With October being Menopause Awareness Month, this is a great opportunity to focus conversation on something which affects half the population here in Northern Ireland – and indeed, the world over. Still sometimes considered a taboo topic, the menopause (and perimenopause) is a significant time in a woman’s life – and how this transitional period is experienced is very much individual to each person.

Menopause, as explained by the NHS, is “when your periods stop due to lower hormone levels. It usually affects women between the ages of 45 and 55, but it can happen earlier.” Menopause can also occur following surgery to remove the ovaries or uterus and can be triggered by cancer treatments such as chemotherapy.

Perimenopause, meanwhile, is when the symptoms of menopause occur alongside your periods, so it ends once periods have stopped for 12 months – and then menopause begins.

Common menopause and perimenopause symptoms can include (but are not limited to):

• Mental health issues such as anxiety, problems with memory or concentration (‘brain fog’), depression, mood swings and low self-esteem.
• Irregular periods.
• Physical symptoms such as hot flushes, trouble sleeping, palpitations, headaches/migraines, muscle pain and various other symptoms.

The theme for World Menopause Day 2024 – which takes place on October 18 and is spearheaded by the International Menopause Society – is Menopause Hormone Therapy (also known as Hormone Replacement Therapy or HRT in the UK).

HRT is “the main medicine treatment for menopause and perimenopause symptoms … which replaces hormone that are at low levels. There are other treatments if you cannot, or choose not to, have HRT.” (NHS).

In the first of our series of menopause-related blogs this month, we’ve subsequently spoken with one of Northern Ireland’s first accredited menopause specialists, Dr Siobhan Kirk, to get her views on using HRT and to chat about the menopause in general, along with its potential associated effects on mental health.

Always access accurate advice

An accredited menopause specialist and trainer with the British Menopause Society, Dr Kirk is also a fellow of the Royal College of Obstetricians and Gynaecologists and the Faculty of Sexual and Reproductive Healthcare (FSRH). In addition to this, she is on the Specialist Register for Community Sexual and Reproductive Health and is chair of the NI FSRH Committee and FSRH rep on the Royal College of Obstetricians & Gynaecologists (RCOG) NI Committee.

As a full-time Consultant in Sexual and Reproductive Health in Belfast HSC Trust, Siobhan primarily works with women presenting with POI (Premature Ovarian Insufficiency), as well as with those who are in early menopause following cancer treatment or surgery. Patients also include women with complex medical problems and those experiencing bleeding issues with HRT.

Initially only one of two accredited menopause specialists in Northern Ireland, Dr Kirk said that there had been an increased uptake in menopause training over the past few years, which was great. However, she added that, alongside the certified advice available to women, there was also a lot of misinformation circulating about the menopause, so her advice was always to seek support from reputable sources.

“Women need more accurate information,” she said. “There are a lot of people jumping on the menopause bandwagon and trying to make money out of women. There’s a lot of misinformation out there.

“The majority of menopause care is delivered through primary care, so that’s where education needs to be focused. General practice is on its knees all over the UK, so it’s difficult, as it’s very hard to do a menopause consultation in 10 minutes. It’s also a bit of a postcode lottery for treatment and advice.”

Considering this year’s World Menopause Day theme of HRT, Dr Kirk said that because every woman experienced the menopause differently, how they managed it was therefore very unique to them. As a result, HRT could work well for some, but might not be the best option for others. Some women may also experience lots of menopause symptoms, while others may experience fewer symptoms or, indeed, none at all.

“HRT is a very individual thing,” she said. “Not everybody needs HRT and not everybody gets symptoms. The main reason for taking it is for the symptoms, but some women can feel left out if they have no symptoms. There are a lot of women coming forward for advice who are doing fine and don’t have symptoms. There are unrealistic expectations too – some people think HRT can fix everything.”

Menopause mental health

Dr Kirk added that it was important to consider the mental health implications of the menopause alongside any physical symptoms women may experience.

“Sometimes the psychological symptoms can be worse than the hot flushes and the sweats,” she said. “Unfortunately, some of these women are still being offered anti-depressants, rather than HRT. Sometimes, CBT (Cognitive Behavioural Therapy) might be a better option as well – it’s all very individual.

“We need to raise awareness of the psychological aspects of menopause. The anxiety is quite often crippling and it’s often out of your control – for example, lying awake at night worrying about things. If you have no previous history of mental health issues and it all ties in with perimenopause, then HRT is the first plan, rather than anti-depressants.Existing mental health conditions can also exacerbate those experienced during menopause, sopsychologists and psychiatrists need to educate themselves around this.”

When it comes to advising women on where to go for accurate advice on the menopause and perimenopause, Dr Kirk said she recommended visiting the Women’s Health Concern website for accredited information.

Women’s Health Concern (WHC) is part of the British Menopause Society and has been providing accredited, independent advice to women on menopause, gynaecological and reproductive health since 1972. According to their website, lifestyle choices play a key role in managing menopause symptoms:

“Hormone Replacement Therapy (HRT), Cognitive Behavioural Therapy (CBT) and other complementary and alternative treatments can all be very helpful, but the transition to menopause is a good time to review your lifestyle. Not only can this help manage menopausal symptoms in the short term, it can lay the foundations for good health through perimenopause, menopause, and the years to come.”

Other local menopause resources are Menopause NI – which aims to raise awareness and to educate about the menopause – and Menopause Together (Northern Ireland’s first menopause charity), both of which are running conferences in October.

Dr Kirk added that, with more conversations happening around menopause online and elsewhere – which was positive – this did also increase the risk of inaccurate information circulating. Obtaining advice from reputable sources such as Women’s Health Concern and linking in with reliable support locally was therefore key.

For women seeking help with the menopause her top tips are:

• Access accurate sources of information.
• Make the GP your first port of call.

Resources:

• NHS: https://www.nhs.uk/conditions/menopause/
• British Menopause Society: https://thebms.org.uk/
• Women’s Health Concern: https://www.womens-health-concern.org/
• International Menopause Society: https://www.imsociety.org/?v=7885444af42e
• Dr Siobhan Kirk: https://www.drsiobhankirk.com/
• Menopause NI: https://menopauseni.com/
• Menopause Together: https://menopausetogether.org/

Many of us love a good story, but did you know that reading – as well as writing your own stories – can positively influence your mental health?

Whether you enjoy fiction or non-fiction, research indicates that reading can help to improve our wellbeing, while creative writing can also increase happiness and thereby support our mental health.

Literacy as a therapeutic tool

No matter what age you are, the research shows that literacy can boost your mental health and wellbeing, with children, teenagers, students and older people all benefitting. So, if you’re struggling with your mental health, then activities such as reading, journaling or writing stories and/or poetry can all have therapeutic benefits.

Even the simple act of writing down a list of what’s worrying you can alleviate anxiousness, so putting pen to paper (or writing on your iPad or computer) can really help. It allows you a space to express thoughts, feeling and emotions and has long been used as in therapy to help people cope with difficult experiences.

Research into the ‘Emotional and physical health benefits of expressive writing’ (Cambridge University Press, 2018) found that writing about traumatic, stressful or emotional events improves physical and mental health – both in clinical and non-clinical environments.

A study from the National Literacy Trust (2018), meanwhile, showed that “children who are the most engaged with literacy are three times more likely to have higher levels of mental wellbeing than children who are the least engaged (39.4% vs 11.8%).” [1].

Another 2023 study [2] which looked at the effects of literacy on student mental health and wellbeing found that “through reading, creative writing, and bullet journaling, the students found relaxation and immersion, were able to release and process emotions, and reflect on their mental health.” By engaging in these activities, the study also showed that the students built up more positive self-esteem and had increased opportunities for benefitting from supportive relationships.

The researchers discovered that, of the 400 people surveyed from the website, more than half said that reading and writing poetry had helped them cope better with feeling lonely or isolated. Meanwhile, 50% said that poetry had helped them manage their feelings of anxiety and depression.

Creative writing at Action Mental Health

At Action Mental Health, we offer a wide range of programme and services to help people manage their mental health and wellbeing, some of which include creative writing workshops. Indeed, our Skills Coach Trainer, David Allen, has facilitated a variety of creative writing-related workshops for clients through our Antrim and Larne outreach programme, focusing on everything from narrative fiction and short story writing to poetry and children’s picture book writing.

“We’ve covered areas such as plot and structure, characters, setting, point-of-view, narration, dialogue, themes and symbolism,” he said.

“With the poetry, we looked at different forms of poetry, such as blank verse, free verse and sonnets, along with figurative language, rhyme, rhythm and meter. I think our clients also enjoyed the children’s picture book course, as we were able to incorporate many of the above elements, but adapt them for young children.”

He added that Michael Di Maggio, a client from the Larne outreach programme was so inspired that he actually went on to publish his own children’s book, Luna’s Mission to the Moon.

Clotworthy House exhibition

With the Five Ways to Wellbeing focused on connecting with people, getting active, taking notice, learning and giving, creativity feeds into each of these in various ways, with creative writing just one example of something you can do.

Joining a book club or reading group is another way to connect with people and get creative, while workshops like those offered at Action Mental Health and other organisations are also great ways to enhancing wellbeing.

Having participated in various creative workshops recently, our clients from Antrim will subsequently be exhibiting some of their work at Clotworthy House at Antrim Castle Gardens in October.

One piece of work that will feature is a poem entitled The Fear, by Jill O’Neill, which she was motivated to write after attending one of Dave Allen’s creative writing courses and describes living with poor mental health.

John Davis, service manager at Action Mental Health’s Antrim location, said: “Our client art exhibition will be open to the public until the end of October. The exhibition will consist of a selection of work completed by our Antrim clients, showcasing their work using different mediums, such as fine art, abstract art, pencil and photography.

“This is a great opportunity for clients to see their work displayed in public areas and to be purchased, which really does boost their confidence and self-esteem.”

The launch event will take place at Clotworthy House at Antrim Castle Gardens on Monday, October 7 at 10.30am. It will be officially opened by the Mayor and the exhibition will be available to view until the end of the month.

References

[1] Clarke, C., Teravainen-Goff, A. (2018) Mental wellbeing, reading and writing: How children and young people’s mental wellbeing is related to their reading and writing experiences. National Literacy Trust, London.

[2] Peach, E. (2023) Creative Mental Health Literacy Practices: A Qualitative Study Exploring How Students Use Literacy to Promote Wellbeing and Manage Mental Health Conditions While at University. Int J Environ Res Public Health; 20(15): 6475.DOI: 10.3390/ijerph20156475

[3] Caleshu, A., Waterman, R. & Kemp, S. (2023). Poetry and COVID-19: the benefit of poetry and the poetryandcovidarchive.com website to mental health and wellbeing. Journal of Poetry Therapy, 37 (3), 198–218. https://doi.org/10.1080/08893675.2023.2250921

Grief is something which will affect us all at some point in our lives, but everyone experiences it differently and will cope with it in their own unique way. What works for one person won’t necessarily be right for another – and that’s ok.

While there are no defined ‘stages’ of grief, there are some common emotions and reactions linked to loss. Physical effects can include weight change, poor sleep, resulting in tiredness and aches and pains from stress-related tension. Behavioural effects can include withdrawing from social activities/not leaving the house, forgetfulness, poor concentration, excessive worrying about loved ones. Emotional effects can include sadness, loneliness, anger, guilt or feeling numb.

No one’s experience of grief will follow the same path and, for some, this will be meandering while for others, it might be more linear. Whether grief ebbs and flows in your life in varying periods of intensity or peaks at a certain point, there’s no ‘right way’ to experience grief and all responses are valid. Learning to live with grief, in whatever form it takes, is a challenge, but there are ways in which you can support yourself and others.

While a nothing can make grief ‘go away’, there are things you can do that help you while navigating grief:

• Self-care e.g. drinking enough water, showering and getting dresses, going outside

• Speaking to someone, whether a therapist/counsellor or friend/family member

• Looking after your physical as well as mental health e.g. getting enough sleep, moving (simply getting outside to go for a walk), eating well

• Writing down how you feel – putting things onto paper can help you tell your own story and has been proven to reduce stress

Sometimes it’s hard to know how to support someone who is experiencing grief. There are small things you can do that could make a big difference:

• Listen more, speak less.

• Help with daily tasks e.g. cook a meal for them or do the shopping.

• Encourage them to seek professional support if needed – and offer to drive them to their first therapy session.
• Give them time and understand that there is no instant ‘cure’ for grief or a ‘one size fits all’ approach to handling it.

If you or someone you know is grieving and you would like to explore professional support, you can reach out to:

• Cruse Bereavement Care: https://www.cruse.org.uk/

• Bereaved NI (NI Bereavement Network): https://bereaved.hscni.net/

• Blue Cross Pet Loss support: 0800 096 6606 / https://www.bluecross.org.uk/pet-bereavement-and-pet-loss /

And if you require urgent help, you can contact Lifeline (Northern Ireland’s crisis response helpline): 0808 808 8000 / https://www.lifelinehelpline.info /

Artwork from an eight-week project which aimed to bring people together to reduce isolation and support better mental health and wellbeing was officially launched at a special exhibition on Thursday, August 29.

Entitled ‘Home is Where the ’ART is!’ the exhibition explores the concept of ‘home’ and features work from people attending Action Mental Health’s southern Services. The project was funded by the Arts Council of Northern Ireland’s Rural Engagement Arts Programme 2023/24, with the resulting artwork displayed at the Lough Neagh Discovery Centre at Oxford Island.

Artist, Hazel Boland, who also works as an artistic educator, programmer and engagement coordinator, facilitated the project, which brought together people from Armagh, Portadown and Newry. She said it was wonderful to see how everyone had worked together, offering support and encouragement to each other along the way.

“One of the quotes from the Armagh group was ‘trust the process,’” she said at the launch event. “You can’t always visualise something or see the outcome but you just have to go for it. Everybody embraced it, even if there was a bit of fear to start with. “There was lino printing and then something very different, which was the felting. Everybody tried both and the more they did it, the more confidence they had. I think the work is amazing. What I like about the exhibition today is that everybody has come together for it. It means much more to see what everybody has produced all together in the one place. I think you’ve all done a fabulous job.”

Throughout the project, participants had the opportunity to express themselves in their medium of choice, as well as enjoying social interactions within the group settings. The artwork subsequently communicates to others – be it friends, family or the wider community – positive mental health messages to help reduce the stigma surrounding mental ill-health, which often prevents people from accessing the support they need to stay well.

Also saying a few words at the launch were some of the project participants, including Francis Johnston from the Action Mental Health Newry service, who was surprised at just how much he enjoyed the experience. With his last brush with art being in third year at school, Francis said it had been “amazing” to be introduced to new materials and creative processes, such as working with vinyl.

A participant from Armagh said her experience had been equally positive and that the group, who did not view themselves as artists, had thoroughly enjoyed the sessions with Hazel.

“Hazel proved that you can produce something,” she said. “She had faith in us when we had no faith. As the weeks went on we got more into it. The felting we produced has a deep meaning to every one of the members of the Armagh group. The name we gave it is ‘Our Circle of Community’. It represents our safe place, where we feel secure.

“We can find things very daunting. We didn’t have much faith in ourselves at times, but Hazel kept trusting us and delivered this programme, which we thoroughly enjoyed.”

Colin Loughran, service manager at Action Mental Health, congratulated everyone who took part in ‘Home is Where the ’ART is!’ He added that the aim of the project had been to “bring everyone together – and I think we’ve done that.

“It’s really reassuring to hear that the work we’re doing is helping and making a difference,” he said. “I’d also like to thank Siobhan Black and Alison Reid, who coordinated the project with Hazel – and of course, to thank the Arts Council NI for their funding. In the earlier part of the project, someone said that ‘home isn’t a place, it’s where you feel most comfortable.’ I think ‘Home is Where the ’ART is!’ really hit the mark.”

While it’s important to stay informed about current affairs, exposing ourselves to a constant stream of distressing news can take a toll on our mental health. It’s therefore crucial to find ways to protect our wellbeing amidst the chaos.

Whether we’re impacted directly by events or indirectly via what we read or hear, this can affect our mental health in various ways – for example, causing fear, anxiety or feelings of helplessness. Recognising this and understanding the validity of our responses is therefore first step to protecting our mental wellbeing.

Here are some tips from Action Mental Health to help you cope with distressing news:

• Choose reliable sources: Our social media feeds can quickly become saturated with different voices and channels each putting their own spin on an event or issue – and some are more biased than others. Ensure you’re getting your information from reputable news outlets to avoid sensationalism and misinformation that can amplify distress.

• Set boundaries: Designate specific times for checking the news instead of having a constant stream of updates. Consider turning off notifications to avoid being overwhelmed. Taking a step back from the news doesn’t mean you’re ignoring the world’s problems; it means you’re prioritising your mental health. By finding a balance, you can stay informed and compassionate without becoming overwhelmed.

• Acknowledge your emotions: Allow yourself to feel and process emotions rather than suppressing them. Writing in a journal can be a helpful outlet.

• Practice mindfulness: Deep breathing or meditation can help centre your thoughts and reduce anxiety. Getting a change of scenery, especially if you can get outside and move your body, can help your perspective and also ease physical symptoms.

• Connect with others: Sometimes talking to friends and family can provide comfort, whether you’re discussing the issues that are worrying you or just seeking some encouragement and connection.

• Take positive action: Volunteering or supporting community initiatives can mitigate against feelings of helplessness and help you gain a sense of community and solidarity as you stand with others for good. If you don’t feel like you can leave the house, you can write to people in positions of power, sign petitions or donate to important causes – these are incredible ways to make a difference.
• Seek professional help. If you find that distressing news is affecting your daily life, speaking to a mental health professional can provide strategies and support tailored to your needs.

We know things feel hard right now – but you’re not alone.

Last year, Matthew took on the Dublin Marathon to raise vital funds for Action Mental Health. We asked him to share a little bit about why he did it – and this is what he said…

Hi! My name is Matthew Heath. I’m 28 years old and living in Belfast, Northern Ireland. I am a Software Engineer by profession and love the chase of new challenges and learning new things.

My running journey started in March 2023 with limited fitness and a desire to get away from my laptop every so often. I began with an 8-week Couch to 5K program, aiming to complete leg one of the Belfast Marathon Relay with colleagues. After successfully achieving that goal, I gradually increased my distances, tackling a 12-week training block for the Hillsborough Half Marathon, marking my first step towards longer distance races.

I first came across Action Mental Health while scrolling on social media. Before this, I had limited knowledge of the services available locally. The post I saw highlighted various fundraising challenges organised to support and enhance their services, and one of these was the Dublin Marathon.

I was struck when I saw the post – Action Mental Health were providing vital services and support to those struggling with mental health issues, offering a lifeline to many in the local community, and I realised that participating in Dublin Marathon was the perfect opportunity to combine my new passion for running with a meaningful cause, raising awareness and genuinely making a difference for people.

So, for the Dublin Marathon, I took on another 12-week marathon-specific training block, running 5 days a week to try and hit my ambitious target of under 4 hours with a mix of easy, tempo, and interval runs, maxing out at around 70km during the peak week.

The training itself was both challenging and rewarding, providing me with an outlet to refresh my mind across many miles. Having structured sessions mapped out on an app for 12 weeks gave me the accountability I needed to stay on track. Additionally, the support and encouragement from the Action Mental Health team were crucial to keeping me motivated even when the training got tough – they were there every step of the way!

On race day, I was incredibly nervous, as many people are before a big event. I had been constantly checking the weather for weeks leading up to the marathon and barely slept the night before! After loading up on pasta the previous evening and having two bagels for breakfast, I set off in Wave 3 at 9:25 am.

The course winds its way out from Dublin city centre towards Phoenix Park and through several quaint villages. The latter part of the route passes by UCD, into Ballsbridge, and past the Aviva Stadium.

With over 16,000 people running in Dublin, the event featured a diverse mix of characters and abilities, all cheering each other on. The support along the entire route was amazing, with numerous cheer zones providing much-needed boosts. Dublin is known as the ‘Friendly Marathon,’ and it certainly lived up to its reputation. Despite the classic Irish weather of experiencing all four seasons in one day, many people lined the streets offering nutrition and even deep heat spray!

The race ends with the ‘Purple Mile’ towards the finish line, and this was probably my favourite part. Both sides of the streets jam packed with noisy supporters in the heavy Dublin rain and knowing that all the hard work had paid off to get to the finish line of my first ever marathon was special. The post run feed and hydration were also exceptional – who knew a burger and Guinness could taste so good?!

It was (and still is!) fantastic knowing that my efforts would mean more people in Northern Ireland could access mental health services when they really need them. At just halfway through the collective efforts across the #teamAMH runners, we had already raised enough to provide 22 secondary school classes with mental health awareness sessions, potentially impacting over 600 pupils. Given the ongoing concern about access to mental health services in Northern Ireland, it is crucial to advocate for local charities that are helping to address some of the stark statistics associated with mental health issues.

Creating greater awareness around local charities making a real difference in people’s lives is something I hope to continue doing and would encourage others to do too. With such a range of services, from counselling to mental health education in workplaces, Action Mental Health really is making a significant impact here in Northern Ireland.

If I were to speak to someone who was considering taking on the challenge this year, I’d want them to know that it is an incredibly rewarding experience. It will push both your physical and mental limits, but the sense of accomplishment is unmatched. The support from the Action Mental Health team and fellow runners is fantastic and you’ll be part of a passionate group working towards a common goal of improving mental health services for all.

Enjoy the process and trust in your training. Increase speed and volume slowly over time to avoid potential injuries (I found this out the hard way!), and if it is your first marathon, don’t put too much pressure on yourself. Go out there and soak up the amazing Dublin atmosphere and all that is has to offer!

We still have a few spaces left for Dublin 2024 – get in touch today to ensure you don’t miss your chance! Contact [email protected].

Omagh-based Powergrid Civils (PGC), the specialist engineering and consultancy company operating throughout the UK and Ireland, have just announced a partnership with Action Mental Health, which will help support the charity’s vital work in local schools and community groups.

Founded in 2012, the company has built an enviable reputation for their corporate social responsibility when it comes to supporting local communities through donations, sponsorship and time. As a result of this partnership, Action Mental Health will now be able to expand their delivery of mental health programmes to children and young people across Co. Tyrone, helping them reach many more schools and community groups. One of the schools involved is Omagh Integrated Primary School, where pupils will take part in the charity’s Little Healthy Me and Healthy Me programmes which are vibrant and engaging mental health promotion programmes, designed specifically for primary school children.

Lisa Colton, Managing Director, said, “We recognise how difficult it is for charities to raise funds to support the great work they deliver in our communities.  We feel proud that our business is in a position to support Action Mental Health in the delivery of their mental health programmes to our local schools and community groups”.

Michael McClean Project Worker at Action Mental Health said: “We are delighted that as a direct result of our partnership with Powergrid Civils we can now reach even more children and young people in Omagh and across Co Tyrone. with our invaluable range of mental health programmes. It is so vital that we equip the younger generation with the skills and knowledge that they need to deal with the inevitable challenges they will face growing up, and indeed right throughout life.”

For more information on Action Mental Health’s programmes for children and young people please visit: https://www.amh.org.uk/services/amh-menssana/

Caption: (left to right): Declan Colton (PGC), Lillia Wilson (Pupil), Michael McClean (Action Mental Health) Gavin Gallagher (Omagh IPS Principal), Lisa Colton (PGC), Brendan McCanny (PGC), Clodagh McCanny (Brendan’s daughter).