In research undertaken for my book BACK FROM THE BRINK TOO, people who had been through a severe bout of depression told me that if they had their time over, they would seek expert help much earlier. How do you access that expertise?

Alarmingly, during a doctor’s initial six year university education, most institutions devote miniscule coverage  to depression, anxiety, and other mental illnesses. However, the research firm Ultrafeedback surveyed 2434 Australians, and found that 26% of those surveyed had discussed depression with their GP in the last 12 months (second only to back pain with 33%).

To be fair, GP’s have a huge number of specialty areas to cover and many choose to focus solely on physical health. If you are really struggling emotionally it is quickly evident how important it is to have a well-trained GP with a caring manner. A good GP can be a lynch pin - integrating care involving other specialists such as psychologists and psychiatrists.

Understanding a GP’s Qualifications

There are GPs that are interested in mental health and study much more about it after graduation. There are some special Medicare item numbers related to mental health which all GPs can use and another set which are only available to GPs who have undertaken a certain amount of extra training. The most that is required of a GP to be accredited by Medicare to claim Mental Health item

numbers is 20 hours of specific training. This may be all the training your GP has had or they may have had much more.

A body called the GPMHSC accredits GPs for the special mental health item numbers. Six hours accredited training gives a GP a “Level 1” qualification. An additional 20 hours training provides a “Level 2” qualification. These levels of qualification allow a GP to claim or charge the special mental health item numbers. Most GPs do not display these qualifications but you can ask the GP or the reception staff whether the GP has Level 1 or Level 2 mental health accreditation. They should know the answer because of the item numbers they claim or charge.

Sources for finding a good GP

1. Family and friends – If you have a loved one who has had a positive experience interacting with a GP about depression or anxiety, ask them about the experience to see if the doctor might be right for you.

2. Postcode search on beyondblue website – On the home page of www.beyondblue.org.au there is a facility that allows you to enter your postcode. This will allow you to access a list of GPs and psychologists in your area that have a special interest in mood disorders.

3. Call your local General Practice Division - The Australian General Practice Network (AGPN) is the peak national body representing 111 general practice networks and eight state based organisations around the country. Go to www.agpn.com.au and identify your local division. Call and ask which local GPs have completed further studies in mental health.

Preparing for a mental health discussion

These suggestions are designed to maximize the probability of an accurate diagnosis and appropriate treatment plan. This will also allow the GP to determine if they are able to meet all your care needs or whether additional assistance may be required from a psychologist or psychiatrist.

Consider taking a loved one with you to assist in getting the most out of the visit.

1. Advise the receptionist that you would like to book a “long consultation” to discuss a mental health issue. If they don’t do this, it is unlikely that the practice is the right one for you.

2. Prepare to describe as succinctly as possible what symptoms you have been experiencing and for how long, the level of your disability as it impacts your home and work life, any triggers such as stressful events, the level of emotional support you have access to, family history of depression, and whether you are attempting to self-medicate with alcohol or drugs.

Assessing the visit

Ask yourself:

1. Did the GP seem to care?

2. Did they ask the right questions to understand my situation?

3. Did they propose a preliminary diagnosis and outline a holistic treatment plan that you have confidence in?

If you can’t answer yes to all three questions, it would be advisable to explore other options.

A more rigorous diagnosis

Mood Assessment Program (MAP) – The Black Dog Institute has developed MAP as a tool to help GP’s and psychologists make more accurate mental health diagnoses. It incorporates nearly a quarter of a century of sophisticated clinical expertise in assessment, diagnosis and management planning for people with mood disorders (both depressive and bipolar disorders). Your GP or psychologist must be a registered MAP user and can then provide you with a unique access code to complete an online assessment. Your doctor will receive the report to discuss with you at the next visit. There is no charge for MAP. See www.BlackDogInstute.org.au

Graeme Cowan is the author of BACK FROM THE BRINK TOO: Helping your loved one overcome depression, which was SANE Australia’s 2009 Book of the Year. He went through a 5 year episode of depression which his psychiatrist described as the worst he had ever treated. He now speaks and consults about how to inspire the discouraged to bounce back and thrive. Over 40 free resources can be found at www.Facebook.com/BackFromTheBrink

Tags: anxiety GP, depression GP, depression treatment, mental health GP, natural depression treatment, overcoming depression

Theoretically Christmas is a joyous occasion but let’s face it, it can stress us out. Lots of presents to buy, too much food and alcohol consumed, and exercise ignored.

For some it represents seeing people that have been avoided all year. Not surprisingly, calls to helplines and charities go through the roof during the holiday period.

This can lead to us feeling overwhelmed and unable to cope. It can prevent us from experiencing the extraordinary benefits of a holiday. We can be consumed by what isn’t rather than what is.

Imagine if it wasn’t like that. Imagine if you returned to work in January full of zest and purpose.

Here are 3 proven strategies that can help.

Plan ahead

There are 3 main aspects to consider here, your finances, your wellbeing, and next year.

It is so easy to spend money we don’t have during this period: presents, parties, food etc. Credit card bills can mount up. Consider setting a total budget that you will spend for Christmas, plan how to spend it, and then record everything you spend. You may also consider non-monetary gifts like doing what a good friend of mine does who has a very low income. He writes a note to each of his family thanking them for something they have done for him that year that he has truly appreciated. They often say it is their favourite present. For the last 10 years my family has taken  a Kris Kringle approach for everyone over 18 – it is so much better to focus on buying one great present than try to second guess and buy something different for 12 people.

Wellbeing strategies can fall by the wayside when there are so many distractions. Plan one week ahead and work out when you plan to do some pleasant exercise (more later), activities and rest. If you don’t plan it in advance it won’t happen.

Next year: If it is too late to make changes this year, you can resolve that this never has to happen again, and write down what will be different next year.

Boost Mood

Your mood is largely within your control. Here are 3 things science says will boost your mood.

30 minute brisk walk (or equivalent) significantly improves your mood after 2, 4, 8, and 12 hours compared to those that don’t exercise (Mayo Clinic 2008). Exercise boosts energy, confidence, and sexual desirability (American Fitness, 19 (6), 32-36). Exercise 6 days per week. To ensure this happens, you must have a ritual and modest goals. A ritual is something you do every day, which prompts behaviour eg. Put a pedometer on when you brush your teeth in the morning, and record your daily steps when you brush your teeth at night. Why not buy a pedometer or download a smart phone app.

Rest well – we have forgotten how to switch off. We think it isn’t productive. A NASA study of 4000 of their employees shows that those that took a 30 minute nap or meditation after lunch increased their productivity by 35% and decision making ability by 50% (Power of full Engagement , 2005). Getting a good night’s sleep is like setting the reset button. From a health, appearance and wellbeing standpoint we need somewhere between 7 and 8 hours sleep each night for optimal benefits (Rath et al Wellbeing, 2010)

Why not go to your library and take out a few relaxation of meditation CD’s and see what works for you. Use your time off to build the critical skill of knowing how to let go.

Be grateful – Writing down 3 things you are grateful for each day stimulates a 6 month boost to your mood. (Seligman et al 2002). Why not buy a small note book to place near your bed for this purpose.

Difficult person plan

The thought of seeing someone that pushes your buttons can cause underlying unease or outright anxiety. Here are 3 things to keep in mind.

Plan for the worse – hope for the best. It is very, very rare for a leopard to change their spots. It is better to go into the situation with a realistic view of what to expect based on past interactions. At worst you will be pleasantly surprised. If you have spent a lifetime having difficulty with this person it is unlikely Christmas lunch will be different.

Avoid alcohol and controversial topics. Whilst having a few drinks is logical course of action when thinking about seeing this person, this is rarely the case. Alcohol can inflame the situation. If you feel compelled to have drink, why not intersperse each drink with water and limit yourself to 2.

Walk away. Your wellbeing is your first priority. Is this person really worth your angst. If you feel your agitation rising, just walk away. Find someone else to talk to. Help in the kitchen. Play with the dog. Go out to the garden. Ride into the sunset. It’s just not worth it.

I hope this may be of assistance. May the best in life and love and happiness be ahead of you.

Graeme Cowan inspires the discouraged to bounce back and thrive. He is an Australian based speaker and author of the BACK FROM THE BRINK book series.

www.Facebook.com/BackFromTheBrink

www.Youtube.com/user/Strive2ThriveTV

Tags: avoiding Christmas stress, Christmas anxiety, difficult person, holiday stress, overcoming depression, wellbeing strategies

There are proven things that leaders can do to create and enhance robust work cultures in challenging times. It is also very easy to be distracted and have practices that destroy organisational energy.

Many people confuse busyness with effectiveness, and hours worked, as a measure of productivity. Multi-tasking is standard practice. Research by David Meyer shows that switching tasks increases the amount of time it takes to finish the primary task you were working on by an average of 25 percent.

In short, juggling activities is incredibly inefficient and ultimately weakens a culture.  This juggling contributes to extraordinary levels of unhealthy stress. The recent RUOK?atWork survey showed that 40% of Australian workers” typically feel stressed out every day with 12% experiencing extreme stress.

Extreme stress leads to suboptimal performance and for some, depression and/or an anxiety disorder. A recent Medibank report reveals that 34% of all lost productivity can be attributed to the absenteeism and presenteeism (people at work but not fully productive) related to depression and anxiety disorders.

Having carefully weighed up the evidence, I believe that these 5 things are critical to having a robust and resilient work culture that thrives.

1. We trumps me

Ideas workers are motivated by purpose. Knowing how their work contributes to the greater good is essential for an energised work force. Leaders who can communicate their mission in a compelling way will increase their employee’s energy levels. No I’m not talking about “Our mission is to maximize shareholder value” but something that let’s everyone know your raison d’être. For example Ramsay Healthcare’s (RHC) “People caring for people”.  Most organisations have these statements framed on the on the wall, it quite another for leaders to consistently “walk the talk”. If it is done well it will pay dividends. In the last 10 years RHC have returned 2500% to shareholders versus 147% for the ASX.

Only 27% of highly stressed employees in the RUOK?atWork Survey agreed with “my organisational purpose energises me” compared to 66% of employees with low levels of stress.

2. Acknowledge Progress and Setbacks

In a surprising study summarized in Harvard Business Review (May 2011), researchers Teresa M. Amabile and Steven J. Kramer interviewed over 12,000 employees – particularly knowledge workers and members of project teams - to discover what motivates them. Respondents said employee recognition is the least effective way to motivate them. Yet, 95% of managers surveyed said they believed employee recognition was the most important way to motivate employees.

In their research, the authors conducted an analysis of daily diaries kept by teammates on a variety of projects. Their conclusion is clear: what motivates people on a day-to-day basis is the belief they are making progress – successful steps forward to achieve a goal.

So, as a leader, what specifically can you do to motivate your team members by supporting their progress?  It is not hard to see where coaching fits in here. However the authors go on to highlight a couple of interesting areas on which to focus introducing the concepts of Catalysts and Nourishers, Inhibitors and Toxins.

It is also essential that supervisors learn to identify and develop employee’s strengths and utilized these to coach and mentor.

Mastering the art of asking “Are you OK?” is essential to stop little problems turning into big ones.

3. Encourage physical wellbeing

In the recent RUOK?atWork Survey only 42% of highly stressed employees said their employer encouraged physical wellbeing compared to 73% of low stress employees. Physical wellbeing can be encouraged by having walking or standing meetings, enrolling employees in the Global Corporate Challenge, having flexible work arrangements that allow time for exercise, gym subsidies.

Interestingly, when we asked employees what were the most effective strategies for reducing harmful stress “doing more exercise” rated second after “speaking to someone at work”. All other strategies nominated were very expensive for a business, such as “take days off” and “look for a new job”. Other elements of wellbeing include knowing and practicing how to relax.

4. Focus on outputs not inputs

Despite extensive research in Daniel Pink’s book “DRIVE: the surprising truth about what motivates us” showing that autonomy and mastery motivate employees, many employers still operate with Industrial Age thinking. For example, most legal firms operate on the billable hour method where employees are asked to account for every 6 minute interval. They are evaluated by how many hours they bill. Lawyers also have the highest levels of depression, substance abuse, and anxiety levels of any profession. This obviously has massive implications for the systems and processes that are utilized by organisations. Do they encourage or inhibit flexibility and mastery?

5. Invest your time wisely

Jennifer Aaker and Melanie Rudd from Stanford University published “If Money Doesn’t Make You Happy, Consider Time,” in the Journal of Consumer Psychology, 2011. They discuss how happiness is indeed a consequence of the choices people make. So what can people do to increase their happiness? Their answer is surprisingly simple: invest your time wisely.

Although happiness is clearly relevant for individuals, businesses should also pay attention. Building a workforce of highly qualified, hard-working, and loyal employees is an essential aspect of staying competitive in today’s global markets. Therefore, being concerned about employee happiness is not just a moral thing to do, but it makes smart business sense as well.

They conclude that the activities that generate the greatest wellbeing are spending time with people you like, work on projects that energize you (these usually allow you to use your strengths), enjoy experiences without actually doing them, focus on the here and now.

What has been your experience? I would welcome your comments/suggestions/questions.

Kind Regards

Graeme

Tags: anxiety at work, depression at work, graeme cowan, mental health at work, resilience, robust cultures, thriving cultures, work stress, workplace mental health

For mental health week I think it is essential to celebrate our uniqueness. I am convinced that honouring our uniqueness in the key to a thriving life. At conception, we won the race from 500 million other sperm. It was the ultimate survival of the fittest. The more we strive to understand the unique elements of our DNA: our strengths, values and passions, and live them, the more effortless our lives become. There is an Indian proverb that says:

Relaxation is who I am; tension is who I think I should be

If we have a predisposition to depression, bipolar, or anxiety it should not define who we are. Sure we have to learn to manage it and be aware of our early warning signs, but there is no reason why that should define us or limit our contribution. Our strengths if developed and celebrated will always outweigh any weakness.

Discover and celebrate your strengths

If you haven’t discovered your top 5 strengths out of a possible 24 strengths, I can’t think of a better time to do it than for Mental Health Week. Martin Seligman and positive psychology movement have made a free assessment available to discover you strengths. They have shown that those people that use and constantly develop their strengths will have a much more fulfilling life than those who don’t. Discover yours now.

Brisbane seminar this Saturday - 7 essential strategies to beat depression for good

I have been often asked when I am presenting interstate. I do travel a lot but unfortunately it is usually for private conferences – not open to the public.

This Saturday October 15 from 2-5pm I will be presenting at the Relaxation Centre in Brisbane. For more information and to register.

In an endeavour to share what I have learnt for those who aren’t able to attend my seminars I have created the following:

BACK FROM THE BRINK Facebook Page

The BACK FROM THE BRINK Facebook Page allows me to share my thoughts on how to bounce back from depression and adversity to live a meaningful life. I have shared over 40 free downloadable resources under these categories:

· Anxiety

· Bipolar

· Carers

· Clinician Resources

· Diagnosis

· Facts

· Lifestyle treatments

· Old people

· Medical Treatments

· Wellbeing

Click the link. Click “LIKE”. Click “Free Stuff”

Let me know if you have any questions/comments/suggestions.

Strive2Thrive YouTube Channel

I have also created this channel to share some insights. Some of the videos on there include:

· Finding a GP that can help with depression

· What if you partner has depression

· Rituals for behaviour change

· Guiding principles to build resilience

· Depression treatments that really, REALLY work

Click here to check them out and subscribe to be advised of new additions. If you have a question you would like me to cover, please let me know.

RUOK?Day 2011

As a Director of RUOK?Day I was delighted with the coverage and impact we achieved this year. I will share more details of this in my next post, but we were delighted to learn that awareness of the day increased from 28% in 2010 to 68% this year. Over 2500 organisations participated in the RUOK?atWork program this year compared to 700 in 2010. More information soon.

Kind Regards

Graeme

Tags: Bounce Back, depression treatments, mental health, natural depression treatments, overcoming depression, resilience

When “BACK FROM THE BRINK: Australians tell their story of overcoming depression” was launched in 2007, I was fortunate that it generated a lot of publicity and I found myself having contact with the general public through talk back radio, book signings, and talks. What truly surprised me was that about 70% of the people who spoke with me were the loved ones of someone living with depression – I thought it would be those with depression. I came to understand that these people were quite desperate to get quality information about how best to assist to person who was struggling. They were also struggling with their own mental health whilst trying to support someone else. That lead me to write “BACK FROM THE BRINK TOO: Helping a loved one overcome depression” which became SANE Australia’s 2009 Book of the Year.

A couple of weeks ago I was in Brisbane delivering a session called BEATING DEPRESSION TOGETHER designed for those with depression and their loved ones. It was once again reinforced how isolated and alone these loved ones feel.

I advocate four things to keep in mind when you discover that a loved one is depressed:

1. learn about depression types and effective treatments
2. help find competent professionals for them
3. It’s not your fault
4. Take care of yourself – you can’t sustain care if you burn yourself out.

I go into a lot of depth into each of these in BACK FROM THE BRINK TOO.

Where can depression caregivers get emotional support?

ARAFMI – Association for the Relatives and Friends of the Mentally Ill

This group has been around for a long time and from anecdotal feedback, it appears that its support groups appear to be more focussed towards those supporting someone with a chronic illness such as schizophrenia. In their resources section they do have a very good overview of legislation pertaining to carers. They have support groups and discussion forum – including “living with a husband with anxiety and depression”.

Carers NSW

There is a Carer’s group in each state – each with a separate website. This group is targeted to all carers – not just those with a loved one with a mental illness. Having said that, because mental illness is a significant area they have dedicated group focussed on the needs of this community. They have a good listing of information and resources for carers. They also have a 6 carer phases interactive course.

Partners in Depression

I really like what I hear about this group. My friend Lucy Brogden is the patron for the organisation and first brought it to my attention. It is run by the not for profit Hunter Institute of Mental Health and the development of the course was jointly funded by beyondblue. It has also received some funding from NIB Health Fund.

Their centre piece is the Partners in Depression Program.

Partners in Depression is a group education program designed to address the information and support needs of those who care for or love a person experiencing depression. It is a six session program run by two facilitators in community settings.  

The six session format of the program includes coverage of the following topics:

• Session 1 - Introductions and building awareness
• Session 2 - Insight to caring, understanding depression and its treatments
• Session 3 - The caring and support experience
• Session 4 - The support experience and introduction to cognitive behaviour therapy
• Session 5 - Suicidality, self harm and communication strategies
• Session 6 - Help seeking, support and resources and planning for the future

I really like the fact that it has been developed knowing the significant stress that is placed on a caregiver and it provides practical steps. They have developed a train the trainer model which means there are now a number of groups run around Australia.

What’s been your experience?

Have you tried any of these groups? What’s been your experience? Have you found other places to get emotional support? How do you sustain your energy?

Kind Regards

Graeme Cowan

Tags: back from the brink, depression, effective depression treatments, graeme cowan, natural depression treatments, overcoming depression, partners in depression, partners with depression

In an alarming indictment of Australian risk management procedures, over 50% of employees don’t believe that there are systems and management practices in place to stop little problems turning into big ones, or in providing clear guidance for handling a crisis, an RU OK? at Work survey revealed.

It also showed that 13% of Australians feel that nobody at their workplace cares about them as a person.  Graeme Cowan, Director of R U OK? at Work says these figures have huge implications for morale and organisational productivity.

 Not happy Jan….

The survey, conducted in July by AMR Interactive, was designed to drill down to root causes of workplace stress. “The R U OK? at Work survey shows how these issues are manifesting,” says Cowan with 40% of people saying they typically feel tense or stressed out at work; with 10% highly stressed.

Cowan believes management need to do more to monitor staff and be proactive when noticing problems. “We’re seeing a real gap here, where people need to be checked in on. The survey shows the most vulnerable do not seek help. Managers are letting them fall through the gaps.”

This stress has substantial implications for productivity, with 75% of stressed workers reporting that they are not achieving all they are capable of. Only 30% of these stressed workers are satisfied with the work/life practices of their organisation compared to 80% satisfaction for non stressed employees.

 In a stark comparison, 77% of non stressed workers said their organisation encouraged physical wellbeing, whilst only 39% of stressed employees felt the same.

What can employees  do  to help colleagues?

1.       Learn how to ask “Are you OK?” to someone you think may be struggling and encourage them to seek expert help – to access free guides register your business at www.ruokday.com.au

2.       Encourage your team to participate in RUOK?atWork on Thursday September 15.

3.       Consider walking meetings. A Harvard study shows they produce high quality outcomes in 20% less time.

Implications for leadership

1.       Examine why most employees don’t believe there are systems in place to stop little problems turning into big ones.

2.       Consider how you can better encourage physical and mental wellbeing in the workplace

3.       How can you better communicate to employees the community benefits of your organisation’s mission and build in better recognition practices?

What is the RUOK? at Work Program?

On Thursday September 15 participating organisations will invite their employees to reach out to someone they are concerned about – either a loved one or a work colleague - and ask “Are you OK?”

In the time it takes to have a coffee, you can start a conversation that could change a life. Join 2000 organisations and register for free at www.ruokday.com.au to access full resources and merchandising material.

About the RUOK? at Work Survey

AMR interviewed 764 employed Australian residents living across all states and territory, to understand Australians’ experience of stress in the workplace from July 11-29, 2011. The data has been weighted to be representative of the employed Australian population. The questions were based on the findings of a global literature search that identifies root causes of harmful stress.

The full survey results and commentary can be down loaded.

For further information please contact Graeme Cowan on graeme@graemecowan.com.au or 0414 487 072.

Tags: anxiety at work, bounce back and thrive, depression at work, graeme cowan, lost productivity, ruok?atwork, ruok?day, stopping little problems becoming big ones, workplace mental health, workplace stress

In 2000 I was the Joint Managing Director of a Management Consulting Firm. It was also the year I crashed and burned and descended into unimaginable 5 years of hell which my psychiatrist described as the worst depressive episode he had ever treated. It’s hard to imagine that over that period I tried 23 types of medication, had 20 treatments for ECT (or shock therapy), was hospitalized 3 times and made a number of suicide attempts.

I was fortunate that my organisation was quite supportive, but I was on my own to navigate EAP services, Income Protection Insurance, Rehabilitation consultants, GP’s, psychologists, psychiatrists, “independent” psychologists and psychiatrists, Superannuation Trustees, Advisors to the Trustees, 3  Trustee Adviser Administrators, private detectives, forensic accountants, and Group Insurers. When you are in the black hole of depression clarity is impossible. I’ll let you in on a secret; I was the only one who had the vaguest idea what was going on. If I showed you the goat track of a process map that outlines how all these parties work together you would just shake your head in disbelief.

But enough about me…….

The World Health Organisation says that depression is the most disabling illness in the western world today. A recent study by Medibank Private shows that depression, bipolar, and anxiety disorders account for around 35% of all workplace productivity loss. In research I did in 2007, only 9% of people with depression were comfortable discussing it with work colleagues. We have the biggest cause of lost productivity in the Australian workforce, and only 9% of those affected feel comfortable talking about it. The ultimate pink elephant in the room. What is even more astonishing is that a study done by the University of Queensland, found that for every $1 spent on a program focussing on early intervention and treatment, over $5 in incremental productivity gains were realized versus a control group. Proposals that offer a 500% ROI never come across board tables for consideration, so why is reform “in the too hard basket”?

Industry superannuation funds representing over 6 million employees have banded together to form SuperFriend, so that a cohesive plan can be established to address this madness. It’s time for HR Managers to also show some chutzpah and in the spirit of Peter Finch from the movie Network start shouting from the windows “I’m as mad as hell and I’m not going to take it any more”.

EAP is a dinosaur

EAP can be a valuable service to those that are struggling but at best they only address the tip of the iceberg. Conducting “Resilience” and “Worklife Balance” courses can also be helpful, but as the seminal global study conducted by VicHealth called “Workplace Stress in Victoria” revealed, only a systems approach which incorporates prevention and early intervention strategies yields the best results for both the employee and employer.

To understand what is meant by a systems approach it is worth looking briefly at the legal industry.

A study completed by the Brain and Mind Research Institute in 2008 showed that 31% of lawyers have a high to very high emotional distress level compared to the general population of 16%.  To their credit, Australia’s 5 largest law firms have jointly established a group called “Resilience in Law” to start to address these disturbing figures. They have prepared an excellent video where a brave group of employees (including a couple of partners) have discussed living with a mood disorder. They are also endeavouring to train their employees to be more resilient. Admirable initiatives, but the systems approach requires a much deeper understanding of the root causes of depression. In my view, it’s hard to envisage any significant progress in the legal profession, when the insidious “billable hour” dominates. It is a system that rewards long hours and ineffective work, dominates Performance Management and Remuneration, and creates a culture of “fudging” to meet revenue targets. It’s  not congruent with good personal wellbeing. The system is contrary to all evidence, on the requirements to engender an engaged and motivated workforce in the knowledge economy.

What we can learn from Chairman Mao?

Addressing systemic problems requires a long term perspective, and considerable will. What can we do right now? In 1965, Chairman Mao, became frustrated by the inertia from the Chinese Health Ministry in addressing rural health problems. He sent many of the Western trained doctors to work in the rice paddies and replaced them with carefully selected villagers, who were trained in the basics of epidemic prevention, hygiene, sanitation, wound care and good nutrition. At first glance, this would seem to be another of the disastrous strategies of the Cultural Revolution, but a strange thing happened. These “barefoot doctors” came from the local villages and were chosen because of their credibility and influence in the community.  The simple preventative health changes they recommended were much more readily adopted than if they had been mandated from Peking. The World Health Organization regarded the barefoot doctor program as a “successful example of solving shortages or medical services in rural areas”.

I strongly believe if a similar strategy (in the context of a systemic approach) was followed by organisations it would also yield substantial benefits. In any organisation there are people that have tremendous influence which often has no correlation to where they sit on an organisational chart.

Imagine if these barefoot doctors were trained to help identify someone who may be experiencing extreme stress, and encourage them to visit a local GP or Psychologist with rigorous mental health diagnostic skills. Imagine if they knew that recovery from depression and anxiety wasn’t just dependent on taking a pill and seeing a psychologist but also depended on getting regular exercise, the emotional support of family, friends, and work colleagues, and learning how to relax. Imagine if they knew the importance of following up to see if the person had taken action and was following the proposed treatment plan.

Register for RUOK?atWork – Thursday Sept 15, 2011

RUOK?atWork is a not for profit initiative created to build a nation of barefoot doctors in the workplace to stop little problems turning into big ones. Last year almost 700 organisations including the CBA, Rio Tinto, Optus, NSW Fire Brigade, and Queensland Police participated. They invited their employees to reach out to someone they were concerned about – whether a loved one or work colleague – and ask “Are you OK?”. User friendly materials encouraged a 3 step process, Breaking the Ice, Asking Non Judgemental Questions, and Encouraging Action. Even more importantly, the resources provided simple guidance on how to find expert help. Ninety five percent of those that participated last year said they planned to do so this year (with 5% undecided).

Register for Free at www.RUOKday.com.au to access “How to ask RUOK?”

Tags: depression at work, mental health at work, mental illness at work, wellbeing at work

In the lead up to ANZAC  Day this year I had the opportunity to speak with a couple of veterans – one from WWII and one from the conflict in Afghanistan. Both confirmed that they had experienced a lot of stress when returning to Australia yet both said they found it very hard to talk with their colleagues about their anxiety.  Although I have never been into battle, I could closely relate to their apprehension of admitting a “weakness”.

While my wife slept beside me, and my young daughter was in the next room, I made the incredible decision to choose death. I didn’t even know what clinical depression was the first time I tried to take my own life. I was 31 years old and by all appearances had a successful life. I was married and had a one year old child and had recently moved into a new home. I had a successful career in sales and marketing but had just taken a career fork, moving into recruitment. Whilst I was enjoying my new role, I really hadn’t had enough time to excel at it, and I was accustomed to doing well at that to which I applied myself.

The uncertainty I was feeling about my career filled me with anxiety. I had continuous tension in my back that wouldn’t go away. Worse than the physical symptoms were the dark thoughts that wouldn’t go away. I saw myself as a failure and my self esteem plummeted. I would be wide awake at 3.30am, staring at the ceiling. I don’t know why I couldn’t reach out and tell someone how bad I was feeling – but I couldn’t. I felt that a man should be on top of life and vainly tried to think positive thoughts – but nothing changed. The early morning waking would leave me drained and hardly capable of working a full day, but I forced myself to keep going and the cycle of decline continued.

Since that momentous night 21 years ago, I have often reflected on why men find it so difficult to ask for help when they are experiencing tough times.

A lot has happened since then  – I’ve had other severe depressive episodes, been divorced, lost my job, written a book - BACK FROM THE BRINK, and now speak regularly on how people can bounce back and thrive from challenging times.  I’m now very grateful to lead a fulfilling and very happy life.

One of the most common questions that is asked at my seminars is “How do I get my husband/boyfriend/male to seek help when he so obviously needs it?”

The numbers don’t lie

Australian men have a life expectancy of 79 years versus 84 years for women.  They account for 78% of suicides, 77% of accidental drowning, 75% of motor vehicle accident deaths, and 67% of melanoma deaths, 67% of lung related deaths, 62% deaths due to cancerous tumours, and 61% of deaths due to heart disease. In the last year 25% of men haven’t seen a doctor compared with 10% of women.

Why is this so?

 It is clear that women are healthier than men, but why this is so is not clear. One of the most credited theories is that men have been socialized to self sufficient and encouraged by our culture to be tough. Many men believe that complaining of feeling ill or visiting the doctor is a threat to their masculinity or a waste of time, unless they are sick or injured.

In a recent survey conducted by Harris Interactive of 1,100 men for the American Academy of Family Physicians, 58% of men said they were reluctant to see a doctor. When asked why the two main reasons were:

·         I only go to the doctor if I am extremely sick: 36%

·         I am healthy, I have no reason to go to a doctor: 23%

The problem with this philosophy is that little problems have the habit of turning into big problems if they are ignored.

Of the men, nearly 80% said their spouse/significant other influences their decision to go to the doctor.

How do we start to influence males to visit their doctors more frequently?

Guiding Principles

Be sensitive to the male ego. I remember my wife being totally perplexed and wondering why I had not discussed my absolute despair with her prior to making an attempt on my life. Accept that for many men it is very hard to talk about emotions and feelings of doubt and inadequacy. It is best to talk about behaviour rather than threaten his self-esteem.

Try multiple choice. If a man has difficulty discussing feelings, he may respond better to multiple choice. For example, ‘Are you feeling worried, sad or angry right now?’

Affirm his competence. Again, remember the male ego. You could say, ‘I have always been impressed with how well you have managed so many things’.

Structuring the conversation

Break the ice

Discuss the weather, friends, family etc in a private place – walking outside is ideal.

Non Judgemental Questions

For example, you could say, ‘I’m concerned about you waking up at 4 am and not being able to get back to sleep. What are the things that are causing you to lose sleep? Why does that worry you so much? What do you think can be done about it? Have you considered asking someone else for help/advice?’ If they are struggling to come up with answers, then this might be the time to suggest strategies or someone they could talk to.

Encourage Action

Remember that nothing happens until someone moves. If you have a regular GP you should offer to make an appointment for them (and accompany them if they are willing).If they strongly resist going to the GP you could suggest they do an anonymous online depression test at www.blackdoginstitute.org.au

Subscribe to the Strive2ThriveTV YouTube Channel

I have established a YouTube Channel that provides some further background to my research.

Some of the videos include:

1.       Resilience Guiding Principle One – The Moodometer

2.       Resilience Guiding Principle Two – Strive2Thrive Roadmap

3.       Resilience Guiding Principle Three – Taking Action

4.       Resilience Guiding Principle Four – Problem Solving

5.       What depression treatments really REALLY work

View Strive2ThriveTV

Join the BACK FROM THE BRINK FACEBOOK FAN PAGE

At this page you will find free downloadable pdf resources (over 40 available), videos and a community that is happy to share ideas and resources to bounce back and thrive from adversity and depression. Ask me any questions.

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When Adversity Strikes, What Do You Do?

This Harvard Business Review article by Paul Soltz, tells how our core stories are about what happens when human beings and adversity collide. From those moments tragedies unravel and greatness is spawned. Adversity both destroys and elevates. It both strangles and sparks life.

What is your relationship with adversity? What role has it played in becoming who you are, in forging your essential character and mindset? How has it influenced your optimism, energy, opportunities, relationships, health, performance, capacity, and leaps of faith? Can you think of any force that has been more profoundly formative? Read More

 As always, if you have a comment about any of these topics please respond to the blog.

Kind Regards

Graeme

Graeme Cowan is an International Speaker and award winning Author of the BACK FROM THE BRINK book series who educates people on how to bounce back from challenging times.  www.GraemeCowan.com.au

Tags: anxiety, depression at work, depression treatments, mental health speaker, overcoming depression, resilience speaker, work stress

Provocative title?

Can I ask you to invest 20 minutes of your time to answer a survey that will send loud shockwaves through the mental health policy world. If you can’t spare 20 minutes now, please schedule a time in your diary when you can complete the Holistic Depression Treatment Effectiveness Survey.

Let’s face it; the “experts” have failed badly. Despite endless reports, meetings, and proposed new strategies, the mental health landscape is littered with defeat. Despite increasing spending the World Health Organisation says that depression is now the most disabling illness in the world, and its incidence is climbing rapidly.

The experts and the bureaucrats constantly say they are following “evidence based” medicine when they claim the only effective treatments for depression are antidepressants and psychological counselling.  If it is, why are the rates of depression climbing so rapidly. We can only assume they are under informed, underfunded, or incapable of implementation – or perhaps a combination of all three.

Their blinding us with science!!!

The scientific reductionism approach to medicine is highly flawed when it comes to something as complex as human psychology (from Latin word psyche which means “study of the human soul”) Ever see a published psychology study about the soul? It assumes you can find “one silver bullet” that will turn you from despair to wellbeing.

I’m not the only one to doubt the veracity of “evidence based medicine”. In his recent book “WRONG:  Why experts keep failing us” David Freedman reveals some startling facts. When examining hundreds of studies from prestigious medical journals, often it was only a matter of months, and at most a few years, before other studies came out to either fully refute the findings or declare that the results were “exaggerated” in the sense that later papers revealed significantly lesser benefits to the treatment under study. This study revealed that there was a TWO OUT OF THREE wrongness rate in published medical research from the most elite medical journals. What is even more worrying in that this “most trusted research” represents only one tenth of one percent of all published medical research. Unfortunately psychological research has a reputation for being the least reliable of all.

The other huge flaw in the “evidence based” approach is that research funds tend to follow the money – huge amounts are spent on “commercially viable intellectual property” e.g.  gene therapy or identifying new pharmaceutical compounds, and relatively nothing is spent on lifestyle strategies such as the role that exercise, relationships and good nutrition can play in ones mental wellbeing.

Not all doctors are equal

Can we also assume that doctors and psychologists are following the best “evidence based approach”? Unfortunately, or perhaps fortunately, not. A recent study published in Discover called “Reckless Medicine” revealed that less than half the surgeries, drugs, and tests that doctors recommend have been proved effective. No wonder healthcare costs are ballooning out of control.

I’m not saying that research is not important, in fact quite the contrary. What I am saying is that we are giving “experts” standing behind “evidence based” research much too much say in how mental health services are run. Text book theory doesn’t translate to good patient care.

Please have your say

Take the survey now: http://www.surveymonkey.com/s/DepressionTreatment

It’s time that the real experts – those who have lived with a mental illness, to start telling the leaders of mental health policy and funding what should be done to start improving things. It’s time for us lunatics to start running the asylums.

In collaboration with the Black Dog Institute I have developed a survey designed for us fellow travellers to tell us what works best from MOST THINGS you have tried. It covers lifestyle strategies, psychological counselling, emotional support and pharmaceutical intervention. It also asks what can be done to make the most difference in reducing stigma in the community and the workplace.

It takes about 20minutes to complete, but I believe it is one of the most important things you can do to change a system that is clearly broken. Already 4000 people from around the world have completed the survey and I would like to grow that number to 10,000 so that our voice can no longer be ignored. What those 4000 have already said is vastly different to what is happening now.

Please have your say

Please provide your input by doing the survey: http://www.surveymonkey.com/s/DepressionTreatment

Many thanks.

Approaching Seminars

Sunday March 20, 3.00-5.00pm,

BK Retreat Leura – 1.5 hours west of Sydney – by donation

BEATING DEPRESSION TOGETHER

7 immutable principles for those who wish to overcome depression and the people that love them. In this two hour session Graeme will discuss what advice he would give a best friend if they were beset with depression. It will be practical and eminently implementable.

REGISTER HERE

Wednesday, March 23, 6.00-8:00pm

City Fringe Meditation Space, 99 Crown St, East Sydney – by donation

10 Things Science Says Will Make You Thrive

Many people feel that although they are busy, there is something missing from their life and this only adds to a persistent hollowness. Graeme relates to the true way to thrive is to understand our mood and energy levels and results will take care of themselves by focusing on the process and not on the outcome. But how do you sustain a good mood in a turbulent world? How to know your top 5 strengths and apply them in your personal life and career?

REGISTER HERE

Thursday July 14, 7.00-10.00pm

Relaxation Centre Brisbane

15 South Pine Rd,
Alderley, 4051

BEATING DEPRESSION TOGETHER (same content as above)

Cost $45 per person or $70 for pair

REGISTER BY CALLING 07 3856 3733 or email relaxcentreofqld@powerup.com.au

Back From The Brink Facebook Fanpage

I have created this Fanpage to build a community where we can help each other. You’ll find lots of free resources and videos there. It is also a place where you can make requests to the community. Don’t forget to click the “Like” button.

ACCESS IT HERE

Virtual Seminars

For a long time I have had requests to speak more frequently around Australia, which unfortunately is very difficult with my current commitments. To help address this, I have created a YouTube Channel called Strive2ThriveTV. If you subscribe to that channel you will be notified of new videos when they are uploaded. You can also put in requests for topics you would like me to cover.

May the best in life and love and happiness be ahead of you.

Kind Regards

Graeme

PS. Only we can refer to each other as lunatics J

Tags: depression treatment survey, mental health advocacy, what works best for depression

I think most of us who have struggled with depression or anxiety have experienced the dilemma of whether to disclose our illness to our work colleagues or not. Whilst it makes sense to discuss what we are living with, many of us are fearful that if we are honest, it could jeopardise our career prospects.

I believe that most of this fear stems from the people not be able to have sensible conversations about depression and anxiety in the workplace. This is ironical as it is the biggest contributor of lost productivity.

Whether you work for small company or a large employer, I would like to propose something that we all can do to make a difference. Ask your boss if your work team can start conversations that could change lives on October 7^th by participating in RU OK? At Work. Whilst we all recognize that things won’t change over night – we have to start somewhere. If you don’t feel like pushing it – suggest it to someone else in your team.

RU OK? at Work is the workplace component of RU OK? Day. All workplace posters and guides can be found by going to RU OK? at Work and registering.

R U OK? Day, now in its second year, is the first national initiative of its kind. On R U OK? Day on October 7, all Australians will be encouraged to use the time they take to have their coffee to connect with their friends, loved ones and colleagues by reaching out to anyone doing it tough and having a conversation that could change a life.

Simply ask: “Are you okay?” and help stop little problems from turning into big problems.

Why start a conversation? Because a lack of connection can have a critical impact on someone’s social and emotional well-bring and, at times, this feeling of disconnection can place people at risk of taking their own lives.

That’s why R U OK? Day on October 7^th will bring Australians together in a bid to help prevent risk factors contributing to suicide. It will also promote awareness of help and support services available by raising the profile of existing organisations that provide such services to those who need support.

More information on RUOK? Day  and resources for how to have an effective conversation and where to get help can be found at www.ruokday.com.au.

What are your suggestions, questions, comments about RU OK? at Work? Please reply to this post.

Kind Regards

Graeme

Tags: adversity, anxiety, depression treatments, ruok, work stress, workplace stress