Mental Health Issues Among UK University Students: Are Universities Doing Enough?

Mental Health Issues Among UK University Students: Are Universities Doing Enough?

By Dr Meetu Singh | January 2025
mental health issues of students

"The greatest glory in living lies not in never falling, but in rising every time we fall."

According to recent studies, mental health issues are becoming increasingly common among university students in the UK. In a survey conducted by charity Humen, almost 50% of the 7,200 students surveyed reported that mental health difficulties had a negative impact on their university experience. There has been a staggering 450% increase in students declaring existing mental health issues during the university application process (UCAS, 2021). This is a worrying trend, as mental health problems can have serious consequences for students, ranging from poor academic performance to self-harm and suicide.

Becoming a student can be a stressful experience, with many students having to adjust to a new environment, manage their finances, and cope with the demands of academic work. While stress itself is not a mental health problem, it can lead to mental disorders like depression and anxiety. The COVID-19 pandemic has further exacerbated the mental health challenges. Anxiety, depression, insomnia, substance misuse and suicide risk were increased after the first cycle of lockdown in the UK. 

Given the high prevalence of these disabling issues, It is important for universities to take proactive steps to support their students’ with their mental health. And should be well equipped to recognise the impact that stress can have on students, to then be able to provide support and resources to help them manage their stress levels and maintain good mental health. This may involve providing access to mental health services, promoting mental health awareness and education, and creating a supportive and inclusive campus environment. By prioritizing the mental health of their students, universities can help to ensure that students are able to achieve their full potential and have a positive university experience.

 

Common Mental Health Disorders Among University Students

University students in the UK often experience various mental health disorders that can affect their academic performance and overall well-being. Here are some of the most common mental health disorders among university students:

Depression

According to a survey by the mental health charity Student Minds, depression was the most commonly reported issue in this group.

Anxiety

Anxiety disorders are reported by a third of the respondents in the Student Minds survey reporting anxiety.

Eating Disorders

Eating disorders, such as anorexia nervosa, bulimia nervosa, and binge-eating disorder, are reported by almost 20% of students

Substance Abuse

Substance abuse, including alcohol and drug abuse, is a significant problem in this group. According to the Insight Network survey, almost 30% of students reported engaging in binge drinking, and 13% reported using illegal drugs

ADHD

Factors Contributing to Mental Health Issues

Students face a range of challenges, some of the most common factors contributing include academic pressure, social challenges, and financial stress.

Academic Pressure

The pressure to excel academically can come from a variety of sources, including professors, peers, and family members. Students may feel like they need to maintain a certain specific grades in order to succeed in their chosen field.

Social Challenges

Social challenges like transition to university life, especially for students who leave home for the first time, some may struggle to make new friends, feeling isolated or homesick, or experience of a culture shock.

Financial Stress

University students are very likely to experience financial stress, which can impact their mental health in a variety of ways. They may struggle to pay for tuition, housing, and other expenses, and may feel pressure to work long hours or take on debt to make ends meet.

Impact of Mental Health Issues on Academic Performance

In a study on selection and academic performance, researchers found that mental health problems in early childhood and adolescence increase the risk of poor academic performance [1]. This highlights the need for awareness and treatment to provide fair opportunities for education.

The link between academic pressure and mental health problems has been well documented. A study published in the Journal of Affective Disorders reviewed 52 studies involving students who attended either primary school, secondary school, or sixth-form college across the globe between 1991 and 2022. In 48 of the studies, there was a positive association between academic pressure or proximity to exams and mental health issues [2].

Mental health issues can also result in students missing classes and deadlines, which can further impact their academic performance. It is important for universities to provide support and resources to help students manage their mental health and academic workload. This can include counselling services, mental health resources, and academic accommodations.

Policy and Legislation Surrounding Mental Health in UK Universities

UK universities have a legal responsibility to ensure the mental health and wellbeing of their students. In recent years, the UK government has recognized the importance of promoting mental health in universities and has introduced several policies and guidelines to help universities meet their duty of care.

For students grappling with mental health disorders, duty of care becomes even more critical. They require robust support systems that listen without judgment and offer help when needed. A comprehensive and compassionate approach is essential in fostering a thriving campus community.

So, what exactly is ‘duty of care’? It’s a responsibility that businesses and institutions have towards their employees, customers, and clients ensuring their safety and well-being. Translating this concept to universities means safeguarding students’ welfare. A legal duty of care would make universities accountable for creating a safe and nurturing environment, complete with counselling and tailored wellness programs.

However, navigating duty of care is no easy task, particularly when balancing patient rights to privacy and confidentiality. Just like all individuals, students cherish their privacy, especially when seeking assistance for mental health concerns. Universities must skilfully navigate this fine line, ensuring students’ well-being while respecting their boundaries.

Transparency is the cornerstone of managing this complex issue. When students face significant challenges, communication with parents or guardians must be clear and thoughtful, obtaining the student’s consent whenever possible. Striking this balance between care and privacy is essential in providing responsible and effective support.

Real-life experiences can highlight the impact of a legal duty of care for students. Take for instance, the heart-wrenching story of Phoebe Grime, a young student who struggled with mental health issues. Her mother, Hilary, expressed concerns to the university, but the response fell short, leading to a tragic outcome. Instances like this underscore the need for comprehensive duty of care in universities, holding them accountable for their students’ mental well-being.

One such policy is the Stepchange framework, which aims to promote a whole-university approach to mental health. This framework encourages universities to make mental health a strategic priority and to adopt a whole-university approach that involves all staff and students. The framework also provides guidance on how universities can support students who are experiencing mental health issues, including providing access to counselling and mental health services.

Another important policy is the Higher Education and Research Act 2017, which includes provisions for promoting student wellbeing and mental health. This act requires universities to have a mental health and wellbeing strategy in place and to report on their progress in implementing this strategy.

In addition to these policies, there are several laws that apply to universities and their duty of care towards students. The Equality Act 2010, for example, requires universities to make reasonable adjustments to ensure that students with mental health conditions are not disadvantaged. Universities also have a duty of care under common law to take reasonable steps to prevent harm to their students.

In Conclusion, University can be a time of great excitement and new experiences, but also a time of change, academic, financial and social pressure. Given the current social and economic environment mental disorders among university students are a growing concern in the UK. The consequences of mental health issues for students range from poor academic performance and dropping out of university, to self-harm and suicide.

Universities are multifaceted institutions facing various challenges, but this must not deter us from advocating for student well-being. A legal duty of care would set a benchmark for excellence, ensuring that universities prioritise mental health support and continually improve their services.

If you, or anyone that you know, is struggling with their mental health please reach out to Oaktree Connect and get the help and support that you need.

References

UCAS (2021) 450% increase in student mental health declarations over last decade but progress still needed to address declarations stigma, UCAS. Available at: https://www.ucas.com/corporate/news-and-key-documents/news/450-increase-student-mental-health-declarations-over-last-decade-progress-still-needed-address (Accessed: 04 August 2023).

Are you a leader and need mentoring or coaching? We may be able to help. Contact us at contact@oaktreeconnect.co.uk.

Dr Singh is the consultant psychiatrist with a special interest in neuropsychiatry.  Having seen and treated hundreds of patients with ADHD, in London and Birmingham and with masters in Neuropsychiatry, she is well known as an expert in this field. 

Contact: 
Email – clinicadmin@oaktreeconnect.co.uk
Telephone – 020 39277699

Oaktree Connect Fees & Pricing for Other Services

There may be additional fees payable after your assessment, for which you will receive an invoice: for example, for the costs for prescribing medication agreed between you and the psychiatrist at the time of assessment. We try our utmost to stay within the time allocated for the appointment however, you could be charged for any extra time spent in the consultation, if the meeting runs over the allocated time, or where communications with you or reviewing notes etc. exceeds what is deemed reasonable, but this is at the discretion of the clinician.

Cutting Edge Treatments for Fighting Depression

Cutting Edge Treatments for Fighting Depression

By Dr Meetu Singh | January 2025
depression treatment

"Do not dwell in the past, do not dream of the future, concentrate the mind on the present moment."

For 8% of adults and 15% of youth, depression is more than a passing phase. It’s an ongoing condition that interferes with the ability to complete various tasks. It causes substantial disruption in personal and work life, as many of the readers will identify with. Depression can also lead to physical conditions like heart disease, digestive issues, and chronic pain.

The treatments for depression have stayed unchanged with only a few new antidepressants medicines approved by the authorities in the last 20 years, little improvement in side effects or how quickly the treatment can start to work.

The exciting news is that now new research and development has providedl brand new ways to treat depression, even when the traditional means of treatment proved unhelpful. There is also evidence that these novel treatments added significantly efficacy and the swiftness with which they work is superior to antidepressant drugs. Some of them are even less likely to cause side effects. It is fair to say that the treatment for depression is finally entering a modern era.

What are Cutting Edge Treatments for the Treatment of Depression?

Repetitive Transcranial Magnetic Simulation (rTMS)?

rTMS uses magnetic fields to stimulate nerve cells in the brain to minimise depression. It is a non-invasive procedure approved by National Institute of Clinical Excellence (NICE) in the UK and the Food and Drug Administration (FDA) in USA, for patients who unsuccessfully tried other treatment methods, in the past. It may also be used to treat OCD, anxiety, migraines, chronic pain, and tinnitus.

During an rTMS therapy for depression session, an electromagnetic coil is placed on the scalp, stimulating nerve cells in the region of the brain that controls mood. It may activate areas of the brain that experience reduced activity due to depression.

Unlike other treatments, rTMS does not produce serious side effects. Patients may experience slight discomfort or pain, but these symptoms should dissipate within a day. The treatment may be permanent for some, but others may have to return for additional treatments every few months if symptoms return.

A 2024 NCBI report shows two-thirds of patients treated with rTMS experience remission or at least a 50% reduction in symptoms. Combined with brain imaging, remission (relief from depressive symptoms) rates have nearly reached 80% in various clinical trials.

Psychedelic Drugs

Many will find the mention of this treatment here surprising but following research of controlled and clinical use of these substances has been found to be an excellent option. Psychedelic drugs such as psilocybin and MDMA (ecstasy) when used as prescribed by medical professionals, have shown potential to relieve treatment-resistant depression (depression that has not responded to at least 3 other treatment regimes).

Experts believe that these drugs encourage the growth of new connections between neurons in the brain, promoting plasticity. Neuroplasticity is the brain’s ability to change itself and grow, this can help reduce depressive symptoms significantly and over longer periods. It can also be useful in recovery from other mental conditions.

In Australia, the Therapeutic Goods Administration (TGA) made a significant decision in February 2023 regarding the classification of psilocybin and MDMA. The TGA, which functions similarly to the UK’s Medicines and Healthcare Regulatory Authority (MHRA) and the USA’s Food and Drug Administration (FDA), announced that these substances would be moved to schedule 8. This reclassification allows approved psychiatrists to use these substances for patients who have not responded to at least two other treatment methods.*

It is fair to say that psychedelic drug approach has proven successful. One of the most extensive clinical studies revealed that 71% of patients experienced a significant reduction in symptoms within four weeks after a single dose of the drug Psylocybin in patients with major clinical depression. 54% of participants experienced substantial length of remission within the same time frame. These are findings that are quite encouraging and may pave a completely new way of treating depression by the professionals.

However, although psychedelic drugs may be beneficial, they have certain drawbacks. They can produce negative psychedelic experiences even at smaller doses for a minority of the patients. It is clear that their administration has to be closely supervised by professionals in a clinical environment. In the UK a handful of clinics are licensed to provide this treatment currently.

Deep Brain Stimulation (DBS)

Deep brain stimulation is a surgical procedure that involves implanting electrodes in specific regions of the brain. The electrodes produce electrical impulses that affect brain cells and chemicals. A pacemaker-like device implanted in the chest with wires connecting to the brain’s electrodes controls stimulation levels.

The treatment may help treat Parkinson’s Disease, epilepsy, OCD, depression, Huntington’s disease, dementia, anxiety, and other medical conditions.

DBS has been shown to produce an average of 60% response rates in chronically and severely depressed patients. However, the rate of symptom reduction varies greatly. The procedure is also invasive and may lead to complications and side effects. It is therefore used sparingly and more as a ‘last resort’ treatment for life-threatening treatment resistant depression.

Depression Treatment Comparative Table

Review this comparison chart for an overview of the depression treatments included in this article. 

Condition

Side Effects

Success Rates

rTMS

Local scalp discomfort and pain, headache, twitching, tingling, spasms, lightheadedness

66% to 80% success rates with patients achieving temporary to complete remission

Psychedelic Drugs

It may put the patient at risk due to the psychological effects immediately following administration;

It may also cause temporary side effects like headache, digestive issues, rapid heartbeat, and high blood pressure

71% success rates with patients achieving temporary to complete remission

Deep Brain Stimulation

Surgery complications and side effects, including tingling, numbness, muscle tightness, trouble with speech and balance, lightheadedness, mood changes, and vision changes

60% success rates with varying reduction of symptoms.

Oak Tree Connect Offers Successful rTMS Treatment.

Oak Tree Connect offers comprehensive rTMS treatments in our Birmingham, UK facility. We have treated 125 patients with an 86% remission rate. Our dedicated team of highly experienced professionals will develop a customized plan suited to your needs. 

Therapeutic Goods Administration (TGA). MDMA and Psilocybin Hub. Department of Health and Aged Care, Australian Government, 2023 (https://www.tga.gov.au/products/unapproved-therapeutic-goods/mdma-and-psilocybin-hub).

Contact us to learn how our unique depression treatment can improve your quality of life. 

Are you a leader and need mentoring or coaching? We may be able to help. Contact us at contact@oaktreeconnect.co.uk.

Dr Singh is the consultant psychiatrist with a special interest in neuropsychiatry.  Having seen and treated hundreds of patients with ADHD, in London and Birmingham and with masters in Neuropsychiatry, she is well known as an expert in this field. 

Contact: 
Email – clinicadmin@oaktreeconnect.co.uk
Telephone – 020 39277699

Oaktree Connect Fees & Pricing for Other Services

There may be additional fees payable after your assessment, for which you will receive an invoice: for example, for the costs for prescribing medication agreed between you and the psychiatrist at the time of assessment. We try our utmost to stay within the time allocated for the appointment however, you could be charged for any extra time spent in the consultation, if the meeting runs over the allocated time, or where communications with you or reviewing notes etc. exceeds what is deemed reasonable, but this is at the discretion of the clinician.

Self Compassion and Preservation When In Leadership Roles

Self Compassion and Preservation When In Leadership Roles

Part Three of the 'Psychology of Leadership' Blog Series

By Dr Meetu Singh | January 2025

"You can search throughout the entire universe for someone who is more deserving of your love and affection than you are yourself, and that person is not to be found anywhere. You yourself, as much as anybody deserve your love and affection."

It is undeniable that compassion, considered one of the best qualities in a person, is especially commendable in a leader as they work toward the common good, with the expectation that they would care, often unattainably, for every member of the organisation. Most successful leaders therefore aspire to be kind and compassionate, praised and loyally followed if they succeed in that pursuit. Unfortunately, when it comes to being kind to themselves this aspiration is less evident. Self-compassion, for many, carries the whiff, the connotation, similar to those other words with the prefix, “self”: self-pity, self-serving, self-indulgent, self-centred, of being SELFISH.

Directing Compassion Towards Yourself

How many times have you said to a friend who comes to you for reassurance after a particularly harrowing experience or failure, “It seems hard but you will get through this given time, I’m here for you, this is not your fault, you are great, failure is part of life, I know you did your best”, etc.  it can be said with certainty that if you have friends, then not infrequently. You are kind, supportive, think of the best way to be soothing, help them to live through the hard times. 

And yet, if you were the person in that situation, your thoughts would probably be “I’m not good enough, this was a huge failure, it’s my fault/ I was lazy, I need to work harder, I failed.”, critical and even degrading of the self. Where does that compassion you had for your friend disappear? 

Unfortunately, many of us have been set this ideal of modesty, self-effacement, caring for others but harsh, self critical and degrading of ourselves.

This is especially true for women, who, research indicates, tend to have slightly lower levels of self-compassion than men, even while they tend to be more caring, empathetic, and giving toward others.

How Can You Practice Being Kinder to Yourself?

How many times have you said to a friend who comes to you for reassurance after a particularly harrowing experience or failure, “It seems hard but you will get through this given time, I’m here for you, this is not your fault, you are great, failure is part of life, I know you did your best”, etc.  it can be said with certainty that if you have friends, then not infrequently. You are kind, supportive, think of the best way to be soothing, help them to live through the hard times. 

And yet, if you were the person in that situation, your thoughts would probably be “I’m not good enough, this was a huge failure, it’s my fault/ I was lazy, I need to work harder, I failed.”, critical and even degrading of the self. Where does that compassion you had for your friend disappear? 

Unfortunately, many of us have been set this ideal of modesty, self-effacement, caring for others but harsh, self critical and degrading of ourselves.

This is especially true for women, who, research indicates, tend to have slightly lower levels of self-compassion than men, even while they tend to be more caring, empathetic, and giving toward others.

The Evidence Towards This Practice

There is now growing evidence in research that proves that self compassion makes the leaders and those in caring professions less likely to experience stress and burnout; that in general they are more motivated, energised, happy, satisfied with their career, and grateful for being able to make a difference in the world. Also, people with this attitude are more caring, giving and likely to have longer term and stable relationships.

As a leader and manager of an organisation and several teams over the years I have noted that: 

  1. It’s lonely at the top, I realised this when I was excluded from my team social media groups. From being the life and soul of a party and my company staff looking forward to evenings out with me, I turned to a manager not to be trusted, ‘from the dark side’.
  2. Buck stops at you so you end up working the hardest- The authorities, regulators, partners, customers, everyone expects you to make the right decisions at all times
  3. You are closely watched and open to abuse and criticism- By leading, you by default somehow, vouch for everyone’s mistakes and lapses or at the very least for discovering any and correcting these more swiftly than superman.
  4. All your faults and mistakes are visible to all and open to criticism.

You are for all intents and purposes, considered superhuman. This is precisely why YOU have to look after and preserve yourself.

Steps Towards Self-Compassion & Self-Preservation, For Leaders

1. Treat yourself fairly- When in trouble or in a situation where your decision has directly caused failure, advise yourself exactly how you would a friend you care about. 

This is clearly a skill that takes time to master. You need to stand away, take an objective view, weigh up the possibilities and then form advice that would be helpful in managing the current situation and avoid similar issues to occur in the future. 

2. Express Gratitude- On particularly difficult days, consider aspects that you can appreciate in yourself, what you do have, right now. You can choose to write a gratitude journal or go for gratitude walks. By focusing on your blessings you may develop a gentler inner voice and move the focus away from your shortcomings and outward to the world.

3. Enjoy Yourself- No matter how busy you are, indulge in one activity of leisure that you really enjoy, every single day.

4. Seek support- It is a lonely and hard to be a leader, so some support from a confidant or a dear, trusted friend or a coach or a therapist can not be overestimated.

5. Use your brain in its entirety- it is easy to get completely ‘obsessed’ with performance, finances, or any other operations, all activities of the ‘left brain’. Try to wake up that creative side of you that gets quickly buried with the rough and tumble of life. Try creative writing, drawing, acting, designing, gardening, cooking, anything that helps you rest that analytical and logical part and enhances the gentler aspect. You will find that It is soothing. 

6. Learn to calm those thoughts- I know the term mindfulness is thrown about extensively now but it is so because being in the present, deliberating on the here and now, is the key to self preservation. 

7. Socialise- stay close to friends and family- Isolation breeds self-absorbed ruminations, even paranoia rather than performance-enhancing behaviour Lack of time, single minded working ethic can make going out on a night out with friends hard. This is a slippery slope, so sometimes (frequently) being with friends or family may be the way forward, especially when it is impossible to be kind to yourself,

Do not be discouraged if you can not succeed in employing all of these strategies quickly or ever, it is a process of growth and we know that development is ongoing, luckily our brain and mind grow throughout life and so we will learn to be self-compassionate, if we pursue this objective.

Are you a leader and need mentoring or coaching? We may be able to help. Contact us at contact@oaktreeconnect.co.uk.

Dr Singh is the consultant psychiatrist with a special interest in neuropsychiatry.  Having seen and treated hundreds of patients with ADHD, in London and Birmingham and with masters in Neuropsychiatry, she is well known as an expert in this field. 

Contact: 
Email – clinicadmin@oaktreeconnect.co.uk
Telephone – 020 39277699

Oaktree Connect Fees & Pricing for Other Services

There may be additional fees payable after your assessment, for which you will receive an invoice: for example, for the costs for prescribing medication agreed between you and the psychiatrist at the time of assessment. We try our utmost to stay within the time allocated for the appointment however, you could be charged for any extra time spent in the consultation, if the meeting runs over the allocated time, or where communications with you or reviewing notes etc. exceeds what is deemed reasonable, but this is at the discretion of the clinician.

Using Cinema Narrative in therapy for Children & Young People

Using Narrative from Popular Cinema in Therapy for Children & Young People

How Storytelling Can Be Used to Encourage Positive Values and Growth

By Dr Minnie Joseph | January 2025

Cinema narrative therapy uses film to help people process their thoughts, feelings, and beliefs. It’s a combination of narrative therapy and cinematherapy. It is a powerful and innovative tool used by mental health professionals to help people of all ages but especially children and young people. It helps them to understand and reshape their personal stories. Therapists engage with narratives found in films, books, and even YouTube clips. The young people are then able to view their lives from a new perspective, more objectively. This often leads to healing and personal growth.

When I ask my teenage patients to see latest Will Smith film, or check out whether younger children like Kung Fu Panda, I am not striking up small talk. I’m using narrative as a clever tool in a psychiatrist’s kit that can help people unravel issues that trouble them.

For centuries traditional folk and fairy tales have been used to do the very same thing. There is scientific evidence that they have a huge positive impact on positive psychology, helps promote resilience, self realisation, personal growth and meaning in life.

I have therefore explained the various ways in which films can be used in a productive way below: 

The Role of Stories in Therapy

Scientific research and evidence supports the media’s ability to promote resilience, self-realisation, personal growth and meaning in life. Stories offer a structured way to comprehend complex emotions and experiences, allowing individuals to see themselves and their situations more clearly in an objective way.

Understanding Through Stories

Narrative therapy operates on the principle that people understand the world around them—including themselves—better when they can contextualise it within a story. For children, nursery tales and Disney films often illustrate the triumph of virtues like honesty, loyalty, and courage over adversity. These narratives help young minds to grasp the workings of the wider world beyond their immediate family. This offers hope, courage and joy to these young people.

Addressing Distorted Personal Narratives

Children and adolescents who experience distress often develop distorted personal narratives. For instance, a child bullied at school might rewrite her story to view herself solely through the lens of victimhood. Narrative therapy aims to disentangle the individual from their problem, helping them to recognise and celebrate their unique qualities.

Through therapy, I separate the person from the problem. A teenage with a diagnosis of anorexia is just that, a teenager first, then someone with an eating order. This is the problem to tackle; it is separate from the unique and wonderful things that make her who she is.

Using familiar stories, therapists can quickly build rapport with young patients. Films and popular media often speak a language that resonates more with this age group than traditional psychological jargon.

Films as Therapeutic Tools

Incorporating films into therapy can be incredibly effective. Many movies depict characters undergoing transformative journeys that mirror the goals of narrative therapy. For example, in Kung Fu Panda, Po learns to embrace the present and appreciate his unique identity as a panda with a goose as a loving father. Similarly, Collateral Beauty features a father who, after the tragic loss of his child, learns to reframe his narrative to rediscover the beauty in life. It is only when he is able to embrace a fresh story, that respects but contains the past, that the can re-find the ‘beauty’ of life. 

Crafting Your Own Narrative

Ultimately, narrative therapy empowers individuals to become the storytellers of their own lives. By re-telling their stories in a way that centers their strengths and aspirations, rather than their problems, people can foster a sense of agency and purpose. How might you reframe your story to place yourself—not your challenges—at the heart of your narrative? Reflect on your qualities, experiences, and dreams to craft a story that truly represents who you are.

Therapy using narrative takes hold of the idea that we understand things in life – ourselves included – more easily when we wrap them around a story. So younger children can learn about how the world outside their family works from nursery tales.

You are the teller of your own story. How could you re-tell it to keep you, not any problems you are facing right now, at the centre?

Author: Dr Minnie Joseph
Child and Adolescent Psychiatrist

 

Contact: 
Email – clinicadmin@oaktreeconnect.co.uk
Telephone – 020 39277699

Using Emotional Intelligence & Psychology to Succeed As a Leader

How You Can Use Emotional Intelligence & Learn Psychology to Succeed As a Leader

Part Two of the 'Psychology of Leadership' Blog Series

By Dr Meetu Singh | January 2025

Simply put, Emotional intelligence or EI is the awareness of, the ability to understand and manage our own emotions, and those of the people around us. A person with emotional intelligence would be someone who is understanding, empathic, interprets emotional signals and can manage these. This is an essential for leaders, to achieve success. After all, why would anyone want to follow someone who does not know their own self, fails to recognise their own or their colleague or supervisee’s feelings. It is therefore vital for the organisational and individual’s own growth.

Definitions of Emotional Intelligence

Daniel Goleman: In his definition this American psychologist listed the key features of EI, Self-awareness, Self-regulation, Motivation, Empathy, Social skills.

The four-branch model by Mayer and Salovey characterises emotional intelligence as a set of four related abilities: perceiving, using, understanding, and managing emotions. This provides a useful framework to study differences in abilities of individuals in processing information  about emotions. According to them the term emotional intelligence means an intelligence having to do with emotions, understanding these in self and others and being able to express these. They state that EI is just one of hundreds of parts of our personality. However, this maybe a very limited view of this phenomenon. It is an overview of and understanding of emotional reaction in self and others around us. The definition provided by Daniel Goleman therefore seems more appropriate and wholesome.

The world is full of challenges, difficult targets to meet, “left brain” work with hard facts and numbers, it is therefore understandable that more emphasis is placed on IQ. The ‘softer right brain’ skills however are ignored and neglected. At school, formal education mostly concerns itself with ‘hard skills’ with aspects of the soft skills left for the individuals to explore and develop by themselves. As a direct result, most people around us would not even realise that there was this huge gap in their skill set. Such a high IQ leader with low EQ would then be unaware of how members of the team feel uncared for, if that is the case.

A leader’s role is to be highly motivated at all times, consistent, learning and developing skills constantly, provide strength, discipline and stability to a whole organisation. This is a big ask (almost impossible) but through self-awareness and self-compassion they can aspire for it. For if you know yourself, your limits and emotional triggers, and are accepting of these, the first hurdle is crossed. (Know yourself, read my article: Paths to Self-Awareness)

How Can You Implement Emotional Intelligence In Your Practices?

Rather than suppressing these limitations and weaknesses or seeing emotions as limitations which unfortunately many leaders would instinctively do, the next step ought to be for a good leader is to develop strategies to manage the limitations and channel the emotions. Self-compassion is self preservation, without this as a leader you would burn out, sooner or later. (Read: Self Compassion and Preservation). Easier said than done, I hear you say. Many of the readers who are leaders would agree that looking after self, needs tremendous discipline, as similar to mothers, leaders put their own needs below that of the organisation. This is an error that many would regret. 

Following the original description and definitions of EI in the 1990s a large number of psychometric tools designed to measure it were invented and developed. Currently, there are more than 30 scales and measures being used widely. It seems like some have been adopted readily as valid tests by those adept in this field; the non-psychologists of the world find the choice of tests complex with  overlapping and confusing terminology. 

The picture is further complicated by the fact the EI has been further classified into Ability EI and Trait EI, the former are measures which use questions/ items comparable to those found in IQ tests, trait EI scales use self-report items to measure overall EI and its sub dimensions. We then have the mixed EI that refers to questionnaires that measure a combination of traits, social skills and competencies that overlap with other personality measures. 

for the purpose of defining the reason for the tests.

On literature search the following seem most reliable tools:

  1. Mayer-Salovey-Caruso Emotional Intelligence Tests (MSCEIT), Mayer et al. 2002
  2. Self-report Emotional Intelligence Test (SREIT), Schutte et al., 1998
  3. Trait Emotional Intelligence Questionnaire (TEIQue), Petrides and Furnham, 2001
  4. Bar-On Emotional Quotient Inventory (EQ-i), Bar-On, 1997
  5. Emotional and Social competence Inventory (ESCI), Boyatzis and Goleman, 2007)

In summary, emotional intelligence allows you and enables:

1. Recognising emotions, strengths and weaknesses in self and others that helps with finding the right roles for each person within a team.

2. The team members can work in unison, complementing each other at work to reach a common goal, rather than everyone doing everything.

3. Reduces work related stress as people do things they are good at rather than struggling with areas where their struggles lie.

4. Subtle monitoring of the team morale, common vibe helps the leader to make the team feel that they care for them as people rather than performance machines, hence more motivation to achieve their individual performance and potential.

5. Recognising negative emotions or stress in individuals early and supporting the team members early would prevent “blowouts” or crises which can be damaging to the whole team, immediately and even in the long term, helping with avoiding conflicts altogether and when conflictual situations do occur then an emotionally intelligent leader would have the ability to arrive at a more positive outcome by being objective and unbiased.

6. Self care and compassion prevent burn out in the leader, of whom the expectations are exceedingly high.

My next article: Self-Compassion and Preservation for Leaders

Are you a leader and need mentoring or coaching? We may be able to help. Contact us at contact@oaktreeconnect.co.uk.

Dr Singh is the consultant psychiatrist with a special interest in neuropsychiatry.  Having seen and treated hundreds of patients with ADHD, in London and Birmingham and with masters in Neuropsychiatry, she is well known as an expert in this field. 

Contact: 
Email – clinicadmin@oaktreeconnect.co.uk
Telephone – 020 39277699

Oaktree Connect Fees & Pricing for Other Services

There may be additional fees payable after your assessment, for which you will receive an invoice: for example, for the costs for prescribing medication agreed between you and the psychiatrist at the time of assessment. We try our utmost to stay within the time allocated for the appointment however, you could be charged for any extra time spent in the consultation, if the meeting runs over the allocated time, or where communications with you or reviewing notes etc. exceeds what is deemed reasonable, but this is at the discretion of the clinician.

Paths to Self-Awareness – Success in Personal & Professional Life

Paths to Self-Awareness - Measuring and Acheiving Success in Personal & Professional Life

Part One of the 'Psychology of Leadership' Blog Series

By Dr Meetu Singh | January 2025

As someone who has been in a caring business and managed several teams and organisations, I have discovered that self-awareness is the most important skill one can develop. The discovery did not stop there; it is also the most challenging one to hone, especially if you are ambitious, determined, passionate, and ‘left-brained’. This is due to the fact that there happen to be various dependencies here. It requires self-discipline, emotional intelligence and resilience to recognise your weaknesses and faults and to ‘take it on the chin’. However, through some tough experiences myself, I have discovered that it is crucial to success. 

It is about gaining the knowledge of who we are: our strengths and positive aspects of our personality but equally our weaknesses, pain points, ‘triggers’, and negative reactions to people and events are important. These can assist or serve as hurdles with work, especially when managing not only ourselves but for others as well. 

Our reactions to situations and behaviours in response to external events can reflect our personality and past experiences (nature versus nurture) as much as the external event itself. In a team, every member’s behaviour, emotional reactions, and actions impact the other members’ behaviours, where motivation acts almost in a domino effect. Therefore, there is an impact on the team’s performance as a whole from that of individuals.

Self-Awareness in the Home and the Office

This is more pronounced with leaders who are role models for the team- the ‘go-to person’. A leader who demonstrates diligent work, makes an effort to be empathic but firm and disciplined themself, and has a high level of self-awareness is very likely to influence other members of the team. Hence, the team culture moves in that direction.

Positive behaviour by self is likely to be adopted by others in the team, which improves working relationships and openness balanced with restraint. 

Recognising emotional triggers is a crucial aspect of understanding self. These are any instances or events that trigger a strong emotional response in a person. Anger, deep sadness, fear or even ‘paranoia’ are a few examples. They are reflections of negative experiences in the past, like emotional trauma in childhood, current circumstances and, to some extent, personality. Some of these are instances of errors at work, authoritarian management, negative reviews, and disputes with colleagues. They can bring about rifts if looking beyond the current problem and objectivity are not achieved. The most common example could be criticism from a supervisor. This could evoke anxiety and distress in those who suffered due to hyper-critical and authoritarian attitudes taken up by the responsible adults in their household whilst growing up. 

For those who struggle with self-monitoring and reflection, the essential skill must be developed, particularly for leaders. It is difficult to face one’s weaknesses and admit failures or ‘faults’. 

So how do you achieve self-reflection and discovery?

Self-reflection through personal notes & journals has been proven to be so effective that in certain professions- health care services being one- self-reflective exercises have been formalised. They have become mandatory additions to annual professional development activities for team leaders. It forms part of the annual appraisal and performance reviews to emphasise that personal growth is virtually impossible without ’looking in the mirror’ and actively changing behaviours that hamper development and team performance.

Theoretical knowledge is miles away from the ability to apply it to personal behaviours. The significance of reflecting and putting self-observations on paper cannot be overemphasised.

Recognising the triggers following any negative event helps in understanding the facts, triggering factors, and our emotional reactions to specific situations, behaviours that ‘naturally follow’ these. This, followed by viewing the above objectively- preferably with a mentor- can help develop insight into whether our reaction to the event was proportionate and fair.

Recognition of triggers could give a good sense of ways the situation could have turned out differently if our reactions had been more rational rather than emotional. Taking away lessons from this exercise is invaluable in preventing or reducing the intensity of similar situations in the future or at least, better management of behaviour to minimise the harm. New strategies can be developed following this learning.

Seeking Feedback: Gathering, reflecting on, and applying outcomes from feedback is critical to effective leadership. Although feedback on a day-to-day basis ought to be our way of functioning, it can be forgotten and ignored if one is not careful. Some methods that are more practical to apply in daily practice are:

1. Self-observation & Appraisal- Making a note of the daily feedback from colleagues, customers, and personal contacts can help raise self-awareness.

2. SWOT- Building personal strengths, weaknesses, opportunities, and threats assessments based on feedback is an excellent method that helps use one’s strengths to personal advantage, opting for roles and responsibilities that are likely to play to these.

Targeting training on specific skills considered ‘weaknesses’ may eliminate or reduce them with the right attitude and motivation.

3. Psychometric Tools- A scientific and quantitative approach to feedback that can objectively measure the individual’s mental capabilities, behavioural style and personality traits in the form of psychometric tools can be valuable to indicate an individual’s suitability for a role. Therefore, informing individuals and organisations about assigning jobs for themselves and employees can help them meet their potential and not set them up for failure by ignoring their capabilities. Some examples of reliable psychometric tests would be ILM72 for leadership styles and OPQ32, which measures an individual’s personality preferences in the workplace.

Used appropriately, they can help make the assessment measurable, reduce natural subjective bias and increase self-awareness. According to Cut-e- one of the principal psychometric assessment and talent measurement companies- 81% of companies that use psychometric tools make more reliable and less risky decisions although only 57% believed psychometrics could help predict future performance.

The example of Paul Flowers, chairman of Co-op bank is cited to illicit the latter statistic. He was hired because, apart from being a Methodist minister with little experience in banking, he performed well in psychometrics. 

The unfortunate fact is that by searching Google, thousands of ways to ‘pass psychometric tests’ appear, which can help bag a job that may be unsuitable. Trying to fool these tests and ignoring feedback they provide can be an unfortunate way to “lie to self” about one’s capabilities, strengths and weaknesses.

If used judiciously with other methods, their use can be a fruitful exercise for a manager and the organisation and beneficial to increasing a manager’s self-awareness.

5. Multisource Feedback (360-degree feedback, Surveys)- The patterns of peers’, junior, and senior colleagues’ views about one’s strengths, weaknesses, commendations, and complaints are a powerful tool for recognising things that we are ‘blind to’ or in denial about. If colleagues at various levels of experience state similar observations about working with a person, it may become more believable and less likely to be thought of as a biased opinion.

 The exercise of requesting, reflecting on, and encouraging conversation about the observations made by colleagues is not only helpful towards furthering self-awareness. It also promotes dialogue about the leader’s weaknesses when even junior colleagues can voice their opinions. This provides the opportunity for the leader to develop new skills.

Actions You Can Take

“I know all about myself so what next?” I hear you asking. Here is what you can do about these triggers, and saying that this can transform your professional and personal life is not an exaggeration. 

Plan your Responses: Journaling trigger events, responses, objective understanding, and planning new responses are invaluable skills. There is nothing like thinking up a plan with a ‘cool head’. 

If you put these down and record them over time, you will see new patterns emerging. This exercise makes self-management with compassion part of everyday work rather than a one-off rather than forgotten until the next problem occurs.

Recognising and accepting emotions is of paramount importance to then be able to manage these. For example, an individual may be aware that any criticism from their supervisor, even if constructive, is a trigger for them to feel like a failure. Prepare to distract from the situation for a short while until they feel ready to revise the issue. When the initial ‘emotional storm’ settles, devising a rational and pragmatic approach is preferable to an emotional, knee-jerk reaction that could get them into trouble.

Behavioural Techniques like slow, consistent breathing, muscle relaxation and mindfulness can come to assist when faced with situations an individual knows they would find difficult emotionally. Again, this can help remain calm in these situations, giving that time needed for the emotions to settle until the active thinking can begin.

Professional help in the form of mentoring and coaching are paramount when specific emotional triggers become an issue and start hampering the performance of oneself or the team. Therapy for resilient and consistent emotional responses displays our understanding of our issues, self-compassion and motivation to improve.

My next article: Succeed as a Leader- Use Emotional Intelligence

Are you a leader and need mentoring or coaching? We may be able to help. Contact Oaktree connect on Contact@oaktreeconnect.co.uk

Dr Singh is the consultant psychiatrist with a special interest in neuropsychiatry.  Having seen and treated hundreds of patients with ADHD, in London and Birmingham and with masters in Neuropsychiatry, she is well known as an expert in this field. 

Contact: 
Email – clinicadmin@oaktreeconnect.co.uk
Telephone – 020 39277699

Yoga to Manage Anxiety- Scientific Evidence

Can Practicing Yoga Help Manage Your Anxiety? - Yes, Here's How.

The Scientific Evidence Behind Yoga and Mindfulness

By Dr Meetu Singh | March 2024

In a fast-paced world filled with stressors and demands, anxiety has become a prevalent mental health issue affecting millions of people worldwide. The side effects and the high costs associated with the current pharmacological therapies has encouraged exploration of alternative methods of treatment. Fortunately, there are natural and holistic approaches to managing anxiety that do not rely on medication alone. Yoga has emerged as one such powerful tool to combat anxiety, offering both mental and physical health benefits.

In this article, we explore the science of anxiety, the basic tenets of yoga, and the evidence supporting it as an effective anxiety intervention. We will be able to find out about how yoga works by combining physical postures, breathing techniques, meditation, and relaxation to help calm the mind and reduce anxiety. This is the added bonus to the fact that, it also helps improve your overall physical health, which obviously is interlinked with your mental health.

The Science of Anxiety

Individuals grappling with anxiety often find themselves trapped in an endless cycle of excessive worry, fear, and tension. These emotional experiences of anxiety are accompanied by several physical symptoms, such as accelerated heart rate, muscle tension, shallow and rapid breathing, and a heightened state of alertness. These bodily responses are the result of the body’s intricate stress response system, which is designed to prepare us to react quickly in the face of perceived threats—a mechanism often referred to as the “fight-or-flight” response.

Scientific research has delved into the physiological underpinnings of anxiety, revealing intriguing insights into the body’s stress response. Studies consistently demonstrated that individuals with clinical anxiety disorders tend to exhibit significantly elevated levels of cortisol—a hormone produced by the body when in high-stress situations. Cortisol plays a crucial role in regulating various bodily functions, including metabolism and immune response to physical illnesses. In anxiety, the body’s cortisol production can become dysregulated, contributing to the ongoing experience of heightened stress.

Also cytokines, a group of proteins produced by the immune system as part of its response to infection, injury, or stress [1] is elevated, in individuals with clinical anxiety, suggesting a complex interplay between the immune system and the brain in the development and experience of anxiety disorders.

These findings clearly demostrate the intricate relationship between the mind and body in the experience of anxiety, in turn highlighting the importance of holistic approaches like yoga and mindfulness to address both the mental and physical aspects of this condition.

Yoga: History and Key Tenets

Yoga has a rich history dating back thousands of years in India, rooted in the idea of uniting the individual self with the universal consciousness. Its core philosophy is detailed in Patanjali’s Yoga Sutras, which includes moral guidelines, physical postures, breathing techniques and meditation, the principles of which have inspired mindfulness exercise, among other practices. Over time, yoga has become a global phenomenon, celebrated for its ability to create harmony between the mind, body, and spirit, and for its potential to deepen the practitioner’s connection with themselves and their experiences.

In the context of anxiety, yoga is believed to offer profound benefits. Its emphasis on breath work, mindfulness and physical postures, exercise and relaxation is thought to help activate the body’s relaxation response, reducing physiological symptoms like increased heart rate, muscle tension and shallow breathing. Moreover, yoga’s holistic approach can potentially address not only the symptoms but also the underlying causes of anxiety, promoting overall well-being and mental clarity [2].

Yoga promotes slow deep breathing techniques used to relax the mind and body as well as to increase oxygenation (pranayama). As we know, symptoms associated with anxiety include short and quick breaths, with resultant dizziness, yoga helps with breath training which may help during anxious episodes. Considering that yoga involves active attention exercises, it has been shown to increase deeper and mindful thinking processes, hence is calming.

One of the proposed actions of yoga is the activation of the part of our nervous system that slows breathing and heart rate down (parasympathetic nervous system). Studies have also shown that yoga increases the natural level of GABA, a brain chemical (neurotransmitter), which helps with a relief from anxiety.

Yoga & Anxiety: Evidence from Research

 

Several scientific research studies and systematic reviews of these studies provide substantial evidence supporting the effectiveness of yoga in reducing anxiety. One analysis found that yoga was effective in both short-term and long-term anxiety reduction for individuals with non-clinical anxiety (people who have not been formally diagnosed with an anxiety disorder). This analysis also found yoga to be effective in the short-term reduction of anxiety for those with a formal diagnosis, but less so in the long term [3].

Another review of 27 different studies focusing on yoga as either a primary or secondary treatment showed that in majority reductions in both physical and mental symptoms of anxiety [4] was experienced by those who were treated. Further research has shown yoga to be as effective as medication at reducing symptoms of anxiety and depression, and a combined treatment of yoga and medication to be more effective than medication alone [5]. One study looking specifically at the biochemical relationship between yoga and anxiety found that yoga effectively reduced helped reduce high blood pressure, elevated heart rate, cortisol levels, and cytokine production [6], suggesting that yoga’s benefits can be both physical and psychological.

Interestingly, these findings have been supported across every age group and gender. Several studies specifically focused on children and adolescents, showed that yoga was an effective intervention for anxiety in both the short and long term, and was superior to other holistic practices such as mindfulness and meditation [7.8].

Other research has found yoga to be more effective at reducing symptoms and anxiety and depression than other forms of exercise in elderly populations, as well as improving cognitive function [9]. Gender-specific research on yoga has shown it to be effective at reducing physical and mental symptoms of anxiety and depression in both women [10,11] and men [12].

Yoga Helpful Practice

Medication used as the first line treatment of ADHD, including Elvanse (Lisdexamfetamine), Concerta, Ritalin (methylphenidate), do they help improve your performance at work or school? What about your social life, is the medication effective in improving your ability to make and maintain friendships and relationships? Below are some scientific facts and observations about the effectiveness of stimulants in treatment of ADHD.

Breathwork

 

Experts state that taking 3 slow deep (more likely the mean abdominal breaths) causes release of serotonin, a brain chemical that helps with reducing anxiety and depressive symptoms. Yoga helps expand the lungs, which in turn causes a feeling of calm.

– most breath practices in yoga involve inhaling and exhaling through the nose, not mouth breathing, there is evidence that this promotes inhalation of more nitric oxide (no).  Nitric oxide is drawn deeply into the lungs, where it can reduce the respiratory rate, thus slowing down the breathing rate and therefore help reduce hyperventilation. Slow natural breathing, humming breath techniques, gentle breath retention practices and chanting (mantra) or positive vocal affirmations can all help promote increased no levels in the bloodstream, which help reduce anxiety, as well as holding us safe and without self-judgement in the present moment as we focus on our breath.

Physical activity/ Postures

 

Not to be overlooked is the anxiolytic benefit of physical yoga practice! There is substantial evidence that exercise and body movement helps manage anxiety. Most forms of yoga (hatha yoga) are physical mindful. The fact that we are completely focused on the postures and the breath through internalisation, avoids external distractions which induce anxiety. Repetitive physical movements with breath intertwined, which acts like a mindful moving meditation, helps dampen the sympathetic nervous system’s stress response via promoting a return to the parasympathetic response. One breath practice which is strongly  calming is ujayii (victorious) breath.

Regular routine of practice – regular practice is encouraged for longer term management of anxiety. It works best if we have a fix every day!

A space to self nurture and feel safe – there is this ritual; we roll out our mat to practice, maybe light a candle, find our self in a familiar space. We designate a safe place for ourselves where we can put our anxieties at the periphery. The ‘me time’ is anxiety soothing and empowering in its own right.

Effects on improving sleep. Yoga helps improve sleep. Poor sleep makes anxiety states worse so there is a positive feedback loop here.

Anxiety disorders & neurodiversity – may include of comment to broaden things, linking anxiety to other anxiety disorders and neurodevelopmental disorders such as ASD/ ADHD etc

Conclusion

 

In conclusion, the science of anxiety has illuminated the intricate relationship between our mind and body, revealing how the body’s stress response system can become dysregulated in the face of excessive worry and tension. The physiological markers of anxiety underscore the complexity of this condition. However, amidst this complexity, the ancient practice of yoga offers a powerful tool to combat anxiety. Its emphasis on breath work, mindfulness, and physical relaxation activates the body’s relaxation response, alleviating the physical symptoms of anxiety. Moreover, through its holistic approach, yoga’s capacity to address both the symptoms and underlying causes of anxiety promotes overall well-being and mental clarity.

A wealth of scientific evidence supports the effectiveness of yoga in reducing anxiety across age groups and genders. From children to the elderly, yoga has consistently demonstrated its potential to enhance mental and physical well-being and should be promoted as an effective intervention. Whether used alone or in conjunction with medication, yoga proves itself as a versatile and potent tool for managing anxiety.

Dr Singh is the consultant psychiatrist with a special interest in neuropsychiatry.  Having seen and treated hundreds of patients with ADHD, in London and Birmingham and with masters in Neuropsychiatry, she is well known as an expert in this field. 

Contact: 
Email – clinicadmin@oaktreeconnect.co.uk
Telephone – 020 39277699

ADHD & Relationships- How Can I Make Them Work Better?

Managing Your Relationships When You Or Your Partner Has ADHD

Can We Do Them? Yes We Can! Find out How Below

By Dr Meetu Singh | March 2024

Ever wondered why it is so hard to sustain happy, committed relationships with ADHD (Attention-Deficit/Hyperactivity Disorder) like the other millions of people who suffer from this disorder.

From personal experience and research on this topic, we know that ADHD can significantly impact relationships, both personal and professional.

Although the boisterous, interesting and mostly outwardly cheerful disposition of many people with ADHD makes them attractive and engaging at first, the symptoms of inattention, impulsivity, and hyperactivity, disorganisation can create various challenges for them in their ability to maintain healthy and positive, long term relationships.

If you suffer from ADHD or someone you love or care about does the following information will help you better understand these challenges:

Inattentiveness: People with ADHD may have difficulty paying attention to conversations or activities, making their partners feel ignored or unimportant. It can sometimes be taken personally by others as a deliberate act of not listening, purely to insult them.

Impulsivity: Impulsivity can lead to saying or doing things without thinking through the consequences, which can result in misunderstandings, conflicts, or hurt feelings.

Forgetfulness: Memory problems are common in individuals with ADHD, leading to missed anniversaries, birthdays, or other important events, which can be hurtful to their loved ones.

Procrastination: Difficulty initiating tasks or completing them on time can cause stress and frustration, especially when it affects shared responsibilities, such as household chores or financial obligations.

Time management issues: Chronic lateness or difficulty estimating how long tasks will take can lead to frustration and resentment from partners who are left waiting or burdened with extra responsibilities.

Emotional dysregulation: Some individuals with ADHD may struggle with emotional control, leading to mood swings and impulsive outbursts that can be unsettling for those around them.

Difficulty with communication: ADHD-related difficulties in organizing thoughts and staying on topic can make it challenging to have productive conversations, leading to misunderstandings and conflict.

Neglect of personal responsibilities: Adults with ADHD may struggle with managing their own finances, healthcare, and self-care, which can place additional stress on their partners.

Inconsistent follow-through: People with ADHD may start projects or commitments enthusiastically but struggle to follow through, leaving their partners feeling disappointed or unsupported.

Relationship insecurity: Repeated difficulties and misunderstandings in relationships can erode self-esteem and lead to insecurity and anxiety in both partners.

The list seems long but fortunately there are ways to deal with these issues. And it’s important to note that while these challenges can and do make trouble in relationships, individuals with ADHD can still have successful, fulfilling relationships. The likelihood of this is higher with some of the strategies and interventions that can help mitigate these issues. Through years of working with patients I have learnt that those with high motivation to succeed (like in any other endeavour) and most engagement with these strategies have done the best.

Strategies to help reduce issues in the relationship

Education

Learning about ADHD and its impact on relationships can help both partners understand the challenges better. You may want to read articles, asking about other people’s problems with ADHD can be good source of information.

Communication:

A common error is to think that in more committed relationships, the partners know and understand the other person’s feelings and expectations without any verbal communication. This is simply not true.

Like in any other relationship, open and honest communication is essential between partners. Speaking to your partner to set clear expectations can be a valuable way forward. Similarly, discussing your feelings about behaviours and your concerns can improve understanding and reduce future conflict.

Treatment

ADHD is a mental disorder, very well treated with medication and therapy. There are milder forms of ADHD where medical treatment may not be required. But struggling on with severe symptoms that are potentially harmful to a loving relationship is unnecessary painful. The response to medication, in the form of noticeable control of the symptoms is common, when treatment is started and adhered to.

The calmness of thought, reduced impulsivity, less volatile temper and better capability to be able to listen in conversations, all known effects of treatment, do improve relationship dynamics.

Couples therapy:

Many couples who seek couples therapy together benefit from it. Seeing a therapist provides a safe space for the couple to then address the core relationship issues. If both partners engage with the therapy, they can develop effective strategies for coping with ADHD-related challenges.

The willingness to engage with therapy encourages confidence in the significant other that the relationship is valuable. 

Time management and organisation 

I am fully aware that this being one of the major issues with ADHD, simply the knowledge of how to be more organised and a lecture about this is not likely to be helpful.

However, when on medical and psychological treatment for ADHD, it becomes practical to start thinking about implementing strategies to improve time management and organisation which reduces stress in the relationship. These strategies can include writing down a daily list of work, prioritising the most important ones, breaking down larger tasks into smaller chunks and rewarding yourself when you finish a particularly demanding task and many more.

Support networks:

There are now hundreds if not thousands of online support groups for people from any age group or demographic. Also, building and developing a support network that includes friends, family, and or support groups can provide valuable assistance and understanding for both partners. It can validate their experiences and offer more education about personal strategies by the other members.

While ADHD can pose challenges in relationships, it’s important to recognise that with patience, understanding, and the right treatment and support, individuals with ADHD can build and maintain successful and loving relationships.

Dr Singh is the consultant psychiatrist with a special interest in neuropsychiatry.  Having seen and treated hundreds of patients with ADHD, in London and Birmingham and with masters in Neuropsychiatry, she is well known as an expert in this field. 

Contact: 
Email – clinicadmin@oaktreeconnect.co.uk
Telephone – 020 39277699

Oaktree Connect Fees & Pricing for Other Services

There may be additional fees payable after your assessment, for which you will receive an invoice: for example, for the costs for prescribing medication agreed between you and the psychiatrist at the time of assessment. We try our utmost to stay within the time allocated for the appointment however, you could be charged for any extra time spent in the consultation, if the meeting runs over the allocated time, or where communications with you or reviewing notes etc. exceeds what is deemed reasonable, but this is at the discretion of the clinician.

Pros and Cons of ADHD Medication

The Pros and Cons of Taking ADHD Medication to Manage Symptoms

To Take or Not to Take, That Is the Question.

By Dr Meetu Singh | February 2024

If you are considering a costly private ADHD assessment or ADHD testing given the ever-growing NHS waiting list, the first consideration would be if you want the long-term medication, the ‘first line of treatment’? This blog may help you make that decision.

The decision to go on Attention Deficit Hyperactivity Disorder (ADHD) medication should be made in consultation with  qualified professional such as a psychiatrist or a general practitioner with experience in diagnosing and treating ADHD. Needless to say, that before starting medication, it’s imperative to hold a thorough discussion about the treatment options with a mental health care practitioner.

The psychiatrist would provide you with the basic factual information and leave the decision to you. Weighing up the risks and benefits can be challenging given that everyone’s circumstances, physical make up and feelings about being on long term medication differs widely.

This decision about treatment is even harder when deciding about if it’s worth your while to go through the assessment, post 2 or more years wait on the NHS or pay significant amount of money for an ADHD testing with a private psychiatrist or psychologists. It would not be wise to go for a long and expensive assessment if you have reservations about taking stimulant medication.

To add to the complicated scenario, we now (since October 2023) face a severe shortage of ADHD medication (ADHD Medication/ Treatment) including Lisdexamfetamine, also known as Adderall/ Elvanse/ Vyvanse one of the main long acting (once daily dose) drug used for ADHD treatment. This further caused the of loss of trust in consistent supply of medicine.

It is worth discussing about what happens when severe symptoms of ADHD including lack of concentration, impulsivity, and hyperactivity remain undiagnosed and untreated. Effects of the other less talked about but equally common and troublesome ADHD features of emotional instability (ups and downs of mood, irritability and anger issues) and executive function difficulties (disorganisation, lower ability for planning and prioritisation skills) will also be considered as these hinder the ability to take on work and personal responsibilities.

This may help with your ability to make a decision about your assessment and treatment options

Untreated ADHD and Work

 

Adults with ADHD may experience difficulties in the workplace. Imagine a work colleague, who misses meetings or is constantly late or fidgets through them, not taking in any instructions, struggles to keep even the crucial deadlines, gets up from the desk every 15 minutes for a ‘chat’ or ‘little break’. They find reading through reports and completing simple administrative work an unsurmountable challenge and anything that’s not thrilling may bore them to tears with little patience to wait for anything. This is when they are trying.

It’s not surprising then that people with this neurodivergent disorder would not be the most popular workers with a reputation for reliable, consistent hard work even when they try their hardest. And are 60% more likely to be fired, as per the World Mental Health Survey Initiative published in the British Medical Journal, that is if they do not leave on an impulse themselves.

Impact of ADHD at work, including Loss of household income, Poor productivity, loss of employment, stress-induced illness, stigma that you will perhaps definitely have suffered is widely observed and described in detail. ADHD is a disability which is not recognised as such in spite of the law, by many employers.

Social and Interpersonal Challenges with ADHD

 

The struggles and challenges are pervasive, in other words present in every facet of the ADHD sufferer’s life. People with ADHD would often be described as the ‘class clown’, good entertainment but with few or no close friends. They maybe known for their ‘out of sight, out of mind’ tendencies as they find keeping in touch hard with an over-stimulated mind.

Understanding social cues can be a challenge and it does not help that their mind works at a ‘100 miles an hour speed’ so keeping tab of the conversation which is not at the same speed may end up in bouts of oversharing, interrupting or talking in tangents or zoning out altogether, not making for the delightful company. As expected leading to difficulties in forming and maintaining friendships and relationships.

The forgetfulness, difficulty in organising everyday life, not being attentive, impulsive over-spending or risk taking are also not factors that would maintain a long-term relationship with ADHD sufferers.

If you have ADHD, you may feel over-criticised, being treated like a child and micromanaged. Doing things to your partner’s liking may seem like immense hard work but not achievable. Or you may feel constantly guilty about letting your parents or partner down, pronouncing yourself lazy or useless or like an imposter when you do well. Your partner on the other hand may feel unheard, like they were ‘walking on eggshells’ around you and generally dissatisfied with your contribution to consistent housework, taking on parental responsibilities etc.

The mood swings, low frustration threshold (emotional dysregulation) and difficulties in managing anger and impulsive outbursts would add further fuel to the fire.

Untreated Severe ADHD and Risky Behaviours

 

One in four prisoners in Britain have features of ADHD, according to a new report published by The Guardian. This makes the prevalence of ADHD 5 to 10 times higher than its 2% to 4% in the general population. These numbers however are not an indication that people with ADHD have some form of ‘criminal genes’ and need careful consideration and understanding of the different factors that may contribute to this association:

The impulsivity and thrill seeking behaviour which is often part of the ADHD complex is mostly attributable. Many patients who suffer from ADHD would report that they act before considering the consequences. The other issues are associated with their struggle to stick to the societal norms and rules, which they may find tedious or cannot adhere to due to lack of organisation.

We often find that they would sign documents without reading through or promise to commit to activities without getting into the nitty gritty of what the activity is about.

It’s important to emphasise that majority of individuals with ADHD do not engage in criminal behaviour, and there is no criminality gene associated with ADHD. It can be attributed to the factors above. That makes an early diagnosis of ADHD with appropriate treatment and support vital for prevention.

So do the stimulant medicines for ADHD work, are they worth it?

 

Medication used as the first line treatment of ADHD, including Elvanse (Lisdexamfetamine), Concerta, Ritalin (methylphenidate), do they help improve your performance at work or school? What about your social life, is the medication effective in improving your ability to make and maintain friendships and relationships? Below are some scientific facts and observations about the effectiveness of stimulants in treatment of ADHD.

Pros / Advantages of ADHD Medication

 

The evidence from research shows that improvement in the ADHD symptoms related to concentration, attention and memory with medication is significant. There are hundreds of studies that show, improved academic performance in exams, better recall of events and instructions, higher exam scores are some of the findings which prove the above at least in the short to intermediate term. One of the methodical and high value scientific study by Daniel Cox added to the evidence that long-acting methylphenidate (Concerta XL, Medikinet MR etc.) reduce collision rates of young adult drivers with ADHD. with improved concentration and less likelihood of acting impulsively.

Other research, including that by Matthijssen and associates found discontinuation of the stimulant medication ended up in worsening of the symptoms of ADHD sand overall functioning at home, school and work.

An essay ‘Blame it on the Brain’ published by the Royal college of psychiatrists explores criminal behaviours in people with ADHD and if these can be prevented through treatment intervention. Put succinctly this report explores and confirms that treatment helps reduce impulsivity thus reducing offending behaviour across the population that suffers from ADHD.

In relation to efficacy, the positive effects of the medication in clinical practice, anecdotally from patient stories and revies as well as the results of several studies (meta-analysis and randomised control trials) convincingly demonstrate that all the stimulant medication, that is, Dexamphetamine, Lisdexamfetamine, Methylphenidate were better than placebo*

Cons / Disadvantages of ADHD Medication

 

Most significantly the concerns about side effects need to be considered here. Decreased appetite with unwanted loss of significant amount of weight, initial insomnia and dry mouth are the commonest. Understandably, Irritability developing on starting these may occur, increased heart rate and blood pressure are uncommon but most concerning adverse effects from the medical point of view.

These side effects can be prevented, modulated or treated with monitoring and early non-medical and behavioural methods or less often medically. These include taking medication earlier in the day, eat and drink regularly with daily exercise.

Stringent physical health monitoring of pulse rate and blood pressure when starting and increasing the medication is essential. In a small number of patients, treatment with high BP medication may be required, when the benefits outweigh the risks significantly.

Medication effect may reduce over time, also called tolerance. This is a very real problem, managed by a ‘treatment holiday’ at your psychiatrist’s advice. This is a a few weeks’ break from your medication intake may ‘reset’ the body so it recognises the medication as a new one when recommenced. A change in the type of stimulant can also help overcome this problem.

Another consideration is that although very effective in controlling inattention, hyperactivity and impulsivity related symptoms, the ADHD medicines are less effective with improving social behaviours and mood symptoms. This means the medicine is not as useful in case of people who deal with mood dysregulation. Psychological therapy should be used alongside medication.

Summary

 

In a nutshell generally speaking, the common consensus is that given the scientific evidence and patient experience taking medical treatment for ADHD is usually beneficial. Most researchers have concluded that this medication works as cognitive enhancers, and apart from this well-known ability, can improve memory and recall and help reduce impulsivity. Secondary to these core effects the above translate into better performance at work, enhancement of relationships, less risk taking or criminal behaviours.

However, medication cannot and should not replace psychological and behavioural interventions. Therapy alongside support from health workers, family and friends is essential. Medication and these psychological and social aspects of treatment and support together would make for optimal care with the best outcome.

Dr Singh is the consultant psychiatrist with a special interest in neuropsychiatry.  Having seen and treated hundreds of patients with ADHD, in London and Birmingham and with masters in Neuropsychiatry, she is well known as an expert in this field. 

Contact: 
Email – clinicadmin@oaktreeconnect.co.uk
Telephone – 020 39277699
Categories

Patient Talk – What Does Severe Clinical Depression Feel Like?

Patient Talk - What Does Severe Clinical Depression Feel Like and How Does it Affect Life?

One of Our Patients Discusses Their Experiences of Depression and the Recovery Process

By Dr Meetu Singh and Anonymous | October 2023

Why did first you come to Oaktree?

I first came to Oaktree because I had lost trust in the service my GP practice was offering me, having seen 4 of the GP’s at the practice with no resolution of my problems, multiple changes of medication and no plan for taking things forward towards a satisfactory outcome.

 

Could you describe the daily struggles you faced beforehand?

I had no energy, and no motivation. I felt suicidal and had planned how and where I would carry out this act. I carried the means for doing this with me. I felt there was no point in going on with my life if this was all I could expect. I had had bouts of depression before but had been free from these for a significant period of time, following being prescribed fluoxetine (Prozac). In my mind I believed that if this didn’t work, nothing would. I couldn’t sleep at night, and couldn’t do anything during the day. I stopped going out and taking care of myself. I would go weeks without showering or changing my clothes. 

How would you describe your worst days? Your best days?

My worst days, strangely, were the days I had slightly more energy. My anxiety levels rose on these days and I could not control my thoughts. anything and everything was a cause for concern, but my main problems were to do with my depression and me not recovering and how I could go on if this were the case. My best days were not a lot better than this, frankly, but I did feel able to do a little more in terms of self care, though this might only be one thing out of the raft of routine activities that constitute looking after oneself. 

Were those around you aware of what you were going through? Friends/Family/Co-workers?

I wasn’t working at the time and did not see friends. My partner was aware to a limited extent but unsure how to handle or manage my moods or behaviour. Despite this he looked after me as best as he could.

Was there an event or trigger that made you decide get an assessment? 

I decided to get an assessment because the fourth doctor I saw at the surgery put me on a medication which raised my blood sugar to a dangerous level and I could not get this down. On phoning and speaking to him he said to leave it off for a week and then start taking it again. I was horrified by this medical advice and decided at that point I would find an alternative. I felt totally let down.

What did you learn about yourself from that first visit to Oaktree?

That I had severe and lifelong depression, well of course I knew that, but I needed to know that someone else believed that too, as it appeared to me that my consultations with the various GP’s I had seen indicated that they did not think so. 

How has your life improved since then? 

My depression has lifted with the prescription of two different types of medication, which, together, appear to increase the anti-depressant effect of both and provide a safety net, in case one or the other stops working. I have also benefitted tremendously from the skilled support of a consultant psychologist, which has helped me to determine the life events that have led to me suffering from this horrible illness, and to counter their effect through understanding them with a different perspective.

What advice would you give to people going through the same thing?

Don’t think your GP knows everything there is to know about severe clinical depression. They probably don’t. If your mood hasn’t improved in three months, ask for a referral to a community psychiatric team, it will probably take several months to get an appointment anyway. If that doesn’t work, find a way to consult a practicing psychiatrist privately, even if you get no more than a change of medication after your assessment, that may be enough to improve your mood and at the very least, your GP will be provided with a report on your medical condition, and hopefully a treatment plan that they can follow. Try to see a GP who is prepared to listen, make a double or triple appointment if necessary. and don’t get bullied into thinking there’s nothing much wrong with you. There is and if you are ever going to be a productive, reasonably normal person again, you need professional help.

Dr Singh is the consultant psychiatrist with a special interest in neuropsychiatry.  Having seen and treated hundreds of patients with ADHD, in London and Birmingham and with masters in Neuropsychiatry, she is well known as an expert in this field. 

Contact: 
Email – clinicadmin@oaktreeconnect.co.uk
Telephone – 020 39277699