Burnout, depression and anxiety – why the NHS has a problem with staff health

When Laura-Jane Smith took time out of her clinical training for a PhD, she found she was constantly unhappy, and suffered from palpitations, nausea, severe headaches, and breathlessness among other physical symptoms.

The hospital doctor’s days were dominated by negative thoughts. She recalls: “I once walked for 30 minutes with ‘I hate my life. I hate my life’ on a loop of internal monologue that I feared had no end.” Eventually, Smith was diagnosed with depression and anxiety and ended up leaving the PhD.

She is not alone. Countless healthcare professionals suffer from burnout, depression, anxiety and addiction. Estimates from Public Health England put the cost to the NHS of staff absence due to poor health at £2.4bn a year – excluding the cost of agency staff to fill in gaps and the cost of treatment.

In his independent review looking at the impact of staff health on NHS performance, former medical director Steve Boorman, who is honorary professorial fellow of the Royal Society of Public Health, found that health workers often did not prioritise their own health. “They did not want to take time off as they felt patient care would suffer when temporary cover was needed to replace them,” he explains.

Dr Clare Gerada, medical director for the NHS Practitioner Health Programme, explains why this is so: “You only have to look at what you’re trained to do as a doctor or a nurse. You’re trained to put patients first and to put their needs above your own.”

NHS England now has a specific programme, supported by chief executive Simon Stevens, that advocates health checks, access to early physiotherapy and mental health support, and improvements in food available on site and staff vaccination uptakes. But Boorman admits that progress is inconsistent and staff health is still a low priority for leadership and for NHS staff themselves.

“Good staff health isn’t about token Zumba classes or lettuce leaves for the worried, but about helping people understand the impact poor health may have on themselves, their family and those around them – in the case of NHS workers, the vulnerable patients that need care,” he points out.

Smith, who is back at work after seeking help from the NHS Practitioner Health Programme and undergoing therapy, says that finding a space in life for creativity also helped her.

Anxious to prevent a relapse, she has made herself a number of promises: “I will take all my annual leave, I will say ‘no’ more often to extra work tasks, I will value activities that make me happy. By making time for the things that recharge me, I am now more effective – a better colleague and a better doctor.”

Burnout, depression and anxiety – why the NHS has a problem with staff health

‘So, you know I have bipolar?’ – the perils of dating with a mental health problem

Dating is hard. It’s paved with heartache and unrequited crushes and the blurting out of gabbled nonsense in front of the unimpressed person you like. When I finally found myself in a conversation with someone I liked at work, whose head I had resolutely stared at the back of for a full three months, I answered an innocuous, “So, how’s your day going?” with, “I am awash with existential despair.” She stared, confused and unblinking, back into my face. I then followed it up with a tiny, pathetic, “Woo!” She sat down again. I continued to stare at the back of her head from my desk, in the full knowledge that she would never speak to me again. This isn’t just me, right? This is how it is for everyone. This is what it’s like to date. It’s awkward.

But what is it like when, in addition to your inability to say anything remotely funny or interesting to the person you are into, you have a mental health problem as well? How does that affect the way you interact with them? How does it affect a relationship once you are actually in one? And, more pressingly: how do you even tell someone you are, or have been, ill? At what point during the dating process is it appropriate to bring up mental health?

The pressure of not knowing when or how to reveal your mental health status can be an additional and very valid source of anxiety. If you tell them too soon it can feel like you are setting the stakes too high; but if you leave it too long you might find that the person you are dating has offensive views on mental health, doesn’t want to deal with it or just isn’t equipped to handle it at all.

As a serial dater it’s something I’ve contended with a lot. It’s also something I’ve done badly a lot. You would have thought there was a finite number of ways to do this wrong. There is not.

How not to tell someone you are mentally ill

Let’s start with some of the poor ways I’ve handled this so far.

Avoiding telling someone until it was catastrophically too late

Hey! I thought, after a month or two of relative tranquility. I think maybe I don’t have mental health problems any more! I think maybe things are going to be perfect for ever and I’m never going to have to think about this ever again. There’s absolutely no point telling my new boyfriend about it, is there? Nah. It’ll be fine. I’ll be fine. I’m fine.

It was not fine.

At that point I was deeply embarrassed bymy previous psychotic episode, and tried to distance myself from it as much as possible. It was easier for me to avoid the topic and skirt around it awkwardly than to confront it. I chose to blame my breakdown on the stress of starting university, moving away from home, and spending all my time drinking. I didn’t want to think about the possibility that it might continue to affect me for the rest of my life.

But eventually my boyfriend and I did end up talking about self-harm and suicide. It was two years into the relationship and we were in the pub. “It’s all just attention seeking, isn’t it?” he said. “It’s just people who want to feel special: ‘Oooh, look at me, I’m on antidepressants!’ Just get on with it.” He went on to tell me about an ex-girlfriend who had gone on antidepressants after her dad had died unexpectedly; he complained that she lay in bed all day and wouldn’t have sex with him no matter how much he bugged her. It was brutal to hear him write off what was clearly a traumatic experience for his ex as her being “lazy” and trying to “avoid sex” – as if her depression wasn’t about her at all, but was a punishment she had decided to enact upon him. After two dates, this would have been fine – I’d have just dumped him. After two months, even, I could have escaped from the relationship pretty much unscathed. After two years, though, it came as a horrifying blow, one that precipitated the end of the relationship. It forced me to consider how well I really was, and how integral my psychosis, my depression and my mania all were, in their own ways, to my self-image.

We argued about it a lot that day and from then on. He blamed me and said that he wished I would kill myself already and just get it over with if I was so serious about it. There’s no doubt that he was a dickhead about the whole thing, but I can’t help feeling that if I had talked about my experiences earlier in the relationship it might have been avoided.

Rule No 1: it is definitely a good idea to actually, at some point, tell them.

Don’t do it! There is a time and a place for everything. Photograph: Jupiterimages/Getty Images

Blurting it out on a first date

I was on a genuinely brilliant first date. He was tall, good-looking (in a kind of dishevelled professor way) and the first person I had met who had piqued my interest since the breakdown of my previous relationship. I was very invested in not messing it up.

And I was nailing it. There was lots of wine and I was pulling out all of my best anecdotes. Then came this exchange:

Him: “So, you know I have a son?”

Me: “Oh. No. I didn’t, actually.”

Him: “Yeah. He’s 10.”

Me: “Don’t worry about it. I have bipolar.”

Not only had I completely failed to acknowledge anything he had just said, but I had also equated his beloved child with a debilitating and heavily stigmatised mental health problem. I felt like his child and my bipolar were both things that could and would put someone off, and that he had somehow just issued a dealbreaker amnesty by mentioning his son. In fact, he had just wanted to tell me a boring anecdote about a trip to the zoo.

Rule No 2: don’t compare someone’s child to a mental health problem on your first date.

Telling someone during sex

Things you can say during sex: “That feels amazing”, “Keep doing that”, “Could you stop leaning on my hair please?” We’ve all read Fifty Shades of Grey. We know what’s allowed.

But things you should not say during sex? “So, you know I have bipolar?” Don’t ask me why this happened. Don’t ask me about the chain of thought that led me to blurt it out like that.

Just remember rule No 3: never say it when you are literally having sex with someone. Never.

How to tell someone you’re mentally ill in none of the ways outlined above

I would love to be able to say, “Yeah, you should definitely say X after Y number of dates”, but relationships don’t work like a PlayStation cheat code, much as I wish they did. You have to play it by ear, pick up on the person’s vibe and try to work out how best to communicate it to them. I can give you some tips, though.

Actually tell them

Yes, this is obvious, but it’s important. Even if they are the understanding type, it’s best to tell them before you have an episode, because you will need to have a conversation about what you expect from them or what you might need. If they don’t want to date you because they can’t handle it, that’s fine, but it’s unfair on both of you if they are forced to make that decision while you are ill and will cause undue levels of stress when you really don’t need them. It may cheer you to know that a 2013 study undertaken by the charities Mind and Relate found that 77% of people with mental health problems actively told their partners about their mental health problems and just 5% experienced a breakup because of it. A further 74% of partners of someone with a mental health problem said they “weren’t fazed”. So you have almost nothing to worry about.

An honest approach is best Photograph: Hinterhaus Productions/Getty Images

Be honest

You don’t have to tell them all the gross minutiae, but it’s best to be broadly honest. Detail the type and severity of your illness. Tell them how it has affected you in the past and how it is likely to affect your relationship.

Don’t sugarcoat it.

For me, there are two major things that tend to go as soon as I become depressed: being able to leave the house, and being able to take a shower. These are obviously fairly big hurdles in a relationship – having a girlfriend who smells like a bin and who sits in the same spot on the sofa for three weeks may not be the most appealing prospect. But by talking about it – telling someone how best to coax me into leaving the house, how to encourage me to look after myself, how I might respond – I’ve found that these hurdles are far less daunting than they first seemed.

Offer some advice

You’re an expert on your own condition, but your partner might not be: help them out.

Encourage them to research your diagnosis so they know, roughly, what they are dealing with. Tell them what you might need and when, or how they might be able to spot warning signs. As with many people who suffer from mania in some form, the first symptom for me is a complete inability to sleep combined with a desperate compulsion to talk all of the time. Telling someone that those things are meaningful parts of my illness, rather than just random occurrences, means that they’re much better equipped to recognise and deal with them when they occur.

You should also, as a couple, draw up a contingency plan in case of emergency. Which family member or friend should your partner contact in a crisis? What resources do you need? This could be anything from bubble bath, music, books or puzzles to calm you down, to something more serious – do you have spare medication, for example? Make sure you are clear in advance about what actions you are happy to explicitly consent to – it’s important that your partner knows what you are comfortable with. And draw up a list of contacts – local authorities, your psychiatrist or doctor, your support worker, or whoever might be able to help.

Don’t be too hard on yourself

Having someone decide not to date you because they can’t cope with your mental illness sucks. It feels deeply horrible and personal. Talking to a newly single friend recently, she told me that several relationships that seemed to be going well had mysteriously withered away as soon as she mentioned her severe clinical anxiety. Some told her that was the case – that they were unable or unwilling to deal with it – and others mysteriously disappeared as soon as she mentioned it. It, understandably, bummed her out.

There is a silver lining, though: it is far better to be with someone who is willing and able to help you with your illness. Having a mental health problem obviously doesn’t define you, and it’s the same with relationships. But knowing that someone has chosen to stick with you on the bad days as well as the good can significantly reduce anxiety.

• This is an edited extract from Emily Reynolds’s A Beginner’s Guide to Losing Your Mind (Yellow Kite, £14.99). To order a copy for £12.74 go to bookshop.theguardian.com or call 0330 333 6846. Free UK p&p over £10, online orders only. Phone orders min p&p of £1.99

‘So, you know I have bipolar?’ – the perils of dating with a mental health problem

Where the wind blows: how China"s dirty air becomes Hong Kong"s problem

At the age of three, Margaux Giraudon developed something akin to a smoker’s cough. Thereafter, she became all too familiar with the inside of her doctor’s office in Hong Kong.

For years, her father Nicolas Giraudon was told the same thing by doctors: “Your daughter is sensitive to changes in the weather.” Eventually she grew so ill that she was hooked up to breathing machines in the hospital for three days, inhaling medicine delivered in a mist. At that point, Giraudon decided it was time for the family to return to his native France.

“She was scared – she didn’t know what was going on, and she saw the look on our faces,” Giraudon recalls. “Her mother and I were completely shocked. When you have children, you want the best for them; you want to protect them as much as possible.”

For Giraudon, those three days transformed Hong Kong from an international city bustling with excitement and opportunity into a death trap that was slowly poisoning his family. Born on the island, Margaux had developed asthmatic bronchitis, which caused her lung capacity to fall by nearly a third compared to other children her age.

While Hong Kong’s air pollution rarely commands the attention of the toxic cloud that frequently covers northern China, dubbed the “airpocalypse”, the air is anything but clean here. Levels of cancer-causing pollutants have exceeded World Health Organization standards for over 15 years, rising to more than five times acceptable levels at its peak.

In winter as much as 77% of dust in the air comes from China

As far back as 2013, the government called air pollution the “greatest daily health risk to the people of Hong Kong”. Despite awareness of the dangers, this notoriously pro-business city has moved at a glacial pace in tackling the problem, commissioning study after study but taking little concrete action.

The fast-paced business world is what originally brought Giraudon to Hong Kong in 2009. In the six years before his daughter became sick, he didn’t experience any noticeable effects from air pollution. The 42-year-old media executive went hiking in the mountains around the city and jogged all over his new home, realising a lifelong dream of working in Asia. He didn’t buy air purifiers, dismissing the costly machines as a marketing trick.

Margaux Giraudon developed asthmatic bronchitis while living in Hong Kong. Photograph: Nicolas Giraudon

After his daughter’s hospital stay, however, Giraudon transformed completely. He bought a device to measure air pollution and became obsessed. Every room in his house was fitted with an expensive air purifier, and he checked the air quality constantly.

“My flat in Hong Kong felt like living in a spaceship,” he says. “I was measuring the level of pollution 24 hours a day, measuring humidity to combat mould, to make sure everything was within acceptable levels.”

Giraudon would hear his neighbour’s children coughing at night, and knew they didn’t have air filters.

“I became the guy nobody invited for dinner,” he recalls with a sigh. “Especially the newcomers, who were all really excited to arrive in Hong Kong – and then I would come with my readings and warnings. People didn’t want to hear about it.”

Giraudon began taking his testing equipment to his daughter’s school and was shocked to discover the air was terrible. But he also found another group of people who did not want to hear about the problem: school officials. He launched a campaign to clean the air there, and was met with resistance at every turn.

The city is notorious for capitalism run amok, and the authorities have long preferred the status quo or very slow change – a perpetual complaint among activists.

In a sign that ignorance about the health effects of pollution extends to the very top, one former chief executive famously said: “Life expectancy [in Hong Kong] is the highest on earth, higher than that in Japan these days. It must be our air.” The year he made that statement, pollution levels were more than four times WHO recommendations.

Hong Kong is one of the most densely populated places in the world. Photograph: Dale de la Rey/AFP/Getty Images

The source of the smog

While equipping every room of a school or home with filters can clean the air, it’s only a plaster over the larger problem: tackling pollution at the source.

Emissions from cars and container ships are some of the largest contributors to Hong Kong’s smog. Old diesel vehicles still number in the tens of thousands, and ships sailing into the city’s port, one of the busiest in the world, are allowed to burn high sulphur fuel right up until they dock. Power plants, meanwhile, rely almost entirely on fossil fuel, with coal supplying 52% of the city’s energy.

Much of Hong Kong’s pollution, however, wafts across the border from China. About 60-70% of particulate matter comes from the mainland, according to a study commissioned by the city’s Environmental Protection Department. In winter, when the wind direction tends to blow more pollutants towards Hong Kong, as much as 77% of dust in the air comes from China.

Hong Kong has signed a series of agreements with Guangdong province directly to the north – but they are unenforceable, stymying efforts by the local government and activists to have a meaningful impact. In the meantime, the health impact on Hong Kong’s population is severe.

There were more than 1,600 premature deaths last year because of air pollution, according to Hong Kong University’s school of public health. In the first month of 2017 researchers estimate there were more than 300,000 doctor’s visits linked to smog.

A landmark study last year found that air pollution increased the risk of dying from any type of cancer by 22% in Hong Kong. An increase of just 10 micrograms of PM2.5 – a tiny airborne particulate linked to cancer and heart disease – heightened the risk of dying of breast cancer by 80%.

A clean, blue-skied billboard against the city’s polluted skyline. Photograph: Philippe Lopez/AFP/Getty Images

With a government that is scarcely accountable to Hong Kong residents, environmental campaigners are fighting an uphill battle to contain even local sources of pollution. The city’s leader, known as the chief executive, is elected by a 1,200-strong committee made up of elites, where China has considerable sway over the votes. Only half the seats in the legislature are directly elected, with the remaining lawmakers returned by professional organisations that overwhelmingly support Beijing.

Tanya Chan, chairman of the environmental affairs panel in the city’s legislature, recalls constituents clamouring for the government to clean up the air, fearing for the health of their children. “The government can try harder and they should push harder,” she says. “We need to be improving fuel standards and expanding the use of electric vehicles.”

Cleaner air the most challenging product to sell: everyone wants it but it’s not just something you buy

Patrick Fung

Chan is in favour of introducing congestion pricing to some of the city’s most clogged districts, but lawmakers are hamstrung by a political system where all power related to government spending or levies requires approval from the chief executive.

“He is only accountable to a small election committee, where most come from business sectors,” Chan says. “We have no choice but to breathe this air.”

The city’s air quality standards (government targets for clean air) remained unchanged for 27 years before eventually being updated in 2014. But they still fall short of WHO guidelines.

“We need to improve our air quality standard to catch up with international standards,” Chan adds. “That process has been a bit slow and I hope the government will do more, especially for the PM2.5s.”

The Environmental Bureau only began publicising Hong Kong’s PM2.5 figures in 2012, nearly seven years after it began monitoring the harmful pollutant, and only after Beijing began publishing the same information.

But locals are increasingly concerned, and hungry for information.

Hong Kong’s air pollution caused more than 1,600 premature deaths last year. Photograph: Jerome Favre/EPA

The activists

On a recent evening, tucked away on the second floor of a sleepy cafe, about two dozen people gather to receive a crash course in Hong Kong’s pollution situation. The mostly young crowd are a mix of office workers, salesmen and artists, all united by their previous ignorance of the dangers in the air and their anger at the officials they say kept them in the dark.

Leading the meeting is Patrick Fung, chief executive of the Hong Kong Clean Air Network. The 31-year-old has become the face of the fight for better air quality in the city, and while he’s often dressed in tailored shirts and trousers to ensure his message is taken seriously, his shoulder-length hair, goatee and glasses evoke an image of environmental activists from years past.

A lot of the bureaucrats don’t want to be blamed for something,. They just try to keep ignoring it and ignoring it

Peter Brar

In many ways the former advertising executive lives by the phrase: “There’s no such thing as bad publicity,” taking any opportunity to counter the narrative that dirty air is a fact of life.

“I’m just advertising something else now: cleaner air,” Fung says. “It’s the most challenging product to sell: everyone wants it but it’s not just something you buy, some sacrifices need to be made.”

On the most basic level, Fung and his fellow campaigners want the government to update its air quality targets. The Hong Kong government’s targets for annual air pollution are three and a half times higher than those recommended by the World Health Organization.

But beyond that are a host of problems unique to Hong Kong: the city is one of the most densely populated places in the world, with its most crowded district nearly four times more packed than Islington, London’s densest borough. Narrow streets surrounded by high-rises have created “street canyons”, which can trap pollutants between buildings.

Fung’s group advocates for large swaths of the city’s main thoroughfares to be turned over to pedestrians, similar to New York’s Times Square or plans for Oxford Street in London. Cindy Wong listens to Fung’s speech with rapt attention, bombarded with information she had never heard before.

“People in Hong Kong spend all their time worrying: prices are expensive, rent is high, salaries are low, so no one has time to care about pollution,” she says after the meeting. “The government should have a strict policy to control pollution; the government should lead and people will follow.”

Patrick Fung: ‘[Clean air] should be a basic right.’ Photograph: Benjamin Haas for the Guardian

“The air seems much better in foreign countries, in Europe,” Wong adds. Although she’s never been, she often watched with envy as travel programs highlighted tree-lined streets and plentiful gardens in cities abroad.

“A lot of Hong Kongers know about the poor air quality, but they feel powerless,” Fung says. “It’s an issue of justice – this should be a basic right.”

After five years heading the environmental NGO, he says he can tell the air quality by his nose alone. “Everyone in this office can tell just by the smell of the air.”

Ignoring the problem

The vast majority of Hong Kong people don’t have air purifiers, and those that do tend to be wealthier and better educated, according to Peter Brar, manager at air quality testing company Renaud Air, which also sells filters. He estimates about half of all expats have at least one air filter in their homes.

“A lot of the local people who’ve never had an opportunity to live abroad don’t know any better,” Brar says. “They think going to the doctor and getting sick three times a year is normal; it’s not normal.”

Although many in Hong Kong may not be aware of the hazards of dirty air, the government has over a decade of data illustrating the problem – but it has been slow to act.

“A lot of the bureaucrats don’t want to be blamed for something,” Brar says. “They just try to keep ignoring it and ignoring it as long as possible – and saving money, saving money until they have to do something.

“Hong Kong is a very pro-business environment,” he adds. “The government does know the air quality is really bad – but they try to hide the problem.”

In a town obsessed with money, the fact that air pollution is estimated to have caused HK$ 20.bn (£2.2bn) worth of economic losses in 2016 may change more minds.

Brar points to a system where buildings in Hong Kong can apply for a clean air certificate from the government – but the process only tests for PM10, particulate matter akin to dust or pollen, entirely ignoring the smaller, more harmful PM2.5.

He says companies that sell air purifiers frequently meet resistance from schools and business, with executives either in denial or unwilling to spend the money required to provide clean air.

When Giraudon wanted to present a professional report at his daughter’s school, Brar offered to test the air quality for free, but was also rebuffed by school officials. Other schools have been more receptive – particularly international schools that have more money compared to government-run institutions.

Giraudon, however, has left behind his battle for classroom purifiers in favour of a suburb of Annecy, a small French city that has the reputation of having the cleanest lake in Europe.

Having arrived last December, Giraudon reports that his daughter Margaux already seems to be doing better. Frequently sick in Hong Kong, she has yet to fall ill, is coughing less and no longer needs to carry an inhaler.

After eight years of living in Hong Kong, Giraudon admits he misses the excitement, opportunities and low taxes, which max out at 15% rather than France’s 45%.

“But I prefer to pay tax than to kill my children,” he says.

Guardian Cities is dedicating a week to investigating one of the worst preventable causes of death around the world: air pollution. Explore our coverage at The Air We Breathe and follow Guardian Cities on Twitter and Facebook to join the discussion

Where the wind blows: how China"s dirty air becomes Hong Kong"s problem

Cellulite Is Not A Genetic Problem

Cellulite is not a genetic malady or disorder.

Cellulite is not a genetic problem and you do not have cellulite because your mother and grandmother have cellulite.

The only thing that could possibly be hereditary with cellulite is having the same dietary habits as others whom also have acquired it.

If you have cellulite it is because you have a connective tissue breakdown caused from a nutritional deficiency.  As cellulite is the manifestation, or symptomatic of toxic conditions in the body.  Of course this is easily reversible and correctable with the application of factual information.

Cellulite, spider veins, and varicose veins are all caused when there is a connective tissue breakdown and weakened blood vessels.  These breakdowns are caused by being deficient in very specific nutrients, particularly copper, tyrosine, selenium, and Vitamin C.

Connective tissue breakdown occurs when the individual cells are being dehydrated, or starved of nutrients~mineral rich salts, vitamins, and sunlight.  It has been proven the human organism requires 91-93 fundamental nutrients to efficiently function at optimal levels.

“There is only one dis ease and that is cellular malfunction.”

~Dr. Gary Tunsky

Interestingly enough the same 93 nutrients that compose the waters of the oceans. Of course this is why sea water was used in human blood transfusions during the awful wars at sea.  Human beings are made up of almost in our entirety, and in exact proportions as sea water.

But salt is bad for us right?

What appears on the outside, or our skin, is directly related as to what we put into our mouths.  Our skin health and the appearance of it is absolutely akin to what we ingest. The way we look and feel, even the way we interact with others is unequivocally connected to what we consume, or even what we are consumed with.

Two of the main building blocks of our skin are collagen and elastin.  Elastin allows for the stretching or elasticity of the skin, and the collagen is the amino acids that create our connective tissue. When we do not have the proper nutrients such as purified water, Vitamin c, cholesterol, and Omega Fatty Acids, the body cannot build collagen.  This causes erosion, or degradation of the tissue which allows the membrane to stretch.  This deprivation of vital nutrients induces toxins to appear at the surface of the skin, resulting in these issues.

Essentially these problems depict an indication of a toxic disposition in the human body and the solution is essential nutrients and eliminating things that do not honor the human body and mind.

These vital nutrients keep our skin-tight and vibrant.

Chemicals such as artificial sweeteners, glyphosates, genetically modified organisms, and preservatives like hydrogenated oils in the “natural” products, are rife with heavy metals and genetically modified substances that are devoid of any nutritional value.  These known toxins will also compete at the cellular level for sustenance with any real nutrients that may be present in these food like substances.

It is so incredibly vital that our society begin to take notice as to what they are ingesting, to then further finally realize the multitude of toxins they are being exposed to if we are to have any future whatsoever.

The human body is an especially wise regenerative system which is intelligently designed to thrive when supplied with the raw materials, or nutrients it needs.

For this to occur however we must begin to accept the fact that most all the information that most people are privy to is completely inaccurate, such as cellulite and every other health issue being incorrectly labeled as hereditary.

The farce that illness is genetic must be rebuked, properly explained, and comprehension will then need to occur.

However this author does in fact believe it is entirely possible for society to catch up to this fallacy and be completely genetically modified to the point of no return.

So yes eventually everything will be genetic if we stay this course.

Because make no mistake about it, DNA is being damaged and the body is unable to heal, correct or rebuild with inferior materials such as artificial ingredients, artificial light, genetically modified organisms, impure water, table salt, glyphosates, etc.

The devil as it goes, is in the details and what is not being stated, not what is.

Notice: This is not medical advice and should not be construed as such. These are not instructions of any sort. We do not treat illness or dis ease, we nutrify the human body and mind with super foods and documented facts and we do this extremely well.

Thank you for taking the time to read and share.

In Excellent Health,

~Jessop

References:

Dr. Peter Glidden

Dr Joel Wallach Hell’s Kitchen

Valhallafit.com

For specialized training and unparalleled nutritional services kindly contact us.

Valhallafit.com

Cellulite Is Not A Genetic Problem

Having to show ID for NHS treatment is not a problem | Letters

I live in Brittany, France. It is routine for hospitals to ask for proof of identity at the start of treatment, either carte d’identité (ID card) or passport, as well as closely scrutinising the means of payment such as the carte vitale (card issued by the state to show entitlement to healthcare) and assurance mutuelle (top-up insurance for conditions not reimbursed at 100% by the state). When I first moved here six years ago I found it strange that you had to go into the finance office with the paperwork before anything clinical happened, but I now accept that it is a necessary part of keeping the well-oiled French healthcare system running. People seeking medical help in the UK should not fear the proposed changes but welcome them as a means to providing what should eventually become a better service (Show your passport for NHS treatment, 22 November).
Mark Bennett
Billio, France

• I have been resident in Peterborough for 30 years. I am all in favour of getting people to pay what they should, but the Peterborough system is cumbersome and annoying. Two questions arise in my mind every time I have to get out the documents and take them with me to the hospital. First, when one has established one’s right once, why can this fact not be put on one’s medical record so that one does not have to do it repeatedly? Second, if one has been on a local GP’s list for some years and been seeing them from time to time, why can this fact not be conveyed to the hospital and put on one’s record?

I hope that the accounts people who suppose that Peterborough already has a good answer to the problem of getting people to pay will consider these questions.
Jim Haigh
Peterborough

• I have in front of me my official NHS medical card showing my name, address, date of birth, doctor and NHS number. I have never had to show this to anyone, which makes me wonder why I was issued with it so many years ago. I would not object if I had to produce it in order to obtain medical treatment, even retrospectively after an emergency.
Dan van der Vat
London

• Three times in the past week, I have been asked to prove my identity – once when picking up a parcel, once in a mobile phone shop and once in a bank. And now there’s talk of having to prove one’s identity to get treatment at hospitals.

While I applaud these organisations’ attempts to curtail fraud and theft, I’m concerned that all take the same flawed approach.

Many of us have passports, of course. Some have the alternative – a photographic driving licence. But no British citizen is required either to have or to carry either of these documents. Those who prefer not to drive and to staycation must find life very hard.

And then there’s the need to prove one’s address. Organisations require an original utility bill or bank statement – not one printed at home. But those same organisations are often at the forefront when it comes to cutting out paper and moving us all online.

The problem is one of our own making. Some time back, we were told each of us would have to have an identity card. Millions have them in other countries, and find life easier as a result. But this was going to be forced on us, so we Britons objected.

Instead, it seems we have to carry an increasing array of bulky documents around with us in case someone wants us to prove who we are.

Personally, I’d prefer to carry an identity card – something like a bank card with a chip and a pin. Others might not want one, and that’s fine. It they want to weigh themselves down with paperwork, that’s their choice. It isn’t mine!
Colin Maunder
Martlesham Heath, Suffolk

• It does matter that the NHS is being abused by people from abroad seeking free treatment. I know neighbours who bring relatives in to do just that. It matters because we have to pay abroad and we have paid for this service over three generations. Rachel Clarke (I’m a doctor, not a gatekeeper turning ‘health tourists’ away, 23 November) is being naive – and anyway, what are managers for?
Jenny Bushell
London

• Nye Bevan wrote in answer to Tory critics of the proposed NHS potentially providing free healthcare to foreigners: “The whole agitation has a nasty taste. Instead of rejoicing at the opportunity to practice a civilised principle, Conservatives have tried to exploit the most disreputable emotions in this among many other attempts to discredit socialised medicine.”
Ted Watson
Brighton

• What is the problem? I had to cut short a holiday in France in September after a visit to the local hospital A&E department, where I was advised to go home within three days and arrange for an urgent colonoscopy. I had to show my passport at the admission desk and provide details of where I lived etc.

The treatment was excellent and as the French do not appear to use A&E as a proxy GP there were no great numbers in the waiting room. We received a bill one month after we arrived home and can claim back any surplus above what a French national would have paid. The bill was only €138 for four hours’ treatment in the hospital and the advice was spot-on. Letting someone examine my passport seemed a small price to pay.
Toni Reilly
London

• Those who do not travel or those who cannot afford it may not have a passport. But everyone who is registered with a GP should have an NHS medical card and number, which states that it is proof that that person is entitled to NHS treatment.
Katharine Makower
London

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Having to show ID for NHS treatment is not a problem | Letters

Private providers are part of the NHS’s problem, not the solution | Letters

I’m afraid Stephen Dalton is wrong about pretty much everything (Private money is the NHS’s saviour, not its bogeyman, 22 November). Where sustainability and transformation plans have been published (most have been shrouded in secrecy, and for good reason) it is clear that cuts and closures are on the way. For instance, 600 GPs are to be reduced to 400 in one part of London alone, and maternity units and A&E departments face the axe. We have the second lowest number of hospital beds per capita in the EU, and that is set to fall further. Dalton says we must move care away from hospitals, but that means investing in primary and community care, both of which have been undermined and cut.

Dalton says that the private sector can help the NHS. Well, up to a point, Lord Copper. The private sector has always been there, but as a peripheral presence and not competing with the NHS. The compulsory competition introduced by Andrew Lansley has been a very costly failure. The private sector is expensive, unaccountable, and will walk away when it can’t make a profit. By cherrypicking profitable services it destabilises the local NHS, which can’t drop the expensive work or turn away patients with complex problems. And its ethos is questionable, leading, for example, to profits being sent offshore with no tax paid.

The answer for the current NHS crisis is to fund the NHS to the EU average (it is currently heading down to less than 7% GDP), to deal with the costly market and PFI schemes which are wasting money hand over fist, to value and support the staff, and to stop re-disorganising it every two years in a futile effort to sort out the last political mess inflicted on it.
Dr Jacky Davis
Founder member, Keep Our NHS Public

• The article by Stephen Dalton is simplistic in the extreme. Here in Cornwall we have examples of two of the privatisations he extols. Both failures.

Twelve years ago a panel I was a member of voted to give Serco the out-of-hours service for Cornwall. It was a mistake. They were condemned by a parliamentary committee for cooking the books and they have since abandoned the contract. I voted against them.

In 2014 the Royal Cornwall hospitals trust board of which I was vice-chairman voted to allow Mitie to run their hotel services, catering, cleaning etc. I voted against. They have proved to be a disaster. If Stephen Dalton wishes to write these misleading articles he should at least give examples of the successes of privatisation. Does Hinchingbrooke ring a bell with him?
Rik Evans
Truro, Cornwall

• Stephen Dalton argues that “examples of beneficial of private sector involvement include … more rapid discharge from hospital through well-established ‘recovery at home’ services and access to private sector community diagnostic facilities”. Meanwhile you report that the private company Mitie has said it would withdraw from its healthcare business, which provides home care for the elderly (Mitie profit warning as it bales out of elderly care, 22 November); your article quotes the chief executive as saying that government spending cuts had made the healthcare business unviable: “If we are serious about social care in the UK it needs significantly more than the funding that has been suggested.” Quite.

More generally it is worrying that Dalton, as chief executive of the NHS Confederation, still does not understand that for private companies profits come before patients, and that any system that has to fork out to shareholders has less to spend on care. Supposed benefits from “greater efficiency” usually means cutting corners and paying workers less.
Dr David Griffith
London

• Despite Stephen Dalton’s assertion of an apparent “political negativity” towards privatisation of the NHS, the non-public-sector involvement within our healthcare system actually continues unabated: the Department of Health’s funding of “independent sector providers” rose from £4.1bn in 2009-10 to £8.7bn in 2015-16. And a study published in the Journal of Public Health in July this year found that: “An increased use of private sector provision by NHS boards was associated with a significant decrease in direct NHS provision and with widening inequalities by age and socio-economic deprivation.”
Steven Jouanny
Sheffield

• We completely agree with Stephen Dalton’s assertion that we need to shift the focus away from hospitals in order to help create a more sustainable NHS. However, being more open to private providers is not the only answer.

The mixed economy for end-of-life care in the UK is a case in point, and the role of charitable hospices in this should not be overlooked. Last year hospices in the UK spent more than £868m on care and supported 200,000 people with life-limiting conditions – a significant contribution to the UK’s health economy.

Hospice care is provided free and yet hospices receive only a third of their funding from the NHS, having to raise the rest themselves through community fundraising. Hospices have a strong ethos of compassionate care, coupled with a vibrant culture of innovation and enterprise reflected in the new and different ways they raise income and successful partnerships developed with other providers.

In these hugely challenging times for the NHS, improving end-of-life care by working more closely with hospices could help deliver the sustainability that is so desperately needed.
Tracey Bleakley
CEO, Hospice UK 

• On the occasion of American Thanksgiving, as a British citizen who lives in the US but finds myself in the UK with an ailing father, I feel compelled to express my gratitude for one of the things that makes the UK exceptional: the NHS and associated strongly held value that good healthcare for all is a right not a privilege. I am a management consultant and have spent a large chunk of my career working within the American healthcare system. The recent US election troubles me greatly as the incoming administration seems to offer little vision for healthcare other than the aspiration to unwind the recent gains of improved access to all. In recent weeks I have sat holding my sleeping father’s hand as he moves beyond a stroke. As I’ve watched the wonderful staff on the Dunkery stroke unit at Musgrove Park hospital in Taunton, which, somewhat ironically, started as an American army hospital during the second world war, I have felt incredibly grateful for the compassionate care he – and my family – are receiving. Absent is the additional stress of wondering how we as a family will be able to pay for his care, which would already be well into the hundreds of thousands of dollars had he been born on the other side of the pond.
Celia Kirwan
Boston, Massachusetts

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Private providers are part of the NHS’s problem, not the solution | Letters

Children need to know stress is normal, not necessarily a mental health problem

There is a statistic often quoted by children’s mental health campaigners: 10% of children and young people (aged five to 16 years) have a clinically diagnosable mental health problem. It comes from a 2004 report from the Office for National Statistics (ONS) (pdf), but its methodology is questionable – the diagnoses were made using transcripts of ONS interviews, by clinicians who never met the children in question. But what’s really revealing is the researchers’ broad definition of a mental health problem.

More than half (5.8%) of those diagnosed with a condition (9.6%) had what are described as conduct disorders – antisocial behaviours, such as aggression or deceitfulness. More than a third (3.7%) had emotional disorders including anxiety and depression, but also phobias – for example, a fear of dogs. The remainder were judged either “hyperactive”, “impulsive” and “inattentive” (1.5%) or had less common conditions (1.3%) such as autism.

In other words, a large part of the children’s mental health problem in this country is antisocial behaviour. What would have once been put down to a child being naughty is today turned into a need, and grounds for potential psychological or even psychiatric intervention.

That’s not to deny that there’s a problem. According to a survey conducted by the Association of School and College Leaders (ASCL), more than half (55%) of schools report increased stress and anxiety among their pupils. Over the past five years, 40% have seen a large rise in cyberbullying; four out of five (79%) report more self harm and suicidal thoughts among students; more than half (53%) rate their local Child and Adolescent Mental Health Services (Camhs) as poor or very poor, and 80% want to see those services expanded. This is despite most schools already offering on-site support with for mental health problems.

Young people are typically waiting months and even years for treatment by their local Camhs. But instead of asking how we meet these needs, we need to ask what has given rise to them.

No distinction

As a society, we are encouraged to understand the challenges children face as mental health or emotional problems – no distinction is made between the two. Behavioural problems at nursery and teenage use of social media are spoken of in the same breath as eating disorders. The impression is that a big and growing problem exists and that these very different concerns are somehow related or on a continuum – and that the apparently unprecedentedly challenging world of today is to blame.

The ASCL interim general secretary, Malcolm Trobe, said earlier this year: “Children today face an extraordinary range of pressures.” These include “enormously high expectations, where new technologies present totally new challenges such as cyberbullying”.

Nihara Krause, a clinical psychologist and founder of teenage mental health charity Stem4, says that young people today experience “levels of competition and performance anxiety unknown to any generation”.

“The increase in mental ill-health among our young people is exacerbated by our trophy culture. Outside school, our body-obsessed, share-everything culture subjects them to a new form of scrutiny,” she says.

There is a real problem here, but perhaps it’s not that young people are increasingly mentally or emotionally unwell, or because the difficulties they face are uniquely challenging. Maybe the issue is that we’ve adopted this narrative of vulnerability, and affected the way young people understand themselves and what they are capable of.

Young people are picking up the message that they are defined by their vulnerabilities, and that they are unable to deal with with what in the past would have been regarded as unremarkable facts of life. But what does it do to children if they are told that they can’t cope, that they must seek professional help? It means children and families feel less able to draw on their own informal ways of working things out – not least because families themselves (and parents in particular) are often seen by the experts as part of the problem.

If we want to prevent the problems campaigners describe, we need to hold the line – as parents, as teachers, as adults. We need to teach things that bring children out of themselves. We should give them something to aspire to or embrace. We need to prepare them for adulthood, and let them know that a certain amount of stress and feeling down is just part of growing up.

When teachers become glorified therapists rather than educators – by trying to treat young people rather than instruct them, by massaging young minds rather than filling them up with the knowledge – they can unwittingly contribute to the problem. And worse, they are being distracted from the one thing that they are qualified to do and that will help the young flourish and grow into well-adjusted young adults: teach.

Dave Clements (@daveclementsltd) works in health and social care and is convenor of the Social Policy Forum. He will be speaking at the Battle of Ideas on 22 October on Young People and Mental Illness: A growing problem?

Children need to know stress is normal, not necessarily a mental health problem

The army has a trauma problem, and it"s costing soldiers" lives – video

Post traumatic stress disorder is rife in the British army and we are failing soldiers, says journalist Matthew Green. He argues that the government needs to be honest about the toll that military service takes on the mental health of armed forces personnel. Only then, he says, will real change happen

The army has a trauma problem, and it"s costing soldiers" lives – video

The army has a trauma problem, and it"s costing soldiers" lives – video

Post traumatic stress disorder is rife in the British army and we are failing soldiers, says journalist Matthew Green. He argues that the government needs to be honest about the toll that military service takes on the mental health of armed forces personnel. Only then, he says, will real change happen

The army has a trauma problem, and it"s costing soldiers" lives – video

A World Without Down’s Syndrome? review – straight from the heart, and that’s the problem

‘This is Olly, my son,” says actor and writer Sally Phillips, over footage of her grinning 11-year-old cracking jokes to his siblings at the dinner table. Aside from being an amateur standup, paint-flinger and epic hugger, Olly has Down’s syndrome, a condition he was diagnosed with at 10 days old. Phillips wants to talk about a new test offered on the NHS that will give expectant mothers a non-invasive, 99% indication of the Down’s status of their unborn baby. Other countries using the test have had an increase in the rate of post-positive-result terminations. As it stands, nine out of 10 British women choose abortion if their baby is diagnosed in utero.

In her documentary, A World Without Down’s Syndrome? (BBC2), Phillips hopes to kick off a debate on the wisdom of introducing the test, which she fears will cause the number of terminations to go up here, too.

She goes to considerable lengths to take in all aspects of the subject, meeting parents, experts, educators and scientists in places as far apart as Iceland and California. But she is both the perfect person to give an account of Down’s syndrome and the worst possible person to present this documentary about the pros and cons of screening.

How could anyone look at Phillips’s son and say they wouldn’t want their child to be like him? This is the nub of programme, the undeniable foundation on which her argument is built. Now take that out into the world, this image of Phillips metaphorically clutching a picture of lovely, funny, warm, wonderful Olly in her hands and try to get a sensible conversation going about the pros and cons of screening. It isn’t possible for the other side of the debate to flow freely under these circumstances.

What I get instead of an even-handed discussion is at least a light shined on something that has only ever been in my peripheral vision. Phillips is right that the subject needs raising because the way a pregnant woman is spoken to about a Down’s diagnosis undeniably needs to change. “I expected tragedy and got comedy,” is how she puts it. A long list of potential health problems, as currently provided in NHS leaflets, isn’t enough to go on when you’re deciding whether or not to bring a life into the world. She has so much insight and intelligence to bring to this, but her interactions with experts and parents on the other side of this debate often leave her tearful and frustrated.

Producer/director Clare Richards does try to keep a careful hand on the tiller, often framing setups with Phillips’s own disclaimers about being a novice film-maker, and occasional questions about whether she is getting it right. Phillips herself said in an interview (on ITV’s This Morning) that she wanted someone else to make this film, someone with documentary experience. Presumably, her celebrity status made her a more appealing prospect for the broadcaster than a scientist or journalist with that degree of distance.

As she treads on ever more tricky territory, you can see why she was reluctant. The most difficult scene is her interview with Kate, an expectant mum who terminated a pregnancy after a positive Down’s diagnosis. As she describes aborting her 25-week-old foetus, Phillips tears up and bows her head. She acknowledges Kate’s bravery in talking about such a hard choice, but then she takes out an iPad and shows Kate a video clip of a young American gymnast called Chelsea, who also has the condition. Phillips’s smile seems to be urging Kate to see what she can plainly see: that their lives are no less valid. That people with Down’s can go on to great things.

“Do you mind if I ask you the really difficult question?” Phillips says, in the most direct confrontation of the programme. “So, you think her life would have been better not happening?” she asks tentatively. Kate takes a moment, then says that she thinks it should be up to each mother to decide.

“Kate didn’t want a child like mine,” says Phillips in voiceover after their interview. That wholly emotional summary of what we’ve just seen is why this doesn’t work as a documentary. When a subject is so close to the presenter’s heart that it is indivisible from it, the result is impassioned but not impartial.

As Phillips herself says, this is “a film that asks the question – what kind of society do we want to live in?” The answer here is unequivocal from minute one: a society that cares about everyone, no matter what their chromosomal makeup. Who could disagree?

A World Without Down’s Syndrome? review – straight from the heart, and that’s the problem

I"m a better doctor for accepting that I have a mental health problem

I didn’t realise I had a mental health problem. I’m a GP and it’s a common misconception that we don’t get them. We get stressed, of course. We get burnout – yes. But we don’t get mental health problems.

When I found myself working in a practice hit, like so many others, by the lack of GPs and nurses of course it was difficult. Spending days as the only doctor for 8,500 patients was horrific. On-call days started early with visits that were left over from earlier in the week because we hadn’t had enough doctors to go out. There was a list of patients to call back before the phone lines even opened, booked in by the receptionists because they had nowhere else to put them. Blood results to look at. Medication queries to answer. Letters to read and file. Repeat prescriptions to sign. Complaints letters to respond to. Care Quality Commission boxes to tick.

It was never ending. Somehow, in the middle of all this, I was expected to try and make a quiet calm, caring bubble with each patient for ten minutes. I was meant to put all this out of my mind and focus only on them. It’s what they deserved and it’s what I wanted to do. But I couldn’t.

Medicine is a busy job. General practice is a busy job. I never expected to have quiet days. But when arriving at 7am, and leaving at 11pm isn’t enough – what is? The constant pressure and the never-ending demands on my time got to me. I wanted to be a good doctor for my patients, and a good colleague to the staff who were all struggling. I pushed myself because that’s what we do. It didn’t matter that I hadn’t stopped to eat, drink, go to the toilet – as long as I was doing the job that was all that counted.

But what I couldn’t see was that I wasn’t doing the job. I was nowhere near being the doctor I wanted to be. I was so tired, I couldn’t concentrate. I had to double check everything I prescribed in case I’d made a mistake. I sat and filed hundreds of blood results like a robot. Clicking “normal” over and over again but not realising my brain could well be missing something important. My judgment went out of the window. My referral rates went up. I did blood tests on everyone because I couldn’t think through what was wrong with them. I thought I was being stoic, carrying on. I couldn’t admit to myself that actually I wasn’t safe.

I ignored all the signs – sleepless nights, early morning waking, overeating, drinking too much, no enjoyment in anything, dreading the next day. I ignored that I was burnt out. I ignored that I was depressed.

I did this very successfully for months, until – inevitably – it crashed down. One more frantic on-call day was the tipping point. I resigned and got ready to walk away from my career in medicine. I was 34 years old.

With the help of friends, family and my GP I got better. I started to value my own health and wellbeing. I can’t be the best doctor if I don’t look after myself. The more I talk about it, the more colleagues I find feeling like I did. This isn’t safe, and it isn’t fair on anyone.

I’m a GP. I have a mental health problem. But I’m a better doctor for accepting that.

Dr Zoe Norris is supporting Mind’s work to improve the mental wellbeing of primary care staff at work

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I"m a better doctor for accepting that I have a mental health problem