Sir Terry Pratchett, OBE. 1948 – 2015

Terry Pratchett

As someone who is passionate about helping people who are living with dementia, I was really sad, and quite shocked, to hear about the death of Sir Terry Pratchett at just 66 years of age. Sir Terry had been diagnosed with dementia, eight years ago, following an initial suspicion that he had had a stroke. Unfortunately however, Sir Terry turned out, more seriously, to have an uncommon form of early onset Alzheimer’s, known as Posterior Corticol Atrophy.

Sir Terry was best known as the writer of the fantasy Discworld series, and had produced over 40 books in that particular series; the last one being completed as recently as the Summer of 2014. In total however, Sir Terry was the author of over 70 books, including books for children. His books were translated into many languages and enjoyed success worldwide. Indeed unsurprisingly, Sir Terry gained his knighthood for services to Literature. His determination, creativity and his prolific amount of writing were all impossible to ignore!

As an avid bibliophile myself, and having two degrees in Literature, I greatly admire Sir Terry’s outstanding talents and huge achievements. My life would be so empty and would have an unfillable void without my books. Without authors like Sir Terry, producing rich material for our imaginations, our lives would undoubtedly be missing an essential dimension, arguably as precious as the air that we breathe.

Sir Terry’s passions evidently ran deep throughout many areas of his life, as he had been a keen campaigner for the Right to Die and an advocate for Dignitas. Additionally, he campaigned tirelessly for dementia and raising the public’s awareness. As shown in the photograph above, Sir Terry even managed to carry on writing while living with dementia. What a positive image of hope and inspiration for people living with dementia.

Sir Terry died a natural death at home on the 12th March. He was apparently surrounded by his family and had his cat asleep on his bed. The family’s grief must be so profound and hard to bear, but how proud they must feel, and what comfort they can take, from Terry Pratchett’s immense achievements and effects upon the world.

A Just Giving page was set up in his memory. Donations are for the Research Institute for the Care of Older People. It can be accessed at:

http://www.justgiving.com/Terry-Pratchett

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Hospital Visit

a & e

I was recently unfortunate enough to suffer a minor trauma to my right (and dominant) hand. The incident resulted in a visit to a nearby Accident and Emergency, who after cleaning and bandaging my wound and administering some painkillers, sent me on to a specialist hospital in a neighbouring county.

Upon visiting the specialist hospital, I was expecting to receive some speedy wound stitching within the clinic, and then an immediate discharge back to my home. I was somewhat surprised therefore when the doctor advised that I would require a small operation under local anaesthetic. The procedure was carried out in the theatre within the hour, and then I was back on the ward to be admitted overnight.

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The reason for my overnight stay was due to my need for IV antibiotics over the next 24 hours. The cannula was skilfully inserted into my uninjured left hand, and then a drip with antibiotics was attached onto the cannula every 8 hours. My injured hand was securely bandaged and had to be kept dry, so it was therefore fairly difficult to carry out simple things like eating and drinking, dressing and using the bathroom.

I was admitted to a very comfortable side bedroom with an en-suite bathroom. Post-surgery, I was promptly brought a cup of tea and some digestive biscuits, and was also asked to choose a meal for lunch and for the evening. There was a television to watch if I wanted, but, being a bookworm, I enquired whether there were any paperback books upon the ward. Not realising that I was having to stay overnight, I had arrived without a book. For me not to have a book is highly unusual, as I cannot possibly stand a day without some form of reading. A lovely health care assistant promptly found me three different titles, and I happily passed the time indulged in a gripping crime novel.

The same wonderful health care assistant found me a clean nightdress, toothbrush, toothpaste, comb, soap and bath-towel. Being an unexpected admission, I had left home totally unprepared.

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The nurses were also really lovely, chatty and helpful. I even met a fellow student nurse, who, unlike myself, was training to be a general nurse. The student nurse was really pleasant and carried out my admission assessment, cleaned my wound and gave me a tetanus injection. It was great to chat about placement experiences and our hopes for the future. The student was training at a different university to mine, but our courses sounded fairly similar in the common foundation element, and we therefore had lots to talk about. Furthermore, the student was a mature student like myself, and it turned out that we were the same age.

Hospital food often receives many negative comments, but the meals that I had as a patient were very acceptable, satisfying and tasty. There was plenty of choice on an illustrated printed menu, and I was also relieved to find that there was a genuine vegetarian section. When I say genuine, I refer to the fact that many people erroneously think that vegetarians eat fish! This is completely wrong, and in fact refers to a pescetarian diet. I personally am a ‘real’ vegetarian, and definitely do not eat fish or any animal by-products. It was therefore reassuring to find that the hospital were aware of this difference, and catered very well for me with at least 10 different meals.

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My stay was a comfortable one, with a constant stream of hot drinks, plenty to eat, and a good book to read. I struggled to shower with my one hand, but since coming home, have perfected a one-handed bath.

It was frustrating to temporarily lose my ability to drive a car, and I have had to rely on trains in order to get to university. Waiting around for trains is a negative, but, on the positive side, it was good to utilise the travel time for some valuable reading time. It was also interesting to view the journey from a different perspective, through both town and country.

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I am unfortunately temporarily unable to work in my part-time job as a carer, but should hopefully get a clean bill of health soon. Washing people in showers and moving people in hoists is naturally quite impossible with one hand out of action!

It has been an interesting experience to view a hospital from the perspective of a patient, and I really felt that I should share what a positive experience it was. The hospital was clean and comfortable, the staff were friendly, hardworking and efficient, and I was very well looked after for the whole of my stay.

I am due to visit for a check up on Friday, and hopefully will be able to get rid of my dressing. Well done National Health Service for a great level of provision! It makes me very proud to be a student nurse.

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Further thoughts on Dementia

dementia friends

The final day of my last university module was spent taking part in a Dementia Conference. As this is my particular area of interest, I had very much looked forward to attending the event. The speakers included a carer and a person living with dementia. The day was fascinating and illuminating, and I enjoyed it immensely.

The Carer’s Perspective

One of the speakers was a lady who cared for her husband who was living with dementia. As the lady recounted their story – of struggles and humorous episodes – I was very emotionally touched by what she had to say, and at times had to compose myself and blink back the tears. The speaker’s patience and kindness were especially evident, but so too were her frustrations and ordinary everyday ‘non-perfect’ human qualities. The lady worked extremely hard to care for her husband, and had completely changed her life by giving up her former job in a position of high responsibility, in order to take care of the person that she loves. As well as her husband becoming a different person, the lady spoke about her own loss of identity – through her former role as a career professional and as a wife. It was really quite sad, but the change was inevitable, and it therefore had to be embraced in as positive a way as possible.

One of the speaker’s main messages to our audience was that it was really difficult to obtain an initial diagnosis of dementia. Many professionals discount symptoms or misdiagnose them as depression. The lady was also keen to stress how the voice of carers is often completely ignored, perhaps on account of their non-healthcare professional status, and ironically, despite carers often being experts on the person in their care. The lady additionally felt that people were often given no information following a diagnosis, and were just left alone to get on with their lives, as though nothing was different. This must be a very disempowering situation, and one that could lead to very negative outcomes. At this point in the conference I made a mental note to myself, to always support the people in my care and their families, and to keep them fully informed about what is going on in the short term, as well as what to expect in the long term.

The Person living with Dementia’s Perspective

A lady living with early-onset dementia (a pre-65 years of age diagnosis, which can be as young as 40) bravely addressed our audience, in order to share her story. Due to the unreliability of her memory, she read from a pre-prepared script, which was suitably lengthy, informative and interesting.

The lady had formerly worked in a highly responsible job, and had started to notice problems with remembering things and repeating herself within her career role. After her diagnosis, the lady made the decision to give up her job, despite not being forced to by her employers. She decided upon her own considerations and realistic self-honesty, as she did not want to make any grave mistakes and end her career with disaster. This decision must have been really hard to make and to accept, but to partially counteract it, the lady positively decided, at this point, to do all the things that she still wanted to do, like travelling, before her decline becomes too restrictive.

The lady explained how her life remains full through involvement with dementia groups and by socialising with other people living with dementia. The negative side of her experience has mainly come from other people’s perceptions within the general public. For example, a shop assistant was irritated because the lady took a long time to get the right money together, and the assistant apologised to the customer waiting behind, rudely pointing out how long the lady was taking. The other customer apparently joined in with the rudeness by agreement and general sighing. In a state of growing agitation, the person with dementia meanwhile, dropped all her money onto the floor and must have felt so embarrassed. What a terrible episode this must have been for her, and sadly this was unfortunately not an isolated incident.

In order to help with daily life, the speaker explained that she does have a badge stating ‘Please be patient, I have Alzheimer’s’. For personal reasons however, she chooses not to wear it; perhaps because of wanting to avoid people’s pity, patronising comments or just being treated differently. Bearing such incidents in mind, the need for developing dementia friendly communities is compellingly clear. As dementia is on the increase, the general public desperately need to be educated about the condition and how they can help. To alleviate ignorance, discrimination and stigma, public awareness is vitally crucial.

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In fact, this final point above reminds me of a comment that the speaker, who is a carer made: she said that some people that she and her husband knew, before his dementia diagnosis, now crossed over the road in order to avoid them. She felt that they were probably too embarrassed to talk to them, and they may well be afraid of dementia as a condition. The lady expressed a belief that, for many people, dementia is the new cancer. Before much investment in research, resulting advances in treatment, routine screening and increased public awareness, cancer used to be a particularly feared disease, which was often akin to an actual death sentence. Although there is still plenty to be done, recovery from cancer is now generally much improved, if detected early. As dementia currently stands however, there is no cure. Dementia is a progressive disease which commonly declines over 10 to 15 years, and eventually leads to death. Consequently much of the public are afraid of dementia, but like cancer, we must not give in to it. Until a cure is found, we must help people to live well with dementia. 10 to 15 years is a long period of time, and the person living with dementia is still there inside. Sometimes it is just a little bit harder to find them! Improved knowledge, the development of effective communication techniques and acceptance are key. If you are not already, I would urge any reader to become a dementia friend, and to see how you can help people living with dementia. Only together, can we make our society dementia friendly.

dementia friends

Exploring Advanced Dementia

Appropriately for Mental Health Awareness Week, I today attended a seminar which explored advanced dementia. The seminar was kindly hosted by a local hospice, and examined many concepts regarding the topic of dementia: including types of dementia and their features, the importance of getting to know each person with dementia as an individual, effective communication throughout the different stages of dementia, recognising that we might be the problem and not the dementia, and making environments dementia friendly.

A new concept for myself was the introduction of the Dementia Bookcase. This is an analogy which I found useful and apt; so please let me explain. Imagine a bookcase with four shelves, which represents the life stages of the person with advanced dementia. Childhood is at the bottom, adolescence and early adulthood is second up, mid to late adulthood is on the second from the top, and now – the present – is on the top shelf.

Now – the present

Mid to Late adulthood

Adolescence / Early adulthood

Childhood

Working from the top, the metaphorical ‘books are falling off’ and cannot be replaced; rather sadly like the brain cells of the person with dementia. The next shelf down, of mid to late adulthood, is now forgotten, and this is particularly hard for a carer / partner who has cared for the person with dementia – even worse for a second (later married) wife. On the third shelf, of adolescence to early adulthood, the person with dementia remembers going out to work as a milkman. He wakes up at 4:00 in the morning, and is desperate to get out, because he needs to deliver the milk. On the bottom shelf, as the person is getting nearer to death, he remembers being a child and may ask for his mother or father, and may well be concerned that they do not know where he is. If childhood experiences were bad, this stage may be emotionally difficult. At this final stage, spirituality becomes extremely important, and will allow the individual to form a vital connection with a thing that is special to them. Depending on the person, this may be through a piece of music – or singing or dancing, watching football or stroking an animal. Whatever the choice, it can be a joy to witness a person ‘coming alive’ in this way.

donkeys

record player

Another thing that really struck me today was a discussion regarding validation. Imagine a situation in which the person with dementia asks for their wife, but you know that the person’s wife is dead, and has been for 20 years. What should you do? Do you lie? Do you tell the truth?

If the person wants their wife, then you should validate the person’s needs by talking about her. “Tell me about your Sarah, where did you meet? Can you remember your wedding day? What was it like when you had your first child?” Talking about the person’s wife will bring comfort and a moment of happiness. They will feel that you really care. The person may well soon forget what you have just talked about, and may ask about Sarah again, or possibly they might not. Validation is surely better than telling a bare-faced lie? Consider for example: “Sarah is staying with her mother at the moment, but she is probably going to come and have tea with you tomorrow.” Or even worse, imagine the alternative, although it may be true? “Don’t you remember? Sarah died 20 years ago.” Imagine the person with dementia having to live through the pain all over again; it just seems so cruel. Validation is surely most appropriate.

On a warmer note, a concept called doll therapy was also briefly discussed. There was a story regarding a lady who longed to see her daughter, who was living far away in another country, and did not get to visit her mum as often as she would like. The lady believed that her daughter was still a child; and so when finding a doll in the residential home where she lived, the lady joyfully announced that the doll was her daughter – she had come back to her mum. The lady became totally attached to her newly found ‘daughter’, and took her around with her all of the day, slept with her at night, and ‘fed’ food to her at mealtimes. The doll became quite grubby with food around her mouth!

feeding doll

Some people may criticise this behaviour, and consider it inappropriate for a grown woman to be ‘playing’ with a doll. Doll therapy however, was clearly hugely beneficial for this particular lady. While it is clearly not ethical to treat a person with dementia like a child, through representation of the person’s former memories, doll therapy serves a completely different function. To live in the person with dementia’s world is a good and productive task of engagement. Approaches such as doll therapy can bring much happiness and benefit. The world of dementia may at times seem strange, but as discussed today, perhaps we are the problem and not the dementia? Person-centred, individualised care remains to be the main priority.

Fifth placement over and exam complete!

Last Friday I officially completed my fifth placement out of an eventual nine – so there are just four more to go before I qualify as a nurse. Yesterday I also sat the Year Two Semester Two exam on physiology, pathophysiology and assessment, which was three hours in length. All the hard work is hopefully starting to pay off, and the distant end of March 2016 is gradually getting nearer, and is less than half-way now.

My fifth placement with the Crisis Team (now called the Home Based Treatment Team) was exceptionally good, and I feel that I learned plenty. My prime objective was to complete a full patient assessment and all the associated paperwork – face-to-face client contact, initial assessment documentation, risk assessment and care plan. Fortunately this placement provided plenty of opportunities to practise these skills, and I had the benefit of working alongside a very experienced team, who demonstrated some very skilled interactions and interventions with clients.

It was good to support patients within their home environment, and to help prevent them from deteriorating and having to go into hospital. Naturally, this was not always possible, but on the opposite side of this process, we would often support patients upon arriving back home after being discharged from hospital. When improvement and stability was gradually achieved, it was then also possible to transfer the care of our patients back to the Community Mental Health Team.

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Alongside the placement I was able to complete four ‘spoke’ days, in order to gain extra experiences. Two days were spent with the RAID (Rapid Assessment Interface and Discharge) teams at two separate A & E departments, one day was spent at an inpatient psychiatric hospital, and another was spent with a Community Mental Health Nurse. During the latter, I was fortunate enough to experience a visit to a closed high security prison, and upon entering, was subjected to a body search and scan, the taking of my index finger prints and the removal of my shoes. It was amazing to go inside the old Victorian prison and onto the wing. If anyone can recall the old prison comedy drama called Porridge; well that is exactly what it was like inside.

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Other notable placement experiences included: talking to a suicidal patient over the phone, and being able to calm them down enough for me to call for an ambulance; making an adult safeguard referral; and taking part in a home visit involving an interpreter. It was a rich and rewarding placement experience with a wonderful team to assist me in my learning; I was very fortunate.

I had been building up to yesterday’s exam for the whole of my placement, and initially I was concerned that I would forget much of my university lecture content whilst working in the community, but fortunately this was not the case. The main medical conditions that we focused on were diabetes, heavy alcohol consumption, osteoarthritis, and stress, anxiety and depression. During placement I was able to meet real-life patients with all of these conditions, and I found that I was able to talk with them and advise them directly, with confidence, about many aspects of their condition. Much of my recent learning became relevant with clear practical application and knowledge based in reality. Accompanied with some evening and weekend revision, I felt well prepared for yesterday’s event.

exam room

Like all exams that I take, I wrote non-stop for the whole duration of three hours. Historically, I never finish exams early, and usually have to rush with the final question; and yesterday was no exception. Fortunately I was able to sleep well the night before, and did not let nerves affect me too much. I was panicking a little about remembering quotations and evidence sources to back up my knowledge, but most of them proved to be lodged in my brain and were utilised on the day. I do not yet know when the results are due to be released, but I am guessing that it might be in a couple of months’ time. Fingers and toes crossed – how will I bear the suspense? I will be very scared on the day that the marks are released.

mental capacity act       mental health code      mental health act manual

Hungry for yet more learning, I am now looking forward to starting the final semester of Year 2. The module is called Nursing Practice and Decision Making, and I am already acquiring some of the texts ready for some preparatory reading. There is still a small part of Semester Two remaining, and I am particularly looking forward to some specific learning regarding dementia; as this is a topic that is personally very close to my heart. Additional to my university learning, I have also secured myself a day on an Advanced Dementia student seminar next month, which I am greatly looking forward to. I have also just become a Dementia Friend too.

dementia friends

Alcohol and the Liver – Revision

liver and organs

The Liver

The liver is situated above the pancreas, stomach and duodenum, and has the gallbladder near to its central area. The liver is made up of lobules, with hexagonal cells called hepatocytes. These hepatic lobules are supplied with oxygenated blood from the heart through the hepatic artery. Deoxygenated blood goes back to the heart through the hepatic portal vein.

liver

Instead of capillaries, the liver’s circulation relies on the sinusoids or blood channels, which have kupffer cells inside. The kupffer cells eliminate worn out red blood cells and other unwanted debris. The liver has bile channels called canaliculi, which meet to form a common hepatic duct that supplies bile to the gallbladder. The alkaline bile is stored there until chyme (broken up food) enters the duodenum, and then it is used to emulsify the fats and neutralise the acid.

hepatocytes

The liver is basically a chemical processing plant…

The liver stores glycogen which can later be turned into glucose through the uptake of insulin. It does this to maintain blood glucose levels. The liver also makes glucose from fructose, galactose and amino acids. It also stores iron and copper, and vitamins A, B12, D, E and K. The liver converts the vitamin D into its active form, so it can assist calcium in being absorbed into the body.

In a high protein diet, the liver will break down the protein into carbohydrates and amino acids. Amino acids are DEAMINATED, or broken down, by the liver. 8 amino acids are acquired through a balanced diet, and the liver makes 12 more using the 8 that are available. Through this process of TRANSAMINATION – the manufacture of amino acids – 20 amino acids are accessed. As the amino acids are deaminated by the liver, nitrogenous waste is made, via ammonia, urea and urine. Ammonia is toxic, and so is changed into urea (less toxic), and then changed into urine and eliminated.

The liver also makes four proteins that circulate in the blood: globulin and albumen are plasma proteins, while prothrombin and fibrinogen are clotting proteins. The clotting factor of a person’s blood is measured using the INR (international Number Ratio).

The liver also makes cholesterol, including HDLs and LDLs. High density lipoproteins contain more protein than fat, and are good cholesterol. Low density lipoproteins contain more fat than protein, and are bad cholesterol.

The liver metabolises, or breaks down, all prescription and recreational drugs, including alcohol. It also changes the bilirubin so it can be excreted in the bile. Bilirubin is the broken down product of the haemoglobin from red blood cells.

Liver Disease

When the liver is damaged, bilirubin will accrue in the body, and the person will develop jaundice, appearing yellow in their skin and the whites of their eyes. The person’s faeces will be pale and clay-like.

jaundice

The blood will no longer clot easily, and there may be problems with excessive bleeding and bruising. The liver will swell up and cause the abdomen to be bloated. The person will lose weight, and experience nausea, vomiting and tiredness.

Blood tests can reliably diagnose problems with the liver, as enzymes will be raised if liver cells are damaged. ALP, ALT and AST will all be elevated, as will Gamma GT. The latter is more specific to alcohol liver disease, while the others may be more specific to liver diseases, such as Hepatitis A, B and C, and cancer.

liver healthy and ill

The Short Term Effects of Alcohol

Alcohol is a diuretic and can cause dehydration. Alcohol produces a false feeling of bodily warmth and may lead to hypothermia. Alcohol is also a depressant and will exacerbate any underlying anxiety and depression, thus reducing the efficacy of anti-depressant drugs. Unfortunately when depressed, many individuals use alcohol as a negative coping strategy. Alcohol increases the release of dopamine, and triggers the reward areas of the brain, thus making us feel happy and relaxed. This feeling does not last however, and if drinking continues, areas of the brain will be physically depressed, including judgement and reasoning, visual and spatial awareness, the management of emotions and memory impairment. Rash impulsive decisions may be made as a result, and some people may become verbally or physically aggressive, thus getting into trouble, such as fights.

jaundice man

Females may become sexually disinhibited, as their testosterone levels go up, and may thus place themselves in danger. Males, in contrast, tend to lose sexual drive through the reduction of testosterone, and can experience problems with erectile dysfunction.

The brain’s cerebellum will be affected and the person’s balance and gait will become unsteady. The body’s reflex reaction times will significantly slow, and so falling over and sustaining an injury becomes more of a risk.

Driving a car is definitely to be avoided, although many people over-estimate their abilities when under the influence of alcohol. The reality of course, is that their reaction times behind the wheel will be much slower, and so last minute braking is virtually impossible. Speeds and distances will be extremely hard to judge. It is always best to avoid drinking altogether when planning to drive, as just one unit of alcohol takes approximately one hour to be metabolised by the body.

drink driving

When drinking lots of alcohol, many people experience an increase in their appetite and often will order late-night takeaways. People drinking at home may be more tempted to cook something independently, and there have been many instances in which individuals have set their homes on fire, through oil in chip pans catching fire, because they had gone to sleep.

Exceeding sensible alcohol limits can be a high risk behaviour. It is best to avoid alcoholic binges, and to drink responsibly and safely, perhaps enjoying alcohol with a meal. Drinking alcohol with food reduces its absorption, as well as being pleasant and adding a sense of occasion.

food and wine

 

Stress Revision

I continue to be extremely busy on placement within the community, working alongside the Home-Based Treatment Team (formerly called the Crisis Team). This week I also spent two days with the Rapid Assessment Team at two separate local hospitals. The teams deal with mentally ill people who present at Accident and Emergency, and also assess patients who are in hospital already (usually with physical problems), but are also presenting with signs of possible mental illness. Many of the A & E attendees are referred to the Home-Based Treatment Team where I am presently working, and the people are then supported in the community through daily home visits.

a & e

Aside from this, I am still busy revising for my forthcoming exam which takes place towards the end of September. At the moment I am revising stress, and in order to help me clarify my learning (like last week with the diabetes topic), I thought that I would try to rewrite some of the main facts that I have learnt.

Long-term Stress and the Effects upon the Body

Short-term positive stress, sometimes known as eustress, can be beneficial, and can help us to achieve things, such as passing an exam! Long term stress, in contrast, is negative and distressing to the individual’s body and their mind.

Short-term stress can produce temporary beneficial changes, such as raised blood pressure and raised blood glucose, and the body’s homeostasis is quickly regained. Long term stress also produces the same increases, as well as a weakened immune system. The body’s homeostatic levels however, are eventually re-set at a much higher level, and the resulting consequences can sometimes be serious illness, such as myocardial infarction and cancers.

When faced with stressful circumstances, the brain’s hypothalamus causes the body to go into fight or flight mode. This stimulates the sympathetic branch of the autonomic nervous system, which then stimulates the adrenal medulla to release adrenaline. The adrenaline causes the heart rate to increase and the blood pressure goes up. If the stress is short-lived, as in healthy individuals, the parasympathetic branch of the autonomic nervous system will eventually take over, and a state of relaxation and calm will once again return. In long-term stress however, the heightened, and potentially damaging, effects of the sympathetic branch are maintained by the release of several hormones.

fight or flight

Stimulated by the hypothalamus, Corticotrophin Releasing Hormone (CRH) stimulates the production of cortisol, which leads to loss of appetite and loss of libido. It also causes a reduction in the immune system, the slow healing of wounds, muscle wastage, loss of bone mass and the breakdown of glycogen to glucose, thus increasing blood glucose levels. The CRH also stimulates the release of AdrenoCorticoTrophic Hormone (ACTH). ACTH stimulates the adrenal medulla to produce aldosterone and cortisol. The aldosterone stimulates the kidneys to retain sodium, which then attracts water, and so the blood volume and blood pressure therefore increase. High blood pressure (hypertension) is associated with problems such as stroke, heart disease and diabetes. Growth Hormone is also released, and this breaks down fat and converts glycogen to glucose. Thyroid Hormone is additionally released, and this stimulates Thyroid Stimulating Hormone (TSH). TSH increases the speed of all bodily reactions, including the metabolic rate, thus increasing the chances of weight loss.

blood pressure

Stressed individuals frequently experience poor sleep, and this inability to rest and recuperate, sadly and ironically, enhances the stresses. Negative coping strategies such as alcohol and drug misuse can make the problem worse, as can poor diet and lack of exercise. Sleep, when achieved, stimulates the parasympathetic branch of the autonomic nervous system, which in turn reduces the adrenaline. Sleep is therefore a great healer in recovering from stress.

Lack of sleep and stress can be antecedents to anxiety and depression. Concentration is diminished or lost, and the small things in life can soon start to feel like huge mountains. Other complications of stress can be migraine, Irritable Bowel Syndrome, ulcers and gastritis.

snoopy sleeping

Needless to say, stress is not good for our working lives either. The Health and Safety Executive (2012) stated that 10.4 million working days were lost through stress, while the Labour Force Survey (2012) found that females generally experienced higher working stress, and that the age group of 35–44 had the highest amounts of individuals affected. This could perhaps be on account of the females’ additional responsibilities such as children, household chores, and possibly caring for elderly parents.

Stress is clearly a potentially negative force, and one that can damage both our bodies and our minds.