Aphantasia: Nearly 30 years on from traumatic brain injury, using the internet I found out about Professor Zeman and Aphantasia. This explains so much of the loss with head injury that is never discussed but can have profound impact and possibly be responsible for multimorbidities.

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Ireland: Traumatised refugees from the Ukraine are entering Ireland in numbers beyond our understanding. What we do know is that our psychiatric/mental illness provisions are much underfunded and already in crisis. Could there be an answer in this venture established in 2017. My personal experience with mental illness, tells me yes.

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Leaps by Bayer Invests in Woebot Health

March 15, 2022


An estimated 280 million people suffer from depression globally, making it one of the most common mental disorders and the leading cause of disability worldwide, according to the World Health Organization. Its prevalence and the vast unmet need for care led Leaps by Bayer, the impact investment arm of Bayer AG, to make its first investment in mental health with Woebot Health. Dr. Jürgen Eckhardt, Head of Leaps by Bayer, explains why.

You’ve made a $9.5 million strategic investment in Woebot Health, your first in mental health. What prompted it?

Our investment strategy centers around solving 10 of the greatest challenges we see facing humanity today. We call those challenges Leaps, and we revisit and reevaluate them every other year or so. We recognized the increased prevalence of and unmet need in mental health, with depression and anxiety highest on the list. As such we created Leap Five – Protect the Brain and Mind – to address both central nervous system disorders and mental health issues.

Why Woebot Health?

First, it’s a data-driven company that combines psychology and technology. Woebot Health has already produced a lot of rigorous clinical evidence supporting its approach, including numerous randomized control trials and observational studies. These studies are at the core of the company’s platform and products, which are based on sound and validated behavioral therapies: Cognitive Behavioral Therapy (CBT), Interpersonal Psychotherapy (IPT) and Dialectical Behavioral Therapy (DBT).

What else did you consider?

We also looked at the model they’re working to achieve. With mental health, you never know at what time of day or night someone may need support. Woebot Health is providing an AI-powered, chat-based tool that can be a 24/7 digital therapist. But Woebot is so much more than an app; it listens, learns and delivers personalized advice and solutions in an approachable, conversational manner. The innovation – and empathy – in that approach certainly differentiates it from all the apps out there. But also, they’re not trying to bypass the healthcare system or replace healthcare providers. They’re actually making it easier for providers to deliver care either through prescription digital therapeutics or non-prescription therapeutics. The end result is they’re not just trying to take something directly to consumers. Rather, they’re showing data to healthcare systems and working with them to show how this approach can be value saving or value driving.

Can you talk a bit more about the value you see Woebot Health providing to healthcare systems?

When you look at value-based healthcare, you look at emergency visits, the number of people who aren’t able to see a therapist, and what that ends up costing. Woebot Health can address not only the wide discrepancy between the number of providers and patients that need help, but also hopefully reduce emergency room visits that can result from inadequate care. This is a company that wants to integrate with the healthcare system to make lives easier not just for the patients, but also the providers, and ultimately provide savings while delivering better, more effective care.

What do you hope comes out of this investment?

I’d like people to have 24/7 access to digital behavioral health solutions to help with the unmet need. And to see Woebot Health develop both prescription and non-prescription therapeutics and bring these helpful mental health solutions to people around the world.

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Can COVID make your brain shrink? A recent Oxford University study revealed changes in several parts of the brain after people contracted the virus, including those who experienced mild symptoms. Source: Al Jazeera

Posted by Fred Bassett

DOCTOR’S NOTE

Features|Doctor’s Note

Can COVID make your brain shrink?

A recent Oxford University study revealed changes in several parts of the brain after people contracted the virus, including those who experienced mild symptoms.

Drawing of a brain
[Muaz Kory/Al Jazeera]

By Dr Amir Khan

Published On 24 Mar 202224 Mar 2022

We have known for some time now that COVID-19 can affect the nervous system.

Some people who contracted the SARS-CoV-2 virus have suffered from a number of neurological complications including confusion, strokes, impaired concentration, headaches, sensory disturbances, depression, and even psychosis, months after the initial infection.

COVID and the Russian invasion: Ukraine’s dual crisis

Now, researchers at the University of Oxford have conducted the first major peer-reviewed study comparing the brain scans of 785 people, aged 51 to 81 of whom 401 had contracted COVID and 384 had not. There were, on average, 141 days between testing positive for COVID and the second brain scan.

The study revealed that, when compared to the scans of a control group, those who tested positive for COVID had greater overall brain shrinkage and more grey matter shrinkage and tissue damage in regions linked to smell and mental capacities months after the initial infection.

Although the research does shed some light on the ongoing symptoms of long COVID, I would caution against generalising the findings to the population at large before more research is conducted.

Researchers said even though the effects were more pronounced in older people who had been hospitalised for their symptoms, even those with mild symptoms had some changes.

“Despite the infection being mild for 96 percent of our participants, we saw a greater loss of grey matter volume, and greater tissue damage in the infected participants, on average 4.5 months after infection,” said Professor Gwenaëlle Douaud, lead author on the study. “They also showed greater decline in their mental abilities to perform complex tasks, and this mental worsening was partly related to these brain abnormalities.”

The study was conducted when the Alpha variant was dominant in Britain and is unlikely to include anyone infected with the Delta variant. The researchers also did not say if vaccination against COVID had any impact on the condition.

The scans they did reveal changes in several parts of the brain after people contracted COVID, including:

  1. Greater reduction in grey matter thickness and tissue contrast in the orbitofrontal cortex and parahippocampal gyrus. The orbitofrontal cortex is the part of the brain that controls reward, emotion and fluctuations in mood and feelings of sadness. It is also involved in cognitive function and decision-making. The parahippocampal gyrus plays a role in the control of our emotions as well as an important role in memory retrieval and spatial awareness and processing. We have seen symptoms of depression, anxiety and “brain fog” where people are prone to memory issues after a COVID infection.
  2. Greater changes in markers of tissue damage in regions functionally connected to the primary olfactory cortex. This is the part of the brain for processing and perception of smell; it also helps link smells to certain memories and survival responses. Loss of sense of smell has been a hallmark symptom of COVID and this may explain why that is.
  3. Greater reduction in global brain size, essentially meaning the participants’ brains were smaller after testing positive for COVID than when scanned before the infection.

It is not uncommon for our brains to shrink as we get older, the natural ageing process results in the loss of grey matter every year, on average between 0.2 percent and 0.3 percent, according to researchers.Sign up for Al JazeeraCoronavirus Newsletter

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But the study found that, compared with uninfected participants, those who contracted COVID – even those who had mild cases – lost between 0.2 percent and 2 percent between scans.

The study also found that participants who had suffered from COVID exhibited a greater decline in efficiency and attention when performing a complex cognitive task.

The Oxford study is the first study to make such a direct link between COVID infections and changes in the brain. It goes some way to providing us with the beginnings of an explanation about the myriad neurological symptoms people with long-COVID complain about, although researchers stress that more studies are needed.

We do not know whether the changes in the brain demonstrated in this study are long-term or permanent, or whether they would be the same for younger people, who generally (but not always) get milder COVID symptoms.

Since the study was conducted during the reign of the Alpha variant, more work needs to be done on those who contracted the Delta and Omicron variants to see if similar changes are found.

The timing of the study also means that the participants were unlikely to have been vaccinated. Now, with so many people vaccinated, it would be useful to know if the vaccines offer a layer of protection.

Source: Al Jazeera

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“ADD or ADHD”. Decades and finally there are some indications that it could apply to you. Excellent article from ADDitude. “I am an Excellent Starter. The Trouble Is Finishing.”

18th March 2022

Guest Blogs

“I Am an Excellent Starter. The Trouble Is Finishing.”

“Beginnings are delicious and full of excitement. But there is no real satisfaction without completion. I want a finished product, a publication, the glory of a checklist full of checkmarks. But with an ADHD brain that struggles with poor working memory, extended focus, and slogging through the mundane, it’s challenging to get to The End of anything.”

Jill Finnessy, ADDitude blogger

By Jill Finnessy Updated on February 22, 2022

Paint Roller On Yellow Wall At Home

I am an excellent starter. The trouble is I am not much of a finisher.

In the nooks and crannies of my house you can find any number of creative projects I’ve begun with vim and vigor. I have a stack of unfinished books on my nightstand. My desk is filled with thank you notes I wrote months ago, brimming with warm sentiments of gratitude that will never reach the intended recipients. I have a planter in my dining room that sits plantless, a box of frames that sit pictureless, and a slew of half-written articles and stories lingering lifeless in the abyss of my laptop.

I lose steam before I get to the finish line. I’m running out of juice for this blog post right now. I’m thinking of closing my laptop and folding laundry while I watch the rest of “60 Minutes.” I could at least finish that.

If it’s not about losing steam, it’s about memory. Unless I’ve explicitly written it down to remember, or left it laying out to see, I will completely forget what I was working on the day before, not to mention weeks or months before.

At 42 years old, I have given up on so many wonderful ideas. It’s hard not to give up on myself sometimes, too — especially when my cynical inner voice says, “Oh, you think that’s a good idea? Don’t kid yourself. You’ll never finish it.”

[Get This Free Download: Finish Your To-Do List TODAY]

Beginnings are delicious and full of excitement. But there is no real satisfaction without completion. I want a finished product, a publication, the glory of a checklist full of checkmarks. But with an ADHD brain that struggles with poor working memory, extended focus, and slogging through the mundane, it’s challenging to get to The End of anything.

To be clear, it’s not like I don’t know what completion looks like. In fact, I hadn’t realized that I’ve developed tricks to get to the end zone over the years until I started teaching them to my son, who also has ADHD.

How to Finish What You Start: My Top 5 Tips

1. Outsource your brain. Life requires a lot of upkeep, thought, and mental planning. Trying to keep it all in your head won’t work. (And ADHD doesn’t help.) So use calendars, lists, alarms, reminders, and other external tools to help free up your brain space and organize your time around the things you want to accomplish.

2. Say no frequently and without guilt. Say it with me: I do not need to be on that committee. I do not need to complete that Airbnb review. I do not need to make the meatballs from scratch.

[Read: Put a Bow on Finished Projects]

3. Set up a track and reward system. I hate keeping sticker charts for my kids (add them to the list of things I start but never finish), but there’s something incredibly satisfying about checking a box and reaping the reward. While I don’t have an actual sticker chart for myself, I do keep a weekly list of to-dos that I check off as I complete. The more checkmarks I gather, the closer I am to a cookie break or a show on the couch.

4. Make time your benchmark. Some projects are lengthy, lasting days, weeks or months. Give yourself credit for the time you dedicate to a project on a given day, even if it’s just a few minutes. I did not finish writing this blog post in one day, but I did spend an hour working on it. Time to watch Ellen and eat chips and salsa.

5. Forgive thyself. I am not maliciously forgetting the coupon envelope when I go shopping. Could I have set a reminder to defrost the chicken the night before?  Yes. But can I turn back time?  Nope. Breakfast for dinner it is!

Beginnings are beautiful, hopeful, and bursting with potential. But when too many beginnings pile up, we feel their unfinished presence like a stack of unpaid bills, gnawing at us, taunting us, and reminding us that we lack follow-through.

Sometimes we need to appreciate beginnings for what they are: Tiny experiments that can fizzle out or blow up in our faces. That does not mean that we failed.

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It’s a balancing act between self-discipline and self-forgiveness. I have to trust that if it’s important, it won’t let me abandon it; the unfinished task will call me back and make me find time for it. And if it doesn’t call me back, then maybe it was only meant to be a beginning — a step towards something else more worthy of a sticker and a well-earned reward.

How to Finish What You Start: Next Steps


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“When the student is ready, the tutor will appear”. He did and introduced me to the quest to find answers through reading, youtube, lectures. What I found out most recently is that the foundation of much of the anxiety started when I was 3 years old and hounded by nightmares of those close to me “dying”, being murdered by a Volkswagon car. At age of 32 a traumatic brain injury changed my destiny, the level of perfection which started from childhood, became the real rod upon my back. Perhaps this is why the neuropsychologist stressed to me that the outcomes from brain injuries differ. ADHD was not talked about in the 1960’s but with the benefit hindsight, it needs to be looked at now. Perfection is a hard task master and it consumes your brain … my advice is be alert to it and learn to accept “Enough” not “Perfection”. ADDitude “Adults Living with ADHD” is an article I can concur with. See below. (I highly recommend this article, each and every line, I can identify with … and I am a believer in lifelong learning…6 decades now).

Inside the ADHD mind

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When Perfectionism Stems from ADHD: Challenging the Fallacy of “Not Good Enough”

Perfectionism, when unhealthy, drives a person to exhaustion striving for a flawlessness that’s neither reasonable nor healthy. Though it may seem contradictory, perfectionist traits may stem from ADHD — an overcompensation for past errors or for feeling “not good enough.” Letting go of perfectionism does not mean eliminating worries around mistakes, failure, and judgment, but rather accepting that they are part of life — and one that can help us grow.

Sharon Saline, Psy.D.

By Sharon Saline, Psy.D.

Verified Updated on February 14, 2022

Vector illustration in super mom concept, many hands working with very busy business and housework part, feeding baby, cleaning house, cooking, doing washing, working with laptop. Flat design.

Perfectionism is rarely an enviable trait. It is not on-time birthday cards and spotless kitchens, or even taxes submitted before the deadline. Perfectionism is an unhealthy obsession with flawlessness that causes people to set unattainable personal standards, compare themselves to others, and never quite feel “good enough.” It can make criticism, even constructive, cut like a knife. And it can advance mental health conditions, like anxiety.1

According to the American Psychological Association (APA), perfectionism is the tendency to demand of others or of oneself an extremely high or even flawless level of performance – above and beyond what is required by the situation.1

Though the link may seem unlikely at first glance, perfectionism is also strongly associated with attention deficit hyperactivity disorder (ADHD or ADD).2 For some, perfectionism is a psychological overcompensation for past ADHD-related errors or for feelings of inferiority. For others, it is a form of self-punishment or even procrastination. Perfectionism often stems from this: incorrectly estimating the demands of a task or situation, misunderstanding when to let some things go and the inability of accessing resources to help you cope with a perceived challenge.

Decreasing perfectionism begins with cultivating self-awareness and adopting strategies to dissolve patterns of anxiety and negative self-talk. People with ADHD may also benefit from improving the executive functions that help them combat procrastination and other self-defeating behaviors that feed into perfectionism.

Perfectionism can manifest in various ways, including the following:

  • All-or-nothing thinking; a fixed or rigid mindset (believing that mistakes represent personal, unchangeable flaws)
  • Setting unreasonable standards
  • Negative comparisons; not feeling “good enough”
  • Self-criticism; negative self-talk
  • Living by “shoulds”
  • Procrastination (to avoid failure or discomfort, perfectionists may delay tasks)
  • Fear or reluctance to ask for help
  • Sensitivity to feedback; defensiveness
  • Easily discouraged due to incomplete or imperfect results
  • Fear of social rejection; low self-esteem

[Get This Free Download: 9 Truths About ADHD and Intense Emotions]

These manifestations may be associated with any of these three main types of perfectionism identified by researchers3:

  • Self-oriented perfectionism: Associated with unrealistic, irrational standards for the self and punitive self-evaluations. This type of perfectionism can reveal a vulnerability to a host of mental health diagnoses such as generalized anxiety, depression or eating disorders.
  • Socially prescribed perfectionism: Associated with beliefs that others are harshly judging and criticizing you. With this kind of perfectionism, you may think that you must be perfect to obtain approval or acceptance from others. This type is also directly connected to social anxiety.
  • Other-oriented perfectionism: Associate with imposing rigid, unrealistic standards on others. Individuals with this type of perfectionism may evaluate others critically, often without forgiveness or empathy. As a result, they often struggle with all kinds of relationships, from professional to romantic and familial.

At its core, perfectionism is related to anxiety. Anxiety doesn’t like discomfort and uncertainty, and it tries to make the resulting feelings of fear and worry go away immediately.

Perfectionism acts as a maladaptive, inefficient coping mechanism for managing anxiety. Perfectionists try to avoid a possible disappointment, potential embarrassment or inevitable punishment due to failure. To prevent stress and reduce insecurity, perfectionists create and impose rigid standards that they must meet to feel worthwhile. But these high, difficult-to-meet standards can end up fueling anxiety just the same, driving a vicious cycle.

[Read: You’re Not Perfect, So Stop Trying to Be]

In adults with ADHD, the rates of anxiety disorder approach 50% and symptoms tend to be more severe when ADHD is in the picture.4 This comorbidity contributes significantly to the prevalence of perfectionism in individuals with ADHD.

Perfectionism and ADHD Overlap

Perfectionism and ADHD share many traits, including the following:

  • Fear of failure and of disappointing others. People living with ADHD frequently experience moments when they’re aware that they’re struggling or have missed the mark in some way, and they don’t know how to make it better. (These moments can evolve into persistent worries that lead to chronic, low-level anxiety.) Older teens and adults with ADHD will often engage in perfectionistic behaviors to avoid unpleasant or embarrassing outcomes.
  • Setting unrealistic or impossible standards of performance. Many people with ADHD blame themselves for things that aren’t their responsibility, or they beat themselves up over relatively small mistakes.
  • All-or-nothing thinking. If it’s not perfect, it must be a failure.
  • Constant comparison to others. People with ADHD often critically compare themselves to neurotypical peers.
  • Sensitivity to criticism, sometimes intensifying to the level of rejection sensitive dysphoria.
  • Easily discouraged by setbacks. It can be hard to begin again, especially when the initial motivation was hard to muster.
  • Rejecting praise, or believing that you don’t really deserve success (shrugging it off as luck)
  • Depending on others for validation and approval. 

Perfectionism, Procrastination, and ADHD

ADHD and perfectionism also share the trait of procrastination. Putting off tasks is a known challenge with ADHD, and it often occurs when a task seems too large, takes too much effort or appears downright unappealing.

Procrastination is also inherent in perfectionism, however the nature of the delay may differ:

  • Perfectionism procrastination results in an inability to start or finish a task if certain idealistic conditions aren’t in place. These “successful” conditions are believed to limit mistakes and reduce future shame.
  • Avoidance procrastination results in putting off or delaying a task that seems too difficult or extremely unpleasant. In this scenario, a lack of confidence in one’s ability adds to someone’s difficulty in gauging how to measure and approach the task. This type of procrastination is often the product of a previous experience of failure.
  • Productive procrastination results in engaging in less-urgent tasks that are more easily accomplished and delaying the more urgent, unattractive ones because of underlying doubts or fears. This delay tactic provides short-term relief but increases long-term stress.

How to Escape the Trap of Perfectionism

1. Build Awareness

  • Practice mindfulness. Neutrally observe a judgmental thought when it arrives. Notice how your body feels when you’re overwhelmed or drifting into perfectionistic territory. Reflect on tools to stay centered rather than getting hooked by thoughts about unattainable excellence.
  • Investigate perfectionism with curiosity. Notice when you push yourself to do something perfectly or criticize yourself for fumbling. What standard are you trying to meet and why? Identify the underlying worry and try shifting to wondering about an outcome instead of predicting a negative one..
  • Address the psychological precursors of perfectionism. Do you need to feel accepted, good enough and praised? These core psychological desires among other hopes for validation, inclusion and connection frequently lie underneath perfectionism and go along with having ADHD.
  • Address imposter syndrome, fear of failure, and shame. “People don’t know the failure I truly am.” “If I mess up, I’m a bad person.” Sounds familiar? Expectations of judgment, humiliation, or rejection due to mistakes reflect a fundamental, false belief of deficiency that often accompanies ADHD and perfectionism.
  • Create and repeat soothing, supportive phrases such as “I’m trying my best, and sometimes it doesn’t work out” or “We all make mistakes. It doesn’t mean I’m a bad person.” Save these phrases in your phone or on a sticky note so you can refer to them later. They will help you talk back to the negative voice and nurture your positive attributes during stressful moments.

2. Shift Your Focus

  • Pay attention to what’s working instead of what isn’t. Notice the good as much as or more than you notice challenges. Try to track the positives in your day using voice memos, journaling, or sticky notes. Research shows that gratitude reduces negativity and fosters a positive outlook.5
  • Learn to enjoy small achievements as much as big ones. This is notoriously difficult for any perfectionist, but with practice, you’ll learn to set accurate expectations for yourself and others. By appreciating the “little” things, you will soon notice how they add up to a larger sense of self-worth.
  • Stop comparing your insides to people’s outsides. Avoid “compare and despair.” Many people hide their worries and fears. Don’t assume they’re in a better place because they look or act more put together. Instead of looking sideways, glance backward to acknowledge how far you’ve come and forward to acknowledge where you’re going.

3. Accept Mistakes

  • Know that learning – and making mistakes – are essential parts of living. A fixed mindset limits you to believe that mistakes represent personal, unchangeable flaws. With a growth mindset (or one of a “recovering perfectionist”), you know that you can stumble, pick yourself up, and try again.
  • Practice self-compassion. Be kinder to yourself when things don’t turn out as you hope. Avoid harsh self-talk and turn your attention away from the internal noise of worthlessness. (This is where mindfulness helps.) Play music, or shift to anything else that will distract you from the negative thoughts.
  • Notice your progress. Anxiety erases memories of success. If you have trouble remembering your successes, enlist a friend or a loved one to help jog your memory. Keep track of these moments of triumph because they offer you hope for the future.

4. Receive Feedback with Grace

  • Feedback is a fundamental part of life. Someone will always have something to say about you and your actions. Try to accept what you hear, negative or positive, with neutrality and grace. Consider the source and mull it over before deciding if it has validity.
  • Use reflective listening to deflect an overly emotional response. After you receive feedback, ask “What I heard you say is X, did I get that right?” This will ground you and prevent impulsive emotions from taking over. Plus, you acknowledge what they said without being defensive.
  • Determine if there is any truth to what you hear. Do you deny a compliment? Can you learn something from the feedback and make a change? Think: How can this feedback help me move forward in my life?
  • Acknowledge feedback and be accountable without accepting unnecessary blame. Your goal is to stay present, avoid defensiveness, and stop a shame spiral triggered by critical feedback. Apply what makes sense to you and use it for your advancement. This about you being a fuller version of yourself, not a better one.

5. Set Realistic Goals

  • Use your own compass to determine what’s possible. Start to consider what you can actually handle rather than blindly applying unachievable standards set by others. Think about what you would like to move toward versus what you think you should.
  • Set limits if you’re unsure about meeting a request. Be honest with yourself about what you can actually handle. If you are unsure, take the time you need to figure it out.
  • Differentiate your goals. There are goals that we can complete most of the time with minimal support, those that we can tackle with some support (middle range), and those that are not in our wheelhouse yet (top tier). Knowing how to classify your goals will dictate how much space and resources you need to accomplish them. Try to have no more than two major goals at one time.

6. Improve Executive Functioning Skills Tied to Perfectionism

  • Time management: Address the time blindness that comes with ADHD by externalizing time and reminders, and by following routines. Use electronic and paper calendars to note deadlines and use alerts and alarm for reminders.
  • Organization: Use lists to do a brain dump and then prioritize your to-dos by separating out actions for certain days or actions based on similarities. Use organization systems that make sense for your brain. Remember, aim for efficacy, not perfection.
  • Planning and prioritization: Use the Eisenhower Matrix to organize tasks by urgency and importance. Consider how you like to approach tasks: Do you prefer to start with easy tasks to warm up and then move to something harder? What types of things distract you? How can you prevent last-minute rushes and crises?
  • Emotional control: Find simple ways to support yourself when you feel uncomfortable such as affirmations, deep breaths, or reminders of past successes. Create a plan when you are feeling calm about what you can do when you are activated. Write it down on your phone and then look at when big feelings begin to rumble.
  • Metacognition: Tap into your state of mind and think about your thinking. Ask: “How am I doing? What’s helped me before, which I could apply to this situation?” Reflect on open-ended questions that foster honest thinking, without criticism and “shoulds.”

Every so often, it’s natural to worry and feel pressure to perform well. Overcoming perfectionism does not mean eliminating these worries, but rather changing your reaction to them. Follow an approach of radical acceptance. Value who you are: a mix of strengths and challenges just like everyone else, without judgment. When you believe in your ability to grow, learn, and adapt, you will increase your resilience and be able to confront your anxieties around “not getting it right.” Instead, you’ll focus on the many ways you do.

Perfectionism and ADHD: Next Steps

The content for this article was derived, in part, from the ADDitude ADHD Experts webinar titled, “Perfectionism and ADHD: Making ‘Good Enough’ Work for You” [Video Replay & Podcast #385] with Sharon Saline, Psy.D., which was broadcast live on January 19, 2022.


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Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Sources

1 American Psychological Association. (n.d.). Perfectionism. In APA dictionary of psychology. Retrieved January 27, 2022, from https://dictionary.apa.org/perfectionism

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2 Strohmeier, C. W., Rosenfield, B., DiTomasso, R. A., & Ramsay, J. R. (2016). Assessment of the relationship between self-reported cognitive distortions and adult ADHD, anxiety, depression, and hopelessness. Psychiatry research, 238, 153–158. https://doi.org/10.1016/j.psychres.2016.02.034

3 Flett, G.L., Greene, A. & Hewitt, P.L. (2004). Dimensions of perfectionism and anxiety sensitivity. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 22, 39-57. https://doi.org/10.1023/B:JORE.0000011576.18538.8e

4Katzman, M.A., Bilkey, T.S., Chokka, P.R. et al. (2017.) Adult ADHD and comorbid disorders: clinical implications of a dimensional approach. BMC Psychiatry 17, 302. https://doi.org/10.1186/s12888-017-1463-3

5 Cunha, L. F., Pellanda, L. C., & Reppold, C. T. (2019). Positive Psychology and Gratitude Interventions: A Randomized Clinical Trial. Frontiers in psychology, 10, 584. https://doi.org/10.3389/fpsyg.2019.00584

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Before leaving this article: Michelle Marcella Clarke was diagnosed with breast cancer in 2017. Yesterday I met with Professor John Crown, Oncologist, he mentioned it was now into the fifth year since we first met. This is a positive because there has been no relapse.

I wrote a book during the period with cancer, sadly my mother died while I was having chemo.

Book is published by Amazon. Fortune Favours the Brave, by Michelle Marcella Clarke

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Copyright © 1998 – 2022 WebMD LLC. All rights reserved. Your use of this site is governed by our Terms of Use and Privacy Policy. ADDitude does not provide medical advice, diagnosis, or treatment. The material on this web site is provided for educational purposes only.

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Functional Cognitive Disorder: dementia’s blind spot

Mild Cognitive Impairment: but there are tests and scans and one will be told they have Alzheimers or dementia. Professor Howard undermines their symptoms by saying because they can read /write they do not have degeneration of the brain so they are misleading people about the diagnosis of alzheimers/dementia. Personally I think people who have MCI can work on their memories and aid the delay of full impact of dementia. There will be good days and bad days. Anxiety stress and fatigue all have an impact

george rook

[Study reported in Brain (Brain. 2020 Oct; 143(10): 2895–2903. PMCID: PMC7586080 Published online 2020 Aug 13. doi: 10.1093/brain/awaa224 PMID: 32791521 Functional cognitive disorder: dementia’s blind spot)]

Some will have read recently in social media comments made by Professor Rob Howard about whether some of us have been misdiagnosed with dementia. We find these comments hurtful.

I read a study (of which he was one of the authors) published in 2020 in the journal Brain, the title of which is Functional Cognitive Disorder: dementia’s blind spot.

Prof Rob Howard seems to be saying in his various comments on social media that those of us who can and do speak publicly, and write, about living with dementia do not have dementia. His hypothesis is that we have been misdiagnosed.

For example, I cannot have dementia and be able to read his paper and write this blog, because the neurodegeneration implicit in dementia…

View original post 947 more words

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Post Pandemic Stress Disorder: Recommend this article. My experience is depression as young as 8 year old; hounded by anxiety without it ever being discussed. Tackle this crisis now; do not let children suffer throughout their lives. Listen to people who have experienced the pain of depression, anxiety, excessive stress, phobias, etc. “One in four people will experience mental illness in their lives, costing the global economy an estimated $6 trillion by 2030.”

2017 it was a diagnosis of breast cancer so I wrote book not knowing what the future had in store in the hope that my experiences may help another. Fortune Favours the Brave by Michelle Marcella Clarke is published by Amazon. Below is an article from The European Sting and given the traumatic times we have had as a result of COVID-19, this is worth reading.

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You are here: Home / World Economic Forum / An expert explains: How to talk to children about mental health

An expert explains: How to talk to children about mental health

February 14, 2022 by World Economic Forum1 Comment

(Credit: Unsplash)

This article is brought to you thanks to the collaboration of The European Sting with the World Economic Forum.

Author: Kate Whiting, Senior Writer, Formative Content


  • The world is facing a mental health crisis for children and adolescents, due to the COVID-19 pandemic and historic underfunding.
  • One in seven 10-19-year-olds experiences a mental disorder, according to the World Health Organization.
  • The World Economic Forum’s UpLink platform is launching a new challenge to source innovations that use digital technologies to help improve youth mental health.
  • Here, pediatrician and adolescent medicine specialist Dr. Hina Talib explains three ways to speak to children about their mental health.

“Mummy’s been having a lot of big feelings recently… I feel a bit confused… I feel like I don’t really know what I’m doing.”

These are lyrics from Adele’s 2021 song My Little Love, in which she speaks to a child about her mental health.

“I’m having a bad day, I’m having a very anxious day… I feel very paranoid, I feel very stressed,” the singer says.

It can be hard knowing how to talk to your children openly about your own mental health as well as theirs, but these are conversations that are increasingly important around the world, as people try to cope with the impact of the COVID-19 pandemic.

What is the World Economic Forum doing about mental health?

One in four people will experience mental illness in their lives, costing the global economy an estimated $6 trillion by 2030.

Mental ill-health is the leading cause of disability and poor life outcomes in young people aged 10–24 years, contributing up to 45% of the overall burden of disease in this age-group. Yet globally, young people have the worst access to youth mental health care within the lifespan and across all the stages of illness (particularly during the early stages).

In response, the Forum has launched a global dialogue series to discuss the ideas, tools and architecture in which public and private stakeholders can build an ecosystem for health promotion and disease management on mental health.

One of the current key priorities is to support global efforts toward mental health outcomes – promoting key recommendations toward achieving the global targets on mental health, such as the WHO Knowledge-Action-Portal and the Countdown Global Mental Health

Read more about the work of our Platform for Shaping the Future of Health and Healthcare, and contact us to get involved.

The mental health impact of COVID-19 on children

Children and young people have been particularly hit by the direct and indirect effects of the pandemic, including school closures that, combined with historic underinvestment, have led to a mental health crisis.

As UK-based paediatrician Dr Ranj Singh told the World Economic Forum last year: “We must never forget that the mental health fallout from COVID is something that we’re going to be dealing with for quite some time now.

“This is especially true amongst the younger members of society who haven’t had that social or peer support and school support that kept them on track.”

One in seven 10-19-year-olds experience a mental disorder, according to the World Health Organization. Suicide is the fourth leading cause of death among 15-19 year-olds.

In the US, approximately 4.4 million children aged 3-17 had been diagnosed with anxiety even before the pandemic, according to the Centers for Disease Control and Prevention.

How mental health affects children of different ages in the US.
How mental health affects children of different ages in the US. Image: CDC

But in most of the world, there is not the data available to develop effective policies and services or to allocate resources towards proven interventions to promote and protect mental health, according to the World Economic Forum’s UpLink platform.

UpLink, which pairs entrepreneurs with investors and support to accelerate solutions to global problems, is launching a new challenge to source innovations that use digital technologies to help improve youth mental health.

How to talk to your children about their mental health

For parents and carers who are trying to have those conversations with children about their own mental health, UK charity Mind offers advice. These tips include explaining as simply as possible how your mental health affects how you feel and how you behave, making regular time to talk to older children about how they are feeling and reassuring them that they are not responsible for how you feel.

Pediatrician and adolescent medicine specialist Dr. Hina Talib tells UNICEF talking to your children about mental health starts with one moment and one question: What’s on your mind? Here she describes three things that could help.

1. Start from a positive place

“Tell your child you love and adore them. You could have the conversation when you’ve just shared a joke and laughed together, or enjoyed a favourite snack. Avoid having the conversation when emotions are already running high – or first thing in the morning, when you and your teen might not be on your best form.”

2. Try to listen more than you talk

“Listening is a difficult skill that takes practice, but it’s so important your child feels listened to. Try and say about half of what you had planned to say. Be aware that your initial reactions, a comment, an eye-roll, or a sigh, can have such a big impact on your child and future conversations about feelings. Try to take a deep breath before responding.”

3. Work in partnership with your child

“Ask their permission on how they would like you to respond before jumping in to offer advice. They may just want to vent, or they may want to figure out the next steps on their own, with your guidance as backup. The most important thing is to remind them that you’re on their team, no matter what.”

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This article was written by one of our passionate readers, Mr. Tomasso Merlo. The opinions expressed within reflect only the writer’s views and not The European Sting’s position on the issue. The epochal political challenge of the European peoples is their unification and the birth of a common continental democracy. The European dream, however, is […]

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Trinity College Dublin: Senate Elections. Please vote for Tom Clonan (please share with Trinity College Dublin graduates). I would gladly vote; but this blog tells the story how I studied to finals for BESS but became ill so I have not degree to vote for Tom Clonan

Dr Tom Clonan Retweeted

Rossa McPhillips MBE

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He’s got my vote in upcoming #TCDSeanad Election. A caring father and robust SME on a range of subjects

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Please ask Trinity Graduates – family, friends, neighbours, colleagues to Vote Tom Clonan No 1 in the #TCDSeanad Elections. I am the only Independent Candidate- with a proven track record of positive change in Gender Based Violence, Disability & Health -Vote Independent -Vote Tom

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“Asylum” I shudder deep within but that is Fear. This article by Rosita Boland (Saturday 29th January 2022 Irish Times) is comprehensive. Asylum means “Refuge” but the history of the treatment of people diagnosed with mental illness is a journey we all need to explore; some of us have been there and you will see from my blog my experiences. I have written book “Fortune Favours the Brave” by Michelle Marcella Clarke on Amazon. I believe this article should be read far and wide in Ireland which has a miniscule budget allocation for mental health/illness as I prefer to use. COVID-19 was Public Health No 1 but following it is Public Health No 2 … it is called Post Pandemic Stress Disorder. The time is now to learn from people who know from experience mental illness.

Wed, Feb 2, 2022 Dublin 9°c

An open secret: Ireland’s lunatic asylums and mental hospitals

Tens of thousands of people were resident in institutions – often for decades

Sat, Jan 29, 2022, 06:00 Rosita Boland 16  Eddie Lough, who lives in Ennis, was a former assistant chief nursing officer at Our Lady’s Hospital. Photograph:  Eamon Ward

Eddie Lough, who lives in Ennis, was a former assistant chief nursing officer at Our Lady’s Hospital. Photograph: Eamon Ward    

“Lunatic asylums. Mental hospitals. Psychiatric hospitals.” The language associated with mental health in Ireland has changed over the decades, and continues to change.

More than two dozen “lunatic asylums” were built throughout Ireland in the 1800s. They were often enormous structures, and constructed to endure. There is probably still one of these original buildings in the county you live in, though now it will carry another name.

St Otteran’s Hospital in Waterford was formerly the Waterford Lunatic Asylum. St Loman’s Hospital in Mullingar was the Mullingar Lunatic Asylum. St Canice’s Hospital in Kilkenny was the Kilkenny Lunatic Asylum. There were many others, and their population remained consistently high throughout the decades.

In 1951, the town of Ballinasloe in Co Galway had a population of 5,596. There were 2,078 resident patients in the town’s St Brigid’s Hospital, formerly Connaught Lunatic Asylum. In 1956, as recorded in Brendan Kelly’s book Hearing Voices: The History of Psychiatry in Ireland,  20,063 people were in public mental health hospitals.

Unlike those other Irish institutions behind walls  that housed vulnerable people, such as mother and baby homes and industrial schools, asylums for the mentally ill were never run by religious orders. They were State-run and funded, usually at a local level. This also meant that, unlike the autonomously run religious orders, they were regularly inspected. In addition, they employed a great number of local people who worked there daily. For instance, many asylums had large farms and vegetable gardens. They were integrated into wider Irish society in a way that the more secretive religious-run institutions were not.

Ennis Lunatic Asylum in Co Clare was by far the largest public building in the county when it was constructed in 1868. It had a grand Italian-style palazzo at its centre. To my knowledge, its ever-more derelict presence on the outskirts of the town on the Gort Road continues to hold that record, more than 150 years later. The building cost £54,000, and was on a site of 52 acres. Its name changed over time to Ennis Mental Hospital and, by the time it closed in 2002, Our Lady’s Hospital. Full capacity was 600, although it was frequently overcrowded.

The resident medical superintendent: ‘The asylums were a creation of the society they existed in’

Kieran Power, now retired and who lives in Co Galway, has had a unique insight into how these former mental hospitals in Ireland were run. Every mental hospital was headed up by a resident medical superintendent (RMS). The RMS was the key job within the asylum. He (they were always male) had responsibility for all aspects of the hospital’s administration, including patient admission, care, discharge.

Power’s father, Patrick Power, spent most of his working life in these hospitals. Kieran was born when his father was working in St Columba’s Hospital, formerly the Sligo Lunatic Asylum. In 1957, when Kieran was six, the family moved to Ennis, where Patrick Power was the RMS until 1982. Power himself went on to work in the same area of psychiatry, and later held the role of clinical director in Ballinasloe from 1989 to 2009. In all, he either worked or spent time in five mental hospitals around the country.

“I have spent all my life in mental hospitals,” as he puts it.

As a child growing up living in the RMS’s quarters at the centre of the hospital, he recalls the family’s integration with the patients. “We mixed with them; there were no restrictions on us meeting patients. In fact, we had a patient who used to come up and do housework. She became one of the family and used to go away with us on holiday. She died in 1971, but she was very close to us.”

At the time this woman died, she had been a resident for some 30 years. “She was there because of family,” Power says. “They admitted her. She was in for, as a lot of the older people were, the longer stay; a lot of them came in for what would nowadays be regarded as anxiety and depressive states. And then they sometimes contracted TB. They got it in the hospital. TB was a major problem in all these places.

“This woman would come up and cook our meals. She got paid by my dad. She would babysit us at night if they were out, and that’s where we learned how to play cards. She taught me how to play 25.”

I ask if it was true that patients got TB in hospital in the 1950s.

“It was true in the 1990s,” he says. “I was clinical director in Ballinasloe for 20 years, and in 1991 we had to get a portable TB X-ray machine because, by then, they had disposed of all the walk-in mobile TB vans. We had an outbreak in 1990 in Ballinasloe and I remember we had to get a portable X-ray machine, lead-line the room, employ a radiologist and a radiographer, set up an isolation unit and treat patients.”

He tells me about a male patient he encountered in Ballinasloe who was typical of patients of all five hospitals he lived and worked in over his lifetime.

“He called himself the [Lord of Ballinasloe]. He had a delusion that he was the [Lord of Ballinasloe] and he used to go to the bank in town and they would give him old pennies and he’d walk through farmyards dispensing the pennies to the labourers. They humoured him. Now, if that man was living in Ennis town or Kilrush, or Ballinasloe or any small rural town, he wouldn’t have been tolerated. He would have been ridiculed. In the hospital, he was able to live as free a life as was possible. All the hospitals were full of characters like that. These places were called asylums for a reason.”

When people were admitted, they were sometimes living in better conditions than they would have been at home

It’s fair to say that most people today would now consider the existence of these former asylums to have been aberrations. What is Power’s response to this?

“I suppose like institutions of any descriptions, they were a creation of the society they existed in. We also have a whole generation of people now who didn’t know what these places were,” he says. “One of my problems with the sociologists was, and still is, their spin, if you like, on these places: that very often people were being detained at the pleasure of the medical staff.”

He points out that, contrary to popular misconception, medical staff never sought out patients.

“When people were admitted, they were sometimes living in better conditions than they would have been at home. If you go back to the 1920s and 1930s, this is certainly true of parts of Clare and rural Ireland generally. And they were in places that were much better regulated. There were regular inspections of the hospitals.”

Why was it that so many people were long-term residents?

“It very often didn’t suit families to take them home again. You had the shame; you had the stigma when people had been residents. Families also often wanted people out of the way because of ownership of land. This was a constant thing, even up to the end of my time. Families who would have had another generation of sons in the meantime, did not want those long-term residents home.

“A lot of people who were hospitalised would have had rights of way to family properties. When the occupants at home wanted to give a site, for instance, to another member of the family, a son or daughter, they would have to get rid of the right of way for the person who was in the hospital. We frequently had families coming in and taking relatives out and having them sign documents unbeknown to us.”

Did this happen in his time?

“Oh yes, that was happening in Ennis, and so it was certainly happening everywhere else. I recall it very vividly in the 1990s.”

Power says it was common practice for some residents to leave the hospital during the summer, to go and work on farms. They came back again for the winter. Sometimes they worked for relatives and sometimes for people who wanted labourers.

“I know from my own experience in Ballinasloe that there were people who would go out for the summer to help the farmer cutting turf. They were nearly fostered by particular farmers.”

I ask if their families knew this was happening.

“Some of them didn’t even have families that were engaged with them,” Power says. “They got paid for their work, and they got their board and keep. They would stay out for the summer, and they came back in again in the winter. They were the knights of the roads.”

The smell of urine was indigenous in the place. At this stage we were literally papering over cracks. You could buy a modern bed, but that bed was still in a 150-year-old building

By the time Power was clinical director in Ballinasloe in 1989, he was working in a building that had been constructed in 1833; an astonishing 150 years earlier.

“I remember public representatives writing to me complaining that their constituency members had reported the smell of urine on a long-stay ward. The problem is that a lot of these public representatives didn’t actually come in to visit the hospital and see for themselves. I remember writing that to a minister at the time, explaining that the building had been there since the 1830s, and that the smell of urine was indigenous in the place.

“At this stage we were literally papering over cracks. You could buy a modern bed, but that bed was still in a 150-year-old building.

Assistant chief nursing officer: ‘Asylum is a good word; it’s a refuge’

Eddie Lough, who lives in Ennis, was a former assistant chief nursing officer at Our Lady’s. He worked there from 1967 until its closure in 2002, and was in his 20s when he went to work there first. We meet in a cafe in Ennis.

Eddie Lough at Our Lady’s Hospital in Ennis, Co Clare: ‘Blaming the asylum as an institution and the staff isn’t right. It was society that sent people in there, and society that kept them there in a way.’ Photograph: Eamon Ward
Eddie Lough at Our Lady’s Hospital in Ennis, Co Clare: ‘Blaming the asylum as an institution and the staff isn’t right. It was society that sent people in there, and society that kept them there in a way.’ Photograph: Eamon Ward

“As youngsters, we cycled very fast past the high walls of the mental hospital. It wasn’t Our Lady’s then,” he says. “It was the asylum to us. It was a place to be feared, and the people who were in there were to be feared. People didn’t know what went on there. It was as if the place was invisible. I really believe it was invisible to those who didn’t have anything particular to do with it, or have any relatives in there. People didn’t want to know about it.”

Lough went to work there in his 20s. “To be honest, in the 1960s, there wasn’t a hell of a difference between the 19th century and the 20th century. It was horrible. Unbelievable. A lot of people had been there for 20, 30, 40 years.”

Over time, Lough says he changed his perspective. “Asylum is a good word; it’s a refuge. People now, unless they understand history, when they are talking about what happened in those places, they are looking at it through modern eyes. You have to go into the time machine and go back. People were sent in there for various reasons.

“Many people had no place else to go, and their families didn’t want them back. People today think there were no discharges, but even back in the 19th century, residents were discharged if they had someplace to do, or had some relative to go to.

“The other thing that people forget today is that the asylum or hospital never sent for anyone. Blaming the asylum as an institution and the staff isn’t right. It was society that sent people in there, and society that kept them there in a way, because either there was no place for them to go or their family didn’t want them. Now, there were definitely people in there who were disturbed and who were a danger to themselves, but that goes without saying. You could say the same for today’s mental health services.”

Before Our Lady’s closed 20 years ago, Eddie Lough took it upon himself to salvage its extensive paper archives. These were strewn haphazardly through the vast and damp basement and, without his far-sighted intervention, much of the hospital’s archive would undoubtedly have been destined for skips.

“I became aware of the records in about 1995,” he says. “One effort had been made to put admission forms together into cardboard boxes.” That was it. Nothing else had been done to record or preserve these documents.

In his own free time on his days off, Lough began to sort through the papers. He found minute books, ward books, admission and discharge books, committal forms, account books, and many other documents, some going back a century or more. “I managed to get a room cleaned out, and get shelving in it. In about 1998, I put a sign on the door saying “Archive Room”. Once I had done that, the papers couldn’t be dumped.”

The documents, which occupy an entire room, and number in the thousands, have yet to be catalogued

After the hospital closed, an agreement was reached between the then Mid-Western Health Board and Clare County Archives about the records Lough had saved. The documents, which occupy an entire room, and number in the thousands, have yet to be catalogued. They relate only to the former Our Lady’s Hospital in Ennis, and many go back to the 19th century.

There is a list of the documents, which took a year to process. Under the procurement agreement, an arrangement was made that determined the majority of the documents would be closed for up to a century. This was due to the sensitive nature of the records, and the fact that many former residents and their family members were still alive.

It is, however, possible to make an application for specific research purposes to view these records, and there are different levels of access.

I made an application for level one access. This grants access to the entire archive. It took some weeks, but the application was eventually granted, on the understanding that none of the information I used in this article could identify any of the people named in the documents.

As the records are not catalogued, and there are so many thousands of them, the best I could do was call in some dozen diverse files by way of pure guess. A proper analysis of the entire archive would take months, if not years. I read the files I had requested over a day and a morning in one of the county archive reading rooms in Ennis.

These are some of the things I found out by looking at the files I randomly requested.

In 1950, there were 77 staff employed at the hospital, at an annual cost of £31,716. Fuel for the year – which was turf, in open fires – and light, cost £11,491. Provisions were £14,786.

A ward book for the male section of the hospital for the first six months of 1969 had specific printed categories to denote the number of residents and their status. There were 380 male residents present on January 1st, 1969. The ward book was filled in every evening. The categories include “Receptions [Admissions], Discharges, Deaths, Escaped.”

There were also records in the ward books of the number of patients employed each day. On that day, 20 were working in the farm and gardens; two under the category of “bakers, tailors, shoemakers”; three under “carpenters, painters, masons”; seven between the “engine house and officers’ quarters: and five in the “dining hall and kitchens”.

Attendances at the on-site chapel were also recorded daily. On that day, 119 males had been to the Catholic church, and zero to the Protestant church.

I read this note: “Patient A got out of bed at 7pm and made an attempt to escape. Went outdoors in his dressing gown. Taken back by nurses.”

In the pages of that ward book for the following days, there are various other accounts of patients attempting to escape.

“Patient B absconded from dining hall at lunch time. Ground searched immediately. Found and taken back.”

“While returning from supper, Patient C and Patient D absconded. Missed immediately. Search of ground and town carried out by nursing staff. Reported to Ennis gardaí.”

One of the files I requested turned out to be reports on 45 patients, both male and female, who were admitted in the early 1960s and prescribed Niacin. At that time, it was being trialled in various mental hospitals in Ireland, and employers there were asked to observe results of the trial, and return their reports to a named doctor in St John of God Hospital in Dublin, whose letter is part of the file.

Any identifying details of patients in this file who were prescribed Niacin as part of their treatment have been edited out. They all came from Co Clare, as did all residents of Our Lady’s Hospital.

Case One

“[Patient E, a young girl] admitted 1964, who lived at home on a farm. She had run away from home and expressed the idea that her father was trying to kill her. At the time of admission, she admitted to feeling persecution, regarding her neighbours and friends, and described visual hallucinations, during which she said she saw ‘a pathway’, long along which she was to travel, that she came to where the path divided in two, and she could choose either right or left pathway and these were for her choosing between right and wrong.”

It was interesting to note in this case that her attack was precipitated by her father having arranged a marriage for her with a man of some 56 years of age. She was altogether against this marriage herself.

This patient received electronic convulsive therapy (ECT), Largactil, and Niacin, and was later discharged. The notes record the marriage was called off.

Case Two

“[Patient F, a young man]. August 1963. He requested that we phone Bishop X, requesting that the bishop proceed to [Patient F’s] hometown in Clare, to take charge of his room. He stated he had been in touch with his parish priest, with Bishop X, the Apostolic Nuncio and the pope about the secrets of Fatima. The secrets of Fatima [according to the patient as recorded] are three in number, 1) disease will disappear from the world 2) the complete unity of all Christian churches will come about 3) the present pope is not the senior pope. Another pope will be elected and this pope will marry and will live on Scattery Island on the Shannon. This pope will be none other than [Patient F] himself.”

Prior to admission, Patient F had lived with his mother and an “invalid” sister. He spent several months in the hospital, receiving ECT, Niacin and “various tranquillisers”. The notes on his case end with the observation that on initial admission, he had been “mad as a hatter”.

Case Three

“[Patient G, a young man]. Shabbily dressed, noted to be of subnormal intelligence… had served two jail sentences for breaking and entering. Had tried to assault his parents… admitted to hospital because he had broken a shop window in X village in Clare without any apparent reason. During his stay in hospital he expressed great admiration for criminals and especially those involved in the Great Train Robbery in England. He said he would like to have been in on that job. Eventually he ran away from hospital. Some time later arrested for housebreaking and sent to prison.”

The notes record Patient G had “a long history of schizophrenia, his brother also was a paranoid schizophrenic, and had also been a patient in Ennis, and he also had an uncle who suffered from mental illness.”

Eddie Lough at Our Lady’s Hospital in Ennis, Co Clare: Before Our Lady’s closed 20 years ago, the former assistant chief nursing officer took it upon himself to salvage its extensive paper archives. Photograph: Eamon Ward
Eddie Lough at Our Lady’s Hospital in Ennis, Co Clare: Before Our Lady’s closed 20 years ago, the former assistant chief nursing officer took it upon himself to salvage its extensive paper archives. Photograph: Eamon Ward

Catholic Church: References

Having read all 45 case studies in this 1960s file which I randomly requested, it is striking how frequently patients in that file referenced the Catholic Church in bizarre ways. It’s possibly an indication of the church’s influence in Irish society at that time. These are some of the notes recorded by staff members of these patients who had been admitted.

I am acting for God. I am going to be the next pope

“She said that people had spread false rumours about her, especially to the clergy and for this reason she abused them… She stood outside shops and shouted abuse at people inside.”

“Shows delusions about a daughter of hers being in a convent… prays excessively… talked about having an apparition of the Virgin Mary while she was in church a month ago and a message being conveyed to her about receiving communion.”

“I’ve a special mission in life. I should have been a priest or a brother.”

“I am acting for God. I am going to be the next pope.”

“[Patient H] went on to state he had a mission in this world from God and that he was to save the world. [He said] I am Jesus, do you see him speaking through my lips.” [Patient H] then went into a long rigmarole about himself being the Word. Earlier that day he had gone out into the street semi-nude and set about preaching to those who were passing by. To others in the ward, he said, “I am Jesus, oh you of little faith, get down on your knees.”

“On admission [Patient I] said, ‘I have not been well for two years. I now think people believe I am the Devil. I can hear him in my room at night.”

Patient J was a “regular” patient. “For the last 10 years, he had delusions of a religious nature. For instance, in an extract from a letter he wrote: “I was praying up to the Sacred Heart picture that day and gradually and gently I was forced back against the wall and the upper portion of me felt like Christ crucified and I even saw the head and shoulders on the picture coming to life. It was a miracle.”

Patient K was “praying loudly and singing hymns. He had a large crucifix with red tapes hanging around his neck. Completely preoccupied with religion. Each time he came there was a strong religious content to his delusions. He was in the habit of building altars in the house and going through all the action of saying Mass… during his stays in hospital, he was very preoccupied with religious matters. For instance in church he would kiss the floor before he knelt to pray. On one occasion when it was proposed he should take ECT he stated that Jesus and Mary had spoken to him and had advised him not to have it.”

Patient L “lay in bed, his arms crossed cruciform on his chest. Admitted to visual hallucination of the Blessed Virgin Mary and believed he had seen the Blessed Virgin Mary… and to hearing her speak to him.”

There is much about the asylums that we now rightly regard with horror. Surprise should not be one of them

Over the many decades of their existence, tens of thousands of people in Ireland were resident in either “lunatic asylums” or their successors on the same sites, and in the same buildings, “mental hospitals”.

One thing is certain. These institutions were not places of secrecy, contrary to what people today may believe. They were connected with the societies within which they functioned. Many local people worked there, and went home each evening with their stories.

It is impossible to think that small, tight-knit communities of towns and villages all over Ireland throughout the decades from where these patients came did not know where their neighbours had disappeared to. Or why some of them never came home again. Or know why it sometimes suited families that people in their midst would not return.

It is a fact that our former mental hospitals in Ireland were open secrets, which is an uncomfortable truth to contemplate today. There is much about them that we now rightly regard with horror. Surprise should not be one of them.

If you have a story to share about residents or employees of any former mental hospital in Ireland, please email rboland@irishtimes.com

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A foggy trundle to match my foggy head….. 

Sunday newspapers and a magazine introduced me to this woman. Dementia, alzheimers, frontal lobe dementia, people with amnesia from traumatic brain injuries, people who have had strokes, the Pandemic which has lasted almost two long years has not been in our favour. Why? There is a need for stimulation, engagement, chat, gatherings like choirs. Wendy is an inspiration. She was diagnosed with dementia in her 50’s, at the time she held an important organisation role within the NHS which she had to leave. But she did and Wendy applied something inherent in her personality and adapted. Wendy does not say “she suffers” from Dementia but says she lives with it. Wendy now in her early 60’s has written two books, she has a form of mentor to assist her. Lifelong learning is so very important.

Which me am I today?

It’s been such a crazily busy month that it was inevitable that good days would be followed by bad days…and I’ve had so many hazy days of late because of it, but sometimes you have to put up with the bad to allow the good to happen….I even published 2 blogs on Friday when one was meant for yesterday🙄

It may sound strange but on foggy days in my head, I feel quite at one with the weather if it’s foggy too and feel as though nature has tuned itself into me as I walk through the haze.

It was on one such day last week that I wrote this blog…..

I woke with the familiar tell tale signs; the hazy feeling, the emptiness. I asked Alexa the day and time and she thankfully filled in the detail of the day. Luckily she told me it was a Saturday, so…

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