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Mental health moocs – Free online courses

25 Aug

FutureLearn The Mind is Flat.Update small

Scroll to the foot of the post for updates on newer courses



One day about a month ago, I introduced two people at the day centre to the concept of the “mooc” – the massive open online course. They were so thrilled that I thought I’d do a little blog about them, to share them with others who might not know that there’s a wealth of online courses from some of the world’s top universities available free of charge.

If you’re looking for courses, a good place to start is FutureLearn from the Open University (@futurelearn, @OpenUniversity) and Coursera (@coursera). FutureLearn only went live this year. Coursera has been running for longer and offers courses from mainly US universities (bear in mind that, in the field of mental health, US thinking and teaching can be very different to that elsewhere). There are many different courses, at all levels, from improving your writing skills through to niche high level academic courses.

Please note:

  • All courses and course material are free of charge. There is no charge to participate in the course. All you’ll need is online access to be able to read or watch course material and to take online progress quizzes and so on. If there’s material to read, it will be available online or to download (for instance, selected book chapters).
  • Typically courses are composed of lots of bite size chunks, including videos, material to read, progress quizzes and end of section reviews.
  • One of the really helpful aspects of moocs is the way they’ve been developed to facilitate online interaction between the (sometimes) thousands of online participants. For instance, courses may have online discussion forums where people can post questions and receive answers from fellow participants. There may also be online groups you can join if, say, you want to take the course in a hurry, at a more leisurely pace or if you’re from a particular country. And, if there isn’t one to suit your needs, why not set one up yourself?
  • Some providers offer optional extras for a small fee, including:
    • Certificate of completion (if you want to have evidence you’ve competed the course, for instance for a CV or job application)
    • Recommended course textbook (there may be a discount rate for course participants buying a recommended book)
  • All courses are complete and beneficial in themselves. However, some may also whet your appetite to take a longer fee-paying course with the same institution. The stand-alone course is worthwhile, but afterwards you may receive online marketing for a related fee-paying course. It’s easy to opt out if you’re not interested.
  • Many moocs will be re-run periodically so, if it’s too much the first time round (I couldn’t join the dots the first time I tried a mooc, which was a bit frustrating), you can always try again later. Or go for a different course.

If you’ve got a particular area of interest, have some spare time on your hands, or want to take your mind out for a little walk to see how it does, why not sign up for a free course? Give it a go. Here are some courses I’ve come across related to mental health. Let me know if you come across others so I can share them here.


Courses that started recently (you can still join) or are currently open:
  • The Clinical Psychology of Children and Young People“The course will cover the basic guiding principles of the Clinical Psychology of Children and Young People and illustrate how theories of psychological development can be applied in understanding children and young people’s mental health and well being within a wider societal and cultural context. We will also discuss current psychological models of prevention and treatment for Children and Young People. University of Edinburgh (@UniofEdinburgh) (Coursera) – 5 weeks of study, 1-3 hours of work per week – Started 28th July, runs to 7th September
  • Introduction to Psychology“This course is all about you … your mind, your behavior, and what underlies them both. It will be a fast paced tour of the most important experiments in psychology, one that is intended to fascinate, inform, and provoke deep thought. Come learn about yourself with us!”University of Toronto (Coursera) – 8 weeks of study, 4-6 hours of work per week
  • Social Psychology – “Ever wonder why people do what they do? This course offers some answers based on the latest research from social psychology.” – Weslyan University (US) (Coursera) – 7 weeks of study – 4-8 hours of work / week – Started 14th July, runs to 15th September


Upcoming courses:
  • Major Depression in the Population: A (US) Public Health Approach“Illustrates the principles of public health applied to depressive disorder, including principles of epidemiology, transcultural psychiatry, health services research, and prevention.” – Johns Hopkins University (US) (@JohnsHopkinsSPH) (Coursera) – 7 weeks of study, 2-4 hours of work per week, starts 3rd November
  • The Mind is Flat: the Shocking Shallowness of Human Psychology – “Make better personal and professional decisions and consider the psychological dimension to key ethical and political choices.”University of Warwick (FutureLearn ) – Duration 6 weeks, 5 hours study per week – Starts on 13 October – #FLmindisflat
  • Psychology and Mental Health: Beyond Nature and Nurture“How a psychological understanding of our emotions and behaviour can give us new ways to improve mental health and well-being.”University of Liverpool (FutureLearn ) – With professor of clinical psychology Peter Kinderman (@peterkinderman) – 6 weeks of study, 3 hours per week – Starts 8th September


Courses that may run again if enough people sign up:
  • Drugs and the Brain“The neuroscience of drugs for therapy, for prevention, and for recreation.  Drug addiction and drug abuse. You’ll learn the prospects for new generations of medications in neurology, psychiatry, aging, and treatment of substance abuse.”Caltech (US) (Coursera) – 7 weeks of study, 4-6 hours of work per week
  • The Social Context of Mental Health and Illness“Learn how social factors promote mental health, influence the onset and course of mental illness, and affect how mental illnesses are diagnosed and treated.”Toronto University (Coursera)
  • Why We Need Psychology“For adults with an interest in the study of human behaviour – especially those who have often considered studying psychology but who have yet to begin.”University of London (Coursera) – 6 weeks of study – 8-10 hours of work per week


  • Medicines Adherence: Supporting Patients with their Treatment “How can healthcare professionals help patients to improve their health through medicines adherence?”Kings College London (FutureLearn) – Duration 2 weeks, 2 hours per week, started 25th August – A course to teach doctors, nurses and other healthcare professionals how to get patients to adhere to treatment. Wouldn’t it be nice if medics were taught to work in partnership with patients?



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Tweet chats part 3: Troubleshooting

17 Dec

Twitter cup cakes

Following parts 1 and 2, here is the third instalment of my introduction to tweet chats. Most tweet chats are great fun and informative, though occasionally you can run into problems. Here’s some advice, just in case things start to go wrong.


  • The tweet chat is too fast – I can’t keep up!

    Tweet chats are meant to be enjoyable, so don’t worry about missing things. Popular chats can move very fast. Just follow the topics or lines of conversation that interest you, and chip in when you can. You can always catch up later by reading the transcript.

  • I’m a bit lost / I don’t understand!

    Lurk for a bit to try to tune in, but don’t be afraid to speak up and ask for help. Generally, tweeps are a friendly bunch who really enjoy helping others. And, if you have a question about what’s going on, there are bound to be others thinking the same thing.

  • Someone’s arguing with me!

    It’s fine to disagree on a tweet chat, and often controversial topics are chosen to generate heated debate! But keep it to a discussion, not an argument. If you don’t want tweets from a particular tweep, block them and ignore them in the tweet chat. Simples.

  • I’m being harassed, intimidated or abused!

    Sometimes people can get passionate about a topic they care about. Sometimes misunderstandings can occur, given the brief nature of the tweet. Sometimes a tweep or two will be downright nasty. If you feel you’ve been harassed, intimidated or abused in a tweet chat, here are some options to consider:

    1. Take a screen shot of the offending tweets. This provides a record for later.
    2. Save the offending tweets using a service like Storify – ditto.
    3. Block and report the offending tweeter using the button on the screen. If enough people do this, it can result in their account being suspended temporarily. And, at the very least, you won’t have to see their nasty tweets any more.
    4. Send a direct message (DM) to the tweet chat organiser. They may be able to take action at the time or (more likely) afterwards. (You’ll both need to be following each other to be able to send a DM.)
    5. Email the tweet chat organiser with copies of the offending tweets.
    6. If warranted, report the matter to your local police. You’ll need copies of the offending tweets as evidence.
    7. If the offending tweets are from a professional (such as a doctor, nurse or solicitor) whose conduct online is governed by a code of professional conduct (like one of these), consider reporting them to their governing body. You’ll need evidence for this.
  • Someone’s spamming the hashtag / trying to derail the tweet chat!

    Sometimes someone will spam the hashtag or try to derail the tweet chat for their own purposes (eg to push their own agenda or promote a product). Consider whether any of the measures above may be appropriate (other than calling the police). Or just ignore the tweep.


Here are some suggestions received earlier:

  • If in doubt … pause. – Ian Hulatt (twitter @IanHulattRCN)
  • Enlist someone to back you up in helping lead the chat to greet people, catch important questions or take over if you have technical problems. – Nedra Weinreich (twitter @Nedra)

If you have some personal favourite top tips for tweet chats or have comments on mine, let me know by adding them to the comments below – or tweet me!


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Merry mental health Christmas !

7 Dec
My photo of Santa with baubles

My photo of Santa with baubles

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Scroll down for Christmas 2014 ideas



With Christmas just 3 weeks away, here are some gift ideas on a mental health theme. They might be gifts for a friend or family member who’s managing a mental health problem themselves. Or perhaps that’s you and you want to help others understand the issues a bit more, or need ideas for gifts on a budget.

If you have more suggestions, please tweet me or add them to the comments below. Here are some suggestions I’ve received from the lovely twitter people so far (and here are lots of interesting book recommendations too).

The following gift ideas are covered:

  • Christmas cards from mental health charities
  • Subscriptions and memberships
  • Different ways to make charitable donations
  • Gift voucher ideas
  • Free and low cost gift ideas with a mental health theme if you’re on a budget or prefer to do stuff rather than buy stuff (my favourite way of giving gifts)
  • General well being and quirky gift ideas


Christmas cards:

  • Rethink Mental Illness  – £3 pack of 8 cards (plus £1 postage)
  • Sane – Packs of 10 ranging from £2.95 to £3.95, with free postage for orders over £15

Here’s a website (Combined Charities Christmas Shops) which sells Christmas cards and goodies for all sorts of different charities.


Subscriptions & memberships:

Why not give a magazine subscription or membership of a mental health charity to spread mental health awareness?

  • £10 – One in Four magazine subscription – Just £10 for 4 glossy magazines a year! “Want real life stories from people who’ve been through it and lived to tell the tale? Want the latest news, views and opinions? One in Four is a glossy full colour quarterly 32-page quarterly magazine written by people with mental health difficulties who lived lived through it and found ways around it.  It’s the perfect guide to getting stuff in your life sorted.”
  • Membership of one of the mental health charities:
    • £6 (unwaged) or £26Mind annual membership“Become a Mind member and we’ll keep you up-to-date with all of the latest mental health news. We’ll let you know about Mind events and groups in your area. And we’ll support you to get your voice heard. A standard one-year membership costs £26. A one-year membership if you are unemployed, receiving benefits, retired or a full-time student costs £6.” Members receive the quarterly Mind Membership News magazine; regular email newsletters; a 10% discount on Mind’s publications; the chance to vote for our trustees and to become a trustee yourself; Mind membership card.
    • £2 monthly or £24Rethink Mental Illness membership“As a member you can help to make a difference and be involved in many different ways. As a member you’ll get an enamel badge & welcome pack, an invitation to our spectacular annual event, National Members’ Day, our quarterly membership magazine Your Voice, opportunities to have your opinions and ideas heard by people who help shape mental health policy & involvement in the governance of Rethink Mental Illness.”
  • £10 – 3 Rethink sleep packs (or £65 for 20 sleep packs)You can probably relate to the experience of a restless night’s sleep and the effect this can have on your mood, emotions and management of day-to-day tasks. You may have even said, ‘all you need is a good night’s sleep’ – more often than not, this advice is true. With your help we can help a person with mental illness at their lowest point; they can be welcomed into a crisis house as an alternative to hospital admission. Here, they are in a calm and safe environment. And now with the introduction of Sleep Packs, we’re hopeful that people will have the best possible start to their recovery. It costs just £3 to fill each Sleep Pack with these simple but crucial items, please give the gift of sleep and help improve someone’s life. Thank you.” Each sleep pack contains an eye mask, ear plugs, lavender essential oil and bubble bath, a sachet of milky drink plus top ten tips for a better night’s sleep.
  • Subscription to a mindfulness site – for example Headspace (you can try for free beforehand)

    The Big Give Challenge #TBGchallenge

    The Big Give Challenge #TBGchallenge


Charitable donations:

One idea for a Christmas present is to make a donation to a mental health charity on someone else’s behalf. You’d then give them a Christmas card which mentions your donation.

  • Buying presents through certain sites means a donation will go to a mental health charity – for instance, Give as You Live (twitter @giveasyoulive) – “Shop online at your favourite stores and raise funds for charity – at no extra cost, just by shopping online!”
  • Sometimes a donation will be doubled – eg through organisations like The Big Give which have pots of matched funding that open at given times (and run out, so you have to get in quickly when you hear they’ve opened!). Here is a list of charities The Big Give currently matches funds for, including ones with a mental health theme in the UK and overseas.
  • Make a one off donation or a regular donation to a mental health charity, such as:
    • Mind
    • Rethink Mental Illness – one off or regular donation
    • Sane“Please give a gift to improve mental health. Each £10 enables one person to receive the precious gift of 30 minutes personal and emotional support, helping them on their journey from crisis to recovery. To thank you for your generosity, SANE will send you a Black Dog Campaign #StopStigma wristband for each donation that you make.”
    • There will also be many local mental health charities you can donate to. Please let me have details if you’d like one added.
    • Here’s one I spotted today: “5 Quid for Life is a small charitable trust which provides financial support to people with mental health problems who have lost their benefits as a result of the UK government’s welfare reforms.” (twitter @5quidforlife) [NB: The organisation says it’s too small to register with the Charities Commission, so I’m not sure about regulation or transparency or the establishment of the trust.]
  • Please bear in mind that, if you are a UK tax payer, your purchase or donation may be increased by HMRC by an extra 25% if you make a gift aid declaration at the time you make your donation.


Gift vouchers:

  • An NHS prescription prepayment certificate – A humorous and serious suggestion from Larlot ‏(twitter @CharmandersFire), as an alternative to an M&S or Boots gift card! If you’re not entitled to free prescriptions, a prescription costs £7.85 per item, but a 3 or 12 month PPC covers all your prescriptions for that period, no matter how many you need. £29.10 for 3 months or £104 for 12 months.
  • Buying a voucher for something that will make a difference. There are lots of shops and online services that offer vouchers for anything from a massage (lots of tweeps recommended this one!), or haircut to a visit somewhere unusual like a bird of prey sanctuary.
  • Home-made gift vouchers. This is something you’ve paid for (or will pay for when it takes place) and write out yourself in a card, such as:
    • a cleaner to visit and help your friend or family member get on top of their cleaning
    • personal trainer to come round for a few sessions, to get your friend and family member started if they’ve put on weight and are having trouble getting motivated or putting together a plan.
  • Personal IOUs (see below).


Mental health books, CDs and DVDs:

Lots of interesting books recommended as Christmas gifts by some of the lovely twitter people are included here. What are your ideas for a good mental health book gift? That might be:

  • A biography or life story of someone living with a mental health problem or who’s got through adversity – either to help the recipient understand more about your (or someone they know’s) mental health problems, or to provide inspiration from someone who’s overcome adversity
  • A book on a practical skill they’ve said they want to learn
  • A self-help book that you think the person might find useful or inspiring (though that’s probably a delicate balance – I once received a Jane Fonda work out video and, whilst I did have a few pounds to lose, it wasn’t necessarily the present I wanted to receive! It might be best to keep the self-help books to ones you’ve discussed with your friend or family member and which they’ve shown an interest in reading)

    Science Museum: Mind maps - stories from psychology

    Science Museum: Mind maps – stories from psychology

  • An uplifting arts book
  • Something on their hobby or special interest


Free and low cost gift ideas:

  • Personal IOUs: Give an IOU slip or card for something you can do (a skill you have) that your friend or family member will value. For instance, an IOU offering/promising:
    • for them to come round for tea and cake, or a Sunday roast
    • to do their washing up 5 times
    • to help them go shopping / choose a new mobile phone contract /change utility provider
    • to take their dog for a walk
    • to knit them a jazzy scarf
    • to go out to a free event or venue, such as a city farm, park, festival, museum, talk or event (such as this one from Dr Tom Werner, Mind Maps: stories from psychology, on at the Science Museum in London)

    Be imaginative! The thought you put into choosing what to offer to make the IOU personal, and the time it will take you to fulfill your promise, is what shows you care. And take responsibility for setting a time and date and organising the whole thing to make sure it does go ahead!

  • Challenge yourself by signing up yourself and a friend to a fundraising event with one of the mental health charities. There are lots of ways to get involved (or you can organise something yourself,) and it can be a fun way to get out and do something unusual and possibly get fit! Here are some ideas from the Mental Health Foundation.
  • Simple hand-made crafts. Don’t worry about them being perfect as it’s the personal touch and the time and effort you’ve put in that counts. For example:
    • Hand-made Christmas cards. You can often buy packs of 10 blank cards and envelopes in pound shops that you can decorate yourself with a bit of glue, glitter and imagination.
    • Hand-decorating a Christmas bauble. You could even make a different one each year, so a little collection grows.
    • Hand-made sweets or edible Christmas decorations strung with ribbon to hang on the tree.
  • Free e-books. There are thousands of books available free of charge and you can download them onto any computer (you don’t need a Kindle or other e-book reader). These might be about a specific diagnosis, a real life story or general well being. You could download these for your friend or family member, or send or give them a link to suitable ones. You’ll have done the research or running around, which will be appreciated.
  • Plants. If you’ve got a window box, garden or allotment, you can often dig up the odd plant or two to give away as an inexpensive gift.


General well being and quirky gift ideas:

  • Give the gift of comedy, such as these DVD suggestions from Seaneen Molloy (twitter @Brain_Opera) or tickets to a live stand up show. Some places have open mic nights which are free – and you never know, the acts could be really good!Dopamine earrings
  • Dopamine molecule earrings (recommended by twitter psychiatrist @Dopamine_Diva)
  • My favourite: lavender bath soak!
  • Socks. You can never go wrong with socks.
  • A SAD (seasonal affective disorder) light box or sunrise wake up clock


Hopefully that’ll have given you a few ideas for gifts with a mental health theme. Feel free to leave your comments and suggestions below – or tweet me!

Finally, some tips for good gift giving:

  • ‘Tis the season to be jolly. Don’t leave it till the last minute so you’re stressed and rushing. Enjoy the pleasure of getting gifts for people. Either gather together gifts slowly over time – or go out one afternoon and get everything in one go then be done with it.
  • The “perfect” gift. It’s not important to get the “perfect” gifts for every one. What matters is you’ve thought of that person and got them something, no matter how small or how little it cost to buy.
  • Children. When buying for related children, remember they won’t know how much you spent: just make sure you give the same number and same size gifts!
  • Your time, thought and attention are the best gifts you can give.



Update smallUpdated ideas from the lovely twitter people for Christmas 2014!



Tweet chats part 2: What to expect and some do’s and don’ts

3 Nov

Tweet tweet Cobalt 123

Last month, I put together a beginner’s guide to tweet chats. Here, I develop that further, sharing some more of the things I’ve learned along the way about tweet chats. The aim is to help those new to tweet chats to join in and get the most from them!

If you’ve ever wanted to take part in a tweet chat, wanted a few tips to help you along, or wanted to send someone else a guide to encourage them to join in, I’m hoping my tweet chat guides will be a good starting point. In part 1, I covered:

  • What is a tweet chat? – tweet chats in a nutshell
  • What’s in it for me? – what can I gain from participating in a tweet chat?
  • How do I follow a tweet chat? – how do I sign up and join in?
  • How do I find tweet chats?

Here in part 2, I cover:

  • Tweet chat do’s and don’ts – some suggestions for getting the most from your tweet chats
  • What can I expect during a tweet chat? – The 8 stages of a (well-run) tweet chat. This might also be helpful if you’re thinking of running your own tweet chat

If you have some personal favourite top tips for tweet chats or have comments on mine, let me know by adding them to the comments below – or tweet me!

[Update: Here’s tweet chats part 3]


Tweet chat do’s and don’ts:

Here are my suggestions for getting the most from tweet chats.

  • Have fun! … Or at least get something positive from it.
  • Use the hashtag. Use the hashtag. Use the hashtag. Er so, in other words, remember to use the hashtag in every tweet. That way, peeps following the tweet chat in or equivalent (see part 1) will see your contribution to the conversation. No hashtag, no visibility in the tweet chat. Simples.
  • Don’t be afraid to ask! If you have a “stupid question”, there are bound to be others with the same query too.
  • Encourage and help others. You’ll soon learn that Twitter people love to help others. And, soon enough, you’ll be offering your own advice and examples to newbies too.
  • Debate – don’t argue. Do feel free to disagree and engage in robust debate! On the other hand, don’t turn it into an argument or slanging match.
  • Give people the benefit of the doubt. It’s easy for misunderstandings to arise in 140 characters, especially in a fast moving tweet chat.
  • Take care of yourself. Tweet chats can sometimes be pretty intense and stimulating – a bit of a bear pit – especially the popular ones. Is this what you need right now? Sometimes, it’s a good idea to just lurk – you can always catch up later with the transcript.
  • To swear or not to swear – it’s a contentious issue. Some feel uncomfortable with swearing in tweet chats, finding it aggressive and rude, and will back off from engaging. Some feel strongly that Twitter should be a reservoir of courtesy and will claim the moral high ground if “language” is used: for them, one swear word is enough to invalidate any otherwise valid point you may have made. Forever. So be warned.
  • If you’re a professional, be professional. Take a look at your professional code of conduct (if you have one) for advice on how to conduct yourself on Twitter. Some professional duties apply at all times, even when off duty.
  • Respect the topic. Tweeps have come together to discuss a particular topic, so keep your contribution relevant. Questions and comments are encouraged, but please don’t try to derail the focus of the chat. If it’s a topic you’re unsure of, maybe read up a little in advance so you can get something out of it. If unsure, consider contacting the tweet chat organiser in advance for guidance.


What can I expect during a tweet chat?

A well-organised tweet chat will typically have the following 8 stages. And, if you’re thinking of organising your own tweet chat, this is how I’d recommend doing so.

  1. Advertising – In advance of the tweet chat, the tweet chat organiser will give notice that the tweet chat will take place. This might be on a tweet chat listing, in a blog post or via social media such as twitter. Some tweet chats are general get togethers at a particular time using a hashtag, whereas others will have a topic set by the organiser. Sometimes the organiser will post links to brief reading material or questions to be discussed.
  2. Advance notice – In advance of the chat (for example, at the same time the week before; at the same time the day before; and then starting from a couple of hours before), the tweet chat organiser will tweet reminders of the time, and hashtag, together with any topic, reading material or questions.
  3. Introduction – At the start of the tweet chat, the organiser will introduce the topic to be discussed, and tweet links to any advance reading or guidelines.
  4. Hello’s – As tweeps join the chat (whether to lurk or participate), some will say hi (and later goodbye). Many will not and will just tweet in when they have something to say! (I’m usually one of those!) Tweet chats generally take a little while to get going, so don’t be afraid to lurk till you catch the vibe.
  5. Questions – To get the tweet chat going (and to give it a boost if it starts to flag), the tweet chat organiser may post questions at the start and along the way. This helps to prompt and guide the discussion. Feel free to respond to these questions at the time or later. But you don’t need to respond to the questions specifically: they are just a guide.
  6. Conclusion – The tweet chat organiser will give an alert when the tweet chat is coming towards the end, so people can make last minute points, then draw it to a close. That’s the end of the official tweet chat – though of course you can keep on tweeting. These tweets may not make it into the official transcript (see below) – but they may be the part of the tweet chat you get most from. This is especially so if you prefer a slower pace, or if you’ve made connections you want to follow up.
  7. Transcript – Some tweet chat organisers will post a transcript of all the tweets made using the hashtag shortly after the event (or the next day), together with a summary and maybe a word cloud. This can be a helpful catch-up, whether or not you participated in the tweet chat.
  8. Follow up – One of the great things about participating in tweet chats is you can find interesting new people to engage with, so you’ll find tweeps following each other and making contact long afterwards.

I hope that’s given you an idea of what to expect from a tweet chat and how you can get the most from taking part. Let me know you top tips for tweet chats!


Still to come:

  • Tweet chat trouble shooting – some tips for when things go a bit eek!
  • Mental health tweet chats – links to popular ones, how to find others & some extra things to think about



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Tweet chats for newbies: Getting started

13 Oct

Snow White bluebirdUpdate small


See also Part 2 (tweet chat do’s and don’ts; and what you can expect during a tweet chat) and Part 3 (tweet chat trouble shooting)


Whenever I have the chance to participate in a tweet chat, I always get a great deal from it. Whether it’s finding interesting new people to follow, learning something new, or having a view challenged or confirmed, it’s never dull.

I’d been on Twitter for a while before I learned what a tweet chat was, another little while before I dipped my toe in the water and it was another while longer before I realised I didn’t have to sit at a computer watching tweets then tweet in on my phone! If you haven’t heard of tweet chats, are curious but cautious or would like a little help to get you going, here’s my introduction – what Americans would probably call “Tweet chat 101” – in the spirit of sharing.

Initially it was one big fat blog post, so I’ve broken it up into bite-sized chunks, of which this is the first. It covers the following topics:

  • What is a tweet chat? – tweet chats in a nutshell
  • What’s in it for me? – what can I gain from participating in a tweet chat?
  • How do I follow a tweet chat? – how do I sign up and join in?
  • How do I find tweet chats?

Follow up posts will cover topics such as:

  • Tweet chats on mental health topics with links to some of the best!
  • What can I expect during a tweet chat? – what format does a well-run tweet chat follow?
  • Tweet chat do’s and don’ts – tweet chat etiquette & suggestions for getting the most from your tweet chats
  • Tweet chat troubleshooting – some common problems and what to do about them

If you have some personal favourite top tips for tweet chats or have comments on mine, let me know by adding them to the comments below – or tweet me!


What is a tweet chat?

A tweet chat (or Twitter chat) can simply mean a spontaneous discussion on Twitter between several tweeps (people with Twitter accounts) on a particular topic. In this post, I use the term to mean when the following:

A tweet chat is when people with a common interest gather together on Twitter at a designated time to discuss and share ideas.

So that everyone interested can follow along, people include a unique tag (#) called a hashtag (such as #mhchat) in each tweet. Typically a tweet chat will take place once a week or once a fortnight and will last an hour.

What’s in it for me?

What can you gain from participating in a tweet chat? The benefits depend to a large extent on why you’re using Twitter in the first place. There are so many different reasons. In general, however, here are some good reasons to join in:

  • Find follows – Engaging in a tweet chat on a topic you’re interested in can be a great way to find like-minded people to follow from amongst the millions around the world on Twitter – and to make new online friends – in one concentrated blast.
  • Share and learn – A tweet chat is an excellent way to communicate and share knowledge on a topic- and to learn in ways you may never have anticipated.
  • Engage – As tweet chats are open. public and in real time, you get the opportunity to engage with, make an impact on and learn from people you might never meet in real life.
  • Spread awareness – Engaging in tweet chats can help you spread awareness of your own brand and ideas, and create content and connections to enhance your personal influence. That’s a bit of a mouthful but what it means is that, if you’re starting out or branching out, tweet chats can give you a leg up.

How do I follow a tweet chat?

First, you’ll need to sign up to get a free Twitter account. Then, once you’ve found some relevant chats (see below), you can check the designated hashtag at the time the chat is scheduled to take place. Alternatively, follow the tweeps who run the chats (the organisers or moderators) to get updates on their upcoming sessions.

This is what you'll see when you first log in to - type the hashtag into the box

This is what you’ll see when you first log in to (though with your Twitter background, not mine) – type the hashtag into the box

Once a tweet chat starts, an easy way to follow along is to use a free service like TweetChat (the one I use) or Twitterfall. Just log in with your Twitter user name and password, type the relevant hashtag in the box in the top middle … and you’re off!  (You can also follow a hashtag in services such as  Tweetdeck or Hootsuite: set up a search for the hashtag, and all of the tweets with that hashtag should show up in the search window.)

Only tweets which include the hashtag will appear on screen; they’ll be in a stream, updated as new ones come in – like the screen below right. This means you won’t be distracted by seeing tweets by people you follow who aren’t using the hashtag; and you won’t miss out on tweets by people you don’t follow.

You can watch the chat, tweet into it and reply to others’ tweets – all at the same time, in the same screen

This is what a tweet chat looks like in (though it will have your Twitter background)

This is what a tweet chat looks like in (though it will have your Twitter background)

Popular tweet chats can have tweets coming in at a furious rate, so you might want to just observe (“lurk”) for a while – maybe even the first couple of times – till you feel comfortable joining in. When you want to tweet into the chat, remember to include the relevant hashtag so others following the chat can see them. If you’re signed in with a service like TweetChat, the hashtag will be added automatically.

How do I find tweet chats?

To find a relevant tweet chat, ask tweeps you know, search Twitter or search online for “tweet chat schedule”.

In my next post on tweet chats, I’ll post tweet chats which cover mental health topics. In the meantime, if you have some personal favourite top tips for tweet chats, have comments on mine or know of some great tweet chats, let me know by adding them to the comments below – or tweet me!


Web links thumbnail.




Help yourself! What are your favourite free online mental health resources?

9 Oct
My photo of Souzou: Outsider Art from Japan at Wellcome Collection

My photo of Souzou: Outsider Art from Japan at Wellcome Collection


Update small.

More links have been added below (scroll down) – please keep them coming!



In the resources section of my website, I have a little page tucked away entitled self help. It’s where I’ve posted links to useful online resources to help you manage your mental health. It’s a random collection of what I happen to have stumbled across, mostly on twitter. I have to admit that I haven’t tried any of them personally – but they come highly recommended.

I’d like the page to be as helpful as possible – and I also know there will be things out there that I’d find useful myself, if only I knew about them! – so I’m inviting suggestions of free online resources that you have used and found helpful – or, alternatively, ones that you’d recommend people steer clear of! I’d like to mine the hive mind and see what we can come up with to help ourselves – so we can side-step those pesky waiting lists for treatment or do our best whilst waiting for treatment.

So far, my self help page includes links to three areas:


Free online cognitive behaviour therapy (CBT)

What is CBT? As Living Life to the Full describes it, “CBT is a structured form of psychotherapy that aims to alter the unhelpful thinking (cognitions) & behaviour that commonly occur during times of distress.” The 4 resources I’ve come across so far are:

  • e-couch – An online programme for preventing and coping with depression, generalised anxiety disorder and social anxiety
  • Living Life to the Full (twitter @llttfnews) – This was recommended to me during a ward round. It’s a free life skills resource teaching practical skills using CBT. The strapline is, “Be happier, sleep better, do more, feel more confident” – which sounds pretty good to me!
  • MoodGYM – An Australian National University training programme that teaches CBT skills for preventing and coping with depression.
  • Moodjuice – A site developed by Choose Life Falkirk and the Adult Clinical Psychology Service, NHS Forth Valley. The site is designed to offer information, advice to those experiencing troublesome thoughts, feelings and actions.


Free online mindfulness

What is mindfulness? It’s a method of mental training, a simple form of meditation that can be quite quick to do – and can be done any time, any place, anywhere. The resources below include guided mindfulness exercises you can listen to online or download for later.

  • Frantic WorldFree meditations from mindfulness, taken from the book ‘Mindfulness: Finding Peace in a Frantic World’. The book contains the complete 8 week mindfulness course developed at Oxford University.
  • Free Mindfulness – A collection of free-to-download mindfulness meditation exercises.“
  • MindfulFree online audio and video mindfulness instruction, online courses in mindfulness and other resources
  • UCLA Mindful Awareness Research CentreFree guided meditations


Free online bipolar disorder resources:

  • Beating Bipolar“Beating Bipolar is an interactive internet based programme that aims to improve understanding of the condition. It includes video of professionals and people with lived experience of bipolar disorder and discuses various approaches that many have found to be beneficial.”


Have you used a free online resource that’s helped (or hindered!) you to manage your mental health? If so, I’d really appreciate it if you could share that with me – so I can share that with the lovely twitter people and readers of this blog. I know you’ll have some great ones, so I’m really looking forward to being able to add them to this blog … and thank you in advance!

.Update small


UPDATE: Here are some of the fab links I’ve been sent already (they’ll be added to the self help page shortly):




Madsplaining … as it was mansplained to me. On offering advice to people with mental health problems

18 Aug
The Yolkr - teach your granny a new way to suck egg yolks from egg whites

The Yolkr – teach your granny a new way to suck eggs (or at least to suck yolks from whites)

Madsplaining: Offering unsolicited advice to someone on how they should manage their mental health (especially by peers and mental health professionals)

On twitter (and no doubt on other social media platforms), we mental health folks share a lot of detail about our lives. We talk about our good and bad experiences of mental health treatment, medications, symptoms, cheese sandwiches, our lives in general. Sometimes, when someone’s sharing a problem they’re experiencing with managing their mental health, other tweeps – those with lived experience or mental health professionals (or both) – will chip in with helpful tips.  We can be a sharing, caring bunch.

“Oh, I tried X and it works wonders for me. Why not give it a go?” “I saw a documentary about this new thing the other day that I thought would help you with that thing you mentioned.” Sometimes this moves towards more generic helpful tips, along the lines of, “Have you tried a nice cup of tea / hot bath / going for a walk / phoning a friend?” Advice and tips on all sorts of things. It happens offline too.  It can be good advice. Generally it’s well-meant. But …  is it welcome? Well, maybe yes. And maybe no.

The thing is, if someone is managing a mental health (or physical) condition, especially if they’ve been doing so for a while, they’ve probably had a good old go at trying the various drugs, treatments, therapies, supplements and diets on offer. They may be working their way through them with their healthcare team. They may be researching in the library or online. They may have joined a self-help group or forum. They may even have tried any number of hocus pocus remedies that make it into the Daily Mail or documentaries. So, when someone tweets about their condition and you’re tempted to mention something off the top of your head, think: are they asking for advice?

If it’s an offline friend or family member you know well, do they see a doctor and take medication regularly for their condition? Do they have a self-management plan? If someone is managing a long-term condition, the likelihood is they’re keeping some sort of track of how they’re doing. “Are you sure you’re not doing too much and, you know, starting to go hypo?” “Isn’t it time to go to bed now?” “Did you forget to take your medication today? You seem a bit … you know.”

Such comments can be helpful: sometimes we can ignore our own self-management early warning signs and only pay attention when we hear it from someone we trust. If you know someone well enough, or if they’ve asked you to be part of their self-management team – an early warning ally, as it were – it may be appropriate to chip in. But otherwise?

Unsolicited advice to someone managing a long term health condition can be seen as patronising. It may feel like criticism. It can be viewed as a sign that the advice-giver does not respect the person’s ability to manage their own healthcare needs properly. It can be seen as a suggestion that the person does not know their own mind … which, in the context of managing a  mental health problem, puts the advice-giver in really dodgy territory. Really dodgy.

Why am I writing this post now? Because only today I was reminded of how quick I can be to offer unsolicited advice. To leap in with handy hints and tips about how they could make their life better … if only they’d do as I suggest.  Partly that comes from my work background; partly because, being fairly long in the tooth, I (think I) know a lot of stuff; and party because I have a caring nature & like to help. Once, in response to a tweet from veteran mental health writer and thought leader Mark Brown (twitter: @MarkOneinFour), I tweeted “helpful advice” about light boxes. Of course, he’d tried that back at the dawn of time. Luckily he let me off the hook graciously.  Earlier today, I spotted a tweet about a medication issue I had faced myself. I replied with several helpful practical tips … Or so I thought. Because then I remembered … no advice had been sought. And that’s when I coined the term “madsplaining“. Let me explain.

I first came across the term “mansplaining” (with an “n”) when tweeter Phil Dore (twitter @thus_spake_z) used it.  When I did an online search, this (from Urban Dictionary) was on the first page that came up:


“Mansplaining: To explain in a patronizing manner, assuming total ignorance on the part of those listening. The mansplainer is often shocked and hurt when their mansplanation is not taken as absolute fact, criticized or even rejected altogether. Named for a behavior commonly exhibited by male newbies on internet forums frequented primarily by women. Often leads to a flounce. Either sex can be guilty of mansplaining.


A lot of the terribly clever online debate passes right over my head, and that’s as far as my knowledge of “mansplaining” goes (though I understand it’s been used online in feminist discourse for several years).  As it happened, it fitted perfectly with an encounter I’d recently had with a trainee psychiatrist: he was very new to twitter, had dived into an ongoing conversation with a patronising explanation, and was then flumoxed when I pointed that out. The “flounce” went on for quite some time.

And so what do you think happened when I first tweeted the word madsplaining …? Yes, you guessed it: I got mansplained!


So after “mansplaining”, do we have madsplaining? ie offering unsolicited advice to someone on how they should manage their mental health (My tweet)

I think that would be psychsplaining. mad folks being splained to. but i notice your rhetoric is from feminist & poc activism… Erick Fabris (twitter: @exic)

Oh hi Erick, are you mansplaining to me what I mean when I say madsplaining …? (My tweet)


Priceless. Well, thanks for asking, Erick, but I do mean just that: madsplaining. As other tweeps chipped in:


This is perfect! madsplaining gets right on my tits! “Have you just tried….?” “Everyone worries…” Hahahahaha my new word!Molly Teaser (twitter @mollteaser36)
Always fascinated about how much they know about their advice and how little they know of me. It’s the assumption that just because their advice works on their own neurosis, it works for everyone else. MH Extremist (twitter @wildwalkerwoman)
“You mean: “Snap out of it” “cheer up!” It’s all in your mind” “What have you got to be depressed about?” YES. Can you imagine this: “Cancer? You don’t look like you have cancer. Pull yourself together, get over it.” Ect” MScarlet Wilde (twitter @wilde)


I draw a distinction between madsplaining and what I call “patienting“, which is when someone uses your status as a “mental patient” to try to shut you up. An example would be (as has happened to me several times on twitter) a mental health professional will say to me something along the lines of, “Think you’d better take your meds now, love”.  Perhaps that’s a topic for another blog.

And, finally, here’s a little interchange to bring a smile to your face:

Or will this all turn meta and become splainsplaining?Phil 

I blame you entirely, Phil, for introducing me to the word “mansplaining” … which you can take any way you like ;-D (My tweet)

The concept of splainsplaining is kinda blowing my mind Dr Sarah Knowles (twitter: @dr_know)

Don’t worry, I’ll splainsplainsplain it to youPhil

*head explodes*Sarah

Sometimes I love twitter. And sometimes I need to take my own advice.



web links 5.




  • My twitter conversation on Storify:
  • What have you got to be so depressed about?Men Will Pause blog by Scarlet Wilde (twitter: @wilde), written in response to the madsplaining twitter conversation
  • Eric Fabris‘s website – Mr Fabris is a Canadian researcher, artist and writer. Amongst other things, he lectures at the Ryerson University School of Disability Studies.




Let’s talk about poo! It’s tweet chat time …

28 Jul

Keep calm and poo with pride




Here’s the transcript & fab wordcloud from the tweet chat on 1st August – patients & nurses all talking about poo!


This Thursday 1st August at 8pm, We Nurses will be hosting a tweet chat about constipation problems, at my suggestion. Here’s my earlier blog on constipation induced by psychiatric medication, including 25 tips you can try for yourself. It is my most read blog piece ever. I guess that makes me some sort of Poo Queen. Hmm …

However, if it gets people talking about an important but often overlooked or covered up topic, that’s all to the good. Let’s break the taboo about poo and make a date in our diaries for this Thursday’s poo chat!


.web links 5


Background reading:

The Bristol stool tart cake!

The Bristol stool tart cake!


Additional information on constipation:




Constipation: embarrassment, discomfort … and Poo Pride!

14 Apr
Alternative Bristol stool form chart from

Alternative Bristol stool form chart from


On Thursday 1st August at 8pm, the #PooPride tweet chat with We Nurses took place – woo Update smallhoo!



Having been on twitter for a little over a year, I’ve seen lots of topics discussed. Bowel problems aren’t one of them. Which is odd, given the effect many psychiatric medications have on your digestive system. My hints on twitter about my debilitating bowel problems seemed to go unnoticed. However, since there are a lot of people taking psychiatric medications, and for long periods, there must be a lot of people out there with constipation and other bowel problems who are suffering in silence.

At Easter, Charlotte Walker (@BipolarBlogger) blogged about a weekend away and how medication and bowel problems had affected her. I recognised the juggling act and stress of taking medications and planning toilet breaks. Then, yesterday evening, I spotted a tweet by Charlotte about constipation, to which I responded. When Charlotte asked me if I had any recommendations, it turned out that, after years of managing my own bowel problems, I could come up with 20 off the top of my head! (See below.)

That started up a spontaneous tweet chat. (All the tweets are linked below.) Then, because the issue is much wider than our personal experiences, because people were suggesting medications and treatments to try, and because constipation can cause serious complications, I decided to see if we could have an organised tweet chat involving medical professionals too. Watch this space!

Here’s the tweet of Charlotte’s that caught my eye:

“Dear antipsychotics, love what you’re doing on the bipolar, great stuff. Just concerned my bowel may RUPTURE, ease off a bit there, maybe?”

Charlotte explained that she was experiencing antipsychotic-induced chronic constipation which had flared up into faecal impaction. Not fun. Not fun at all.

Problems with your digestive system – whether it’s too much movement, or too little, or both; whether it’s frequency, consistency or volume; or colour, smell, blood or mucus; or some other charming symptom – can be a blush-making topic. I know, because I’ve blushed those blushes.

The first time I plucked up courage to mention to a medical professional the bowel problems I was experiencing, I received a reaction I hadn’t anticipated: laughter. As a result, I didn’t raise the issue again till an Atos medical. Through bodily sobs and streaming tears caused by shame, I forced myself to describe my symptoms. This time, the reaction was disbelief: zero points. Laughter; then disbelief. After that, through trial and error, a keen  memory for toilet locations and a well-stocked handbag, I gradually found ways to manage my bowel problems myself.

That was no longer possible, however, when I was detained in hospital. The combination of enforced inactivity, a diet devoid of fibre and the side effects of psychiatric medications meant my bowels came to a halt. There was one fortnight when I passed just one motion. Thank goodness for stretchy trousers that could accommodate my massive and growing belly, taut as a drum, as I waddled round the ward in pain, unheeded and untreated except for senna.

Since then, through my own efforts and working with my GP and the specialists she’s referred me to, I’ve found a way to manage the problems. And I can talk to pretty much any health professionals without embarrassment now so I know that, if problems come up in future, I’ll be able to talk about them and, hopefully, get the help I need.

You know you’ve got constipation when your digestive system has slowed down so you pass motions less often than you want to or when your stools are hard and difficult to pass. You may also have indigestion. It’s uncomfortable. It’s embarrassing. It’s even potentially dangerous. It’s an important topic.

Normally, constipation is a short-term problem which responds well to lifestyle changes and, if necessary, treatment. However, if constipation is drug-induced and there isn’t an alternative, you may be looking at a multi-pronged approach in order to successfully keep on top of constipation. So, for those of us taking medication, it’s a topic of even more importance.

Below, as a starting point for discussion, as food for thought, are the twenty tips I came up with off the top of my head for Charlotte to try out, plus a few more I thought of later. They are things that have helped me personally (or people I know) to manage the impact of drug-induced constipation. They’re aimed at someone who’s otherwise physically healthy. They’re tips you could use as a springboard for discussion. They’re common sense, not rocket science. They’re not comprehensive. For medical advice, take a look at the NHS website or ask your medical practitioner. Maybe they’re worth a try. We’re all different, after all.

As Charlotte tweeted later that evening:

 “Goodness! What a lot of people have followed me since @Sectioned_ and I started talking about constipation! #goodtoshare

And, as Phil Dore (@thus_spake_z) tweeted:

“Poo Pride! :D”


Bristol stool form scale

My personal tips on dealing with drug-induced constipation:

1. Keep a poo diary

If you keep a record of the motions you pass, you may start to see a (monthly or other) pattern. Women in particular can find their bowel movements are affected by their monthly cycle. Maybe it’s not a relapse or a remission; it’s just your monthly cycle. If you get to know the effect (if any) that your monthly cycle has on your bowels, you’ll be better able to distinguish what works and what doesn’t for your constipation. And improving constipation involves trial and error.

What to include in the poo diary? Time of day you pass (each) motion, what you were doing at the time (eg had you just smoked a cigarette). You’ll need to keep a record of what you eat and and your fluid intake, to see what effect that has too.

Also, include your Bristol stool scale number. It classifies stools into 7 different types. The ideal is around around a 3 or 4. The official Bristol stool form chart is above.

Bear in mind when looking at the chart above that your poo may not be the same as the colour shown: stools vary in colour depending on what you’ve eaten. I’ve pooed red after beetroot juice and green after spinach. Taking an iron supplement can (I’m told) blacken stools (and harden them). If there’s blood or mucus in your poo though, that’s not a good sign. Mention it to your medical practitioner.

Such a detailed diary won’t be necessary forever, but it’s a useful tool to see where you are now, and to identify any patterns emerging. Try to keep one for at least 2 weeks (men) or two cycles (women).

2.Eat or drink something

Stimulating one end of the alimentary canal (the long tube that runs from your mouth to your bum) can stimulate the other. Therefore, when you want to poop, first eat or drink something. I find that, if it’s going to work, it does so within around half an hour. So if I need to leave the house by 10am, I’ll eat drink or something (however light) at 9am to give it a chance to work its magic.

3. Try a stool softener

An effect of some psychiatric medications is to reduce the fluid content of foods. A stool softener (or osmotic laxative) is a medication that draws water into the stools, making them softer and therefore easier to pass. Lactulose is the stool softener I’ve tried and it’s worked for me. Brilliantly. Movicol is another one, though I haven’t tried that.

A downside is its taste: exceptionally sweet. But hey, just clean your teeth afterwards. Especially as another side effect of some psychiatric medications is dry mouth, or rather reduced saliva – and hence reduced protection for the teeth.

4. Use a jug

If your problem is hard stools, it’s water that will soften them; so you’ll need to take in sufficient fluids during the day. To ensure I push through enough fluids, I fill a jug with water on rising and fill my glass from it throughout the day. That gives me a goal to work through during the day.

Don’t drown yourself in fluids late in the day and end up wetting the bed. And yes, I have done this too: the meds I take knock me out so I sleep like the dead and wake up in a puddle. The way round that is to spread my fluid intake throughout the day so it’s not gulped down in a rush towards bedtime.

5. Prunes

Fluids rock. As do prunes. Drinking prune juice helps me too. And it’s super yummy. As are prunes with custard. I’ll take any excuse to eat prunes.

Beware though: don’t take too many. Once, before I knew the laxative effect of prune juice, I drank a whole litre in one go. That’s how I know it works. Now, I just drink a glass.

6. “Doing a Paula”

If you’re just not going, your bowels may be sluggish. Your digestive transit time (the time it takes from something going in your mouth to it coming out the other end) may have been slowed – whether caused by medications, or enforced inactivity if on ward, or lack of motivation to get active (a side effect of some drugs). If you want to know your transit time, you can do the sweetcorn test (eat some sweetcorn and see how long it takes to spot it in your stool – transit time should be around 24 hours).

One way to get the bowels moving is high impact exercise, which can stimulate the bowel to open. If I’m indoors, I’ll fire up my trampet and bounce along for a song. Jogging works too. Just be sure you know those toilet locations or have a handy pack of tissues in your bum bag.

Incidentally, if you normally have healthy bowels but find yourself almost or actually involuntarily evacuating your bowels during a run (pooing yourself), that may not necessarily mean you have a bowel problem. It can happen to normal, healthy runners the world over. It’s an occasional downside of the pastime. After all, the phrase “Doing a Paula” derives from the reason Olympic athlete Paula Radcliffe had to retire from the Athens marathon. Don’t panic. Just plan ahead. And learn the technique that enables you to delay passing a motion.

7. Vitamin C

Heard of the vitamin C “bowel tolerance dose”? Taking over 1g vit C gives me the trots. Everyone’s dose is different. I know the trots aren’t ideal, but sometimes you just need to pass a motion.

Incidentally, if you’ve recently changed your diet to include a high dose vitamin C supplement and find your stools are loose, the vitamin C could be the problem. Don’t automatically assume you’ve caught a bug or got IBS (irritable bowel syndrome). Experiment with the dose till you find the one that works for you.

8. A bathroom step

Essential bathroom kit is a little step (about 8” high), so that, when you sit to poo, your knees are a little above your bum. Sitting in this position relaxes your lower body and places your bowel in the correct position to pass a motion easily. It reduces the need to strain (which risks causing haemorrhoids/piles). And, bonus, it also means you can rest your reading material on a flat surface!

They’re cheap as chips (mine cost £2). Once you’ve used one of these, you’ll never want to poop any other way. If you’re visiting, you can usually find something to stick  under your feet – eg a couple of thick books, a pack of loo rolls – so your knees are at the right height. Simples.

9. Try training/routine

This is a controversial point because some bowel specialists I’ve seen say it’s impossible to train the bowel and others say the opposite.

The idea is that, at the same time each day – eg half an hour after breakfast (when you’ve stimulated the bowel by drinking or eating something) – you go into the bathroom whether or not you want to pass a motion. A sort of potty training for adults. You sit on the toilet, hang out there for 5 minutes, then leave. If you pass a motion good; if not, no problem. Maybe next time.

10. Latex gloves

This comes from a little trick I recall my mother showed me as a child. To get newborn kittens to poop for the first few weeks, rub their little bottoms. It worked. Why wouldn’t it work for humans too?

The idea is to very gently circle the anus with a gloved finger to relax it and, hopefully, give it that little extra  nudge it needs to stimulate the passing of a motion. Use lubrication of some sort (eg vaseline).

11. Smoking

Seriously. There’s a reason people smoke after a meal! I nearly took it up  in hospital again because I was so blocked. (Also because only the smokers were allowed into the garden.) Before I became a non-smoker, smoking a cigarette was a guaranteed way to bring on what I believe the Girl Guides call the “daily clear out” (though I suspect they don’t get the little girls to smoke).

12. Coffee

Again, there’s a reason people drink coffee after a meal. If you don’t like the taste, think of it as medicine: it may not taste good but, if it does the job, that’s what matters.

13. Stimulant laxatives

Senna is a laxative that works by stimulating the muscles of the gut to push your poo towards the anus (a stimulant laxative). Maybe this is just what you need. Bear in mind though that that senna is aimed at relatively short term use because it can, over time, make your bowels lazy.

Personally, senna was not good for me. When the nurses offered me various medications on ward, I made the mistake of thinking that, because it is a natural product, it would be the best choice. Wrong.

In fact it’s what caused me to blow up like one of the sheep in Far From the Madding Crowd: I wanted someone to spike me in the guts to relieve me of the terrible pain. I felt like I was going to die. In one fortnight, I only passed one motion.  I didn’t know what was causing the problem. I thought I’d be even worse without the senna. Luckily I was able to speak to a hospital pharmacist for an hour, and he helped me to work out what the problem was and what would help. If in doubt, seek medical advice.

Bulk-forming laxatives such as Fybogel are a third type, which help stools retain fluids.

14. Fibre

It’s a key recommendation for the prevention and management of constipation to have sufficient dietary fibre. Most adults don’t eat enough, and constipation is your clue that that means you.  You can increase your fibre intake by eating more fruit, vegetables, wholegrain rice, wholewheat pasta, wholemeal bread, seeds, nuts and oats. Eating more fibre helps keep bowel movements regular by helping food pass through your digestive tract more easily. High fibre foods can also make you feel fuller for longer, in case you’re struggling with cravings (another side effect of psychiatric drugs which contributes towards weight gain).

If you decide to increase your fibre intake, however, do so gradually: a sudden increase may make you feel bloated, produce more flatulance and give you stomach cramps. Eek!

15. There may be no magic bullet

Bear in mind that, though the hard stools and slow transit may be caused by psychiatric drugs, they may not be fixed just with drugs. It may take a package of measures to bring constipation under control. But finding the right drug/combination can surely go a long way to helping.

And be prepared for the fact that you may end up taking more drugs to deal with side effects (like constipation) than the number of drugs you take for your primary psychiatric symptoms. That’s just the way it is. Just as every surgery causes scars, so every drug has side effects. It’s just a question of finding the side effects profile you’re prepared to live with.


You could try each of these suggestions to see which ones work for you. Perhaps put them together into a morning routine, tweaking as you go to work out the right combination for you: we’re all different.  However, it’s hard to tell what’s working when you’re doing lots of different things at the same time. You could consider doing them all at the same time and then gradually cutting each one out, one by one, to see what works; or stopping everything then adding them back in one by one.

17.Input and output

Reducing food intake (a little) can help. I wouldn’t have got quite so bunged up if I hadn’t eaten quite so much! Obviously we all vary and some people are under-weight or need to follow a special diet. On the whole, however, many of us would benefit from cutting down a little on what we eat. And, the less you put in, the less there is to get stuck inside!

18.Wet food

If the problem is constipation & hard stools, eating “wetter food” (eg soups, stews, curries) can also help a little. If you live on crisps, you’re asking for trouble.

19.We can all learn

Even clued up healthy eaters who think they know a lot about diet and lifestyle may benefit from a food diary & having their diet tweaked by a dietician. I’ve learned new stuff from the professionals I’ve seen. Even if we’re doing everything we know 100% spot on, science might have moved on since then. There are lots of fad diets and food myths we might have fallen prone to without noticing, so reviewing a food diary or having a professional do so can lead to improvements – even small tweaks – being found. And, with constipation, it’s these little things that add up.

We might even learn that things we thought were healthy options were actually contributing to bowel problems. For instance, taking supplements is always good, right? Wrong. For instance, taking too much vitamin C can cause loose stools, whilst taking iron tablets can harden stools. Fibre is always a good thing, right? Wrong. For some, a high fibre diet can irritate the bowel and lead to bloating and frequent loose stools. What you may think is IBS may resolve entirely on a lower fibre diet. Exercise is always good for you, right? Wrong. For some, high impact exercise can lead to involuntary bowel evacuations (“Doing a Paula”). If so, stick to gentler exercise. Or practice bowel control techniques.

20.Try it

Even if you’ve tried something before, it may be worthwhile trying it again. Bowels can be contrary beasties. “I’ve tried everything already” may mean you miss out on doing something that now works.

21. Tummy massage

Another way to stimulate the bowels to start moving is with tummy massage. Use the heel of your hand to make a big circle in a clockwise direction (the direction the bowels go in). Alternatively, lie on a hard surface face down and roll around. Or lie on your back with your legs in the air and cycle, to get the tummy muscles moving. All very elegant!

22. A hot bath

As Sylvia Plath wrote in her novel The Bell Jar, “There must be quite a few things a hot bath won’t cure, but I don’t know many of them.” A hot bath is another great way to get the bowels moving.

23.Specialist help

Ask your GP for a referral to a specialist clinic. If at first they say there isn’t one (my otherwise excellent GP did), do your research so you know the right terminology to use when asking for the service. For instance, I’ve had referals to a community dietician; a colposcopy clinic; a continence clinic; a bowel education group; a colonoscopy consultant; and a hospital consultant for anatomical investigations.

24. A tricky balance

Once you start taking steps to actively treat constipation, you might push your bowels the other way. Oh joy! Your bowels become as unpredictable as climate change. You might swing back and forth between the two before getting it right. Ho hum. You’ll get there. And in the meantime, be prepared.

25. The pitfalls of syndromes

If, along your constipation journey, someone mentions IBS, be careful how you use the diagnosis. With family and friends it may provide a label that helpfully enables you to side-step that awkward conversation about symptoms. However, if you’re going for medical treatment and you mention IBS, you’ll most likely see the doctor’s eyes glaze over. In essence, a syndrome is the medical profession’s way of saying they don’t know what’s wrong with you. It’s saying you’ve got a collection of symptoms they don’t know how to treat. It is a label that says to a medical professional, “Nothing you do will make the patient better. Next!” Use with care.

If you have any tips for easing constipation that you’d like to share, please feel free to comment below. Happy pooing!



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.Bristol stool chart NOV 2013



Mental health nurse & patient tweet chat: what do newbies need to know?

11 Feb

Psychiatric Nurse - Garrison - Book cover

Update small..

The tweet chat took place on Thursday 20th February 2014 with We Nurses – catch up with the discussion by taking a look at the full transcript!


I’m planning my first one hour tweet chat in a couple of weeks (date to be announced). (Check out my quick guide to tweet chats for more on what they are – this and other helpful links are below). Here’s what I have in mind, for an inpatient mental health nursing tweet chat:

  • Patients: Are you a patient who’s experienced inpatient mental health nursing? What would you like the newbies to know – the student nurses about to start a placement or the newly qualified mental health nurse. What things that nurses did – good or bad – made a difference to your experience on ward?
  • Students: Are you about to qualify as a mental health nurse? Are you a student nurse about to start your mental health placement?  What is the balance between fear and excitement? What would you like to know? What practical concerns do you have? What do you want help with to make your first days on ward a success?
  • Nurses: Are you a qualified mental health nurse? Are you a student nurse who has completed your mental health placement? What tips would you like to pass on to newbies about to qualify or about to undertake a placement? What are those little insider tips that really helped? What would you have liked to know when you were a newbie?

I’d like to be able to share some really useful tips to help new mental health nurses and nursing students make their best start on ward, because that benefits both staff and patients. Here are some example questions I’ve thought up that students might want to know the answer to:

“How can I prepare for my placement so I get the most from it?”

How can I put the knowledge I’ve learned at university into practice on the ward?”

“How can I settle in as quickly as possible so I fit in with my nursing team and ward life?”

“How can I switch off after a shift?”

“What should I do if I see another nurse doing treating a patient unkindly?”

Here are some examples of useful tips to pass on:

The Bic 4-colour pens are really useful for filling in your paperwork.”

“Remember to always respect the patient as an individual and see past the diagnosis.”

“Don’t make assumptions or have preconceived ideas based on what you’ve been told before. Remain open-minded and make your own judgments based on your own personal experiences.”

As I’m not a nurse and haven’t run a tweet chat before, I’ve invited @MHnursechat – associated with the awesome We Nurses website and tweet chats – to run a joint tweet chat with me. We’re going to be discussing how this will work and, hopefully, setting a date. Very exciting!

In preparation for the tweet chat, I’m asking you to please share your tips and questions. That will help set the agenda to be followed and the areas we’ll focus on in the tweet chat – so it covers the most burning questions and drills down to the most useful tips. It may be that there will be more than one tweet chat on this topic – perhaps one covering what nurses need to know in their first few days, and another for when they’ve been there a few weeks. We’ll see. A tweet chat needs to have enough of a focus to engage people without overwhelming them, but at the same time enough breadth so it doesn’t peter out prematurely! If there are other topics you think would be good for tweet chats then please let me know!

You can comment below or tweet me (please don’t try to pack more than one query or tip into each tweet ) @Sectioned_ (please remember the underscore). It’s helpful if you could say whether you’re offering your comment from your experience as a patient, nurse or student. Look forward to hearing from you!

Why a tweet chat? I’m often interested in discovering what other tweeps think about topics and then sharing those insights. So, quite a few times, I’ve tweeted questions then collated the responses into a Storify story which I’ve sometimes turned into a blog. (I was rather excited to learn that this is called “crowd sourcing” and “curating the chat”.) This time I thought I’d try making it a bit more organised & involve more people: I’m beginning to learn just how valuable Twitter is as a way to bring together groups of people to share views openly in a way they might not otherwise do. (I’m told this is called “disruption” – disrupting the natural order of things and mixing it up, like mental health peeps and staff learning together.) (Thanks to Victoria Betton for all the cool jargon!)

Why this topic? After all, I’m not a nurse. As a child, however, I remember being taken to one of the big long-stay psychiatric hospitals of the sort portrayed in the film One Flew Over the Cuckoo’s Nest. I remember the high ceilings, big windows and long corridors. Happily I wasn’t being booked in myself. I was visiting family friends who worked there as psychiatric nurses. Members of my family also worked on psychiatric wards and in nursing.  When I was sectioned a couple of years ago, my inpatient experience fell far short of the care I would hope all psychiatric nurses aim to deliver. You could say that everything that could go wrong did go wrong. But, as I’ve been around nurses my whole life, I know that the image and practice of mental health nursing has come a very long way since the fearsomely controlling figure portrayed by Nurse Ratched. For me, nurses are (or should be) an essential part of the team that helps get me well. So I’m all for sharing tips and best practice to help nurses be their best. I’m hoping this tweet chat will be one small way to do that.



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  • Guide to tweet chats – all you need to know to join in your first tweet chat or get more from them
  • Mental health jargon buster and acronym buster – please send yours in! We’ll try to avoid jargon during the tweet chat itself, but if the jargon’s in the jargon buster, I can just tweet a copy of that by way of explanation

For the nurses and student nurses amongst you, here’s some nurse-focussed content: