For some time now, I have been emailing you with advice about how to overcome depression. I would now like you to tell me what you find most effective. But first some background……

UNDERSTANDING WHAT REALLY WORKS

I get very irate when I hear “experts” in the media saying that there are only 2 evidence based treatments for depression, antidepressants and psychological counselling…. What utter baloney. Don’t get me wrong – I still take antidepressants and have benefitted from psychological counselling, but I also know that there are many, many, other factors that contribute to our mental health. Things such as exercise, emotional support from loved ones, fulfilling work, relaxation and nutrition to name a few.

WE THAT LIVE WITH DEPRESSION AND BIPOLAR ARE THE REAL EXPERTS ON WHAT WORKS

Some of you who read my first book, BACK FROM THE BRINK, would know that I included the results of two surveys: one done for the book by Ultrafeedback in 2007 and one undertaken by the Black Dog Institute(BDI) in the previous year. The results from those surveys certainly challenged traditional approaches towards depression treatments.

Well it is now 2009 and I’ve decided to revisit this issue again with a survey that looks at the effectiveness of a broad range of strategies. It really combines the best features of the Ultrafeedback and BDI survey.  Through my association with www.DBSAlliance.org in the US, I am having people with depression from across North America also completing the survey, and hopefully other depression websites from around the world will help make this a truly global one.

I NEED YOUR HELP

I would love you to spend 10 minutes completing this survey and I will share the results for free on www.IamBackFromTheBrink.com  once the analysis has been completed – the survey will close on December 11, 2009. To access the survey please go to:

http://www.surveymonkey.com/s.aspx?sm=XI_2bk_2f_2fgIwvYmsvuAz2UBlQ_3d_3d

I really appreciate you taking the time to complete the 10 minute survey and I look forward to sharing the results with you.

PLEASE FEEL FREE TO INVITE OTHERS WITH DEPRESSION TO COMPLETE THIS SURVEY

The more that complete this survey the better so please feel free to forward this on to anyone you know who has experienced depression.

http://www.surveymonkey.com/s.aspx?sm=XI_2bk_2f_2fgIwvYmsvuAz2UBlQ_3d_3d

Kind Regards

Graeme

Tags: depression, depression survey, depression treatment survey, depression treatments, effective depression treatments, holistic depression treatments

Article in The Economist June 27th, 2009 - Page 89

A friend recently made me aware of a very interesting article in The Economist.

The hypothesis

Randolph Nesse, a psychologist and researcher in evolutionary medicine at the University of Michigan, likens the relationship between mild and clinical depression to the one between normal to chronic pain.

Dr Nesse’s hypothesis is that, as pain stops you doing damaging physical things, so low mood stops you doing damaging mental ones - in particular, in particlar pursuing unreachable goals. He asserts, that pursuing such goals is a waste of energy and resources. Therefore he argues, there is likely to be an evolved mechanism that recognizes certain goals as unattainable and inhibits their pursuit - and he believes low mood is at least part of that mechanism.

The evidence

In a study published recently by Carsten Wrosch from Concordia University in Montreal he studied depression in teenage girls. They measured the “goal adjustment strategies” of 97 girls aged 15-19 years over the course of 19 months. They asked participants about their ability to disengage with unattainable goals and re-engage with new goals. They also asked them about a range of symptoms associated with depression, and changed over the course of the study.

Study findings

Their conclusion was that those that experienced mild depressive symptoms could indeed disengage from unattainable goals. It also found a remarkable corollary:those women who could disengage from the unattainable, proved less likely to suffer more serious depression in the long run.

Mild depressive symptoms can therefore be seen as a natural part of dealing with failure in young adulthood.

My take on this theory

As I have highlighted many times before, it is so difficult to make conclusive statements about “depression” as the term covers a multitude of conditions. Having said that, my gut tells me that there is something to this theory. I guess that comes from my own personal experience. On each occasion I have experienced a severe depressive episode, it has often been close to a downturn in the economy. I formally worked in recruitment, which is an industry very closely linked to the health of the economy and is also very accountable.

When I began missing my budgets, rather than blaming the economy, I tended to blame myself for not working hard enough. This also would explain why those with perfectionist personality traits are so vulnerable to depression - you can never achieve the goal of perfection.

It also reinforces my belief that when you are depressed you should set “whisker goals”. These are small attainment goals that put you on a path of “wins” that often have a positive impact on self esteem. It is also essential to celebrate these small wins so your brain knows that it is doing something right. A small celebration could be buying yourself a coffee, gelato, chocolate or your favourite magazine.

Your thoughts please?

I would be very interested for others to share their opinion regarding this theory. Please do so by responding to this blog.

Kind Regards

Graeme

www.IamBackFromTheBrink.com

Tags: depression, depression help, depression treatments, goals, rational thinking

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

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

With a new year in front of us we always wish that it will be better than the last year. Whilst many of the people who review this blog have depression and just want to get over it, I think dwelling too much on what you don’t want rather than what you do want can be counter productive.

Focus on what you do want

The science of happiness has shown us that contented people regularly set goals for themselves (see previous entries). Whilst the thought of this for someone with depression often seems particularly onerous, I believe that it has many advantages.

My experience with goal setting

During a depression outpatient course at I completed at Northside clinic, I was encouraged to set weekly goals around exercise and contact with family and friends. We not only had to write these down but we had to schedule them into a diary and report back to others on our progress the next week. I found that although I often didn’t feel like it, I would often force myself to get out of bed and go for a walk. I inevitably felt better after having taken the walk. The same applied to my contact with family and friends. It is very common to want to isolate when depressed, but like the exercise, I often felt better having made the effort to meet with loved ones. Of course I was also seeing my psychiatrist as well and found  a medication that also seemed to help. Eventually this goal setting involved leisure activity and meditation and finally it progressed to doing voluntary work and then writing “BACK FROM THE BRINK”.

After some time to reflect, I began to realise that I was seeking 3 outcomes in life:

1. Physical and mental vitality
2. Good relationships with support, fun and intimacy
3. A career that enabled me to contribute and prosper

I decided that I would set weekly goals around these 3 outcomes: vitality, intimacy, and prosperity. When you have depression, I think a week is as far as you want to look ahead and most of the time you should be trying to live one day at a time.

Vitality

By far the most important aspect of this is regular exercise. How much? 30 minutes brisk walk (or equivalent) 6 days per week. Eating well is also extremely important and this should involve lots of fruit and vegetables, omega 3, and low levels of fatty foods. As my health improved I also embraced meditation and continue to do it twice a day, every day.

I also include in this category regualr contact with doctors and psychologists. It is also important to limit alcohol consumption.

Some of the fun things here are sport, hobbies, movies, travel etc.

Intimacy

As my physical health improved I began investing much more time into my relationships, and began to yield the benefits from that. I realised that in my past I often let career come before relationships and realised what I mistake that was. I have come to realise how important having strong relationships are for your mental health. I also joined GROW, a 12 step support group which was wonderful. The mutual support is priceless.

Prosperity

The final part of my recovery came from finding out what I really wanted to do with my career. Whilst I had enjoyed my early career in marketing and human resources, I was really seeking something outside of the mainstream corporate environment. I began doing some volunteer work with Volunteering NSW, helping to place prospective volunteers into the right roles. I saw how people’s self esteem lifted substantially when they found fulfilling work. Eventually things evolved where I began writing my books and speaking about overcoming depression and turning around lifes difficulties. I truly love my work now.

Yearly goals

At the start of each year I now set goals under each of these three categories. Each week I determine what I’m going to do to help make these happen. If ever everything seems too much I give priority to goals in the order nominated: vitality, intimacy and then prosperity.

I really believe that we all have unique gifts to contribute to the world and are capable of very happy and fulfilling lives. Does that mean that I will be forever immune to depression? No it doesn’t, but I try to focus on what I do want rather than what I don’t want.

If you have any comments about setting new year goals, please respond to this blog.

Kind Regards

Graeme

Tags: depression, depression treatments, new year goals, resolutions

I know through the emails I receive and the feedback I get from my GROW group members that  a lot of people find the Christmas period very unsettling and depressing. Often it brings into focus what we don’t have or highlights difficult family relationships.

I came across a very good paper from the Internet called “10 Things Science Says Will Make You Happy”. Whilst I usually shudder at these formulaic papers that promise happiness and fulfillment, this is a little different in that it is based on quantitative studies from positive psychology from the likes of Ed Diener, Standford Psychologist Sonja Lyubomirsky, and ethicist Stephen Post. They have studied people all over the world. Here are 10 scientifically proven strategies for getting happy.

1. Savour Everyday Moments
2. Avoid Comparisons
3. Put Money Low on the List
4. Have Meaningful goals
5. Take Initiative at Work
6. Make friends, treasure family
7. Smile even when you don’t feel like it
8. Say thankyou like you mean it
9. Get out and exercise
10. Give it away, give it away now

For full details of the paper go to the news section of www.IamBackFromTheBrink.com

I think this is a very interesting list as it really parallels my experience in overcoming depression.

Make 2009 depression free

Whilst most of you would know that I don’t believe in quick fixes for depression, I believe the key to starting a more fulfilling life is to take appropriate action. I am going to be reading this paper to my GROW group tonight and ask them if they would like to choose 2 of these strategies that they would like to concentrate on for the next 3 months.

When we meet back on January 5 I will ask them to describe what they will be doing to make these things a higher priority in there life. Over the Christmas break when things get a bit difficult they can reflect on what they will be doing to make 2009 more pleasant.

I hope all my readers and visitors have a restful break and feel the sense of a new dawn in 2009.

Kind Regards

Graeme

Graeme Cowan

www.IamBackFromTheBrink.com

Tags: back from the brink, beating depression, depression, graeme cowan, happiness