I’m childless and lonely. I feel moving would help, but my husband isn’t keen

I’m coming to terms with a life that I wasn’t expecting after 20 years of marriage and am struggling to find a route to a new life. My wish is to live by the coast, about 70 miles from our current home.

My husband and I have come through infertility and eight rounds of IVF without children (adoptions and alternatives have been explored). He is nearly 20 years older than me; I am in my mid-40s, and scared of the menopause robbing me of more of my identity. I don’t necessarily consider myself to be over our loss, but I try to be accepting. Yet it has changed our lives in an unbalanced way. He says that children would have been a bonus, which does relieve the pressure but makes me feel lonely in my recovery. To me, it meant more: the validation of being female, and a space in my heart is missing.

I feel that I’m living a life haunted by what might have been. Our house, bought before we started treatment, has many bedrooms, and my job doesn’t have any career prospects although it is in a field I enjoy. I know that it is time to move on and I could work freelance. My husband thinks that I should stay for the security and the benefits, and his worries are contagious, but I don’t know to whom I would leave my worldly goods if I should die after him.

I yearn for peace and quiet, having also been diagnosed with mild autism. When we go on holiday with our dogs, I find the peaceful places so much better for my state of mind. Walking on beaches is accessible and a rare pleasure for me. I struggle at home in mud and frost.

My husband wishes to stay where we are: he enjoys the city, has friends here and goes to sporting events every weekend. I feel resentful often. While my husband has said he will move, it is said grudgingly. I think life is too short and wish I could make him see that we do have more choices than for me to sit at home on antidepressants.

Yet each time we go away, I ruin the holiday with panic attacks about going home to a life in which I feel lost.

I’m sorry about your failed rounds of IVF: in your longer letter, you called it a trauma but you reduced all of it, pretty much, to a single sentence. Yet its impact, not surprisingly, colours the whole of your letter. The other thing that permeated your letter was identity; you talk of it a few times, once directly. I wonder if you feel that, without the children you planned to have, you don’t know who are.

Barbara Levick, a psychoanalytic psychotherapist (bpc.org.uk), feels that you have had “repeated disappointments” and that “perhaps [not surprisingly], you have real difficulty overcoming the loss. How important is the lack of children to you? It seems a major disappointment, but the catastrophic nature of it is not shared by your husband.”

Or perhaps it is, but there didn’t seem to be a sense of you both having really talked about how you feel. Certainly, I felt you hadn’t told your husband about how you feel. I got the impression of two people, living together in this big house, but locked away in their own worlds.

I kept feeling there were little screams of, “What about me, what about me?” all through your letter. What about you? When do you get to do what you want, say how you really feel? I’m a big fan of good therapy, and I would urge you to hunt some out just for yourself (start with your GP). You need a place where you can talk about how you really feel, and discuss what you really want. “People who are mildly autistic,” says Levick, “can really benefit from some one-to-one work.”

Levick also has the feeling that you have difficulty getting what you want, and wonder why that might be. “I think you need to get yourself doing more of what you like,” she says.

Even without what you have been through, what you want doesn’t seem so very much – a move 70 miles away, to live by the sea, to be able to take good walks. You are not asking for something impossible.

Levick explains that sometimes we don’t do things because guilt or fear hold us back in unconscious ways. I would add that we make excuses for what we can’t do and then we can become so used to those excuses that we start to believe them. Levick feels you are “stuck in concrete”.

I wonder if you could rent a little property by the sea? I wonder how close you could come to making things more into what you need/want? And instead of coming up with reasons why not, think “how could I make this happen?”

Your panic attacks are interesting – talking very generally (and not specifically about you), Levick says that “panic attacks are about [suppressed] aggression. We all have to manage our aggression somehow and it’s a positive thing, it keeps us going. But some children growing up maybe aren’t allowed to express their aggression and then, later, if there are circumstances where the person feels very, very angry that can come out as a panic attack.”

I wonder if any of that resonates with you?

Your problems solved

Contact Annalisa Barbieri, The Guardian, Kings Place, 90 York Way, London N1 9GU, or email annalisa.barbieri@mac.com. Annalisa regrets she cannot enter into personal correspondence.

Follow Annalisa on Twitter @AnnalisaB

I’m childless and lonely. I feel moving would help, but my husband isn’t keen

Harare"s park bench grandmas: "I speak to them and feel a load is lifted off my heart"

The therapy room is a patch of waste ground, and the therapist’s couch a wooden bench under a tree. The therapist is an elderly Zimbabwean woman, in a long brown dress and headscarf.

Her patients call her “Grandmother” when they come along to sit on her bench and discuss their feelings, their depression or other mental health issues.

Outside a clinic in Highfield, a poor suburb just south of Zimbabwe’s capital Harare, there are lots of grandmothers – trained but unqualified health workers – who take turns on the park bench to hear stories. They listen to the battered wife who has attempted suicide twice, the man who hates women after he became infected with HIV, the unemployed single mother driven to despair by the struggle of raising four children.

The benches are a safe place for people struggling with depression, which in the Shona language is called kufungisisa, “thinking too much”.

It is a world away from conventional approaches to mental healthcare, but the Friendship Bench project has changed the lives of an estimated 27,000 Zimbabweans suffering from depression and other mental disorders.

The grandmothers, all of whom are trained to improve a patient’s ability to cope with mental stress, listen and nod, offering only an occasional word of encouragement.

One in four Zimbabweans suffers from some form of mental illness, but there are only 13 psychiatrists in a country of about 15.6 million. A solution had to be found, and it came in the way of a bench and the tradition of respect for African matriarchs.

Clinics screen their visitors for mental illness through a locally developed tool called the Shona Symptom Questionnaire. It has 14 questions, such as “Have you been struggling to sleep?” and “Have you been worrying too much?”

Patients scoring above the cut-off level are referred to the friendship bench. Those who go to the grandmothers are five times less likely to have suicidal thoughts, according to Dr Dixon Chibanda, co-founder of the scheme.

“When they first get to the bench, we use an intervention which we call kuvhura pfungwa [opening of the mind]. They sit and talk about their problems. Through that process, the grandmothers enable that patient to select a specific problem to focus on, and they help them through it,” he says.

Through at least six one-on-one sessions with the health workers, the patients are encouraged to speak about their problems and their mental illness.

Traditionally, elderly women play the role of counsellor for younger members of the community. On the bench, however, the grandmothers listen more, and lecture less.

“We used to talk a lot, ‘Do this, do that’. But now we ask them to open up, open their minds and hearts,” says Sheba Khumalo, a grandmother.

Chibanda says it is mostly women that visit the bench. “From our recent study, we found that 40% of those coming to the bench who show depression are victims of domestic violence. Whether that violence is caused by the economic situation is something that we have not looked at.”

In conservative Zimbabwe, just getting people to open up about their mental health is a victory in itself, says Joyce Ncube, another of the grandmothers.

“Many died just because they had nobody to tell their problems to,” she says, settling on to the wooden seat for a session with one of her patients. “When people keep things inside, their problems start.”

Maria Makoni is a 49-year-old unemployed mother of three who began therapy earlier this year.

“In our culture, you are ridiculed for speaking about your mental health,” says Makoni.

She is tense, but lights up when she speaks about the grandmothers. “I was desperate to find someone to talk to about my problems. When I speak to them, I feel like a load is lifted off my heart.”

When Makoni first found her way to the friendship bench, she was surprised to find she was one of many with similar problems. Now she is volunteering to bring more to the bench. “I am ready to speak to as many people as I can.”

Grandmothers working with the Friendship Bench project chat before counselling sessions begin. Photograph: Cynthia R Matonhodze

For many Zimbabweans, poverty – more than 70% of people live below the poverty line – and unemployment are a source of despair. In such a deeply superstitious and religious society, mentally ill people are sometimes seen as possessed; many are dragged to exorcism sessions at charismatic churches or traditional healers.

Chibanda says such beliefs need not be a hurdle, provided the intervention is packaged well.

“The term ‘opening of the mind’ does not sound medical at all. We have used those words to package a scientific intervention, and this is why it’s acceptable.”

The programme has had to pick its words carefully, as the grandmothers are meant to be more friends than doctors. The scheme was initially called “mental health bench” but nobody came. “The minute we changed it to friendship bench, it became acceptable, even though we are essentially providing the same thing,” says Chibanda.

Researchers say the friendship bench may be a blueprint for mental healthcare in developing countries. In Zimbabwe, the programme will now be rolled out to 60 other clinics across the country.

“This bench is filling that gap we have in providing affordable care,” says Prosper Chonzi, director of health for the City of Harare. “We are glad to see it is being applied to other cities in the country.”

Harare"s park bench grandmas: "I speak to them and feel a load is lifted off my heart"

Rise in middle-aged men taking steroids to feel youthful, experts say

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People who work with users have raised concern about a new trend among men in their 40s and 50s who take the drug to fight some of the signs of ageing

Growing numbers of middle-aged men are turning to anabolic steroids to make themselves look and feel more youthful and boost their sexual performance, experts say.

People who work with users have raised concern about a new trend among men in their 40s and 50s, and some even in their 60s and 70s, who are taking the drug to boost energy levels and fight some of the effects of ageing, such as weight gain and a lower libido. Steroids can cause a range of potential health problems, such as heart disease and blood clots.

Continue reading…

Rise in middle-aged men taking steroids to feel youthful, experts say

Colds feel worse to lonely people, study suggests

Having a cold can be a miserable experience, but it turns out that the symptoms may seem worse if you feel lonely.

A study by a team of US researchers has found while loneliness does not appear to have any impact on an individual’s chance of falling ill with a cold, or the actual severity of the symptoms, it does seem to be linked to feeling more under the weather.

But results show that feeling worse was not linked to the size of a person’s social network.

“When it comes to our health it seems that it is the quality of our social relationships that may be more important than just the quantity,” said Angie LeRoy, a co-author of the study from Rice University.

Writing in the journal Health Psychology, LeRoy and colleagues from a clutch of US universities describe how they probed the link between cold symptoms and loneliness by asking 213 healthy adults to complete questionnaires related to loneliness, their social networks and their mood before being infected with the common cold through nasal drops.

The participants were quarantined for five days, during which time they were asked to record their symptoms, such as sneezing, a runny nose or sore throat, and log the severity of their symptoms on a five point scale. In total, 159 of the participants developed a cold and had complete data.

After taking into account factors including age, sex, the season, education, income and mood markers, analysis of results from these participants revealed that those who scored higher on loneliness were no more likely to get a cold than those with low scores, but they did report symptoms of greater severity.

Delving deeper, the team found that the link was not down to the size of individuals’ social networks. “It doesn’t matter if they had a large social network,” said LeRoy. “It mattered about how they felt about their social network.”

However, when the researchers looked at the weight of mucus produced by each participant in the study, they found that there was no link to loneliness, suggesting that while loneliness was linked to how rotten participants felt, lonelier individuals were not more physically sick.

“Loneliness wasn’t necessary associated to how biologically ill they were in terms of the severity of their cold but it was associated with how severe they perceive their symptoms to be,” LeRoy told the Guardian. The authors say that helping those who are lonely build ties to others could help to reduce how bad they feel when they catch a cold.

LeRoys admits that the study does not show that loneliness is causing the perception of worse symptoms – indeed the authors note that, for example, those who are lonely often have poorer sleep. But, she says: “We measured loneliness before we exposed them to the cold and then we measured their symptoms, which infers that the loneliness came first.”

LeRoy adds that, combined with previous studies highlighting the link between loneliness and negative impacts on health, doctors and other medical professionals should take note of their patients’ mental state both when patients register and when they are unwell.

“How [patients] feel before [they are unwell] obviously could influence how they feel when they are sick, even with something as simple as a cold,” she said.

Colds feel worse to lonely people, study suggests

The 10-a-day diet tested: "I feel like a sentient composter"

Like everyone else in the world, my blood ran cold when I heard that we are now expected to eat 10 portions of fruit and vegetables every day. That is double the previous recommended amount, and even that required too much effort for my liking. Oh, sure, the effects of 10 a day sound miraculous – researchers claim that it would decrease our chance of heart disease by 24%, stroke by 33% and cancer by 13% – but it sounds a bit much, doesn’t it?

Perhaps not. “We wanted to investigate how much fruit and vegetables you need to eat to gain the maximum protection against disease, and premature death. Our results suggest that although five portions of fruit and vegetables is good, 10 a day is even better,” said Imperial College’s Dr Dagfinn Aune, lead author of the research.

What does it mean exactly? It’s 10 servings of 80g portions – so three tablespoons of peas, or one pear, say, is a single portion. So, is it do-able?

A YouGov poll from 2012 reported that only one in five of us manage to hit five portions a day, let alone 10. Brave pioneer that I am, I decided to find out over the course of a long weekend, before Guardian cook Felicity Cloake judged my efforts and offered some suggestions of how better to hit my goal.

Friday
Breakfast

My breakfast usually consists of horrifyingly sugary cereal, to provide me with the artificial jolt of energy required to see me through the morning. Today, however, I eat a grapefruit, a banana and an apple. Better yet, a whole grapefruit counts as two portions. Still, it’s 7.30am, and I’ve already almost hit half of my daily quota. In your face, science. I’m going to live for ever.

Except I’m not, obviously, because as Harley Street dietitian and sports nutritionist Raquel Britzke points out, favouring fruit over vegetables has problems of its own. “Both give you carbohydrates, vitamins, minerals, and fibre,” she says. “But fruits tend to have more carbs, and consequently more sugar, than vegetables. If you have a slow metabolism or are trying to lose weight, I recommend eating seven portions of veggies and three portions of fruit.” Great.

A happy start to the experiment. Photograph: Stuart Heritage

Lunch

G2 sends a photographer to my house, to show the world what I look like when I’m near some vegetables. Inadvertently, my lunch becomes all the things that the photographer tells me to put into my mouth. This ends up being an apple, a banana and two different carrots.

Dinner

On a normal day, my meal of chicken and potatoes would have been entirely vegetable-free but, knowing that I now have a target to hit, I pile up a mound of cherry tomatoes on the side and work through those as well. It’s not quite the advice I was given by another nutritionist, Laura Thomas, who suggested that all meals should consist of at least 50% vegetables, but it’s a start. A bowl of watermelon for pudding and I’ve easily hit my 10.

Total intake: 10 portions.

Felicity’s verdict

Stuart has immediately discovered the easy part of fruit and veg consumption: the fruit bit. Australians are told fruit should make up just two of their recommended seven portions a day because of its effect on blood sugar – and he has got through 60g of sugar for breakfast alone. Although our own government seems to take the view that any fresh produce is better than the traditional British diet of Jammie Dodgers, it might be wise to swap some of this fruit for avocado on toast or a mushroom omelette occasionally, and save the sweet stuff for pudding later in the day.

Saturday
Breakfast

Now that I have a toddler who can shout the word “pancakes” in a vaguely threatening manner, Saturday breakfast is always a rigidly enforced stack of banana pancakes. The good news: one stack has a whole banana in it. The bad news: it also has eggs and flour in it, which fill me up much more than just a banana would. However, I still manage to heroically force down an apple and two satsumas as well. Four portions, done and dusted by 8am. I am the best.

Saturday breakfast: banana pancakes and fruit. Photograph: Stuart Heritage

Except, wait. After checking the NHS website, I realise that a satsuma only counts as half a portion, which knocks me back down to three. Undaunted, I eat two more satsumas to boost me back up, which means that I’ve now eaten four satsumas in a row for breakfast. This is no way for a man to live.

Snack

I put my son down for a morning nap and, because of this stupid challenge, think: “What a perfect opportunity to eat an entire raw carrot.” It has been years since I last ate an entire raw carrot, and now I see why. Raw carrots are rubbish – all chew and no reward. The carrot takes a thousand years to eat. It takes so long that my son wakes up before I finish, and I have to put the rest of it in my pocket for later. All this work, trying to sneak in a vegetable whenever I have a moment of downtime, is starting to make me feel less like a person and more like a sentient composter.

Lunch

A bowl of chicken-and-vegetable soup (which counts as a portion, according to the label), and two portions of grapes. Two portions of grapes is 28 grapes, which I count out one by one like some sort of shivering Victorian waif. What have I become?

Later, while running errands, the wind begins. There is a good three-minute stretch where a brand-new fart pops out of my trousers with every step I take. This is new. So much for science; I worry that if everyone eats 10 portions of fruit and veg a day, we’ll all end up dead from methane inhalation.

Dinner

Meatballs and pasta and tomato sauce (homemade, so it counts) and another big bowl of watermelon. I’ve hit my 10 portions again, and I only had to accidentally fumigate one shop to do it.

Total intake: 10 portions.

Felicity’s verdict

Banana pancakes are a painless way to get fruit into children; top with berries to add an extra portion, and ring the changes with cheesy courgette or crispy carrot fritters occasionally. Equally, at this time of year, when salads feel a bit punishing, soup is a lifesaver: minestrone will happily absorb any old odds and ends you have in the fridge. You can also add finely chopped veg to meatballs and burgers (grated carrot or finely chopped spinach are good candidates) – and, of course, if Stuart ever finishes that sugary watermelon, he could always knock up a chocolate beetroot or parsnip-and-orange cake as an after-dinner treat.

A bountiful breakfast. Photograph: Stuart Heritage

Sunday
Breakfast

The plan was to have a nice, big, healthy breakfast and then head out as a family to a fancy event in London. However, a combination of train cancellations, a sick wife and barely any sleep means that breakfast now consists of a chocolate chip cookie that I made with my son yesterday. The cookie has a glacé cherry on it. Glacé cherries apparently do not count towards your 10 a day. This feels like an oversight on the part of the NHS.

Lunch

Post-event, with my wife home unwell, my son and I find ourselves in the nightmarish epicentre of tourist hellscape London. Thomas’s advice for eating out is this: “Ordering vegetable sides is a good option, but you could also think about replacing one of your protein foods with beans – they can count as one portion per day. Trying to get more vegetarian meals in, too, will make it much easier, and this is consistent with the advice to cut back on red and processed meat.”

However, this is an emergency; I just want to survive today. Lunch ends up being something that can be eaten quickly at the nearest possible kid-friendly place: a burger and chips from Giraffe. (Chips don’t count as a portion, by the way. I checked.) I could have ordered vegetables but, after yesterday’s carrot debacle, I realise that I would still be there chewing on it now if I had. Knowing what a failure today has become, and remembering that Thomas said they count, I order a smoothie. At least that’s something.

On the train home, I distract my son and, when he isn’t looking, eat some of the snacks I bought for him. I manage six grapes and a third of a satsuma, which is about two-thirds of a portion in total. Still counts, though.

Basically watermelon is terrible for you. Photograph: Stuart Heritage

Dinner

Poor marital communication means that we end up eating chips again in the evening. On the plus side, we also have baked beans. Half a can of baked beans equals one portion of vegetables, and for one beautiful moment I toy with the idea of getting back on track by gorging myself on a multipack. However, the NHS guidance points out that anything over half a can still only counts as one portion, because they “don’t give the same mixture of vitamins, minerals and other nutrients as fruit and vegetables”. This, it dawns on me, also applies to my doubled-up portions of grapefuit, apple and banana on Friday. I check the NHS’s five a day website and it explains that “to get the maximum benefits, you need to eat different types of fruit and vegetables”. Stupid NHS. This isn’t why I pay my taxes.

More watermelon for pudding, but this doesn’t really make up for anything, especially since Britzke has decided to single out watermelon as one of the worst fruits to eat, thanks to its high glycemic index. Nutritionally, today has been a disaster.

Total intake: 3.66 portions.

Felicity’s verdict

The problem with fruit and vegetables is that they tend to take more preparation than merely opening a packet (or, in Stuart’s case, the biscuit tin), so it’s a good idea to keep carrot sticks or broccoli florets handy for those moments when you don’t have time to faff about with cooking, ideally with a pot of something delicious to dip them into so you don’t lose the will to live and reach for the crisps instead. In fact, like many healthy eating regimes, fitting more fruit and veg into your diet is much easier with a bit of forward planning. Stock up on frozen veg, tins of beans and pulses, and jars of fruit to add to meals when the salad drawer is bare. Also remember that although the potato is cruelly classed, by the powers that be, as a starchy food rather than a vegetable by the powers that be, the sweet potato is not – and it makes seriously delicious chips. Just saying, Stuart.

MONDAY
Breakfast

Yesterday broke me. Carting a kid about for a day is stressful enough as it is, and fretting about hitting a seemingly arbitrary vegetable target just added another level of anxiety to proceedings. So, today, screw it. I’m just going to eat like normal. And, hey, if it kills me, it kills me. Breakfast is a leftover grapefruit. Happy now?

This only soups up the tally by one. Photograph: Stuart Heritage

Snack

An apple. If we’re being honest, it’s an apple and two Cadbury Creme Eggs. But we’re only counting the fruit and vegetables I eat, not any of my other disgusting dietary habits. Still, that’s two portions so far.

Lunch

More chicken-and-vegetable soup. That makes three portions of fruit and veg. If these were the bad old days, back when we were all gormless knuckle-draggers who only thought we needed to eat five portions a day to be healthy, I’d have been laughing. God, I miss the bad old days.

Dinner

I make shepherd’s pie. It contains two tins of tomatoes, two onions, two carrots, a leek that I had lying around and some frozen peas. If I’ve done my maths right, divided by five, I think this works out at three portions a person. Add in the requisite bowl of watermelon at the end and that’s four portions.

Total intake: seven portions.

Felicity’s verdict

In just four days, Stuart’s achieved fruit and veg enlightenment: the secret to eating more is to incorporate them into your ordinary diet, rather than hoping you’ll magically turn into the kind of person who enjoys snacking on raw kale. Adding extra portions to stews, curries, ragus and the like makes it feel a lot less like eating rabbit food than munching on a raw carrot – next time he could try mixing some celeriac into the mash on top of his shepherd’s pie, too. And don’t worry if some days are better than others: if beans on toast and an apple are the best you can manage, it’s still better than nothing. Even if you do have a Creme Egg on the side.

Total four-day intake: 30.66/40 portions

(If you let me have the doubled-up fruit and veg, which you shouldn’t, but hey.)

Without really trying, I’ve come tantalisingly close to the target. It hasn’t made me too farty. It hasn’t caused me any stress. So perhaps this is the secret here: you should just eat as many portions of fruit and vegetables as you can without letting it take over your life. If it goes belly-up for a day – which it will, because there is more to life than endlessly chewing on foliage – then that’s not a big deal. After all, what’s the point of living longer if it’s just going to make you uptight, unhappy and flatulent? Quit whining, science. I’m doing fine.

The 10-a-day diet tested: "I feel like a sentient composter"

10 Tips: Boost Serotonin Levels Naturally & Feel Happier

Millions are Diagnosed with depression every year,  and it is time we begin feeling happier without relying on medication.

As defined by psychologists, a person has a major depressive episode when he or she has symptoms of major depressive disorder, including depressed mood or feelings of emptiness, hopelessness or irritability, that last for two weeks or more.  And, according to the National Ambulatory Medical Care Survey (NAMCS) found that the number of people diagnosed with depression has increased by 450% since 1987. It is often recommended that we start taking a medication to reduce symptoms. However, medication often comes with sometimes dangerous side-effects. Here are some simple ways to feel happier without needing to take a pill.

1. Get enough vitamin B6 – foods like spinach, turnip greens, garlic, cauliflower, mustard greens, celery, fish (especially tuna, halibut, salmon, cod and snapper), poultry (chicken and turkey) and lean beef tenderloin.

2. Eat brain boosting seed grains instead of wheat. This includes: Amaranth, buckwheat, millet and quinoa are seeds with grain-like taste and properties. These are healthy, high-protein carbohydrates and small amounts of the right carbohydrates are critical to boosting serotonin.

Not only improve mood, you will Sleep better too. A nice dose of serotonin in the early evening will help you sleep better at night.

These grain-like seeds also provide important B vitamins. As just mentioned B vitamins play a critical role in brain health and in the manufacture of all your neurotransmitters including serotonin.Vitamins B1 (thiamine), B2 (riboflavin) and B6 (pyridoxine) as well as vitamin D, folic acid and selenium plus calcium, and magnesium are needed to make serotonin.

For protein meals: focus on digestion and food combining – Eating foods that are high in protein – and specifically have a higher percentage of tryptophan (like turkey, sunflower seeds and pumpkin seeds), will provide much needed tryptophan, the precursor to serotonin. But beware: because research shows that eating protein with carbohydrates actually works against your ability to make serotonin.

Good to know: Plant based protein helps to create more serotonin than animal protein does.

To boost your mood and immunity naturally, protein and probiotics – is the delicious natural answer!

3. Include fermented foods and drinks in your diet – Fermented foods and drinks greatly assist in digestion and assimilation of all the important nutrients you need for serotonin. Additionally, they boost the nutrients in your food by at least a hundred fold.

4. Get massages and other forms of body work – We’ve heard about the healing power of touch, but now research backs it up! A study conducted by the Touch Research Institutes at the University of Miami School of Medicine shows that massage increases serotonin by 28% and decreases cortisol (the stress hormone) by 31%.

5. Have fun in the sun. Early morning sunlight is more intense and this can boost your body’s production of melatonin in the evening. Serotonin converts to melatonin for a great night’s sleep. Getting outside for a 20-minute walk in the early morning sunlight can boost your mood and improve your sleep!

6. Remove toxins from your life that interfere with brain health. Eat foods like dandelion and citrus fruit to help detox daily.

7. Reduce Stress – prolonged physical or emotional stress produce adrenaline and cortisol, which interfere with serotonin. Shifting your lifestyle and adding more relaxation into your week can make a huge difference. Focus on Emotional Healing – Reducing stress and focusing on spending more time relaxing is a first step to boosting serotonin. You can take this even further by taking action in key areas to remove negative emotions like fear, guilt and anger. Meditate & do yoga!

8. Exercise. A comprehensive review of the relation between exercise and mood concluded that antidepressant and anxiolytic effects have been clearly demonstrated. In the United Kingdom the National Institute for Health and Clinical Excellence, which works on behalf of the National Health Service and makes recommendations on treatments according to the best available evidence, has published a guide on the treatment of depression.

9. Eliminate processed sugar (or at least drastically reduce it) – If you have low serotonin, you may have intense cravings for sugar. This is your body’s way of trying to increase serotonin because eating sugar produces insulin, which helps tryptophan go into your brain. However, too much sugar can eventually cause addiction to sugar, insulin resistance, hypoglycemia and type 2 diabetes.

Instead, satisfy your sweet tooth in a healthy way with pure maple syrup, coconut sugar or pure honey.

10. Give more hugs, love more and fear less.

To learn more about how to treat depression, anxiety, and ADHD more naturally, my book Healing without Hurting can teach you how.

10 Tips: Boost Serotonin Levels Naturally & Feel Happier

Soon we"ll be able to spot diseases like cancer before we even feel sick

The sooner a disease is diagnosed, the more likely it is to be well managed or cured. The challenge to finding a disease early is that most of us don’t seek treatment until we have symptoms, which means the disease has already progressed.

But breakthroughs in nanobiotechnology techniques mean that in five years we will be able to examine and filter bodily fluids for tiny bioparticles that reveal signs of disease like cancer before we have any symptoms, letting us know immediately if we should consult a doctor.

Information about the state of our health can be extracted from tiny bioparticles in bodily fluids such as saliva, tears, blood, urine and sweat called exosomes. These particles were first discovered in the 1980s as vesicles secreted by immature red blood cells, but later they were found to be secreted in all cell types. Scientists discovered that exosomes carry information from the cell they originated from, including proteins, RNA (ribonucleic acid) and DNA. Because the state of the originating cell can be inferred from these exosomes, they have been considered as potential biomarkers of disease for more than a decade. Besides cancer, exosomes are being considered as insightful for central nervous system diseases (Alzheimer’s, multiple sclerosis and stroke), renal fibrosis and cardiovascular disease.

At the moment it’s difficult to capture and analyse these bioparticles as they are thousands of times smaller than the diameter of a strand of human hair. But at IBM Research we are developing lab-on-a-chip nanotechnology that can separate and isolate bioparticles down to 20 nanometres in diameter, a scale that gives access to DNA, viruses and exosomes. These particles could be analysed to potentially reveal signs of disease even before we have symptoms.

This technique is known as liquid biopsy, designed to be more accessible, comfortable and convenient than the traditional tissue biopsy or cancer screening techniques many of us are familiar with. The goal is to shrink down to a single silicon chip all of the processes necessary to analyse a disease that would normally be carried out in a full-scale biochemistry lab.

In the future, the lab-on-a-chip technology could be packaged in a convenient handheld device to allow people to measure the presence of biomarkers found in small amounts of bodily fluids, streaming this information into the cloud from the convenience of their home. There it could be combined with health data from other IoT-enabled devices, like sleep monitors and smartwatches, and analysed by artificial intelligence systems for insights. When taken together, this dataset will give us an in-depth view of our health and alert us to the first signs of trouble, helping to stop disease before it progresses.

Treating a disease like cancer is expensive. According to Cancer Research UK, there was a 10% annual increase in cancer drugs prices from 1995-2013. Photograph: KatarzynaBialasiewicz/Getty Images/iStockphoto

The next five years will see significant advances in the application and development of this technology. Practically speaking, it’s difficult to say confidently that it will be in widespread use in our homes by 2022, but based on current developments and advances in research, this innovation will likely be used by physicians in some capacity by that time.

The vision for this technology is that it could be used anywhere in the world, from remote rural locations to developed urban areas. To reach the people who need it most, the technology must be affordable. Putting these capabilities on a regular silicon chip means they can be manufactured inexpensively. The challenge will be to do so at a scale that can reach people worldwide while also educating users and physicians on its benefits.

As we all know, treating a disease like cancer is expensive, and rising. According to Cancer Research UK, there was a 10% annual increase in cancer drugs prices from 1995-2013 and many new immunotherapies have price tags of over £100,000 per patient per year. When your doctor can diagnose cancer in its early stages, your odds of financial hardship – and death – decrease significantly. By making it nearly as easy to detect early stage cancer as taking a home pregnancy test, you could argue that we will change the economics of cancer. If all goes well, we may greatly diminish the physical and emotional toll of this terrible disease for future generations.

Gustavo Stolovitzky is program director of Translational Systems Biology and Nanobiotechnology at IBM Research

Soon we"ll be able to spot diseases like cancer before we even feel sick

Improving NHS services should not feel like a quest in a labyrinth

The surprise in the health service is not how little collaboration there is across professional and organisational boundaries, but how so many people achieve so much in the face of overwhelming odds.

Ministers and NHS leaders encourage and cajole staff to improve services, but even the most driven transformation zealots find themselves worn down by having to fight the system rather than be supported and encouraged by it.

In the words of one GP: “There is a hell of a lot of bureaucracy that gets in the way. The whole thing around designing care is how straightforward it is as a concept, but the bureaucracy cannot disentangle itself from the engineering to allow simple things to happen.

Improving services should not feel like a quest in a labyrinth

“Change can be virtually impossible because money flows will not allow it to happen, so you have teams of people wading through spreadsheets and legal issues. There are boards, frameworks and contracts which create a system that never moves, but people are crying out for a system that allows care to be integrated.”

Arguing that there are ways of working around this misses the point; improving services should not feel like a quest in a labyrinth. On the contrary, a system designed for improvement should be looking for opportunities to sweep away obstructions.

Instead, the NHS has managed to reach the perverse point where a bureaucratic error that allows an member of staff to access patient data without authorisation is treated as a serious problem, but staff not being able to access the notes of someone arriving in A&E is routine.

The imperative to meet national targets irrespective of whether they reflect local priorities is one of the most powerful headwinds. One leading physician described the impact: “We have a significant local transformation plan which will have long-term benefits for mothers and children, and is beginning to gain traction with the local population after a big consultation piece. However, we were threatened with central support being pulled if we didn’t refocus our efforts on our two local trusts’ access and waiting targets.”

Alongside money and staff time, the most precious healthcare resource is data. But too often it is squandered on retrospective beatings around national targets rather than used to inform real-time decision-making and predict future events. Data “tends to be used as whips to constantly show failing, without doing anything to actually change or improve [the system]. It drains resources that could be used to collect more relevant data that would allow people to improve, and find efficiencies.”

Sustainability and transformation plans (STPs) are a credible attempt to get NHS organisations to work together. But while system rhetoric encourages collaboration, outdated accountability and funding rules forces people apart.

The NHS is riven with fault lines. Managers and clinicians look after their own organisations at the expense of others because that is how they will be judged. As one doctor put it: “Drivers, incentives and regulation are the biggest thing. People’s skills have been honed against that backdrop.”

A chief executive said: “The central bodies say one thing and do another. The bottom line is that the regulators are playing politics. You can’t say ‘we are working as a system’ and then say that each organisation has to balance its books.”

I have heard a GP describe a consultant as “the enemy”, not out of personal animosity but simply because he represented the local hospital, the source of most of the difficulties in the GP’s life.

This divisive culture permeates the entire NHS. It can be seen in the poor collaboration between physical and mental health services. I have heard a diabetic consultant admit that he had never met a consultant psychiatrist, despite the high risk of mental illness among his own patients.

There are signs of a more collaborative culture emerging. Leadership and teamwork are increasingly important training priorities for clinicians, and STPs – although subject to stringent oversight – are an attempt to give local leaders at least some power to shape the future.

But creating a system that champions and spreads collaboration and improvement is a long way off. It requires a change of attitude at every level – from the practice manager to the NHS England chief executive – and a recognition that leadership is about liberating the talent below and around you.

Join the Healthcare Professionals Network to read more about issues like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

Improving NHS services should not feel like a quest in a labyrinth

Girls as young as 7 feel pressure to be pretty – body confidence study

A third of seven- to 10-year-old girls believe that they are judged on their appearance and a quarter feel the need to be perfect, according to a study by Girlguiding UK.

The charity’s annual girls’ attitudes survey, published on Tuesday, found that girls were suffering from a crisis in body confidence, with 61% of those aged seven to 21 feeling happy with how they look, down from 73% in 2011.

The study – the largest annual research of its kind – suggests that girls as young as seven feel under pressure to be pretty.

More than a third (35%) of seven- to 10 year-old girls agreed that women were rated more on their appearance than their abilities, and 36% said they were made to feel their looks were their most important attribute.

Campaigners said the findings showed the need to combat the “objectification and harassment … ruining girls’ lives”.

The survey also revealed low levels of body confidence among girls. Almost two-fifths (38%) of the same age group think they are not pretty enough, while a similar number feel they are judged more on their appearance than their ability. Almost a quarter (23%) said they felt they needed to be perfect, while 15% said they felt embarrassed or ashamed by the way they looked.

The majority of seven- to 10-year-olds said that what would most improve their lives would be if people would stop judging girls and women on the way they look.

The survey questioned 1,627 girls and young women aged between seven and 21 about a range of issues from health and wellbeing to relationships and careers.

Sam Smethers, chief executive of the Fawcett Society, said women and girls were “persistently judged on what they look like” and suffered “significantly higher” rates of depressions and mental illness. “This is serious. As a society we need to face up to the fact that objectification and harassment is ruining girls’ lives and we are letting it happen,” she said.

Dr Carole Easton, chief executive of the Young Women’s Trust, said the survey revealed the presence of “gender inequality” from a young age. “If we are serious about ensuring that everyone has an equal opportunity to get on in life, then much more must be done to ensure a level playing field – starting from childhood and into young adulthood, not least by challenging gender stereotypes,” she said.

Becky Hewitt, Girlguiding director said: “This year’s girls’ attitudes survey demonstrates the shocking impact that focusing on girls’ appearance is having on the youngest girls in society.”

“Girls have told us to stop judging them on how they look. Every day in guiding, girls inspire us with their bravery, sense of adventure and their kindness. We are calling on everyone to show girls that they are valued for who they are – not what they look like.”

Lyra, 10, a Brownie from south London, said: “I think more girls are judged on their appearance than boys. I don’t think it’s fair that men get treated differently to women. You have to treat everyone the same.”

Liddy Buswell, 18, Girlguiding advocate and Brownie leader, said she was shocked but not surprised by the findings. “I’ve experienced these issues first-hand. I’ve witnessed girls unwilling to speak to groups because of how they look, I’ve heard girls saying they’ve been called names at school and aren’t confident trying new activities as a result.

“No girl should have to worry about the way she looks – she should be having fun and enjoying herself. This year’s survey is a damning indication that something needs to be done to tackle this growing issue.”

Girlguiding UK launched its first “body confidence” badge in 2014 in response to what it described as a crisis in how girls perceive themselves. It is now launching a new social media campaign to make the public think about how they compliment or praise girls, asking them to praise young women for their achievements or attributes, rather than the way they look, using the hashtag #YouAreAmazing.

Anne Longfield, the children’s commissioner for England, said: “Children I speak to tell me they sometimes feel enormous pressure to behave and look a certain way. It’s disturbing that so many young girls think their appearance is the most important thing about them and large numbers feel they have to be perfect. Concerns about body shape can spiral out of control into eating disorders or mental health problems without the right support.

“Girls, and increasingly boys, are bombarded with images in the media and the 24/7 availability of social media can put additional pressure on children. It can be really helpful if parents are able to discuss and challenge unhealthy attitudes children may have and don’t ignore warning signs. Schools also have a huge role to play in building resilience to the negative pressures and attitudes girls may face, and lessons that do this need to be a priority in all school timetables.”

Girls as young as 7 feel pressure to be pretty – body confidence study

My eating disorder made me feel trapped in a box, but I found a way out

I found out my mum was dying four days before she passed away, and she wasn’t even the one who told me, it was my godfather. I had known she was unwell for some time, but her death still came as a shock. The last couple of days were very painful.

My issues with food started before her cancer diagnosis. At 12, I started to think I was fat. I have always been insecure about the way I look, so I went on a diet and it spiralled out of control. When I found out my mum was ill, everything got worse. I was eventually referred to children’s mental health services because I was so unwell. My life was so out of control that food, the one thing I thought I could control, became my obsession.

By the time my mum passed away, two years later, I was managing my eating disorder but not fully recovered. I was still very controlling about what I ate and worried about putting on weight. My family situation was getting more complicated: I had a difficult relationship with my dad and my grandfather suffered from Alzheimer’s, so I ended up in foster care.

The next few years involved seeing various therapists and moving to different foster families. At 16, when I was sitting my GCSEs I reached my lowest point. As I was walking in to take one of my exams I felt exhausted, cold and tired. My anorexia was the worst it had ever been and I didn’t want to be alive anymore. My latest foster placement wasn’t working out. I felt lost and alone, walking around in a blur. Shortly after this, I was sectioned. Those around me were worried I might kill myself. I ended up being taken into hospital to be looked after.

Sometimes in life you just crack, you cannot really explain it. I cracked and thought, “I cannot do this anymore.” I didn’t know who I was or what I was doing and I was still struggling to come to terms with my mum’s death.

It feels strange to look back at this time because now – as a 20-year-old woman – I am well on the path to recovery. Today, I am happy, with an amazing foster mother and about to embark on a trip to India to learn yoga. I’ve turned my life around, although it hasn’t been easy.

My journey to recovery was not plain sailing. I spent a year in a hospital ward, and it got to the point where I was afraid to leave, because being in hospital changed me. The thought of having to stay overnight in a hospital now terrifies me, but there was a point where, for me, it was the norm.

It was while I was in hospital, aged 16, that I met the woman who changed my life: my foster mum. She gave me hope and made me feel loved. At first, I was cautious because of past relationships, but gradually she helped lift me out of my depression and offered me a new life with her.

I remember we had this really awkward tour around the unit when she first arrived and the nurses were like, “It’s so nice to meet you.” The moment I thought she might be the right person for me was when I was flicking through this Cath Kidston magazine and saw a bag I wanted. The next day she bought it for me and I was so surprised. I suddenly felt that someone had noticed me.

The turning point that finally got me out of hospital was when I wanted to go to a vegan Buddhist camp with her and her family. Me and my foster mum are both very stubborn and we were like, “Let’s do this.” I got discharged three days before the holiday and never went back. It was a lightbulb moment, and I didn’t want to fall further behind in school. After this, I joined college and started my new life in London.

My foster mum is so supportive. She used to sit with me all the time when I ate, even if I took an hour to get through a single yoghurt. She was patient and kind. She never seemed annoyed at me and took me on at difficult time in my life. She also gave me the best advice, telling me that everything passes and a lot of the time we feel bad but then that goes, life is about change and nothing lasts for ever.

She made me realise that people are scared of change because it feels wrong, but if recovery feels wrong then that’s exciting. It’s hard being ill but it’s also hard taking those first steps to recovery, although it’s so worth it.

Having an eating disorder is like being stuck in a box and you know others have left the box before, but you’re not sure how you are going to do it. You hate being in the box, but the outside world also seems scary, so you are sat there looking out through the keyhole thinking, “How do I get out?” I was feeling very suicidal, which was part of the reason why I didn’t eat. My depression led to my anorexia, which was never really about the food at all.

I believe everyone can get through an eating disorder. My experiences have taught me to be more comfortable about being vulnerable. Strength is accepting we are human and bad times and good times all pass. Life has its ups and downs but you must be brave enough to keep going. Real strength is admitting you are vulnerable, and, if you need help, please go and get it.

The Beat youthline can help young people experiencing an eating disorder: 0345 634 7650. In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here

My eating disorder made me feel trapped in a box, but I found a way out

I had heard clean eating made you feel better – but for me it went wrong

I got into clean eating with a friend around my AS levels, when I was 16. My friends only followed the diet for about two weeks but when they all stopped I continued. I got addicted to it and I lost loads of weight.

We all started the diet because we were really stressed and tired and had heard eating better made you feel better, but for me it went wrong.

I cut out snacking, I had smaller portions, and everything was a health food. I prepared all my meals myself from scratch.

I cut out dairy and any drinks that weren’t water. I was eating fruit and vegetables and no carbohydrates and no snacking. I was eating no processed food – I would have a handful of dried fruit if I had a snack. An average dinner would be just meat or fish and a small side of vegetables.

I obsessively watched Lean in 15 – a YouTube channel on healthy eating by Joe Wicks. I used to watch a lot of his videos and also followed loads of “transformation” accounts where people ate healthily to lose weight.

At first I did this all to feel better in myself and then it became about losing weight. I liked how it felt and people saying: “Oh you’ve lost weight and you look great.” I used to limit food groups and obsessively weighed my food. I had foods I was afraid to eat and would avoid, such as carbohydrates. This went on for two years, from 16 to 18, and eventually I was diagnosed with anorexia with orthorexic tendencies.

As well as losing weight, orthorexia made me feel exhausted. I couldn’t sleep because I was really hungry the whole time. I had depression and anxiety and I couldn’t focus on anything at all.

My parents noticed that something was wrong. I actually didn’t know what was happening – they took me to the doctor. I went to the Priory for diagnoses and was referred to Camhs (child and adolescent mental health services). I then got sent there on an outpatient basis and got cognitive behavioural therapy. That helped a lot.

Because of my eating disorder I have body dysmorphic disorder and have always feel more overweight than I am. CBT helped me realise that this was not logical. Medication also helped with my depression and gradually everything got better.

I feel more normal about food now. I am a student at Leeds and cook for myself. I eat out with friends. I still suffer guilt when I eat unhealthily but I can cope.

I think health food bloggers have a big influence on young people and they should make it clear that everything should be eaten in moderation. For example, it’s OK to have a biscuit every now and then – it’s not going to kill you. The expression clean eating makes it sound like other foods are dirty; it’s like making an enemy out of everyday food, making it something negative in people’s heads.

Healthy eating is supposed to make you feel better, but not if you develop orthorexia. Although some people need to be careful about what they eat, others can take this lifestyle to the extreme.

I had heard clean eating made you feel better – but for me it went wrong

"I feel ashamed in a way I never did before": your stories of PIP assessment | Sarah Marsh

The government’s abolition of the disability living allowance (DLA) and its replacement with personal independence payments (PIP) means that people with disabilities – many of whom had been told their support would be for life – are being forced through a process of reassessment. But what’s the impact of this?

It’s a topic that Frances Ryan covered in her Hardworking Britain series last week. She wrote: “The retesting of PIP claims means, in practice, blind people, paraplegics and those with Down’s syndrome will be put through reassessment: forced to provide information about their disability that the government already has and cannot possibly have changed.”

We asked for your experiences of this. Here, five people share their stories.

‘It’s hard to understand why we have all had to go through this’ – Angelene Wright, 66, from Lincolnshire

I’m a carer for my 64-year-old husband who is in the final stages of multiple sclerosis.

My husband received a lifetime DLA award about 15 years ago. He is now unable to walk and we are dependent on our home carers for most of his personal care. I have lasting power of attorney as he can no longer sign his name. He can just about feed himself with special cutlery, as long as the food is soft and cut up small. He is totally dependent on others for all his needs.

We went through the reassessment process earlier this summer. With the help of our social worker and rehabilitation consultant, my husband was granted the new benefit without having to go through a face-to-face interview – only a phone call for extra details from the assessor was required.

The whole thing was very stressful. The initial letter, announcing that his DLA was to stop and telling us to phone the number within 14 days or face losing the benefit, was scary. I have to say that all of the people I had to speak to were extremely courteous and helpful. The 40-page form was a pain to contend with – I’m a retired teacher but it was formidable. Also my original registration of lasting power of attorney was required and was not returned – thankfully, I had it scanned. All they actually needed was our registration number.

When you have been given a lifetime award it’s hard to understand why we have all had to go through this. If a person is incapacitated to the level that a lifetime award was thought appropriate, they are not going to get better. They clearly designed it to try to catch people out and it seems to have caught a lot of the wrong people.

‘Irreversible brain damage is irreversible. I don’t understand why I am being reassessed’ – Anonymous, 31, from Glasgow

I have cerebral palsy, a visual impairment, dyspraxia and epilepsy. I’ve been on disability living allowance (high mobility and medium care), receiving around £450 a month, since I was 16. That’s all my adult life. I thought DLA would always be there and am profoundly shocked that it’s now changed and I am due to be reassessed soon.

I am so scared of what this may bring that it keeps me awake at night. When my DLA money comes in each month, I am very relieved. I have had periods when it was my only source of income and I don’t know how I will manage if it goes away.

Reassessment of lifelong conditions makes no sense to me. It is a waste of money and energy and it is cruel.

Anonymous

I am profoundly shocked about being reassessed. I do not understand why this has to happen – cerebral palsy and epilepsy do not go away. They do not change in any way. My balance is as bad now as it was when I was 16 (in fact my joints are probably in a slightly worse condition). I still don’t have a lower field of vision. I’m still having fits. Irreversible brain damage is irreversible. Reassessment of lifelong conditions makes no sense to me. It is a waste of money and energy, and it is cruel. I know I will never get better. I’ve accepted that and am getting on with my life. I feel ashamed and helpless in a way I never did before.

‘The whole process was costly and demeaning’ – Anonymous, 38, from Staffordshire

I am writing on behalf of my daughter who has a personality disorder and complex mental health needs classed as severe and enduring. She had been given a lifetime award, but last year we had to submit a claim for PIP, which meant reassessment. It was incredibly painful for her to go through this process again, and we submitted medical evidence for every question on the form.

The enhanced living component was awarded, but the standard mobility component was taken away on the grounds that she could walk 10 metres unaided. However, eventually we challenged this and won. We were very relieved and pleased, but the whole process was costly and demeaning. What’s more, no one has actually met with my daughter and every decision has been made on paper. It feels like she has no voice. I am the one who has to pick up the pieces when ignorant bureaucrats treat a fragile, seriously ill person so badly.

Protesters gather in Westminster in 2014 to demonstrate against disability benefit cuts. Photograph: Nick Ansell/PA

‘The arbitrary nature of the system infuriates me’ – Charlie Saben Fox, 61, from Edinburgh

My son has autism, global learning difficulties and epilepsy.

How much help you get really is a lottery and many people seem to be losing out.

Charlie

He has been in receipt of DLA since he was two and was awarded an indefinite award at 16. He was “invited” to migrate to PIP, taking a paper-based assessment. After this he was awarded enhanced daily living and mobility components, but only for five years. I couldn’t understand the length of award as the assessor stated his condition might only change marginally. I called the Department for Work and Pensions to ask for a mandatory reconsideration and they weren’t very helpful. First they told me I couldn’t challenge the five-year award, but eventually I got it extended to 10 years.

I’m pretty strong-minded and wasn’t scared of challenging it, but a lot of people might have been bullied into submission. I’m still angry when I think about it. The arbitrary nature of the system infuriates me most. How much help you get really is a lottery and many people seem to be losing out.

‘By the time I got into the room I was a nervous wreck’ – Catherine Hart, 36, from Sheffield

I have serious mental health problems and my DLA was not a lifetime award, but a long-term one – after being assessed every three years it was extended to every 10 years. That changed under PIP. I had to fill in a very long form within three weeks, but it took them several months to tell me if I had been awarded PIP. This severely affected my mental health.

I was starting to get myself back on track when I was told I had to go in for a face-to-face assessment. My care coordinator was off work ill so I had a stranger from mental health services take me, because I don’t do well getting out of the house on my own.

By the time I got into the room I was a nervous wreck. The person I saw was very sympathetic, understanding and patient. He didn’t rush me for answers when I was struggling to speak, was delicate with his questions about my suicide attempts. He even told me he was sorry to be putting me through this.

It took less than two weeks for the letter telling me that nothing had changed in my award. The letter itself was entitled “Changes to your personal independence payment”, which scared me, until I read further and found out that it would be the same.

All the people I had contact with throughout the PIP process were kind and sympathetic. The problem I had was with the paperwork – there was a lot of it at all stages. To truly reflect how bad a mental illness can be, you have to talk about your darkest times, and this process takes you right back there.

"I feel ashamed in a way I never did before": your stories of PIP assessment | Sarah Marsh