Grace of Eights Mental Health First Aid Training

17/02/2025

If your loved one has recently been diagnosed with a mental health condition, you might be struggling with grief.

When we think about grief, we often picture the loss of a loved one who has passed away. However, caregivers frequently experience a unique and complex form of grief while caring for someone who is still living. This experience is common and deserves recognition.

The Caring Journey: Understanding the Phases

Caring for someone with mental illness often follows a path with distinct phases, each bringing its own emotional challenges:

Phase 1: Recognition
The journey often begins with a troubling awareness - you notice persistent changes in your loved one's behavior, thinking, or emotional state. These aren't just occasional odd moments, but consistent patterns that signal something is wrong.

Phase 2: Diagnosis and Starting Treatment
This phase brings both clarity and new challenges as you receive a formal diagnosis. You begin learning about the condition and navigate the healthcare system, possibly including hospitalisation. This period often brings a mix of relief at having answers and anxiety about the future.

Phase 3: The Adjustment Period
Now comes the complex work of finding the right treatment approach or dealing with side effects, lack of insight, denial or unwillingness to comply with medication and treatment. You might experience setbacks and improvements as medications are adjusted and you search for the right healthcare providers. During this time, you may start recognising your own need for support.

Phase 4: Daily Management
The reality of long-term caregiving sets in. You learn to balance the demands of caregiving with other life responsibilities, sometimes making difficult decisions about work and personal commitments.

Phase 5: Finding Your Rhythm
With time and experience, many caregivers develop effective routines and realistic expectations. You build stronger support networks and find ways to maintain your own well-being while caring for others.

Phase 6: Role Transition
Sometimes, the active caregiving role ends - whether due to recovery, changed circumstances, or other factors. This transition can happen at any point and brings its own emotional challenges.
Understanding Ambiguous Loss

Throughout these phases, caregivers often experience what experts call "ambiguous loss" - grieving someone who is physically present but somehow changed or absent in other ways. This creates a unique form of grief characterised by:
• Feeling stuck between hope and hopelessness
• Ongoing loss without clear resolution
• Uncertainty about the future
• Guilt about grieving someone who is still alive

Living with Both Hope and Loss

One of the most challenging aspects of being a caregiver is managing conflicting emotions. You might feel deep love for the person while struggling with their behaviors. Rather than seeking "closure," many caregivers find strength in accepting that they can hold both joy and sorrow, both hope and grief.

Understanding "Recycled" and "Complicated" Grief

Grief often resurfaces during celebrations or life events, It happens when a carer is reminded of the extent to which illness has impacted on the life of the person they care for.

Many carers attend birthdays, weddings and graduations knowing that the person they care for cannot experience the joy of these special occasions. This reality can be difficult to accept with each celebration acting as a trigger for grief known as "recycled" or "living" grief. Some caregivers experience "complicated" grief, which can take several forms:

• Chronic grief that seems endless
• Delayed grief that emerges unexpectedly later
• Overwhelming emotional responses
• Grief that's hidden or denied

Finding Your Path Forward

While there's no "getting over" these experiences, many caregivers find ways to live meaningfully alongside their grief. Signs of healthy adaptation include:

• Being able to talk openly about your situation
• Finding balance between caring for others and yourself
• Accepting support from others
• Gradually rebuilding a fulfilling life while maintaining your caregiving role

Remember, it's okay to seek help. Professional support services, including grief counseling, can provide valuable assistance as you navigate these complex emotions.

If you need immediate support, services like the Grief Line (1300 845 745) offer free, anonymous counseling from midday to 3:00 AM, seven days a week.

Your grief as a caregiver is real. While the journey isn't easy, understanding these emotions and seeking support when needed can help you maintain both your caregiving role and your own wellbeing.

Resources:
The leading specialist in ambiguous loss: https://www.ambiguousloss.com/
https://whatsyourgrief.com/ambiguous-grief-grieving-someone-who-is-still-alive/
LEAP Institute – managing lack of insight: https://leapinstitute.org/about/

24/01/2025

In our journey through life, we may encounter a profound psychological state known as "the void." This article aims to explore what the void is, how it impacts our mental health, and what we can do to navigate through it.

The void is a state of existential crisis that often occurs at the end of a process of deconstruction - when scepticism and critical thinking have broken down previously held beliefs and truths. It's characterised by a deep sense of meaninglessness, a loss of purpose, and a confrontation with life's

20/01/2025

What's up with burnout?

In recent decades, the term "burnout" has become increasingly prevalent, depicting the experience of employees who find themselves emotionally drained, cynical, and feeling ineffective at work. The conversation around burnout as a distinct workplace syndrome has garnered significant attention from occupational health experts, psychologists, and the general public. However, contrasting viewpoints exist regarding whether burnout qualifies as a well-defined clinical entity stemming directly from chronic job stress.

On one side of the debate lies growing scientific evidence suggesting burnout represents a legitimate phenomenon with serious consequences. In 2019 the World Health Organisation (W.H.O) updated its International Classification of Diseases (ICD-11) to include Burnout as an ‘occupational phenomenon’ – but it was not classified as a medical condition. The W.H.O refers to the definition established by the widely-used Maslach Burnout Inventory, which has burnout characterized by three core dimensions:

1. overwhelming exhaustion,

2. feelings of cynicism and detachment from one's work, and

3. a sense of diminished professional efficacy.

Neuroimaging studies have revealed that burnout is associated with physical changes in brain areas involved in emotional regulation, cognitive functioning, and the stress response system. Individuals suffering from burnout show alterations in the amygdala, prefrontal cortex, anterior cingulate cortex, and hippocampus. This dysregulation may lead to impairments in cognitive abilities like attention, working memory, and creativity. Moreover, the chronic stress underpinning burnout appears to throw the body's neuroendocrine system off balance, resulting in abnormal cortisol levels that promote systemic inflammation and increase risk for serious conditions like coronary heart disease.

While the negative impacts of burnout seem clear from this research, an opposing perspective challenges the fundamental validity of burnout as a legitimate clinical syndrome directly caused by factors in the workplace. Critics argue that the conceptualization of burnout as a combination of exhaustion, cynicism, and reduced efficacy was largely pre-defined before rigorous empirical research occurred. The reasoning for why these three particular symptoms constitute a distinct syndrome, separate from conditions like depression, remains unclear and lacks a strong clinical or theoretical basis. However, for those of us who have experienced both clinical depression and burnout, there is a distinct difference; if you remove yourself from the situation that is causing burnout – your caring role, your toxic workplace, overwork and or struggle for survival – your symptoms start to resolve. With enough rest and recovery, the burnout symptoms lift. If you are experiencing clinical depression, it does not matter how much rest and recovery you throw at it, the symptoms persist. Without effective treatment such as psychotherapy and or medication, clinical depression symptoms do not resolve.

Furthermore, evidence that burnout is primarily induced by unmanageable work stress is lacking. Job stressors have been found to be relatively weak predictors of burnout, and no conclusive proof exists that they contribute more to burnout than other sources of stress outside the workplace. The proposed causal link between occupational factors and burnout appears tenuous.

After nearly 50 years of research on the topic, the inability to establish validated diagnostic criteria for burnout also raises scepticism about its legitimacy as a clinical entity. Some have proposed that burnout may simply represent an artificial construct lacking enough coherence to allow proper diagnosis and measurement of prevalence rates.

Given these issues, some experts have advocated for revising or removing burnout's status from clinical manuals like the ICD-11, which currently categories it as a factor influencing health status. They argue the various existing categories for stress, anxiety, and depressive disorders provide sufficient means to address job-related distress without a separate, ill-defined burnout classification.

As the debate continues, one perspective views burnout as an insidious condition inducing neurological changes and cognitive impairment from the accumulated toll of chronic workplace stress.
The opposing viewpoint argues burnout lacks sufficient validation as a distinct clinical syndrome stemming specifically from occupational factors. Resolving this controversy will likely require more rigorous, longitudinal research to either solidify burnout as a legitimate occupational phenomenon or refine our understanding of how chronic stress manifests across work and personal life domains. With so much at stake for employee health and productivity, the burnout discussion represents an important priority for the field of occupational health psychology.

In the meantime, what can workplaces do to mitigate the risks of psychosocial hazards that can impact mental health? The answer is Mental Health Literacy training to increase capacity for recognising when a team member is experiencing poor mental health or poor performance related to mental health and gaining the skills needed to have a supportive conversation before any major issues or injury occur.

I have trained over 2000 people in Mental Health Literacy Courses – don’t wait until the symptoms of burnout show up in you, your team or the people you love. Contact me to discuss your training needs.

Sources:

Bianchi R, Schonfeld IS. Examining the evidence base for burnout. Bull World Health Organ. 2023 Nov 1;101(11):743-745. doi: 10.2471/BLT.23.289996. Epub 2023 Oct 4. PMID: 37961064; PMCID: PMC10630726. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10630726/

https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases

https://www.psychologicalscience.org/observer/burnout-and-the-brain (Note: the article linked was written in 2016 and the ICD-11 was updated in 2019 – otherwise it is an excellent article on the history of burnout and its cognitive impacts on the brain)