Monthly Archives: November 2017

Parkinson’s and Sleep Problems

One of the things that many people with Parkinson’s Disease commonly struggle with, is our sleeping patterns.  If you listen to anyone living with Parkinson’s, you will almost certainly hear regular expressions of frustration, and even desperation, at the difficulty of achieving any sort of regular sleep pattern.  In fact, in all likelihood, you will also hear of a complete inability to achieve more than three or four hours sleep in any night.

In addition to the life-changing impact upon our physical well-being, Parkinson’s can impact upon our emotional state; for example, triggering stress, anxiety or depression.

With so much to contend with, our ability to sleep may often be disrupted.  Sleep deprivation only worsens the symptoms of Parkinson’s.   The impact of what can feel like a constant onslaught on our ‘whole being’ cannot be under-estimated.

As a Counsellor and Psychotherapist, here are some of the things that I recommend in helping people to start to develop a regular sleep regime:

  • Set your morning wake-up alarm for the same time each day.  If your alarm is music, then set some music that is uplifting and energising to emphasise the difference between the restfulness of night and the activity and motivation of the day.
  • Create a bedroom that sets the scene for peacefulness, restfulness and comfort.
  • Do not consume caffeine or sugar beyond two hours prior to sleep.
  • Ensure your body is tired, by being physically active during the day.
  • Ensure your mind is tired, by keeping it mentally stimulated and active during the day.
  • Avoid napping (no matter how tempting); this can stop you getting sleepy later.
  • If something is troubling you, find a time in your day to talk it through with somebody.
  • Neither go to bed on a very full, or an empty, stomach.
  • Reduce use of alcohol.
  • Spend 20 minutes, of an evening, to think through anything causing you anxiety.  You don’t have to resolve it; just be clear where you are in progressing towards a solution and see if you can move another step forward, towards a solution.  Remind yourself that most difficulties are merely problems that need to be resolved, one step at a time.  Reassure yourself that difficult times are followed by better times.  Try to remind yourself of the support you have from people and of the resources you have; both material and those within yourself.  Try to end your 20 minutes of thought by identifying something that you are currently grateful for.
  • Chamomile tea is a relaxant and can form part of a pre-sleep routine.
  • Create pre-sleep routines to train the mind and body to prepare for sleepiness.
  • Try to get to bed at the same time each day.
  • Once in bed, practice meditation while laying still; reminding yourself that you are safe and that you are comfortable.
  • Once in bed, practice slow and deep breathing.
  • Keep comforting things beside the bed; a night light, a cuddly toy, a loved photo. These can be comforting things to see before you close your eyes and can be of comfort if you see them upon waking during the night.  This can reduce anxiety and stress.
  • If your sleep is disrupted, or you can’t get to sleep, get up for 15-20 minutes and have a short read, listen to soft music or simply practice slow breathing and meditation.  Return to bed, but repeat this exercise if you still cannot sleep.

These recommendations are far from an exhaustive list, but serve to act as a starting point in your progress back to more regular, and restorative, sleep.

If sleeping problems persist, I would always recommend that you see your Doctor, PD Nurse or Neurologist.

 

© Dean Parsons. 2017.

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Parkinson’s and Depression

Many people with Parkinson’s Disease will, at some point, experience depressive feelings or even full Depression.  The treatment for Depression is not an exact science.  Treatment options around the world vary from talking therapies, alternative and complementary therapies through to the use of prescribed medication.

In the Western world, a combination of talking therapies and prescribed medication would appear to be increasingly used as a targeted approach to addressing the suspected cause and effect of Depression; although the treatment options and prescribing regimen appear to vary and it is clear that this area of human illness is not yet fully understood.  Research into new methods of treatment are ongoing.

When depressive feelings occur, they can cause confusion and anxiety.  Often, we can try to shrug the feelings off in the hope that they are nothing serious but, for people with Parkinson’s, it can be one of the symptoms of Parkinson’s itself and may represent an escalation of the illness. 

Depression can cause a variety of very difficult symptoms, for example; a sense of despair, helplessness, powerlessness, a lack of hope, a sense of being ‘stuck’, an overwhelming lethargy, cognitive confusion, behavioural difficulties, a sense of impending doom and an intense self-loathing.  Each individual will experience a range of symptoms, unique to them.  Symptoms may not just be emotional. People are often surprised by the physical manifestation of symptoms of Depression; illness from generally feeling ‘unwell’ through to what might be classed as psychosomatic symptoms of any of a number of physiological illnesses.

There are a number of ways that Depression is considered.  For example; ‘Reactive’ and ‘Clinical’ Depression.  Reactive Depression is often described as a Depression where the onset is caused by an event / situation / experience or circumstances that cause a person to enter into a depressed state.  Clinical Depression, alternatively, is often described as being something innate within the person who is depressed; caused by their own individual physiological genetic make-up.  Cause by an illness such as Parkinson’s can fit into both categories. 

A person with Depression may already have a strong sense of their emotional state and associated symptoms.  They may have been living with the condition for some time and, if they have started to feel the sense of powerlessness, helplessness and hopelessness that are often symptomatic of Depression, they may have very low expectations of talking therapies as a successful form of treatment and low belief in any positive outcome of therapy; a belief rooted in their sense of hopelessness.

Another important consideration, is the extent of the Depression.  For example, is the Depression acute or chronic?  If it is acute, how frequently do the bouts or symptoms manifest and how long do they last?  Can a pattern be identified?  If it is chronic, then what is the history of this; how long has this been going on for and to what degrees or levels during that time?  For people with Parkinson’s, keeping a record of our mood and feelings can be very useful to take with us for each review with our Neurologist and helpful to any of the medical team supporting us.

It is generally considered that it is easier to effectively treat Depression, when the person is experiencing the early stages of its development.  Identifying how far into the experience, or the frequency experienced, that a person suffers will help the medic/therapist to determine the most suitable type of intervention. 

There are also considerations around the level of the symptoms.  For example, there are levels from mild through to major.  Mild Depression is considered to manifest fewer of the full range of possible symptoms but is also considered to be the beginning of the potential for longer term, more major condition.

In Major Depression, a professional might expect to find a greater range of symptoms in effect and may also find that the person’s behaviour has started to become that of internalising their cognitive processes and introverting in their behaviours; particularly around social engagement.  This is where a person with Major Depression may gradually reduce contact with friends, family and work colleagues.  Some may even stop leaving their home / going out.

Some people may not know they are depressed.  Some people may experience their symptoms, the accompanying sense of despair and may develop fears that they are in some way ill; it is not uncommon for people with Depression to develop a sense of imminent death or a phobia about an aspect of their health.

Depression carries the hallmarks of feeling like a very serious illness, while being potentially invisible to others.  It is often the experience of the person with Depression, that they are considered by others to be looking ‘well’ and so are often expected to get on with their life, yet all the while feeling, inside, as though they are a ‘casualty of war’; qualifying them for a bed and treatment or, in worst case scenario – triggering the person to wanting a way out; which is when we identify suicide risk. This is clearly a state of suffering.

I would appeal to anyone with Parkinson’s that feels they may be suffering Depression, to reach out for help.  Contact your Doctor, Neurologist or any of your support team, tell a friend, tell a family member or your employer.  You can seek help anonymously, through services like the Samaritans (UK national emotional crisis support helpline – check in your own country for similar services).  Your Doctor may recommend a short period of time on medication and / or a referral to ‘talking therapies’ with a Counsellor or Psychotherapist, for example.

Help is available.

(C) Dean Parsons. 2017.

 

 

Set Apart

Like the square peg in the round hole
The black sheep or the broken bowl
Like one mature student in the class
The short straw or the met impasse
Like the faded Actor of prior fame
The odd one out or the horse now lame
Parkinson’s sets you apart.

Like the fabled ‘Man in the Moon’
The ‘unsinkable’ Titanic or Brigadoon
Like Marilyn Munster or the odd sock
The ugly duckling or faulty clock
Like the mis-matched shade of paint on the wall
The out of tune singer or the class know-it-all
Parkinson’s sets you apart.

But…

Like a mountain awaits for its peak to be climbed
The race to be won or a developing mind
Like buried treasure about to be found
The piano concerto or the healed wound unbound
Like the young bird’s first flight from the nest
The conquering hero or doing our best
I’ set Parkinson’s apart.

(C) Dean Parsons. 2017.

As broadcast on radio. June 2019.

 

Unhelpful Mind-Reading

In my role, as Counsellor and Psychotherapist, I often meet people who come to see me due to low self-esteem.  For so many different reasons, what has often started out as an uncertainty, self-consciousness or even fear of inadequacy; usually originating in childhood years, has not been resolved and so has remained with the person into adulthood.  This sense of being ‘less than’, in comparison to others, often goes on to become a truly undermining and debilitating force.  One of the key traits of a person with low self-esteem, is that they describe how they ‘know‘ that other people think negatively about them.

Those of my current and former clients who read my Blog, which I am delighted to say many do,  will chuckle knowingly when I state that my usual response to anyone saying that they ‘know’ what other people are thinking about them is:

“Stay out of other people’s heads”!

Unless we ask another person directly, we cannot truly be sure what another person is actually thinking.  We can easily mis-read or mis-interpret the indicators that come from body language and indirect verbal communication.

I believe that something else is at play… 

The subconscious part of our minds is the part of our thinking structure that is most connected to our history.  Our conscious mind, meanwhile, is busy managing everything that is going on in the present moment.

I believe that in any present moment of uncertainty, such as social anxiety, the conscious mind gets distressed and so refers to the subconscious mind for information.  The subconscious mind then taps into all that it has learnt over our lives and accesses information stored more deeply in our minds. In doing so, it finds all of those childhood fears and negative feelings.

Knowing that this information will not help the conscious mind, the subconscious mind panics and triggers those unpleasant old feelings to surface in the present moment. In a state of heightened distress, the conscious mind then cannot make sense of the big emotions it is feeling.  Why are they happening now?

The person becomes filled with very uncomfortable emotions and can even suffer a panic attack at this point because the conscious mind cannot make sense of what is happening in the present moment.  Sensing danger, the subconscious mind then takes over and looks for anything to validate the negative feelings it has triggered.

It looks around.  It seeks out evidence to support the negative feelings it triggerd.  Yes, if the person has low self-esteem, it seeks out evidence to support that low self-esteem, for then surely things will make sense to the conscious mind and the person will no longer panic and will be safe?  The subconscious looks at all of the people interacting with the person and decides that these people must surely be thinking bad things about the person; judging the person negatively.  It explains this to the conscious mind.

This now makes sense to the conscious mind and so there is no need for panic.  The negative feelings ease a little but, alas, the person is informed by the conscious mind that people are indeed judging the person negatively.  The person believes he/she has worked out what others are thinking and is left feeling inadequate and self-conscious, with low self-esteem having been reinforced.  The nightmare of low self-esteem continues…

What To Do:

That’s quite a lot to follow, but do re-read it bit by bit again, until you can clearly see the inter-play between the conscious and subconscious mind.

So, what does one do when this happens?

A simple reminder, to repeat to yourself, in any difficult situation is this:

“Stay out of other people’s heads”!

Why?

“Because you cannot truly go there.  You actually go into your own historic negative beliefs about yourself and risk pulling them into the present moment.  This will only validate the negative”.

 

(C) Dean Parsons.

 

 

 

 

 

 

A Societal View of Tess

I recently re-read one of my favourite books.  As I sit at my desk today, savouring my coffee, I thought it would be enjoyable to write a brief review of this much loved book.  It is one of Thomas Hardy’s (1840 – 1928) best loved works; ‘Tess of the d’Urbevilles’.  This story’s main protagonist is a young woman called Tess Durbeyfield who, following a chance meeting between her father and the local Parson, is seemingly compelled into the grand heritage of her family history; driven by the aspirations of her impoverished father.

Hooking the Reader:

The book opens at that chance meeting between Tess’s father and the Parson, who sits elevated above Jack Durbeyfield by being on his horse.  The Parson makes fun of Jack’s low status by mockingly calling him ‘Sir John’; revealing the true status of the grand family heritage that Jack would have been born into, had the family maintained its wealth and status.  As Jack, intoxicated from alcohol, reels from this information, he instantly assumes a sense of high position and demands, beyond his means, a ride home by the coach and horses of his local pub.  This sets the scene for the ambitious manipulations to come as Jack seeks to restore a sense of high status in local society; gaining the reader’s curiosity.

We are soon introduced to Tess; presented as having something captivating about her, something she cannot see herself.  Hardy uses the setting of a May Day dance to reveal how Tess’s low self-esteem and poor self-worth not only make her vulnerable, but set her apart from the other young women in the village through her own sense of modesty and reservation.  These usually valued traits become the very factors that make her the object of desire and, ultimately, the victim of male dominance and power that was certainly present in nineteenth-century England, when the story is set.  Here, Hardy hints at a storyline to come, as Tess makes first contact with a young man who feature’s significantly, later-on.

Painting the Landscape:

As the story progresses, Hardy reveals something of the nature of Tess, through comparisons to her mother and to historical context. For example, her mother and the less reserved Jacobean society are seemingly likened whereas Tess is linked through description of Victorian society; implying a sense of being reserved and morally decent.  Hardy also reveals much about his characters and society through his evocative descriptions of ‘Wessex’. 

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Hardy lived during the Victorian era and into early twentieth century, witnessing the transformation of his country from an agricultural land of village life and market-towns into a global power of major cities, industrialisation and mass-mechanisation.  His beautiful descriptions of ‘Wessex’ represent the purity of pre-industrialised England and the purity of Tess, herself, in comparison to the encroaching power of the newly developing human landscape; the city.

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It can be argued that Tess is a representation of ancient, traditional rural England; vulnerable to ‘pollution’, male dominance and destruction as Britain’s aspiration to leave behind her history of agriculture grew, replaced by the promise of industrial revolution and global domination.  It is these cleverly interwoven contexts, and their juxtapositions, that enrich the characters and make them believable.

Reading Becomes Experiencing:

As Tess experiences the attention and behaviours of the male characters, the reader develops a strong sense of connection to Tess and to the landscape, through Hardy’s clever use of our five senses.  He gives depth of detail about the sights, sounds, tastes, material touch and even smells that are peppered throughout many scenes.  This detail creates an organic sense of connection with the story and triggers a strong emotional response in the reader; for the story becomes an experience.  Hardy’s use of colloquial speech, local accents, examples of old local sayings and clearly defined character traits further enrich the sense that the characters in the book are believable.  His use of symbolic descriptions are also effective in representing and creating mood; not least of all Hardy’s use of ‘light and dark’ and of moving the story through the seasons of the year, giving the reader a sense of impact and momentum.

The Genre of Tragedy:

Hardy created a powerful tragedy.  We follow Tess through her personal growth, her response to the efforts of men to claim her, her developing sense of self and her moral view of her world set against the backdrop of a transforming and unforgiving society to which Tess, ultimately, pays the highest price.  

Hardy’s work here is impressive. He conveys a strong moment in English, and British, cultural and political history as the backdrop to describing the aspirations of society’s underclass versus the hierarchical structure of society.  The complex relationship between human nature and societal values remains relevant, to this day.

(C) Dean Parsons.

 

Guest Speaker for Medical Change

I was delighted to be invited, last week, as Guest Speaker at my local Doctor’s surgery, here in the Suffolk Coastal area.  The surgery, which I hold in very high regard, is also a training centre for Trainee Doctors.  My task was to speak with the Year 3 Trainees from Cambridge about my diagnosis of Young Onset Parkinson’s Disease (YOPD).  I was a little nervous, which was to be expected.

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I am used to having trained well established and fully qualified Doctor’s around the  treatment and prescribing regimen for patients with drug and alcohol addiction, and those with blood borne viruses, in a previous professional role.  Now, I also work with many local Doctors and medical teams around the well-being of those of my clients with extra support needs, subject to client consent, so supporting the development of Trainee Doctors did not worry me.    The only discomfort was that, on this occasion, the subject was me!

As it turned out, the planned half hour was, in fact, two small groups each for one hour and with no rest break in between!  I would need to ask the surgery to plan breaks in, if I do this again.

The meeting room was rather dour, in direct contrast to the bright and cheerfully decorated main surgery area.  Each group of very young looking, polite and friendly trainees asked me to talk through the history of the development of my symptoms.  I was pleased to note that they took an interest in my experience as a patient of the NHS and as a person who just happened to have Parkinson’s.  They appeared a little taken aback that my progression to diagnosis had actually taken twenty years; which is sadly not uncommon for people with YOPD.  Sadly, too many young people with Parkinson’s have to take up a long-term battle to have their symptoms taken seriously and to gain access to adequate tests.

While at some points I could feel myself developing an emotional response to telling my story, which I kept somewhat well hidden, I enjoyed having the opportunity to raise awareness and to teach these eager trainees how to recognise the potential symptoms of Young Onset Parkinson’s Disease.  It was a joy to also impart to them what it feels like to be me, through all that I have endured as a result of this disease.

My aim in taking part was to hopefully be part of changing the experience that the next generation of people like me have in their teens, twenties and thirties.  We desperately need more Doctors to have the awareness and the skills to intervene earlier and to provide diagnosis far earlier than the twenty years I had to suffer, when I was seen in previous Doctor’s Surgeries.

This was a valuable experience and one that I hope to be invited to participate in, again.

(c) Dean Parsons.