Tag: wellbeing

Autism and wellbeing

At the Autism Show in June 2021, we heard from speakers around the world about all matters relating to autism, from education to employment and from wellbeing to managing meltdowns. As high proportions of people with autism can be vulnerable to anxiety and depression, maintaining your wellbeing can be a challenge.

Peter Vermuelen, autism consultant and lecturer asked whether happiness is a mission for autistic people – or is it mission impossible? “You need to redefine this as becoming autistically happy,” advised Peter. “Avoid forcing a person with autism into neurotypical concepts of happiness.”

Obviously, autistic people are in fact human and have the same Maslow’s hierarchy of needs as anyone (although you should probably also add wifi and a full battery to the physiological needs). Autistic people have a higher risk for mental health issues – anxiety, depression and trauma are almost co-morbid conditions. The lifetime prevalence for people with autism is 10-65% for anxiety (compared to 15-20% of neurotypical people) and 10-55% for depression (10-30% neurotypical). Autistic people also have a lower quality of life in general, with respect to living arrangements, work/education, social relationships and future perspectives, even when compared to other neurodiverse diagnosed people, such as those with ADHD. This quality of life deficit cuts across all IQ ranges – the ‘severity’ of autism makes no difference to mental health issues.

According to Deci and Ryan’s self-determination theory, we all want to be our own person, to have autonomy, competence and relatedness. For Peter, studies show that the happiest people are the most successful (not the other way round). Even in neurotypical people, negative feelings can cause an overfocus on detail and rigidity in thinking. Positive feelings increase cognitive functioning, flexibility and adaptability.

There are two aspects of happiness:

A pleasant life e.g. joy, pleasure, absence of pain, safety, activities you like (volatile elements)
A meaningful life e.g. purpose in life, personal growth, serving others, life satisfaction (more stable elements)

Peter believes that happiness is within reach of all autistic people but interventions should be autism friendly, individualised and involve the person themselves. Peter’s programme, the H.A.P.P.Y project involves increasing baseline happiness and also adding more of the hedonic, or transitory, pleasure. This includes:

Accepting and loving yourself
Good feeling toolbox, such as a box full of happy things to take to school or work
Flow activities, those where we lose track of time and are distracted from our unhappiness. Special interests are a great fit here!
Physical exercise, as exercise helps with emotional regulation
Problem focused coping strategies. If we make life too easy, this creates learned helplessness. We need to build resilience in small steps to face problems
Emotion focused coping strategies e.g. mindfulness, relaxation, visualisation in an autism friendly way
Positive thinking. If you explore the ‘what ifs’ ahead of time, this can take away the unpredictability of what you are worried about
Gratitude. Make other people happy by writing letters or paying compliments
Kindness. Using your autistic strengths to help other people aids connectedness
Personal projects. Goals give life meaning, so try learning something new (although don’t make happiness your goal)

Peter concluded with my favourite quote of the day: “You can’t stop the waves but you can learn to surf” (Jon Kabat-Zinn).

Sensory processing and autism

Your ability to interact with the world through your senses can have a huge impact on your physical and mental wellbeing. Lorraine Young, an autistic adult and Sensooli Community Manager, highlighted Sensory Processing Disorder (SPD), which is common in the autism community. SPD can lead someone to be under or over sensitive to stimulus such as sounds, smells and textures, causing either sensory seeking or sensory avoidant behaviours.

I always thought we had 5 senses, but apparently there are 8: sight, sound, smell, touch, hearing and also vestibular (balance), proprioception (knowing where are bodies are) and interoception (not knowing if we are hungry, thirsty or need the loo).

Overall, around 1 in 20 people have sensory issues, while 1 in 6 may be significantly affected. Not all people with autism have SPD however, and vice versa. Helpful sensory hacks can use sensory seeking to counteract avoidance, for example using a favourite smell, such as hand cream to counteract a disliked smell. The Tudors clearly had a point with their handy pomanders.

Lorraine recommended using Sensooli to work out your own sensory profile. Sensooli provides sensory products and also support networks. “Sensooli is not a diagnostic tool, it is a discovery tool,” advised Lorraine.

Autism and disability in society

Thomas Henley, an autistic YouTuber and creater of the Thoughty Auti podcast, described how he can both love and hate being autistic. As only 22% of adults with autism are in work and 40% live with depression, social isolation can be a real problem.

Autistic people may experience challenges in society due to the ‘medical model of disability’, which assumes that people are disabled by their individual impairments or differences themselves. This model implies that the autistic brain should be treated to make it more neurotypical in order to achieve a better quality of life. Neurotypical life is the ideal in this model.

In contrast, the ‘social model of disability’ states that people are disabled by the interaction of their differences with external factors or society. In this model, social structures, attitudes and provisions should be adapted to fit the individual better. With improved support and integration, a high quality of life becomes possible without needing treatment. For Thomas, autism is a ‘differability’. “It has its upsides and downsides, just like being neurotypical,” he explained. “There is no ‘right’ way of being! Rather than treat autism, we should instead treat the conditions that co-occur with autism, such as mental health conditions.”

In mental health support there are very few specialists in autism and they tend to be available only privately at a high cost. There are not many targeted services available through the NHS and research into autism and mental health is also not well funded. “Nor is there much research into the upsides of autism!” pointed out Thomas. He remarked that there is an increasing media presence for autism and autistic characters, but many stereotypes still persist.

“Ironically, autistic actors are not playing autistic characters on TV because they often don’t fit the stereotypes!” said Thomas. Seeing truer representations of autism on screen would help to raise awareness and understanding, creating a society that is better able to adapt to the ‘differabilities’ of people with autism and (hopefully) improve their wellbeing.

Working well, wherever your desk

In August, AXA Healthcare updated the remote-working Wellcome Sanger Institute staff on ways to work well, wherever your desk. For those of us on the coroncoaster, who have perhaps over indulged on the quarentinis and gained a corona stone or so, this was a timely intervention.

The key is of course to aim for sustainable health change, not just in COVID times. The basics sound very simple: Think well, move well, eat well. But could this be easier said than done?

According to AXA, 41% of us like working at home but are looking forward to being back in the office. There is a fairly equal split between those who like 100% home working and those who find it a challenge. (For me, it depends which day you speak to me whether I appreciate it or hate it).

AXA covered the 3 main aspects to health – physical, mental and social health.

Mental health challenges you might experience:

Stress, anxiety and depression
Problems setting life / work boundaries
Motivation and self discipline issues
Isolation and loneliness
Presenteeism

Being solitary can give you opportunities for self reflection but risks becoming a negative experience over time. Around 39% of self employed homeworkers feel lonely due to long working hours and a lack of regular communication. If other issues come along, such as personal relationship breakdown or an unhelpful line manager, this can leave you feeling isolated without the support of colleagues.

AXA recommends keeping a balance between time for self and time with friends and family. Have a coffee with colleagues to give you a chance to share feelings and maintain two way communication. Make sure you put these things in place before you feel lonely, rather than as a fix once your health starts to deteriorate. After all, around 59% have found that their mental health has been up and down during COVID.

Looking after your mental health

Put a priority on ensuring you have a good life-work balance. Maintaining boundaries is crucial, including a start/stop schedule – when you are not working, make sure your laptop and phone are off or out of sight. Take frequent breaks with regular social interactions. Get away from the desk and take fresh air to break the cycle of feeling exhausted and unmotivated.

Most importantly, don’t bottle things up and make sure to seek help if you’re struggling before a crisis has a chance to get established. Looking after all aspects of health and wellbeing, such as physical health, will protect your mental health too.

Try to take a different perspective on home working to turn what you might feel is a negative into a positive – think about the increased control, autonomy and flexibility you have with your hours of work.

Five elements of resilience

Being positive – see it as an opportunity for change
Staying focused – identify what is important for you
Be flexible – take a break or switch activities if you are flagging
Be organised – establish a daily schedule
Be proactive – pre-empt challenges if you can

Coping strategies include:

Physical – stretches, exercise to release mental stress and tension
Social – maintain social networks and communications
Mindset – positive outlook, emotional and attentional control

In summary: Stay in touch, look after mind and body, cultivate resilience

How to stay active

General fitness protects against diabetes, cardiovascular issues, dementia, cancer and many other conditions. Government guidelines are to break up long seated periods and to take 150 minutes of moderate exercise or 75 minutes of vigorous exercise.

As life gets busier and busier again, you will probably need to be efficient with your time. Give yourself simple rewards or try something new to stay motivated. Use technology, like SMART watches to track your progress and commit in advance to exercise rather than waiting for the mood to strike. Fix a time to exercise and set achievable goals and you will be more likely to stick to them. I find that the time when I least feel like exercising, when I’m sad or self critical, is when I am most likely to get a boost from it.

There are 3 aspects to fitness, which include cardio, resistance and flexibility and your exercise plan should cover each one.

While working at your desk, set an alarm to move and vary position frequently. Take micro breaks and make sure that the environment is suited to the task you’re doing.

In summary: Optimise your time, utilise what you have, move more – something is better than nothing!

Eating well

Inadequate nourishment can reduce your efficiency by 20%, can affect your sleep quality, weight management, mood and lead to lifestyle diseases, such as diabetes.

A healthy diet is one that achieves an energy balance (between what you eat and what you burn up), is nutritionally dense and sustainable without gaining or losing weight. (Very much easier said than done when you spend your working day literally steps from the fridge!)

Try to eat a variety of fruit, vegetables and wholegrains, while limiting saturated fats, sugary foods and salt. Food is not just energy, it communicates with your body and makes you feel well or indeed, ill.

Plan the meals for the week in advance (preferably not when you are hungry), make a list and include snacks. You’ll eat what you have in the fridge! Avoid highly processed items, which are high in calories and low on satisfaction. Be resourceful with recipes and try something different. I’ve tried getting a veg box delivered to coax me away from the usual endless carrots and spuds. Be mindful of what you are eating and make a meal out of meal times. The days of hastily stuffing down a sandwich at your desk in between meetings should be over (for now at least).

Don’t forget that water and milk are both good for hydration but milk feeds into the system more slowly and has other beneficial nutrients. Dehydration of as little as 2% of body weight can influence mood, lead to greater feelings of fatigue and reduced levels of alertness. Surprisingly, 20% of our fluids come from food anyway.

Aim to drink more, perhaps using fruit slices for flavour without adding sugars. Alcohol and strong caffeine work against the body, so keep to a minimum. You should increase the quantity of fluids when exercising but be careful not to overdo it.

In summary: Use variety, establish routine, be resourceful

Good luck, and whether you are still working from home or returning to the office, keep a close eye on your physical, mental and social wellbeing – this is still the long haul for most of us.

Positive Coping in a COVID World

As it is Mental Health Awareness Week (18 – 24 May), there have been a slew of well-being focused events at work lately. AXA Health Care spoke to us about ‘positive coping’. Those displaying positivity seek out pleasurable and meaningful activities during changing and challenging times. The great thing about positivity is that it can be shared with teams and family.

Any situation leads to thoughts, emotions, behaviours and physical sensations and these will be unique to you, even if the situation is the same for all.

AXA highlighted “5 Ways to Wellbeing” – connect, give, keep learning, take notice, be active. There are plenty of obstacles to wellbeing that can get in your way, including your thoughts, lack of time, less autonomy, varying emotions, other responsibilities such as home schooling and priority management.

The reactions to change and adversity that people experience are many and varied, including fear, shame, feeling drained, anger, anxiety, a racing heart, catastrophizing and uncertainty. It’s important not to judge yourself negatively on your reactions based on the reactions of others; conversely, don’t judge others based on your own reactions.

Traffic light behaviours and self protection

Positive coping strategies typically involve taking a conscious and direct approach to problems. You can use a traffic lights technique to help monitor your reactions. Write down and then look out for behaviours that are positive (green), warning signs (amber) or unhelpful (red) for you. How do you know when you are starting to move into the red zone?

Make sure you protect yourself – stay informed but don’t delve too deeply into areas that make you anxious. For me this means staying off Twitter and being judicious with watching news updates. Write down your core values, the ways of being you hold most important such as accountability, uniqueness, autonomy, reliability. Ask yourself how you can preserve these during challenging times. Focus on your strengths, like creativity, patience and kindness, as these will give you purpose and hence lead to positivity.

Another trick is to identify the resources you have used in the past to overcome challenges. You could use a time line tool to rediscover these. When have you encountered difficulties in the past, what skills did you learn from the experience and what does this say about you? Examples could include changing job, moving house, as well as more recent shifts such as switching to home working or trying to home school. One skill we are all honing at the moment is the ability to multi-task!

What you do in challenging times is important, so identify those small (or not so small) achievements each day e.g. reading a book. You can separate these out into the routine e.g. cooking, the necessary e.g. paying bills, and the more pleasurable e.g. socialising, hobbies, gardening. Try to do some of all these each day if you can.

Positive coping strategies

AXA recommended a few positive coping strategies to choose from:

Self management using the 6Ps – Plan; Perfectionist e.g. be flexible and realistic; Pass it on e.g. can someone else do it, Put things off e.g. does it have to be done now; Proactive e.g. plan ahead; Prioritise – is it A (essential), B (better done today), C (could do it today), D (don’t do today)

Self compassion – how would you treat a friend in this situation? Try to forgive your mistakes, write a positive letter to yourself, try out positive self-talk and tell yourself what you love about yourself.

Solution finder tool – identify the problem, write down all your ideas for solving it, list the pros and cons, choose one, plan it, implement it, review it, keep going or adjust

Immerse yourself in nature e.g. parks, gardens, pets

Diary writing to download events and process feelings, such as gratitude journaling, positive data journaling, positive future writing

Get creative to lose yourself in an activity and get into a ‘flow’ state e.g. arts and crafts, dancing, poetry, playing music

Just breathe – use breathing exercises to get into the ‘rest, digest, restore and repair’ zone. Try this one: https://www.youtube.com/watch?v=-6jDjBSGRVY

Progressive muscular relaxation – tense hands, arms etc one by one then relax

Humour – share jokes, movies, clips, memes

Create a happy box – this should engage your senses: sound e.g. music; touch e.g. fabric; sight e.g. photos, books; taste e.g. foods; smell e.g. candles, handcream. Also add the contact details for a person or organisation you can reach out to if these don’t restore you.

Ways to achieve a positive or balanced mindset

Catch the catastrophes – we are drawn to catastrophizing and worst case scenarios, when even the unlikely scenarios can start to feel inevitable. Write down…

What is the worst possible outcome? (But don’t get too hung up on those!)
What is the best possible outcome?
What is most likely outcome e.g. what is the evidence for that?
Plan for the most likely outcome

Helicopter view – take a step back from your opinion, is there another way to look at something which is not so up close and personal?

Worry tree – if this is not something you can control, let worry go e.g. write it down on paper and throw it away. Have a ‘worry time’ at a specific time of day when you will worry about things, then park them until the next worry time.

Tips for tolerating uncertainty:

acknowledge worries;
pause and try not to react;
pull back;
let go i.e. a thought or feeling is not a fact, imagine it floating away in a balloon
explore and remember that right now all is well, focus on your 5 senses to bring you back to the here and now

Remember to help others, if you can- communicate regularly, show empathy, reassure and most importantly ask for help when you need it.

The Good Mood Café with Jenny Swain

I also attended a ‘Good Mood Café’ by Jenny Swain aimed at parents and carers. She asked us to associate a good mood with a sound, like bird song, waves or for a parent, the blessed silence of contented / sleeping children!

In a household, even at the best of times we will be juggling lots of different moods in family members and these tend to feed off each other. If we focus on how to lift our own mood first, then we can see the domino effect on others around us, akin to putting on our own oxygen mask first.

Mental Health is a continuum, from optimum mental wellbeing to poor mental wellbeing. This is just as true for those with no diagnosable mental health conditions as well as people with serious diagnosable mental health issues. It is very possible for us all to move between the quadrants, day-by-day or over weeks, months or years. Which quadrant do you feel that you are in at the moment?

Jenny also recommends self compassion. To counteract depression and self hatred, practice self care.

Tell yourself that the task was very hard and lack of success is not total failure.
Not everything is our fault. Most people have normal, average lives and very few beat the odds to show ‘brilliance’ – don’t compare yourself unfavourably.
Luck is involved in most success and failure, and this is not in your control.
Remind yourself you are not entirely to blame for everything that happens in your life, or indeed in the lives of your family.
You are not only your achievements – rehearse the voices of those who have been kind to you, especially when you were young
This too shall pass – reduce expectations to zero in a crisis and take some rest

The School of Life has a great video on self care: https://www.youtube.com/watch?v=-kfUE41-JFw

Rumination or over focus on what causes us distress is our enemy, so try to get out of internal loops of negative thinking – “I can’t cope, why can’t I cope, I should be able to cope” and so on. Switch focus to something external to yourself. For example, what were you doing the last time you were outside, walking, relaxing or gardening? Freeze frame that moment and focus on your 5 senses at that point. Don’t forget that physical movements generate endorphins, so get your exercise!

Jenny left us with some challenges – you might want to try a few of these when you have a few moments.

Challenges for achieving a good mood

List 5 things you notice each day that make you feel happy
Identify your 5 favourite tastes or flavours and the associations that go with it e.g. a holiday food
Think about a favourite piece or style of music, then pinch your thumb and forefinger together to ‘anchor’ that good mood feeling in your mind
Create a good mood play list of your favourite tunes
Try a breathing exercise to promote calm e.g. “How to avoid becoming a lizard“

What can you do for 3 minutes or even 30 seconds a day to lift your mood?

Places to go for help

Mental health at work.org.uk: https://www.mentalhealthatwork.org.uk/
MIND: https://www.mind.org.uk/
WHO: https://www.who.int/mental_health/en/
NHS Choices: https://www.nhs.uk/oneyou/every-mind-matters/
CPSL Mind Qwell: www.cpslmind.org.uk/qwell
Learn.4mentalhealth: www.learn.4mentalhealth.com
Anxiety UK: www.anxietyuk.org.uk
Young Minds: www.youngminds.org.uk

Managing you and your child’s wellbeing– being realistic and human (and not super-human!) by the British Dyslexia Association with Amanda Kirby

This week I tuned into a webinar from the British Dyslexia Association with Amanda Kirby on managing you and your child’s wellbeing. Given how I’ve been struggling with my new joint role as my son’s 1:1 learning assistant combined with remote office worker, this seemed like essential listening.

Professor Amanda Kirby describes herself as a medic, academic, entrepreneur and parent of an adult with Dyspraxia, Dyslexia, and ADHD. She is also the CEO of a fast expanding computer educational and work-based profiling company (www.doitprofiler.com)

Amanda opened with a reassuring message to all parents. “Remember what you are not is a teacher, SENCO, IT technician, clinician, speech and language therapist or occupational therapist. You are a parent, and a super one.”

For those of us bouncing between ‘school’ and ‘work’ time at home, Amanda reminded us that children don’t have hours and hours of 1:1 contact time with teachers during classes anyway. “Half an hour working with them on school work is doing well!” she told us.

Managing anxiety

Elevated anxiety levels, whether in you or your child, do not make learning any easier. We should ask ourselves what makes our child anxious in normal times and try to remove these triggers. We can create a low emotional arousal setting for them using things they like, such as favourite foods (assuming you can get hold of them), well-liked music and comfortable clothes. At least we can say goodbye to the scratchy tie and blazer combo for a while.

Amanda compared our overall stress levels to a bucket, which gets filled by drips (day-to-day irritations), dribbles (feeling unwell, sourcing food) and gushes of stress (family illness, threats to income, huge changes in routine). Normally, there is also a tap to drain stress from the bucket, but with fewer ways to let off steam or distract ourselves outside our homes, these release mechanisms have been drastically reduced. More stress in and less stress out can lead to an overflowing bucket.

Physical symptoms of this overflowing stress bucket in adults can include being in a fight or flight state all the time, sleeplessness or feeling overtired, aches and pains and many more. Excess stress has similar effects on a child. They may become more clingy, have tantrums, worry or talk all the time, go silent, relapse to bedwetting or experience tummy pains, headaches, wakefulness and panic attacks.

Amanda recommends the approach that Dr Russ Harris takes in the Happiness Trap. He uses the FACE principle.

Focus on what is in your control – manage your home and workspace, work and leisure activities, stay connected by phone and online
Acknowledge your feelings
Come back into your body (stand up, press your feet to the floor) so anxiety does not overwhelm you
Engage in what is around you (be present, look at what’s in front of you)

Create a daily structure

Structure is important in chaotic times. Plan out a timetable for each family member and put it where everyone can see it. Make sure you differentiate between the week and weekends in some way. If both partners are working from home, could you agree shifts for childcare and take turns? Starting your work earlier or later and doing blocks of a couple of hours is another option.

“Most importantly, show your children you can enjoy yourself, even in these difficult times,” said Amanda. “Plan your days and create a structure or timetable for chores, meals, fun and shared evening activities. There are other ways to learn apart from schoolwork. Weave some maths into cooking for example.”

While establishing a routine is important, do adjust it if you’re tired and step back from the timetable if you need to. Ignore the fake perfection of other people’s routines on social media!

Dealing with worries

If you are tense, your kids will mirror your emotions. Reduce arguments in front of your children and hold family meetings with older children to keep communication lines open. Try to avoid talking about corona or checking the news in front of the children. Be kind and give them some leeway, especially older children who will be really feeling the lack of friends and peers.

Younger children might like a worry box where they put their worries for you to remove overnight (don’t forget like I keep doing with the tooth fairy though!) You can build an anger volcano with Lego or papier mâché and talk about how you feel when you’re ready to erupt. Create a helping hands tree where they write the names of adults who they trust and who will help them.

Activities to try

There is an overwhelming range of ideas for activities online (some resources are listed below), but think about going back a stage and do the fun things you used to enjoy together. Many activities can be done with very little in the way of resources.

Shared games and activities e.g. Lego, jigsaw, board and card games, cooking together, reading a book
Create a project together e.g. family history, family song
Growing seeds e.g. from an apple
Teach a new skill e.g. sewing, knitting, crochet
Learn a song e.g. abba
Baking
Carpentry
Drawing
Write to a pen pal
Cardboard inventions
Tie die T shirt
Yoga class at home
Projects for teenagers e.g. video diaries, blogs, vlogs

The importance of sleep

A good bedtime routine is vital for managing stress and there is a real risk of teenagers turning daytime into night and vice versa. For younger ones, try a bath with lavender oil, read a story, use a weighted blanket or tuck in bedclothes firmly to make them feel safe. A regular bedtime for them gives you an evening too! For teens, try a warm drink, white sound to help get them to sleep, audiobooks and avoid screens at bedtime (adults also take note!)

For parents

As much as you can, focus on the here and now. Be kind to yourself, share jokes, watch comforting programmes on TV – streaming services have never had more on offer. Could you get into photography or a new craft? Listen to music you love and watch old box sets. Have one glass of wine (but no more or it will upset your sleep pattern!)

If you are really struggling to focus, then sort things! Put the Lego away, tidy cupboards, potter in the garden, clean. It brings you back to the here and now.

Teen angst

For teenagers, these are the years when they form their identity and go through puberty. Peer-to-peer interaction becomes much more important to them – and this has just been taken away. Teens are also going through changes in their brains which mean they can act without thinking, struggle to organise themselves and experience emotional dysregulation.

Respect their space and privacy as much as possible. If they have a shared bedroom, put up a sheet to create private space. Try to give more leeway than normal – remember, they are very worried about the future. Leave the door open for communication and just keep trying if it doesn’t work at first. Allow them to stay in their room, but make sure they are safe online and aren’t experiencing cyber bullying. Do eat together to coax them out of their room from time to time and prevent them living entirely off junk food. “They will probably try to take their stress out on you!” cautioned Amanda.

The website Young Minds has ideas to help, for example making a self soothe box.

And finally, don’t forget your pets! They can also get anxious when you do, so look after them and take them out for short walks with you during your daily exercise.

Top tips to remember