With all our medical advances, why is it that the incidence of depression and anxiety is skyrocketing. The World Health Organisation says that depression is the most disabling disease in the Western World today, yet all mental healthcare specialists seem to talk about is “evidence based” treatments such as counselling and anti depressants. Whilst these strategies have been shown to be helpful for some people, if this was really cutting edge advice, why aren’t we seeing the incidence of depression declining or at the very least plateauing. This in no way seeks to imply that medication and psychological counselling don’t have their place in treating depression, just that we are not exploring all the variables

Having interviewed thousands of people who have battled with depression, I am convinced that there are some serious issues with the “evidence based” approach to treating depression. These can be summarised as follows:

1. The “evidence” is where the money is

Unfortunately clinical trials are very expensive to run so private funding will only be directed towards those areas where “investors” can see a return on investment. In the world of depression treatments, this means that the vast majority of funds are directed towards medication and psychological counselling interventions. This means that important lifestyle strategies such as exercise, emotional support,nutrition, relaxation, and fulfilling work are relatively ignored. Ironically these less discussed strategies can be much less costly to implement.

1. When you’re holding a hammer everything looks like a nail

The vast majority of depression treatment studies are undertaken by doctors or psychologists. Whilst there is nothing wrong with this per se, most of these studies are evaluating areas where they have expertise (which makes sense). This means that the comparisons are often looking in isolation at one drug verses another (or a placebo) or one psychological intervention verses another. Quite often meaningful advancements in areas can come from someone outside the established “paradigms”. I love the story of the little boy who came across rescue workers who had been struggling for 3 hours with sophisticated hydraulic equipment trying to dislodge a truck which had been tightly wedged under an overhead bridge.  After being encouraged to leave the site he quietly said “Why don’t you let down the tyres?”.

1. We are not just DNA

As human beings our bodies and minds are intricately linked. Depression treatments that focus purely on a “biological illness” are seriously limited. Much of the despair that exists in the western world today can be linked to loneliness, family breakdowns, excessive and unfulfilling work, and financial crises. Saying that depression is caused by low levels of serotonin is like saying teen pregnancies are caused by a sperm fertilising an egg – yes, but…. Depression treatments that fail to reconnect us with our passions and purpose are ultimately going to be short lived solutions.

What are the right depression treatments?

To find out what works best in managing or overcoming depression, we must ask the people who are living with depression what works best for them. In 2007 I asked just that, and their answers were (in order) exercise, support of family and friends, psychological counselling, fulfilling work, relaxation/meditation, nutrition and medication.

Coincidentally, the Black Dog Institute (BDI) –one of the pre-eminent mood disorder units in the world - also undertook a study directly asking those with depression what helped them most. Although there were some differences in the studies, lifestyle strategies were also shown to be extremely important. One of the authors of the published study, Professor Gordon Parker, who has been practicing psychiatry for over 30 years, has now started advising General Practitioners and their patients to exercise regularly to aid recovery.

If Professor Parker, who has published over 600 clinical papers and book chapters regarding mood disorders, can learn something from these results, perhaps we all can.  

Tags: back from the brink, depression anxiety, depression help, depression research, depression treatments, exercise and depression

I flew to New York on May 25 with the objective of finding Literary Agent to take on my book to complete US versions for the existing two.

On Wednesday I went to the first day of Book Expo America which was dedicated to authors. There were about 400 people there and they had some great seminars regarding how to plot your way through the publishing maze which gave some excellent insights.

We then had the opportunity to do a “pitch slam” with Literary Agents. Over here, publishers receive an average of 300 manuscripts per day and very rarely follow up any directly and rely on the LA’s to vet opportunities.

In “pitch slam” the 400 authors have 3 minutes to tell their story to about 50 LA’s with a view to getting feedback on their project and perhaps a signal of interest that could lead to the LA taking on their project. Before getting to NY I had done a lot of research to find out who would be the best LA’s to take on my project. I had targeted 6. Of the 6 I slammed, 5 expressed interest and my 3 top picks expressed very strong interest including one saying “I’m totally on board – don’t bother seeing any other agents”. I had emailed my top 3 LA’s prior to getting to NY with my new 3 minute keynote demo and I think this added considerable momentum (http://www.pineapplemedia.com.au/Cowan.html  )

I had another great day yesterday and by chance met with Judith Curr the Executive Vice President of Atria books which is a division of Simon and Schuster. Believe it or not she is an Australian who is now based in New York. She was the publisher of “The Secret” which has now sold 7 million copies. She asked me to post her copies of my books and follow up with her executive editor which is very exciting.

A key part of the US success will be getting on board the American celebrities to be interviewed in BFTB. BFTBToo is ready to go almost immediately but it makes sense to launch the 2 together.

On Monday we head to Chicago to see the Depression and Bipolar Support Alliance to get their support (which I need for local credibility with the high profile people) for getting the project underway. I have already had email and phone contact with them and it is looking very good.

On Friday night Hilary and I went to “Jersey Boy” – a musical about Franky Valli and the Four Seasons. It was just sensational – real stand up, shout and cheer show. After that we strolled through Times Square which at 11pm was just jam packed with people – you feel guilty for going to sleep in this place.

Hope all is well back home.

Kind Regards

Graeme

Tags: back from the brink, depression books, depression help, depression treatments

I’ve just had some exciting news that “BACK FROM THE BRINK TOO: Helping your loved one overcome depression” has been named SANE’S 2009 BOOK OF THE YEAR which is very humbling and gratifying at the same time.

After the success of my first book, it quickly became apparent that the family members of those suffering with depression were often desperate themselves. This lead to me researching over 700 depression caregivers and their loved ones, to find out exactly what questions they wanted answered. I’m sure this was a major reason why the book was nominated. I would like to sincerely thank those who participated in the research and of course my parents, who had faith in me when I had lost faith in myself.

FROM SANE’s PRESS RELEASE

SANE Australia Executive Director Barbara Hocking says family members of people with mental illness play an enormous role in providing care and support for people living with depression, as well as other forms of mental illness.

‘Not only does Back From The Brink Too provide much-needed practical guidance for family carers and raise awareness of the key role they play in helping to manage mental illness, but it also works to reduce the isolation many families experience,’ Ms Hocking said.

‘We are delighted to present the SANE Book of the Year Award to Mr Cowan for his contribution to helping the community better understand the experience of mental illness and its impact on families and friends’

Graeme Cowan says of the Award, ‘I am honoured and humbled that SANE Australia has recognised my book. Only after recovering from my own depression did I come to understand the tremendous toll that my illness caused my family.  I would like to dedicate this award to my loved ones and the two million other Australians that support those living with depression and anxiety.’

END OF RELEASE

What is more gratifying than the award is regularly receiving letters and email from people saying that both books have been a tremendous help to them.

If you know someone who is trying to support a loved one with depression, you might consider forwarding this email to them.

Further details regarding the book (and purchasing facility can be found at: www.DepressionCarer.com )

I am heading off to New York, Chicago and Los Angeles on May 25 to meet with Literary Agents and two major US Depression organisations with a view to doing US versions of both books. The award couldn’t have come at a better time.

Kind Regards

Graeme

www.IamBackFromTheBrink.com

Tags: depression book, depression caregiver, depression carer, depression help, depression treatments, overcoming depression

I was recently asked to be one of the judges for the Black Dog Institutes writing competetion entitled “Tackling Mood Disorders in the Workplace”. The winners were announced yesterday by the Minister for Mental Health The Hon Barbara Perry.

PRIZES

1. Maree Matic - Sydney
2. Daniel Taylor - Adelaide
3. Rowena Harris - Tasmania

In addition to these 3 there were 10 “Highly Commended”

JUDGES SUMMARY

The judges were very impressed with the standard of the 200+ submissions to this years contest. Entries came from those living with mood disorders, their work colleagues, and managers. When assessing each contribution we decided to place equal weight on relevant ideas raised, writing style, and practical suggestions to improve the current situation.

The vast majority of entrants still feel very reluctant to disclose their illness for fear that it will have an adverse effect on their career prospects. It seems that a “work mask” is still very much the norm. Comments such as “the act is taking its toll” and “hiding in the toilet is not a long term solution” reflected the quiet despair.

The occupations most frequently represented in the submissions were teachers, lawyers, and recruitment consultants.

It was very difficult to narrow the final field down to the 3 winners and 10 “Highly Commended”, but they provided some clear messages.

Organisations need to be much more proactive in educating employees and managers, in how to recognise and support those with a mood disorder. Whilst the importance of appropriate policies was highlighted, contributors stressed that the most crucial element was a compassionate manager who reached out to address the issue quickly. Many lamented that “values on the wall were not lived on the floor”.

Whilst diversity in gender, ethnicity, and physical disability, is actively encouraged in many organisations, it is sadly lacking for those with mood disorders. In addition to supportive work colleagues, the other critical organisational requirement is flexible hours to allow for doctors/therapist visits, and low mood in the morning, when required.

Those working with mood disorders stressed that they also have an obligation to balance their lifestyle and manage their mental health – “Ironically it was only when I started working on my wellness that my work performance improved.” Many also explained that their mental health was made worse by pursuing the wrong career. Despite the challenges of work, the vast majority stressed how important it was to their self esteem.

It was extremely difficult to pick a final winner, but we felt that the contribution chosen, could well act as a summary for all 200+ entries.

Graeme Cowan, Judges Chairperson May 28, 2009

I couldn’t help but think that this competition was so important as it raised so many ideas regarding how things could be improved in the this area of where we all spend so much time, yet as I have highlighted previously, only 9% of those with depression feel comfortable discussing their condition with work colleagues - how absurd is that.

IF YOU COULD CHANGE ONE THING

If a genie suddenly granted you one wish about how you would change the workplace to be a better place for those who live with depression and anxiety, what would it be. I would love you to respond to reply to this blog with your thoughts.

Kind Regards

Graeme

Tags: anxiety, burnt out, depression, depression cure, depression help, depression treatments, work stress

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Tags: depression anxiety, depression at work, depression cure, depression help, depression treatments

I recently read last Saurday’s Los Angeles times

To read the full article go to the news section of www.IamBackFromTheBrink.com

It provides some pretty startling results from a recent survey:

• 70% of US residents are experiencing significant stress due to the current state of the economy
• 49% say they have regular anxiety
• 48% are sad or depressed
• 33% are experiencing insomnia

A 2007 Medicare Private funded research study showed:

Absenteeism costs the Australian economy $7 billion whilst presenteeism (where workers are not fully engaged due to distress or illness) accounts for $25billion. They found that the greatest contributor to this lost productivity was depression.

An estimate of the cost of depression in Australia is $6.3billion.

A 2007 report ”How to improve the behavoural health of an organisation” by the global consulting firm Sibson showed:

• Mental health issues (of which depression and anxiety contribute the vast majority) account for 47% of all lost productivity compared to 26% for physical illnesses.

So how comfortable are people with depression talking with work colleagues about it?

With the level of stress faced by the workforce highlighted above, you would hope that employees would feel comfortable dsicussing their depression with work colleagues. In research I did for my first book I found the disturbing result that only 9% could discuss this situation with confidence it would not adversely affect how their peers viewed them.

I have recently been asked to be a judge for a writing competition by the Black Dog Institute called “Tackling mood disorders in the workplace”. The 100+ essays I read revealed the sad situation where people with mood disorders are on the whole, terrified of revealing their conditon to fellow employees for fear it will jeopardise their career prospects.

This situation is untenable, and on April 1st I will be speaking at a forum for 100 HR professional hosted by the outplacement, and career planning organisation www.Directioneering.com  to highlight the absurdity of this.

I will also be outlining what I believe is an achieveable path forward to make the workplace as friendly to those with mental illness as it is to people with cancer, a broken leg, blindness or any other physical disability.

In my next blog entry I will address this way forward. If you have any comments regarding what has been outlined, please respond to this blog.

Kind Regards

Graeme

Tags: anxiety, burnt out, depression, work stress

I was very surprised when I did my original research for BFTB, that fulfilling work was rated as the fourth most effective strategy for overcoming/ managing depression. People with depression rated fulfilling work ahead of medication for example, which I’m sure would amaze many people.

FIFTEEN YEARS IN RECRUITMENT AND OUTPLACEMENT TOLD ME THIS WAS TRUE

When I reflected on the thousands of people I had tried to assist with their careers over those 15 years, I intuitively knew how important fulfilling work was to people’s mental health and self esteem.

If you look at the news section of my website - www.IamBackFromTheBrink.com - you’ll see that a number of stories have been published on this topic in the last week, due the the world financial crisis.

WHAT DO YOU DO IF YOU ARE 0-5 ON THE MOODOMETER

If you are depressed, and aren’t capable of working full time, I would strongly encourage you to consider voluntary work. When I was recovering I worked as a volunteer at Volunteering NSW (I know similar organisations exist everywhere).

One of my jobs was interviewing people to help identify which skills they would like to use and then finding charities near them, that would enable them to use those skills. I had the pleasure of watching how long term unemployed and people with a mental illness would grow in confidence when they had the opportunity to positively contribute to a charity. These roles aren’t nearly as pressurized as full time work, yet still offer the benefits of social contact and providing people with a sense of purpose.

Check out www.govolunteer.com.au and http://www.volunteer.com.au/?cid=sk:main:au:nav:vol  to get an idea of the wide array of roles available.

WHAT DO YOU DO IF YOU ARE 4-10 ON THE MOODOMETER BUT NOT ENJOYING YOUR WORK

My strong suggestion would be to do so form of assessment to help understand what skills you get most satisfaction out of using. There are many options out there but a really user friendly and practical one I have used myself is found at www.assessment.com- It is called a Motivational Appraisal of Personal Potential (MAPP) You are asked to go through a questionnaire (takes about 15 minutes) and then you receive your report. There is a free version, but I found the best value one to cost about $US40. This report really resonated with me and gave me a great sense of career direction.

The report identifies your top 10 innately motivating skills but then importantly it then tells you which roles allow you to utilise them. How you go about transitioning to these new roles is too much to cover now, but knowing where you want to head is half the issue.

BLACK DOG INSTITUTE “MOOD DISORDERS IN THE WORKPLACE” WRITING COMPETITION

I have just been asked to be one of 3 judges to help assess the winners in the above competition. It is great this topic is getting some deserved profile. A book will follow on this subject, so keep an eye out for that.

If you have any questions or comments regarding this topic, please respond to this blog.

Kind Regards

Graeme

Tags: anxiety in the workplace, black dog institute, depression, overcoming depression, stress, voluntary work, workplace stress

This is probably one of the most frequent requests I get, and it is extremely difficult to come up with an definitive answer because every situation is unique. Isobel’s heartfelt enquiry is typical.

QUESTION

Tags: caregiver, carer, depression, Emotional Support

GUILT AND DEPRESSION

In the latest seminar series on beating depression I am running, a participant asked a very important question which is listed below. My response also follows. If you have any comments about your own experience with guilt and depression, please respond to this blog.

I was wondering if you would be talking about guilt at all? I was just about to send my question on guilt when you said your goodbyes, so serves me right for not having the courage to do it earlier. I just wondered…. what strategies do you have, if any, for coping with the guilt you feel when you aren’t able to do chores / tasks / exercising / all those things you’re supposed to do for yourself and others ? I find it’s so overwhelming. I sit there knowing I have something I’m meant to do, but no matter how hard I try, I just can’t do it. Because I can’t, and don’t do it, the guilt then sets in, so I have that burden on top of the burden of knowledge of not completing what I was meant to.

Does that make sense? I find the guilt to be a real issue.

On the positive side, after week 1 of the seminar, I have committed to walking with my dogs. I managed two walks ( took the dogs along ! ) and made it to four walks in the second week. This is the third week but I haven’t been out YET…..I hope to get the four walks in though. So, thank you for that encouragement. I hope to add socialising because I’m a master at isolating myself. Working on that. My intention is to just do one thing at a time with the ultimate goal of getting well and back to work.

I trust you’re getting excellent feedback following each week’s seminar Graeme, and it’s good to hear you covering the needs of carers because the poor things really do work very hard. While I’m looking forward to next Tuesday, I am also very sad that it’s the last in the series. It’s been so beneficial.

Jenny, VIC

Dear Jenny,

Thank you for raising this issue.

Inactivity and guilt is so central to people living with depression. From my own experience with depression I know how hard it is to get out of bed in the morning.

Everyone’s situation is unique but I would like to make the following observations/suggestions:

BE GENTLE ON YOURSELF

Give yourself credit for what you are already doing. You have started exercising. If you miss a day, don’t bash yourself up, but just resolve to do it tomorrow. Depression drains you of your self esteem and it doesn’t serve any purpose to get more whips out to lash yourself. Besides it was unbelievably hot in Melbourne last week (and the tennis was on!!)

FOCUS ON ONE DAY AT A TIME BUT PLAN A WEEK AHEAD

This sounds a bit contradictory, but let me try to explain.

When we are not well, we can only see the million problems we have to solve to sort ourselves out but the truth of the matter is, that we only have today.

I found it very helpful in my recovery when I was asked to plan my week ahead – to work out when I would exercise and see other people. There was something about scheduling it with my carer in the diary that made it seem more definite. Knowing that I had to report back to them in a weeks time also made me more committed. Once that weekly schedule was worked out I then tried to only worry about the day.

TRY TO THINK OF WAYS TO GET YOU WALKING EACH DAY

Decide what time each day you are going to walk and stick to it..

Is there a friend who can accompany you on some of those days?

Try to be really observant on the walk.

Maybe consider keeping a walking log. What did you notice today? Were there any animals, birds, unusual scents, colours or sounds? If you went with a friend, what thoughts or feelings did you discuss?

Each day just focus on getting to the front gate. Getting there is at least 50% of the effort.

Make the daily walk the only thing you have to do this week. Having a walk often has an energising effect.. People with depression say it often serves two purposes. It gives them a sense of achievement for the day and it often enhances their mood. Both these outcomes are good for diminishing guilt. This then often provides the energy for other things (but you don’t have to do anything else).

This week try to walk for 6 days. Getting to the front gate counts as a walk.

OTHER RESOURCES

I found an excellent article on handling guilt at:

http://www.livestrong.com/article/14689-handling-guilt/

Hang in there Jenny.

Kind Regards

Graeme

Tags: depression, exercise, guilt, resilience

Through me time with GROW, I have learnt about the “4 Stabilizing Questions”. I have not only found these to be extremely helpful to me but have also seen them work well in the lives of hundreds of others.

These questions are asked when you are worried or stressed about something.

THE 4 STABILIZING QUESTIONS

1. WHAT EXACTLY ARE YOU WORRIED ABOUT?

It’s amazing how things can seem out of control when they are swimming around in your head. Talk with a friend about what specifically you are worried about. Writing the problem down can also be very helpful. Properly clarifying this can definitely make the problem seem smaller.

2. HOW LIKELY IS IT? IS IT CERTAIN, PROBABLE OR ONLY POSSIBLE?

This question highlights that you should only invest time on those things that are certain or at least probable.

3. HOW IMPORTANT IS IT?

Don’t invest time and energy into things that are not important. GROW has another saying - “Be content to be discontent in many (minor) things”.

4.WHAT CAN I DO ABOUT IT?

Important problems start to shrink when you take action. Remember action is the enemy of depression and anxiety. Try this approach and let me know how you find it by responding to this blog.

Kind

Regards

www.IamBackFromTheBrink.com

Tags: anxiety, depression, stress, worry