Dr Jan Orman

I’m pretty sure I’ve lost mine. I lost it in the early part of 2021 and haven’t laid eyes on it since.

Often OK is the very best I can do (especially lately), and I try to be grateful for that, but wouldn’t it be nice to be more than OK, to be flourishing, for a little more of the time! I hope I don’t have to wait for the world to be a better place before that happens.

As a health professional, we’re always going to be faced with the professional and personal dilemma of where and when to draw the line when it comes to advice or treatment of loved ones.

It’s that time of year again where some of us convince ourselves that we’re going to “definitely” stick to those new year’s resolutions….

There's something special and therapeutic about reading. A Summer read encapsulates so much more than just words printed on paper. Dr Jan Orman

Did you know our brains work overtime during stressful times. It’s likely that the holiday period will spark some serious brain activity!

The tobacco industry spends billions of dollars each year to market smoking as exciting, glamorous, and safe and it’s also shown in video games, online and in film. We have all heard the nicotine warnings over the last few decades and how it’s bad for our lungs, but should this message be updated? What do we now know about nicotine?

There are many in the community who aren't in any rush to get out and interact with others. Some feel anxious about Covid lockdown restrictions easing.

What have we learned from the last lockdown? Does having a job and being an introvert make it any easier?

As you may know, I’m a big fan of writing as a stress management tool. There’s even evidence to support the idea!

Do you ever struggle with explanations around mental health interventions? Do you need to learn some interventions that may be useful in your own life?

Once upon a time I would have baulked at any conversation about retirement. Even a chat about superannuation would have given me a vague feeling of nausea. For me, both subjects carried with them very unpleasant notions – old age, senescence, incapacity and burdensomeness.

A taxi driver asked me recently if I was still working. I hurriedly assured him that I was indeed “still working” as I was not yet old enough to retire – that, I’m afraid, was a lie!. What surprised me was the rush of emotion the question provoked and the amazing need to tell that lie. What is the matter with me?

We are all familiar with the notion of boundaries in clinical practice – in fact, most of us have spent a lot of time thinking about the subject and trying to work out where our professional boundaries lie.

Because COVID is not over yet it’s probably worth our thinking again about how we can optimise the benefits of our downtime, as well as manage the stressors at work.

I first encountered the concept of alexithymia when I worked with people suffering from eating disorders. Many people experiencing eating disorders have great difficulty identifying and naming their own emotions.

The answer to that question definitely depends on who you ask. Let’s start with the cynics and get them out of the way.

COVID and all its attendant inconveniences (I guess some would say “tortures”) has forced many of us to revise our personal wellbeing plans and dig out some old strategies that we haven’t used for a while. It’s also made some of us realise that many of the things that we thought were just parts of our normal life were, in fact, wellness strategies.

My patients are loving telehealth. They love it so much that most of them are saying they don’t want to come back to face to face consultations. You probably need to bear in mind that my patients are long-term therapy patients that I know very well.

Is Acadia running your life right now? Are you, like the solitary monks who used that term in the middle ages, suffering from the combination of boredom, frustration, agitation and lethargy that comes with physical isolation?

Like me, you probably spend a lot of time talking to people about how they feel about the COVID 19 pandemic, but do you talk to them about their thoughts and beliefs about it?

Right now, most of us are a bit upset in one way or another. Some of us are very upset. Stress, frustration, grief, anxiety, sadness, isolation, loneliness, worry about the present, worry about the future – all these things are rising to the surface in a world that’s being held to ransom by COVID 19.

At 65 and a half (yes, it’s come to that. I’m actually counting the months again!) I find myself reluctantly looking down the barrel of a shotgun labelled “old age”.  It’s OK, don’t panic – I’m not unwell. It’s just that my body hurts and people keep asking me when I am going to retire. What is that!

Has anyone heard that or a variation of it recently? I’ll bet you have! Many years ago, before I had kids of my own, I used to hear my brother-in-law saying to his bored and whining kids “Come on then, I’ll give you a job. I’ve got plenty for you to do.”

Sally* is the director of new urban private practice. She is a generalist psychologist & qualified teacher in her mid-forties with two ‘tween girls, and vulnerable (but fit) parents. Her clients include young children, teenagers, university students, school staff, NDIS young people, members of the LBGTI community and clients from EAP services..

It’s always helpful to hear how other people cope with life's challenges. Over the next few weeks we are dedicating the Being Well blog to a series called Being Well in Difficult Times. We've asked a range of health professionals 3 big questions to see if there was anything we could learn from them.

How would you feel if you were pregnant right now? It would probably add a whole other dimension to your concern. What if, to add to the puzzle, your work made you responsible for the mental health of others? Elizabeth* is a thirty-something school-based psychologist who is in the third trimester of her first pregnancy. This is how she is coping.

I keep wondering about what we can learn from all these people who live in isolation or confinement. What strategies were put in place and what might the long-term impact of their isolation have been?

Have you thought about what these measures are going to mean for you personally? Even if we avoid the need for self-isolation, we will all need to practice social distancing for possibly 6-12 months until we can all be vaccinated, or until we have developed immunity through exposure to the virus.

Put self-care into your web browser and you will not be able to see the end of the list of hits you get. I tried for “self-care strategies” and got 658 million hits! With so much information out there about how to look after ourselves it can be overwhelming. No wonder people close their ears.

This year I’ve decided to practice what I preach. I’m starting with something that has evolved from last year’s eye-opening experience with keeping a gratitude diary when, along with other members of my team at work, I participated in the 6-week Mental Fitness Challenge on the BiteBack website. BiteBack is a positive psychology-based website for ad

I had an interesting experience at my GP recently. I don’t go to the GP very often. Mostly I don’t get sick. Sometimes I treat my own ills or just soldier on. On the few occasions that I have been to see someone about something concerning me, my overwhelming experience has been of being judged and dismissed. I feel that they think that, as a doctor, I should have not only made the diagnosis but also treated myself. In fact, I should have been better way before I thought to come along!

I talk to a lot of health professionals and it amazes me how often people look at me blankly when I introduce the subject of self-soothing activities. As the conversation progresses I can see most of the blank looks turn to some degree of understanding as they begin to acknowledge the familiarity of the concept in their own lives, but GPs in particular are not generally familiar with the fact that teaching people about emotional management strategies is a core part of therapy, and an intervention that is entirely available to them in general practice.

At the RACGP annual conference this year (GP19) Dr Anita Elias spoke eloquently and persuasively about the psychological impact of young people’s access to, and use of, online pornography. It is no longer just a speculative idea based on clinical anecdotes. Research evidence confirms that viewing pornography at a young age is having a significant and damaging impact on young people’s sexual attitudes and behaviours and their emotional states.

Like many people with ageing brains I am concerned about the things I might fail to remember. My life is full of new experiences. I like to travel and while I’m away I take photos so I will remember those experiences  better (a bit like people with early dementia learn to write themselves notes) and so that I can share the memories with others.

We have been talking about mindfulness in mental health for some time. It’s sometimes hyped as the universal panacea for all things anxious and depressed. Easy, cheap and with no side effects!

If you are like me you know a lot of words that you know vaguely what they mean and can provide a definition but if asked to write a short article...

At the beginning of her book “Simple Self-Care for Therapists” Ashley Davis Bush starts by telling a story about a guest on her online talk radio show who introduced her to something she called her “Word of the Year Program”.

Recently I received a letter from a patient of mine. Joanna is a 50 something woman who suffers from recurrent unipolar depression. She has given me her permission to share her letter with you.

What do you know about Employee Assistance Programs and Providers? It’s all too easy as an employee or even as a mental health service provider to overlook the availability of EAPs, but they can provide useful and affordable support for many people facing mental health challenges in the workforce.

As I write this I am sitting at the window of my cabin on a Hurtigruten cruise watching the Norwegian Coast slide by and contemplating the value of holidays. I suspect I am not alone in saying that the trouble with holidays is that it doesn’t matter how far you go or how long you stay away, you always take yourself with you.

If you have a mobile device and a set of headphones the chances are you already know how great podcasts are to listen to on the run, on the bus or even while you do the ironing!

"Doctor’s experience chronic and unrelenting grief (often other people’s)"

Someone I know once knew used to say that - “Life is like a barstool – the more legs it has the better.” Our careers are just one of those legs. If that is the only leg we have to stand on, it won’t be long before we come crashing down to the floor.

Dr Brachman discusses the development of what is referred to as a new class of drugs that have been shown in her research to prevent PTSD and depression in mice.

Like most of us, I’m not very keen on the idea of aging - not when it applies to me or the people I love. Not aging the way most people think of it anyway.

In the country town where I grew up there was a GP who got very drunk at the golf club on a regular basis. His antics were a source of community amusement, and he had a lot of patients with similar alcohol misuse problems – mostly because he never talked to them about their drinking habits.

A friend of mine came to have coffee with me recently. She was very anxious and upset about her husband’s upcoming prostatectomy. He had developed a fairly aggressive cancer that needed immediate action.

Have you ever spoken to someone and thought “OMG! I would be depressed too if I were in their shoes”? Of course you have! But have you ever met someone who despite all the bad luck and set backs has remained optimistic and been able to make the best out of what would be for others an impossible and unbearable situation?

So much medical focus is on the deficits in people that those of us who work within the medical model tend to forget to look for people’s strengths. We may eventually even fail to see and value our own strengths as they become, in our own minds, just things that everybody has.

We could all do with a little improvement in our “mental fitness.” It would help us manage those moments of anxiety and low mood, but it would also help us manage the ordinary stresses in our daily lives.

There’s no question about it -if you don’t feel so well, if you are feeling stressed and anxious, smoking a cigarette will make you feel better for a while. Many a soldier for whom cigarettes were supplied as part of their daily rations, will tell you so.

Between 2007 and 2010 smoking rates in the general community dropped from 26% to 19%. For people with psychotic disorders the rate did not drop at all.

The Australian Birth Trauma Association https://www.birthtrauma.org.au/ defines birth trauma as “Psychological problems arising from the circumstances of the delivery ……...or the process” of childbirth.

In November 2017 the astronomical world was bubbling with excitement when the first interstellar object ever seen from Earth entered our solar system. Finally, after 8 months deliberation, the scientific jury decided that, despite lacking some of the usual characteristics, this object could indeed be classified as a comet.

I am volunteer youth and community presenter for the Black Dog Institute and I was lucky enough to get the opportunity to feature on the Being Well podcast series made by Black Dog. In my episode I talk about my experience of using the online mental health tool ‘myCompass’ to keep my headspace positive.

I used to be a proud multitasker. I heard somewhere, and I am sure you have heard it too, that women are better multitaskers than men. It was said with pride, and often attributed to the fact that women simply had to learn to multitask well in order to manage their diverse and competing responsibilities.

I made a big mistake last week. It has been a very busy time for me this half year. I’ve had a lot to do and much of it has been quite challenging – pushing the boundaries of what I feel skilled enough to try.

This podcast is en excerpt of the webinar where we discussed the recent advancements in the development of online tools and resources available that are potentially helpful in keeping people safe from suicide.

60-70% of the Australian community will experience a traumatic event at some time in their lives. These are events that have the potential to result in long term psychological complications. Only 20% of those people will develop symptoms of PTSD.

Have you ever wondered why depressed people find withdrawing from the world their best path? (If you’ve been depressed yourself you might also wonder why you do it yourself when you know you shouldn’t).

What do you do when you know you have a problem but you don’t know where to go for help? It’s a common dilemma.

This podcast is en excerpt of the webinar where we discussed the appropriate psychological services for LGBTI+ people with special reference to the services available online.

Do you need to upskill in mental health? 2018 is a brand-new year ripe for a new training resolution!

We need to take sleep seriously. We probably need to put as much emphasis on sleep as we do on diet and exercise if we are going to improve the wellbeing of individuals as well as the population as a whole. And that doesn’t mean taking pills to get more sleep...

Human emotions are a complex thing. Some scientists try to identify and classify emotions using electroencephalographic signals in the deep neural network. Others study body movement and gesture dynamics. Others concentrate on physiological indicators.

I find Christmas a bit stressful but I don’t think I’m alone in that. Everyone has a different basis for their Christmas stress and I know what my problem is. I want to make the celebration perfect for everyone.

– It’s never too early or too late to learn some self-soothing strategies.

It has become pretty clear in recent times that health practitioners are no less subject to mental health problems than the people they treat. More so perhaps! Why might that be?

Here’s something worth reading by Scarlett Winter, a 30 something woman in my practice. It’s her story of recovery from severe and longstanding anorexia nervosa and, although hers is a very specific diagnosis, there is much in it for us all to learn about recovery from mental illness generally.

The next Black Dog Institute / eMHPrac live webinar will be held on 15th November. It’s an auspicious date. It’s the date the results of the national plebiscite on marriage equality will be announced.

Many people who suffer from depression spend a great deal of time looking inward. Even when not depressed, they often have a contemplative or even ruminative style.

This podcast is the highlights of the webinar where we examined the non-pharmacological strategies available to patients with chronic pain and introduce participants to some useful online programs for chronic pain management.

Psychiatry is ideally suited to videoconferencing but there are perils and pitfalls that become apparent once you engage with it that can be quite discouraging. Our guest blogger is Dr Zelko Mustac, a Sydney psychiatrist who has worked for many years in Western Australia and is very conscious of the difficulty of delivering psychiatric care to rural and remote areas. Here is his story:

Humans of New York is an amazing blog. There is always something worth thinking about in its stories of ordinary people struggling with life. The stories are short and easy to read but each one contains an interesting message.

I bought an alarm clock recently. For some years I have used my smart phone as an alarm clock but I’ve noticed that at times of stress when I wake at night I’ve been reaching for my phone and checking my emails. That’s just crazy! There is no expectation on the part of my employer or my patients that I will work in the middle of the night but it has become reflexive and obsessive.

Trying to decide what online mental health treatment programs to use can be difficult. There seem to be so many of them! Which one will be easiest to use? What style is best? Should I choose something specific for the problem or something more general?

Questions exist in the minds of most parents and carers about their teenagers’ use of digital technology. How much is too much?

I think I’ve finally found a cognitive reframe that works for me – and it’s all about terminology.

Many of my consultations these days include some discussion of the distress my patients are feeling about something they have seen or something that has been said or done to them on social media. Often it’s just a misunderstanding by a sensitive and vulnerable person. But it is sometimes due to deliberate attempts by others to upset and disturb them.

Managing bipolar disorder is challenging for patients and practitioners alike. Making the diagnosis in the first place is often a challenge, but once it’s made many patients and their health care practitioners are unaware that there’s more to managing bipolar disorder than juggling the medications and doing the blood tests. Listen to the podcast and read the blog.

Is that a typo in the title? Should it say hugs? Well, “hugs” is getting close but not really quite there.

Do you feel comfortable about using computers to help people with their mental health? If not you are not alone and this might give you some insight into why you feel that way. Earlier this year I read a book called The Sudden Appearance of Hope by Claire North, a pseudonym belonging to British author Catherine Webb. The story revolves around two interesting ideas.

Black Dog Institute’s Lifespan integrated suicide prevention research project includes an arm of mental health education in schools. The schools-based program is a local adaptation of Youth Aware Mental Health (YAM), a program developed at the Karolinska Institute in Sweden. The YAM program has, in longitudinal analyses, been shown to be effective in reducing depression, negative emotional symptoms, conduct problems and suicidal ideation, plans and attempts.

Podcasts are a great way to get a dose of education or relaxation without having to stop whatever else it is you are doing. I listen to This American Life on long drives from one workplace to another, to the BBC Comedy shows while exercising (I need something to take my mind off the pain of it all) and to Radio Lab while I knit or make jewellery or cook dinner.

“Cognitive bandwidth” is a term you may not have heard but a concept that makes sense from the minute you encounter it. In severe depression, and severe anxiety for that matter, concentration and focus are sufficiently impaired that any attempt to try to think differently is fairly futile.

As you may know, my current favourite TED Talk presenter is Swedish Professor Hans Rosling. In a talk I’ve mentioned before, the professor demonstrates in his inimitable way that none of us is very good at guessing the answers to questions about the world.

I was talking to a friend just recently, a well-educated, switched, on double degree carrying medical doctor, and discovered he did not know what a TED Talk was. “How does that happen?” I thought.

In clinical practice many of us see the sad results of homophobia and prejudice. Marriage aside, as GPs we need to know how to help members of the LGBTI community who are experiencing mental health problems.

Julia Reynolds and the team at ANU have supplied a very neat framework for the answer to the question of how to use eMH resources in primary care. I’ve modified it a little for general practice...

In a survey of health professionals conducted by the National eTherapy Centre, 70% of health professionals surveyed were using internet interventions with patients, but this was focused on referring clients to self-help and educational web-based interventions.

Since 2012, 17,000 people have signed up to use Black Dog Institute’s web-based ‘myCompass’ program. What is it?

It’s an old story rising up again. What do doctors do when they experience mental health problems?

Attendees are expressing two big areas of concern in the eMHPrac webinars: suicide and internet security. On each of our webinars our experts have answered these questions as they apply to their own programs.

GPs seem to fall into two groups when it comes to mental health. There’s the group who feel confident and skilled and the group who don’t.

Yesterday I almost cried in the middle of a consultation. I was just back from 2 weeks holiday and one of my regular patients, a young woman  with a big problem with self-harm, came to tell me that...