In research I did for “Back from the Brink Too” I was amazed at how many women were at a loss as to how to encourage their men to see a doctor when it appeared they were showing all the classic signs of depression. Either the man would point blank refuse to see a doctor, or they would assert there was nothing wrong. Having gone through a severe depression myself and tried to pretend there was nothing wrong I have some thoughts on this topic.

Men are socialised to be self sufficient

I remember my then wife, being totally perplexed as to why I had not discussed my absolute despair with her prior to making an attempt on my life. I really believed at the time, that a man should be able to sort out their own crisis. Be sensitive to the male ego. Accept that for many men it is extremely hard to talk about emotions and feelings of inadequacy and doubt. It is best to talk about behaviour rather that threaten his self esteem. For example you could say “I’m concerned that you are waking up at 4am and not being able to get back to sleep again. I want you to know that I love you and I don’t want you feel under any pressure to discuss it now, but I’m here if there is anything you would like to talk about which is worrying you.”

Try multiple choice

Because a man often has difficulty talking about feelings, he may respond better to multiple choice. For example, “Are you feeling worried,sad, or angry right now?”

Affirm their competence

Again remember the male ego. You could say: “I have always been impressed with how well you have managed many things. I know at the moment you seem to be having some difficulty and I was wondering if there was anything I could do to ease your load?”

Engage in problem solving through asking the right questions

Let him appear to be in control. You could say: “I know you have many pressures on your time at the moment, what are the things that are causing you to lose sleep? 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.

The power of the written word

If all else fails you might consider writing a letter following the guidelines outlined above. I have heard many examples of where a depressed person has responded to a letter where all previous attempts to discuss the same thing have drawn a blank.

If you have found a strategy that you have found helpful when talking to a man about depression, I would love to hear from you.

Tags: depression, emiotional support, men

I was fortunate enough to have recently visited Hong Kong.  Whilst there I caught up with some people from Jardine Matheson - one of Hong Kong’s oldest and largest companies. Like a lot of organisations, that had found that their charitable contributions in the past had been quite haphazard.

The launch of Mindset

After some research, they decided to focus their attention on the area of mental health and launched Mindset in 2002. Mindset’s objectives are to change people’s attitudes by raising awareness and understanding of mental health issues, and to provide direct assistance to individuals, families, and organisations in need of help.

Involving some high achievers

Each year 50 Ambassadors are chosen from across the Jardine Companies, who are able to take time out from their normal roles to guide Mindset activities. This group contributed 30,000 hours and are  typically aged 25-30 and are regarded as future leaders within the group.

Mindset Initiatives

Current initiatives include:

1. Education and prevention in schools through the “Health in Mind” program.
2. Re-intergrations - supporting mental health agencies through patient support activities and the promotion of a job training program within the Jardine Matheson Group companies.
3. Financial Support - to fund direct services for the mentally ill such as case managers etc.
4. Community Awareness - to undertake a range of initiatives that enhance awareness of mental health related issues.

Two of the most notable community initiatives are the “Mindset Ratrace” - a community fun run around downtown Hong Kong and “Walk up Jardine House” which both served to raise funds for activities.

Highlights

• More than 25,000 school students reached by the “Health in Mind” program.
• 135 training and placement opportunities offered to ex mentally ill in Group businesses.
• The funding of six programs in support of carers and families and direct services for the mentally ill.
• 19 patient support actvities organized.
• $5HKmillion ($A1 million) Cash contributed
• 30,000 hours by 50 Jardine Ambassadors

It was interesting hearing their experiences in job placement. They initially sought openings in their group and then tried to place appropriate people. Eventually they found that they were best off starting with the candidate and then determining what type of role would suit. The referrals for these candidates come from community mental health organisations.

The company employs a part time administrator whose role it is to co-ordinate activities.

About half the people who have gone through Jardine’s re-integration initiatives remain in full time employment.

Jardine’s are to be applauded for pioneering help in an area of community need that has typically been overlooked by most of the corporate world.

If you have any questions or comments about this initiative I would love to hear them.

Kind Regards

Graeme

Tags: anxiety, charity, depression, mental health, work

I would like to tell you a story about Brian Egan. Brian was a veteran and farmer who was featured in “Back from the Brink” (see www.OvercomingYourDepression.com) He was tortured by his experiences of war and had the added pain of enduring year of drought on the land. Eventually he and his wife Nerida were forced off the land with nothing. He went into a catatonic depression where he couldn’t even talk for six months.

The lowest ebb is the turn of the tide

A psychologist he was seeing suggested that he get involved in helping others worse off than himself. At first he thought he was joking because he couldn’t think of anyone worse off than him. Eventually he started working for a charity but realised that his true interest lay in directly helping farmers who are doing it tough.

The birth of Aussie Helpers

He and Nerida decided to start Aussie Helpers (www.aussiehelpers.org.au)   in 2002. Since then they have helped thousands of farming families with groceries, food, personal hygiene goods, and feed for stock. They work 6 days a week and are passionate about helping others and are now operating in Queensland, NSW, Victoria, South Australia, and Tasmania. Brian has adopted Mother Theresa’s motto that “giving is receiving”.

If you want to help yourself help others

Not content to just “rebuild the bush” Brian and Nerida have now launched another initiative which is endeavouring to kill two birds with the one stone. There is a chronic shortage of labour in farming communities so Aussie Helpers is launching “The Wall of Hope” which will bring homeless people from the cities and train them in how work on a farm.  Donations can be sent to Aussie Helpers, PO Box 405, Charleville, Qld 4470. Brian credits Aussie Helpers as the reason he recovered. I know in my own experience and in talking with many people that have overcome depression that it is often helping others that gets us outside our own head. There are many options to volunteer. If you have a story about how volunteering has helped you I would love to hear it.

Kind Regards

Graeme

Tags: depression, farming, helping, PTSD, rural

There was recently a very good article from the Mayo Clinic on taking medication for depression (see News section of www.IamBackFromTheBrink.com ) As highlighted in my last entry, the average doctor does not have great skills in managing mood disorders and we often feel tempted to take things into our own hands when we perceive a medication is not working or there are bad side effects.

Always consult your doctor

I have learnt through bitter experience that it is always better to consult a doctor when stopping or altering the dosage of a medication. There can be very unpleasant side effects if a medication is stopped suddently. I have also experienced the situation where a medication doesn’t appear to be working at a lower dosage, only to have it work well once the dose is increased.

First rule of recovery

The first rule of recovery is to get an accurate diagnosis from a competent mood disorder doctor. They then will be able to determine if antidepressant medication is warranted and prescribe the variant which has the most probability of working.

In my last Blog entry I highlighted the advantages of MAP, a new diagnostic tool from the Blackdog Institute. This week I noticed a new computerised treatment aid for depression being developed in Texas (see News section of www.IamBackFromTheBrink.com) Anything that can aid the average doctor in being a better diagnostician and treater of depression has to be a good thing.

If you have any personal stories about going off depression medication abruptly, I would love to hear them.

Kind Regards

Graeme

Tags: antidepressants, anxiety, depression, side effects

I recently spoke with Felice Jacka, who is doing her PhD at the University of Melbourne on the role of nutrition in mood disorders. She showed me a slide which I found very compelling. On one axis was the percentage incidence of depression in that country and on the other axis was the kg per capita of fish consumed in that country. There certainly appeared to be a direct correllation between these two. Countries like Japan, who eat a lot of fish had a very low rate of depression and countries like New Zealand who don’t have much seafood in their diet have a high rate of depression.

I have been taking Omega 3 supplements for about 2 years. I don’t believe that this is the total solution to depression but the evidence certainly looks very promising as a supplementary strategy with no side effects.

Kind Regards

Graeme

Tags: depression, mood disorder, nutrition, seafood

In a recent book by Professor Jane Plant called “Beating Stress, Anxiety and Depression” she lists substantial evidence of how often mental illness is misdiagnosed. (see news story at www.IamBackFromTheBrink.com) I suspect one of the reasons for this is that it is a very inexact science (eg. you can’t take a blood test) and it often takes someone with substantial skill and experience to properly diagnose. Another contributing factor is that some medicines taken for other conditions have depression as a side effect.

When I interviewed over 250 people for my latest book Back from the Brink Too, carers say that their biggest regret is not getting their loved one to a competent doctor sooner to get an accurate diagnosis.

Startling delay in diagnosis

Yesterday, I met with Wendy Williamson from the Blackdog Institute and she told me that it takes 15 years on average from the time someone first presents with syptoms of bipolar till when they are actually diagnosed. There is a lot of unnecessary suffering because of this. I’m not sure what the figures are for depression but I suspect they would be equally worrying. What further complicates things is that different types of depression respond better to different types of drugs. Is it any wonder that some patients and their loved ones are frustrated by trialling drugs that don’t seem to work.

A probable solution

Wendy showed me a new software program developed by the Blackdog Institute called “Mood Assessment Program” or “MAP” which seeks to address this frustrating situation.

The patient is required to sit down and answer a number of questions about their history which takes about an hour. The questions cover the symptoms they are experiencing, their psychological profile, physical health, stressful life events that may contribute to the mood disorder, and what drugs and therapy you have tried.

Save time save suffering

The resulting report provides doctors with a comprehensive overview of your personal experience with depression and provides a probable diagnosis of type of illness you are suffering from. It then presents doctors with the treatments that are most likely to effectively treat depression. The MAP system is in pilot mode at the moment but the results are looking extremely promising. The Blackdog Institute is one of the preeminent mood disorder units in the world and this software allows GP’s, Psychiatrists, and Psychologists to leverage their expertise.

If you have any frustrating experiences about delayed diagnosis or comments on MAP I would like to hear them.

Kind Regards

Graeme

Tags: antideppressants, anxiety, bipolar, depression

In a recent discussion paper by Beyondblue, gay men are shown to be three times more likely to have depression and five times more likely to have an anxiety disoder. The full story can be found at www.IamBackFromTheBrink.com news section.

Kind Regards

Graeme

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New research from the UK shows that returning to work can aid depression. The study looked at 500 people who were on sick leave and examined how returning to work impacted their mood. The full story can be found at www.IamBackFromTheBrink.com in the news section.

Back from the Brink Research

Thes findings are congruent with the Ultrafeedback study which was done for BFTB which showed that “fulfilling work” was the 4th most effective strategy for overcoming/managing depression. The role of work in lifting ones wellbeing cannot be underestimated and is a strategy often forgotten by doctors and psychologists.

Voluntary Work

I know through personal experience how detrimental it can be have too much time on your hands when you are depressed. This is the exact problem you face when you are on sick leave. When I was recovering I had a voluntary position as a counsellor helping people find voluntary work that met their interests and capacities. I saw first hand how much getting back in the workforce really helped people. If you have a story about how work helped your recovery I would love to hear from you.

Kind Regards

Graeme

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I have personally experienced the benefits of depression in keeping depression at bay. People often ask me what type of meditaion I follow. I follow a method advocated by the Brahma Kumaris but I always say to people that they should try different approaches till they find one that works for them. The important thing is to find a way of experiencing peace and it doesn’t matter how you do it.

Not as effective when in deep depression

I found that meditation didn’t work for me when I was severely depressed but when I started to recover I found it a great way of preventing relapse. Research also shows that it is not as effective when people are really depressed.

Meditations clinically proven to reduce the chance of relapse.

In a study by John Teasdale et al in the UK he evaluated patients who had experienced 5 or more episodes of depression in their life. One half just received normal counselling whilst the other half went through a Mindfulness Based Cognitive Therapy (MBCT). MBCT incorporates Buddhist style mindfulness meditation along with exercises to help them understand how thinking patterns influence their feelings. MBCT patients were found to have a relapse rate of 36% compared to the control group of 78%.

Personal Experience

I find the practice of meditation give me clarity and perspective. People often say they don’t have time to meditate but I find that I am incredibly productive after it. I think it makes you more effective by helping to ascertain what is really important.

If you have tried meditation to help treat your anxiety or depression please make a comment.

Kind Regards

Graeme

Tags: , anxiety. overcoming depression, depression, meditation

I have had a very busy time over the last days giving talks on overcoming depression. On Friday night I spoke at a fundraising dinner for Lifeline, On Sunday at the Brahma Kumaris in Ashfield, and Monday at Forster on the NSW north coast.

There were probably about 500 people at the 3 talks and I was constantly reminded by the questions, how hard it is for those living with depression and their loved ones,  to navigate your way around the mental health system and find the right help.

I will just talk about Forster as an example (pop about 25000). My talk was at 1.30pm and I wanted someone to be there to answer questions about local resources. The Minister who had organsied the talk had sent a brochure to the local community health group but hadn’t heard back from them. I spoke with them and they said they hadn’t been specifiically invited and everyone was busy so they weren’t able to attend. I then mentioned that I had stumbled across a 24/7 access line for the North Coast. I called that line and found the person on the other end to have a pretty good data base of local  resources. As no local mental health people were able to attend I mentioned that I was going to let people know about the number. We then get a call back to request that the number not be disclosed as it could swamp the system. There is something gravely wrong with this situation. I’m sure the local mental health people are probably under resourced but as the number was listed in the local directory I had no hesitation in disclosing it to the audience. Carers in particular are desparate for information and support. Apparently most Area Health Districts in NSW have these Access lines. I found it by looking up the local yellow pages and their was section called “Community Services”. It was called “Mental Health Access Line”

If you have a success story of how you found your needle, please respond to this blog.

Kind Regards

Graeme

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