by a simple statement of the objections they made to my post above.) This was the substance of their objection:

1. It is ridiculous to post my post, because it is based on just ONE study!.

2. It seemed to Unnamed Person that there is a rigorous 6-year study of antidepressants and talking therapy which I should have posted alongside my post, for the sake of balance. And for the sake of acting responsibly.

I (Jim Byrne) responded like this:

Jim Byrne Hi Unnamed Person,
DrJimCounselling002Thanks for your message. So I looked up the study to which you refer, and this is what I found:

“The international study – an analysis pooling results of 522 trials covering 21 commonly-used antidepressants and almost 120,000 patients – found that all such drugs were more effective than placebos.” (Source, SBS News, Australia: https://www.sbs.com.au/…/antidepressants-really-do-work…).

What could possibly be wrong with the design of that study?

Well, look! They “…pooled the results of 522 studies…”.

What could be wrong with that?

Well, *how many* studies were *conducted* by drug companies, where they *refused* to release the results? It could be that they hide the almost half of studies which show *no benefit*, and publish the just over 50% that show *modest benefits*. (And they try very hard to *hide* the very widespread and *very serious* negative side effects of all of these ‘medicines’. (See this report in The Sydney Morning Herald – an equally well known Australian news outlet: https://www.smh.com.au/…/2008/03/02/1204402265828.html)

Here are some extracts from that Sydney Morning Herald source:

“The key issue is simple. In any situation, to make any kind of sensible decision about which treatment is best, a doctor must be able to take into account all of the available information. But drug companies have repeatedly been shown to bury unflattering data.”

“Sometimes they bury data that shows drugs to be actively harmful. This happened in the case of Vioxx and heart attacks, and SSRIs and suicidal thoughts. Such stories feel, intuitively, like cover-ups. But there are also more subtle issues at stake in the burying of results showing minimal efficacy, and these have only been revealed through the investigations of medical academics.”

“In January a paper in the New England Journal Of Medicine dug out a list of all trials on SSRIs that had ever been registered with the US Food and Drug Administration and then went to look for those same trials in the academic literature. There were 37 studies which were assessed by the regulator as positive and, with a single exception, every one of those positive trials was written up, proudly, and published in full.”

“But there were also 33 studies which had negative or iffy results and, of those, 22 were simply not published at all – they were buried – while 11 were written up and published in a way that portrayed them as having a positive outcome.”

I (Jim) then commented:

So, Unnamed Person, let me sum up. You cannot evaluate the effectiveness of drugs when the companies producing those drugs are allowed to selectively publish the results they want you to hear; and to hide the results they do not want you to hear.

And if some idiot, or charlatan, does a meta-analysis of the studies published by the drug companies, and their patsies, and says this proves those drugs are safe and effective, I have just one thing to say to them: This is not science! This is not good academic work! This is propaganda for the drug companies!

So, Unnamed Person. Who is being ridiculous? Think again about the flag you were flying under: “There is a *rigorous* 6-year study of antidepressants”. That flag is a pirate rag! There is no possibility of rigorous studies of all of the data on antidepressants so long as drug companies are allowed to hide bad data, and to publish what they choose to show us! 

~~~

Unnamed Person‘s response

Later, Unnamed Person, got back to me:

Unnamed Person: OK – if you batter me about what has been omitted, what ignored, what privileged by Pharma, money generally, academic status, medical ranking… then who am i to make such a foolish, academically unfounded post? Goodness, i will not use the word rigorous again. I similarly hope that your posted promulgations are way beyond the deeply adulterated processes they used. Mea culpa – and i look forward to hearing more about external academic critiquing of your claims to efficacy as well.
Jim Byrne Hi Unnamed Person, I did not mean to batter your about. You came out batting for Big Pharma – without realizing that that was what you were doing. You thought you were citing irrefutable evidence of a high quality against my paltry single study. The point about my single study is that it adds a little to the body of knowledge we are building up about the effects of food on mood. People who eat junk foods, or a diet high in carbohydrate are likely to get inadequate amounts of the amino acid studied – argenine. As such, they may be vulnerable to major depression. They should be informed of that risk, and not told that they can eat any kind of diet they like – including high carbs, high sugar, and junk – and then Big Pharma will fix them up with ‘Medicine’. But most of the antidepressants being prescribed for depression should not be in use at all, because the *proportion* of patients who take them, who will develop serious side effects – like sexual dysfunction or suicidal ideation – is well above the 10% safety line – often as high as 40%, or 50% or more than 60%. It is *unethical* for physicians to cause so much predictable *harm*! But they continue to do it, and studies of the kind you cited earlier do help to keep their consciences quiet! PS: I did not mean to beat you up. But if you call my attempts to educate the public – about self-care – ‘ridiculous’, I guess I will normally come out fighting! 🙂
~~~
Some thoughts from Mad in America
PS: Since Unnamed Person was interested in how well or how badly my position on antidepressants might be supported by scientific studies and expert support, I was pleased to see that Dr Joanna Moncrieff has published a piece on the latest hype in the Mad in America online blog – here: https://www.madinamerica.com/2018/02/challenging-new-hype-antidepressants/

Here is an extract from the opening of Dr Moncrieff’s piece:

Challenging the New Hype About Antidepressants

By

Joanna Moncrieff, MD

February 24, 2018

Joanna Moncrieff, MDThe extraordinary media hype over the latest meta-analysis of antidepressants puts the discussion of these drugs back years. Despite the fact that 9% of the UK population are taking antidepressants,1 and rates of prescribing have doubled over the last decade,2 the authors of the analysis are calling for yet more prescribing. John Geddes suggested in The Sun newspaper that only 1 in 6 people are receiving adequate treatment for depression in high income countries. In The Guardian he estimates that 1 million more people require treatment with antidepressants in the UK, but by my maths, if 9% are already taking them and they only represent 1 in 6 of those who need them, then 54% of the population should be taking them. I make that another 27 million people!

The coverage was almost universally uncritical, and said little about the terrible adverse effects that some people can suffer while taking antidepressants, or while trying to get off them. The Guardian even claimed that the new “groundbreaking” study will “put to rest doubts” about antidepressants.

But there is nothing ground-breaking about this latest meta-analysis. It simply repeats the errors of previous analyses. Although I have written about these many times before, I will quickly summarise relevant points.

The analysis consists of comparing ‘response’ rates between people on antidepressants and those on placebo. But ‘response’ is an artificial category that has been arbitrarily constructed out of the data actually collected, which consists of scores on depression rating scales, like the commonly used Hamilton rating Scale for Depression (HRSD). Analysing categories inflates differences.3 When the actual scores are compared, differences are trivial, amounting to around 2 points on the HRSD which has a maximum score of 54. These differences are unlikely to be clinically relevant, as I have explained before. Research comparing HRSD scores with scores on a global rating of improvement suggest that such a difference would not even be noticed, and you would need a difference of at least 8 points to register ‘mild improvement’.

Moreover, even these small differences are easily accounted for by the fact that antidepressants produce more or less subtle mental and physical alterations (e.g. nausea, dry mouth, drowsiness and emotional blunting) irrespective of whether or not they treat depression. These alterations enable participants to guess whether they have been allocated to antidepressant or placebo better than would be expected by chance.4 Participants receiving the active drugs may therefore experience amplified placebo effects by virtue of knowing they are taking an active drug rather than an inactive placebo. This may explain why antidepressants that cause the most noticeable alterations, such as amitriptyline, appeared to be the most effective in the recent analysis.

Antidepressant trials often include people who are already on antidepressants. Such people may experience withdrawal symptoms if they are randomised to placebo, which, given that almost no antidepressant trial pays the slightest attention to the problems of dependence on antidepressants, are highly likely to be classified as relapse.

The analysis only looks at data for eight weeks of treatment, whereas in real life people often take antidepressants for months or even years. Few randomised, placebo-controlled trials have investigated long-term effects, but ‘real world’ studies of people treated with antidepressants show that the proportion of people who stick to recommended treatment, recover and don’t relapse within a year is staggeringly low (108 out of the 3110 people who enrolled in the STAR-D study and satisfied inclusion criteria).5 Moreover, several studies have found that the outcomes of people treated with antidepressants are worse than the outcomes of people with depression who are not treated with antidepressants,67 even in one case after controlling for the severity of the depression (as far as possible).8 The huge increase in prescribing of antidepressants over the last three decades has been accompanied by a substantial rise in the numbers of people who are in receipt of long-term disability benefits due to depression and related disorders in the UK, and this is at a time when benefits for other disorders, like back pain, have been reducing.9

Calling for antidepressants to be more widely prescribed will do nothing to address the problem of depression and will only increase the harms these drugs produce. …

…For more, please click the link that follows: https://www.madinamerica.com/2018/02/challenging-new-hype-antidepressants/

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  1. Lewer D, O’Reilly C, Mojtabai R, Evans-Lacko S. Antidepressant use in 27 European countries: associations with sociodemographic, cultural and economic factors. Br J Psychiatry 2015 Sep;207(3):221-6.
  2. NHS Digital. Antidepressants were the area with largest increase in prescription items in 2016. Cited 2018 Feb 23; Available from: URL: http://content.digital.nhs.uk/article/7756/Antidepressants-were-the-area-with-largest-increase-in-prescription-items-in-2016
  3. Kirsch I, Moncrieff J. Clinical trials and the response rate illusion. Contemp Clin Trials2007;28:348-51.
  4. Fisher S, Greenberg RP. How sound is the double-blind design for evaluating psychotropic drugs? J Nerv Ment Dis1993 Jun;181(6):345-50.
  5. Pigott HE, Leventhal AM, Alter GS, Boren JJ. Efficacy and effectiveness of antidepressants: current status of research. Psychother Psychosom 2010;79(5):267-79.
  6. Ronalds C, Creed F, Stone K, Webb S, Tomenson B. Outcome of anxiety and depressive disorders in primary care. Br J Psychiatry1997 Nov;171:427-33.
  7. Dewa CS, Hoch JS, Lin E, Paterson M, Goering P. Pattern of antidepressant use and duration of depression-related absence from work. Br J Psychiatry2003 Dec;183:507-13.
  8. Brugha TS, Bebbington PE, MacCarthy B, Sturt E, Wykes T. Antidepressants may not assist recovery in practice: a naturalistic prospective survey. Acta Psychiatr Scand1992 Jul;86(1):5-11.
  9. Viola S, Moncrieff J. Claims for sickness and disability benefits owing to mental disorders in the UK: trends from 1995 to 2014. BJPsych Open 2016;2:18-24.
  10. Farnsworth KD, Dinsmore WW. Persistent sexual dysfunction in genitourinary medicine clinic attendees induced by selective serotonin reuptake inhibitors. Int J STD AIDS2009 Jan;20(1):68-9.
  11. Sharma T, Guski LS, Freund N, Gotzsche PC. Suicidality and aggression during antidepressant treatment: systematic review and meta-analyses based on clinical study reports. BMJ2016 Jan 27;352:i65.
  12. Fava GA, Gatti A, Belaise C, Guidi J, Offidani E. Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review. Psychother Psychosom2015 Feb 21;84(2):72-81.
  13. Reefhuis J, Devine O, Friedman JM, Louik C, Honein MA. Specific SSRIs and birth defects: Bayesian analysis to interpret new data in the context of previous reports. BMJ2015;351:h3190.

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Anger, anxiety, depression, and nutrition and physical exercise, imagePostscript

In November 2017, we (Renata Taylor-Byrne and Jim Byrne) published a book on How to Control Your Anger, Anxiety and Depression, Using nutrition and physical exercise.  There is a lot of evidence, and a growing evidence base, that the major mood disorders (which Big Pharma wants to treat with hard drugs with nasty side effects) can better be managed by healthy diet and regular physical exercise (and a good night’s sleep!)

Here is a brief extract from one of the main sections that deal with diet and depression:

(ii) Treating depression

There are many different views about how to treat depression, and here is a summary of some of the most recent explanations of what is happening to us when we are depressed.

Firstly, the views of Dr Kelly Brogan will be summarised, as she has a unique explanation, which she has described in her recent book, titled ‘A Mind of Your Own’ (2016)[i]. She is a practising psychiatrist in America, with training as a medical doctor, and a degree in cognitive neuroscience, including clinical training from the NYU School of Medicine. She uses holistic methods of treating her patients and describes her work as ‘lifestyle medicine’.  In this approach, she uses the techniques of meditation, nutrition and physical activity as crucial daily habits with which to treat her depressed patients (and this approach overlaps, but is not co-extensive with, the E-CENT approach [Byrne, 2016]).

Dr Brogan’s view is that depression is a symptom or sign:  “…that something is off-balance or ill in the body that needs to be remedied”.

She considers that mental illness symptoms aren’t entirely psychological or solely neurochemical. And she points out in her book that there is no single study which has produced evidence that depression is caused by a lack of chemical equilibrium in the brain.

She considers depression to be a grossly misidentified state and in particular for women who, in the US, are being medicated at the rate of one in seven. Also, one in four women in their 40’s and fifties use psychiatric drugs.

She states: “We owe most of our mental illnesses – including their kissing cousins such as chronic worry, fogginess and crankiness – to lifestyle factors and undiagnosed physiological conditions that develop in places far away from the brain, such as the gut and the thyroid”, and she goes on to state that:

“You might owe your gloominess and unremitting unease to an imbalance that is only indirectly related to your brain’s internal chemistry. Indeed, what you eat for breakfast … and how you deal with that high cholesterol and afternoon headache (think Lipitor[ii] and Advil[iii]) could have everything to do with the causes and symptoms of depression.”

Her opinion of the foolishness of applying chemical solutions to people’s problems is very clear. In her view: “… if you think a chemical pill can save, cure or ‘correct’ you, you’re dead wrong. That is about as misguided as taking aspirin for a nail stuck in your foot.”

Her approach is to get a medical and personal history of her clients, their manner of birth (natural or section), whether breast fed or not; and she orders lab tests to ascertain the whole picture of their biological make-up.

She focusses on the information from their cellular analysis and the workings of the immune system, and points out to the reader of her book that, over the last twenty years, medical research has identified the significant part that inflammation plays in the creation of mental illness.

She also focuses on the client’s lifestyle, dietary habits e.g. sugar consumption, the condition of their guts, and microbe balance (in their guts), hormone levels – e.g. thyroid and cortisol – and genetic variations in their DNA, which could affect their susceptibility to depression. And finally, their beliefs about their own health can also play a role, she says.

So Dr Kelly Brogan shares the same conviction as Dr Perlmutter (2015): that the state of our guts is a very important determinant of our emotional well-being.

Dr Perlmutter (2015) states: “Depression can no longer be viewed as a disorder rooted solely in the brain. Some of the studies have been downright eye-opening. For example when scientists give people with no signs of depression an infusion of a substance to trigger inflammation (in the body), classic depression symptoms develop almost instantly”. (Page 76)

Perlmutter is a board-certified neurologist and Fellow of the American College of Nutrition. He is also president of the Perlmutter Health Centre in Naples, Florida. Dr Perlmutter considers that our mental health and physical wellness are totally affected by the internal systems of bacteria that operate in the gut.

But what exactly is going on in our guts? Apparently, we’ve all got millions of microbes in our body and most of them live in our digestive tract (10,000 species!). And each of the microbes have their own DNA, and that means that for every human gene in our body, there are at least 360 microbial genes. These organisms include fungi, bacteria and viruses.  In a healthy gut, most of these microorganisms are ‘friendly’, with a few ‘bad’ bacteria which are controlled by the ‘good’ stuff.

These tiny microbes: (1) strongly influence our immune system; (2) affect absorption of nutrients; (3) signal to us whether our stomach is empty or full; (4) and determine our level of inflammation and/or detoxification (which are directly related to disease and health).   They also affect our moods.

Apparently our guts contain 70-80% of our immune system, and so our gut bacteria participate in maintaining our immunity.

They can also keep cortisol and adrenaline in check. These are the two major hormones of the stress response, which can cause havoc in the body when they are continually triggered and flowing.

And our gut microbes influence whether we get any or all of the following conditions: Allergies, ADHD, asthma, dementia, cancer and diabetes, a good night’s sleep; or whether we quickly fall prey to disease-causing germs. And there is increasing evidence of a link to anxiety and depression.

Dr Perlmutter makes recommendations for changes in people’s diet which he says will:

(1) treat and prevent brain disorders;

(2) alleviate moodiness, anxiety and depression;

(3) bolster the immune system and reduce autoimmunity problems; and

(4) improve metabolic disorders, including diabetes and obesity, which are all linked to overall brain and body health.

He makes recommendations which are very practical, including…

…end of extract…

~~~ 

Endnotes

[i] Brogan, K. (2016) A mind of your own: The truth about depression and how women can heal their bodies to reclaim their lives. London: Thorsons.

[ii] Lipitor is a drug commonly prescribed for reducing high cholesterol.

[iii] Advil (ibuprofen) is a nonsteroidal anti-inflammatory drug (NSAID). Ibuprofen works by reducing hormones that cause inflammation and pain in the body.

For more about this book, please go to: How to Control Your Anger, Anxiety and Depression, Using nutrition and physical exercise.

~~~

Lifestyle coaching on diet and exercise

Blog Post No. 161

By Dr Jim Byrne

2nd February 2018

Dr Jim’s Counselling Blog: Walking the talk of the holistic self-care movement…

Managing my mind by the use of exercise, diet, meditation and self-talk…

Copyright (c) Jim Byrne, 2018

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Introduction

natajim-coaching-counselling2My wife, Renata Taylor-Byrne, sometimes reminds me of the important principle of ‘extreme self-care’.

I didn’t learn any such principle in my family of origin, where the main message was to ‘behave yourself’; and to uncritically go along with the dominant trend of social pressure!

Over the years, I have woken up to the problem of (physical and emotional) stress, and how unmanaged stress leads to all kinds of mental, emotional and physical health problems. Also, because I developed a problem with Candida Albicans overgrowth – a gut dysbiosis problem – decades ago, I had to become clear about the importance of managing my diet – especially the elimination of sugary foods and alcohol.

This morning

Michael-Tse-demonstrating-Chi-KungAt a certain point this morning, I found myself exercising, and wondering if this information would be helpful in motivating some of our website readers (meaning you!) to shift to following the principle of ‘extreme self-care’. So here I am, following up on that thought, as a contribution to your health and happiness.

I got up this morning, at the same time as Renata, and got some salad ingredients out of the fridge, and put them on one side to warm up to room temperature.  (While that was happening, I checked my emails and website traffic, and so on).

When the salad ingredients had warmed up enough, I chopped them up and put them into two bowls.  They consisted of:

Salad bowl 74 leaves of Romaine lettuce (chopped very small)

2 radishes

a quarter of a yellow pepper (diced)

a quarter of a red pepper (diced)

four inches of cucumber (halved and sliced)

a quarter of a red onion (diced)

8 green olives

2 black olives

2 ozs of petit poise

6 fine beans (chopped small)

2 tsps of Maca powder

2 desert spoons of flaxseed

2 desert spoons of mixed pumpkin and sunflower seeds

8 whole almonds

2 ozs of pickled beetroot

~~~

This meal was so much more exciting and enjoyable than a bowl of cereal, or a full ‘English’ (fried) breakfast; or waffles with maple syrup!  Truly enjoyable! However, it would not be a good idea to eat the same breakfast every day.  Varity is important for gut bacteria and the available range of nutrients!

~~~

On my own bowl, I also added some fermented cucumber (instead of kimchi, which I had yesterday), and some Miso (the brown rice variety).

I then ate this as my breakfast, with a mug of green tea.

(In case I am beginning to sound like Saint Selfless, I had a cafetiere of exotic coffee while I was processing my emails!)

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Meditation and physical exercise

Sitting-meditationWhen we had finished breakfast, I read some brief quotes – about living in the moment, in the main – to set the mood for our Zen meditation, which we did for 30 minutes.  And then Renata led our Chi Kung (Chinese exercise) session, which lasted about 20 minutes.  Then we did a couple of minutes of the Plank (from Pilates) – for core strength – and then I did three sets of press-ups (30 presses in each set), and three sets of sit-backs (for 30 seconds in each set), for arm and stomach strength, and for hips and lower back.

~~~

The sun was shining in the front and back of the room in which we meditated and exercised, and we had Mozart playing in the background for the exercise session.  Divine!

~~~

At the end of this time, I was as relaxed, happy and de-stressed as a person could be, and all set for another session on the computer, working on promoting our book on diet and exercise.

Anger, anxiety, depression, and nutrition and physical exercise, imageThe book is called: How to control your anger, anxiety and depression using nutrition and physical exercise; and it is available at amazon, at the following links:

Diet and Exercise book at Amazon.com*** (North America)

Or:

Diet and Exercise book at Amazon.co.uk*** (UK and Ireland)

If you want to order the book from another Amazon outlet, then please go to the webpage listed below, and order it from one of the other links (in Europe, Australia, Canada, etc.), which are listed there.

Renata has just completed a little 2-minute video introduction to this book, here:

Please take a look and see what you think.

DrJimCounselling002If you would like some more information about the book (or to order it from a non-UK/US outlet), you can find a good introduction on our webpages. Just click the following link: Diet, Exercise and Mental Health.***

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That’s all for now.

I wish you a happy and healthy life, and the wisdom to engage in extreme self-care! J

Jim

 

Dr Jim Byrne

Doctor of Counselling

ABC Coaching and Counselling Services

01422 843 629

drjwbyrne@gmail.com

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