For those of you who have been fortunate enough to visit the Northern Rivers area of New South Wales, you will know that our location here affords our clients the luxury of enjoying temperate weather throughout the year.  With the high humidity of summer receding, we are now enjoying crisp, clear days and beautiful autumn sunsets, and as the evenings cool, one can still enjoy a sunny day on the beach here in Byron Bay. But as winter approaches, more opportunities also arise for us to retreat, get warm and snug, and think about how we’d like to live our lives in richer, more rewarding ways.  Now is the time to leave the excesses of summer behind so we can contemplate and initiate the changes in our lives we’ve been postponing but which we know need to happen.

For any of you contemplating treatment at the Sanctuary Byron Bay but who have not yet visited the Northern Rivers area, I’d like to extend a warm invitation for you to come and visit first. Have a holiday and meet with me and some of our key staff.  An initial meeting can sometimes help to reinforce your drive to get well and dispel any fears or anxieties you may have about making changes in your life. If you’ve been contemplating shifting any old habits that no longer serve you well, come and talk to us to see how we can help.

In this edition of our newsletter, Jane Williams, our Clinical Director summarises the contributing factors to depression, highlighting the reality that for many, depression is not just confined to biology and the spurious promise of a magic pill.  As Jane explains, effective treatment needs to reflect the multi-faceted complexities of our existence.

Also in this edition, we look at the largely unrecognised issue of sugar addiction. While it seems trite to lump sugar in with other ‘stronger’, more destructive drugs, the addiction process nevertheless remains largely similar – ie  involving physiological adaptations to maintain equilibrium in the face of imbalances in biochemistry, all of which feed back to and inter-relate with cognition, feelings and moods.  Addiction is a complex process operating at many levels which is why a holistic, multi modal approach is absolutely essential to make any long term change.  Understanding our habitual use of sugar helps us understand how the process of addiction operates subtly in our lives.’

For those of you who are concerned about family members or friends who have yet to recognise the destructive path upon which they are travelling with regards to their habitual use of substances, the use of professional interventions services might be considered.  In this edition, we highlight how we can help.

I hope you enjoy this edition and I wish you all the very best!

Sincere Regards

Michael Goldberg

Founding Director

There is more than one type of depression and these range in severity. Some forms of depression are more biological (endogenous) than circumstantial. Biological depression needs to be treated with a range of treatments including medication. Circumstantial depression on the other hand, relates to what has happened and what is happening in your life, with professional understanding and support required in these cases.

The following are contributing issues to becoming depressed:-

• Exhaustion and adrenal overload which comes from lack of self-care.
• Lifestyle factors- quality of diet and how much you exercise. Fluctuating energy levels caused by high sugar and high-carb diets. Lack of doing the things that we enjoy doing. Our brain needs a healthy diet to make serotonin (the happy hormone) and pleasure to feel good.
• Incongruity between your deepest values and the way you spend your time which can lead to subsequent feelings of purposelessness and meaninglessness.
• Powerlessness resulting from repressed expression of needs, repressed anger, passive communication styles, pleasing others without the corresponding ability to self-orient and meet one’s own needs.
• Feeling compromised. You can’t commit your life’s energy to a compromise. You need to establish what you want.
• Long-term relationship difficulties and needs not being met.
• Lack of love and intimacy and the development of intimate relationships and friendships.
• Unresolved trauma and PTSD and related anxiety symptoms that go untreated.
• Narcissistic pursuits – filling inner emptiness from the outside with substances, entertainment, sex, work etc. Disregard for the development of a spiritual life.
• Long standing unresolved shame and self-worth issues usually from childhood experiences.
• Unresolved grief and loss issues. This includes loss of loved ones, loss of meaningful work, loss of meaning in life and so on.

The above issues which most people with depression experience, CANNOT be treated with medication alone. These issues require exploration, recognition and professional support to work through, and new strategies need to be developed to deal with them differently and more constructively.

At the Sanctuary we approach depression from all aspects. We have an excellent approach to diet and nutrition which supports the brain and body in being able to make more serotonin- the body’s natural anti-depressant. We have personal training to move the body and mind out of ‘stuckness’ and to  help the body produce its own bliss hormones. We have yoga and meditation to assist the body in learning to relax and develop a mindful approach to emotional and mood states which allows distance and detachment from depressed states. We use acupuncture, shiatsu and massage to help support the body, nurture it and move energy around the body out of stagnation. Most importantly we have intensive psychotherapy (at least four sessions a week) which utilises a combination of therapeutic techniques such as Cognitive Behavioural Therapy, experiential therapies such as Voice Dialogue and Gestalt therapy and a framework which understands how the past can shape our present and future. We are very aware at The Sanctuary that depression requires a holistic approach that recognises the interaction between mind, body and spirit.

Despite what we hear about revolutions in medication, there is no simple solution or magic pill for depression, the causes of which can never be merely relegated to biology. After all, we are not mere bodies but instead, a complex aggregation of thoughts, ideas, experiences, biology and emotions.  Depression is not only biological, but also existential.  Depression affects all aspects of being and as such requires to be addressed at multiple levels.

The Sanctuary Byron Bay recently hosted an information night with our special guest, Monica Colmsjö, an educator and clinical nutritionist. Monica is the author of Sugar Dreams: waking up to the bitter reality - a fascinating account of:

• our modern age dependence on processed sugar;
• how sensitivity to sugar’s effects can be ‘hard-wired’ in many of us; and
• how early exposure to sugar can predispose the vulnerable to other addictions later in life.

In this illuminating seminar, Monica recounted her own personal experience with addictions in her family and explained her growing understanding of the bio-chemical nature of the addiction process.  Many addicts, she contends, substitute sugar when coming off alcohol and other drugs thereby prolonging a subtle maintenance of the addictive process, a strategy Monica wryly likens to “swapping seats on the Titanic”. Even those who have had no problems with alcohol and other drugs, can find it hard to shift dependence on sugar, which Monica points out, has been shown to be even more addictive than cocaine.

She urges us to monitor our sugar consumption and advocates the use of targeted dietary supplements to make up for deficiencies in our brain chemistry, which she argues is often the cause of depression, anxiety and other difficulties which leads us to using drugs and alcohol to cope in the first place.

Monica’s contention that sugar is a powerful drug can be tested by just shifting our awareness to how we crave sweet tastes and how we use sweets as rewards.

Try becoming aware of the part sugar plays in your life, even for just a week.  Once you have more awareness, see if you can reduce your reliance on this easy, quick ‘fix’ and then see how you react.  Is the process similar to any other addiction process you have experienced?

Sugar Dreams is available on order from www.sugardreams.com.au

Our intervention treatments include alcohol intervention, drug intervention, suicide intervention and depression intervention. We believe an effective intervention program will:

• Bring together, the intervention client and their family/friends;
• Facilitate a solution focused discussion and to educate all parties about the issues at hand;
• Structure a safe environment so that all parties can face each other honestly and move forward;
• Identify and interrupt any dysfunctional cycles of communication and behaviours that are enabling or unhelpful;
• Provide support for all, promote optimism and instill hope for the future;
• Provide clear, concise and succinct information about treatment options;
• Determine and discuss the needs of each party; and
• Help delineate useful boundaries and limits to behaviour.

Years of intervention research has enabled us to develop a dignified and successful intervention program that helps not only the client but also the people requesting the intervention.

For more information about interventions and the services we can offer, please visit the Interventions Australia website.

We are moving into spring, and the weather in Byron Bay is absolutely beautiful at this time of year, with light sunny skies, turquoise oceans and gentle, balmy nights.  This is the perfect time of year to make changes you’ve been meaning to make; commit to wellness; and to address those issues we habitually avoid but which end up compromising our happiness and health.

At The Sanctuary Byron Bay, we continue to refine and improve our treatment services, ensuring we remain at the forefront of innovation and effectiveness. We continue to assist those with complex health problems by offering a truly integrated approach combining the best of medical and complementary therapies, nutrition and personal care. Importantly, we also continue to ensure your environment is a s beautiful, responsive and comfortable as possible so as to ensure our name truly describes your experience.

Over the years we have treated many conditions – some, extremely complex – yet a few shared threads seem evident amongst our clients: and that is depression or anxiety requiring assessment at the very least, or targeted intervention in more serious cases. More than just sadness and worry, clinically significant symptoms of depression and anxiety can sometimes be missed by health professionals or can sometimes be masked by compensating use of drugs and alcohol. You may not even realise you are suffering from anxiety and depression, yet latest studies suggest over 80% of clients presenting for drug and alcohol treatment also have significant issues with depression and anxiety.  This is only now being recognised as a serious treatment issue requiring cooperation between different sectors of the healthcare system.

At The Sanctuary Byron Bay, we understand depression and anxiety to be multi-layered, complex problems requiring sensitive diagnosis and effective interventions not merely limited to psychological or pharmacological means. Our approach is considered best-practice and there is no better place than The Sanctuary Byron Bay to find the necessary experience and expertise required to address depression and anxiety together with any other presenting issues.

In this issue, we examine the role of diet and nutrition in treating depression, outline a series of practical steps to combat anxiety and introduce one of our carers and his perspective on our unique philosophy of caring for clients at The Sanctuary Byron Bay

I hope you enjoy this issue and I wish you all the very best for the coming Spring (or Autumn for those of you in the Northern Hemisphere).

Planting your own food keeps you in touch with natural cycles, and if grown organically, keeps you healthier and less reliant upon food grown by industrial means.

Carers at the Sanctuary Byron Bay are non-judgmental and empathic companions with a wide range of life experience and life skills.  The one thing that we all have in common is a deep understanding of the healing and recovery process.  We understand the detoxification process and the challenges that inevitably arise. While the program fully supports each individual client to go where they need to go, recognising each client is unique, we nevertheless work within specific boundaries to ensure that even as we function as companions with whom clients, in absolute confidentiality, share a lot of their in-depth journeys, our focus remains on their needs and not our own.

Carers are carefully matched with clients based on a wide range of factors including: culture; age; gender; particular addictions or issues; life-experience; and most importantly the level of care required. For example, for the first week of intensive withdrawal, clients are assigned only qualified registered nurses as Carers.

We are not therapists yet we often become sounding boards as the clients unravel and try to make sense of their addictions and or negative behavioural patterns. We are great listeners and are trained to identify key issues that our therapists may find useful in understanding the overall clinical picture.

As clients have limited access to their normal social networks, a Carer can become someone to share a cup of tea with, a light chit-chat, a good laugh and a joke, what’s happening in the world, perhaps a tear, a rising realisation or ‘ah-ha’ moment but mostly we are there as professional support workers, 24 hours a day, cultivating a sense of safety, trust and nurturing.

The role of a Carer can have its challenges – as with most caring professions it’s not always easy to watch people in pain and in self-harming patterns. Yet the rewards outweigh the challenges. New clients cannot imagine the life changing journey that they are about to embark upon – but through repeated experience, we as carers can – and in those crucial early days of recovery, we can hold the hope for our clients even when they cannot.  So on first meeting a client I imagine them at the end of the program. I see them in 4 to 6 weeks time and I have a little smile. It’s my favourite part of the job, sharing their journey and being witness to what can only be described as a courageous and miraculous transformation.  To be a part of a team that facilitates the process of a client literally regaining and reclaiming their life back is satisfying beyond compare. In a nutshell … that is why I Care.

Paul Pritchard – Carer at the Sanctuary Byron Bay

As society struggles to keep pace with rapid advances in technology and the lightning pace of a digitised world, we are fast losing touch with what can only be described as ‘real food’.

Previous generations, who had little or no access to ‘convenience’ foods, consequently had a much deeper connection with fresh, seasonal produce and the basic raw materials needed to provide essential, daily nourishment. The skills and techniques needed to produce a nourishing diet of healthy, balanced meals were constantly being re-invented, re-worked and refined. Accumulated culinary knowledge was passed down from generation to generation.

In fact the need to eat was more than the necessary inconvenience or the unhealthy obsession it is to many people today; it was the ultimate reward for a hard day’s toil, a sacred experience to be shared and a real cause for celebration.

In many ways we have now replaced, or are fast replacing, our ancient connections with ‘real food’ and basic nutrition with a vast array of unhealthy, modern alternatives. The kitchen is no longer the hearth, the engine room, nor the fundamental centre of many households.

We live in a world where the intrinsic values we place on our different senses have been redefined; where the tangible properties of true taste, texture and aroma have taken a backseat to a bevy of artificial stimulants, such as sight, sound and speed. Convenience rules the day.

We’re encouraged to ‘order-in’, ‘drive-thru’ or ‘heat-‘n’-serve’ processed meals devoid of any real alimentary goodness, so as not to interrupt our all important ‘viewing pleasure’ or to squeeze more work hours into a day. Ironically, the chances are high that we will be watching one of the many primetime shows about food and cooking while we consume our nutritionally bereft ‘TV dinners’.

The impetus to do more, be more, consume more – although it may be of  increasingly of inferior quality – is the ultimate double-edged sword. The more economically advanced our society becomes, the more self-destructive our eating habits.

While modern science, technology and medicine are heralded as being the building blocks for a previously unknown quality of life, obesity, diabetes, depression, disillusion, and a general sense of disenfranchisement pervade the lives of many who have benefited from such ‘progress’. Could it be that we are fast losing touch with one of our more basic, primordial instincts or that our most vital reward center is being ignored and, literally, starved – all in the name of progress?

Fast foods, processed foods, genetically modified foods; foods high in saturated fats and trans-fatty acids, preservatives, additives, flavor enhancers, refined sugars and salts are making us both incredibly unhealthy and unhappy. Perhaps deep down in our collective consciousness we know that we are becoming little more than highly processed human junk.

Besides struggling with physical health, more people now battle mental health issues, with depression predicted to become the second highest cause of the global disease burden within the next 20 years. Recent figures show that, worldwide, 450 million people suffer from mental health problems, including depressive disorders, bipolar affective disorder (manic depression), schizophrenia, Alzheimer’s and other dementias, obsessive compulsive disorder and panic disorder.

Mental illnesses represent four of the 10 leading causes of disability worldwide and affect more than 25 per cent of people at some point in their lives. At any one time, about 10 per cent of the adult population is suffering from a mental or behavioral problem. In practical terms, one in four families are affected by a member with a psychological or behavioral problem.

The majority of the people are aware of the connection between diet and obesity or diet and coronary heart disease. Similarly, anyone who has ever smoked, drank alcohol, tea or coffee, or eaten chocolate knows that such products can improve one’s mood, at least a little and at least temporarily. However, what seems to be less common is an understanding that some foods can have a long-lasting influence on general mood and mental wellbeing because of the impact they have on the structure and function of the brain.

Medical researchers now say that the evidence linking diet with mental health is undeniable. As well as its impact on feelings of mood and general wellbeing, it demonstrates a contributory role in the prevention and treatment of specific mental health problems such as ADHD, depression, schizophrenia and Alzheimer’s.

The implications are far-reaching, both in scope and depth, for a wide range of stakeholders. As policy-makers choose to incorporate the evidence into health and education guidelines, practitioners become more equipped to offer therapeutic treatments that take into account the complexities of mental health problems.

Certainly nutritional influences can be considered among a range of care options offered to those seeking to improve their mental health. Most importantly, perhaps, individuals can be educated to become more aware of the association between their diet and their mental health, enabling them to incorporate important dietary changes alongside their range of other care options.

Mood Food

A poor diet can make you feel anxious and fearful, depressed, tired all the time and even suicidal, according to researchers at Roehampton University in the United Kingdom. But while everyone knows eating plenty of fruit and vegetables, lean protein, and wholegrain foods will enhance health, there’s some special foods you should eat if you want to feel happier.

To boost levels of serotonin, the neurotransmitter that can be low in people suffering from depression, you need poultry, sardines, salmon, fresh tuna, nuts and seeds. Turkey and chicken are also good because they contain mood-enhancing tryptophan, an essential amino acid that is converted into serotonin.

But what about chocolate, which many people swear by as an instant mood lifter? On one hand, chocolate does contain a naturally occurring substance called phenylethylamine that can enhance endorphin levels and act as a natural antidepressant. On the other, it can be addictive i.e. if you don’t have it you’ll feel miserable and it contains lots of simple sugar, which in large quantities is bad for your health.

Happiness Tip:  Put turkey, chicken, fish, nuts, seeds and complex carbohydrates in your grocery trolley. Try making oatmeal cookies for snacks, or turkey on rye with cranberry sauce and snowpea sprouts for lunch. Buy some dark, organic chocolate and have a small amount as a treat. Switch coffee for a herbal tea like green, ginger or berry.

Eat ‘real’ food wherever possible and you WILL feel happier.

Focus on your breathing

Conduct a body scan – notice which part of your body feels relaxed and which parts feel tense.  Feel your way into the relaxed parts, comparing how it feels to the parts that are tense. Note the difference. Initiate a full body relaxation sequence. Tense and release every part of your body from bottom to top. Begin by tensing up your toes, holding the tension for three counts then releasing for three counts. Remember from the body scan exercise, what it feels like to be relaxed and to be tense.  Progress the tension/relaxation sequence up your body slowly until every part of your body has experienced tightening up and letting go.

Stay in the moment – anxiety is often about anticipating a fearful future.  Ask yourself “Is it really likely to happen?”  “Is it happening now?” “Has it happened before?” “What is evidence that the worst is going to happen?” Focus on where you are and go for a walk and notice how you feel after ten minutes.

Take control of your self talk – notice that anxiety is often accompanied by a specific range of thoughts about oneself that are usually negative, fearful and critical – “I can’t cope”, “I’m too weak”, “I’m going to fail” etc.  If you are unaccustomed to witnessing your thoughts, they may be mistaken for being facts, yet thoughts can be actively challenged and replaced.  Start thinking instead, “I am strong enough”, “I will cope”, “I am calm”.  Gently replacing negative thoughts with a patient, moderate and reassuring voice is a skill that requires practice, but is a skill that anyone can learn and practice.

Make yourself comfortable – sit on something comfortable – a soft cushion, a rug or a supportive chair. Be neither too warm nor too cold and ensure your senses are nurtured. Sit somewhere with a beautiful or inspiring view – in a garden, by the sea, in a park.  Listen to something relaxing – soft music, a gentle stream or birdsong.  Try to ensure your surroundings smell pleasant – light scented oils or candles or sit amidst blooming scented flowers.

Jane Williams, Clinical Director

Amos Hee, Medical Anthropologist