Exploring Depression and Stigma

1. Exploring Depression and Stigma

2. Looking after ourselves • Respect each other • Let people speak – no interrupting • No wrong answers • Confidential

3. Introductions • Introduce yourself to your partner and say 3 things you are good at.

4. Contents of the workshop • Depression • Sources of help • Self help • A personal coping strategy • Self esteem • Stigma

5. What is depression?

6. Diagnosis Depressed mood or loss of interest and pleasure in ordinary activities for at least 2 weeks, along with at least 4 of the following: • Significant weight loss or weight gain • Insomnia or hypersomnia nearly every day • Activity level slowed down • Fatigue or loss of energy • Feelings of worthlessness or excessive guilt • Diminished ability to think, concentrate, or make decisions • Recurrent thoughts of death or suicide

7. Seasonal affective disorder (SAD) • Postnatal depression • Bipolar disorder (manic depression) Some people have mood swings, when periods of depression alternate with periods of mania. When manic, they are in a state of high excitement, and may plan and may try to execute grandiose schemes and ideas. http://www.youtube.com/user/NHSChoices#p/search/4/RaC9Zz_2JHM

8. Depression • http://www.youtube.com/watch?v=BfZ7VKhwpeI&feature=player_embedded How common is depression? • Lifetime risk of 7-12% for men and 20-25% for women • 4 out of 5 people feel better in a short time

9. What causes depression? • Genetics • Brains and biology • Difficult life experiences • Early experience • Life events • Ongoing stress • Physical Illness • Alcohol • Gender

10. When to seek professional help? • If your symptoms are present more days than not • When your feelings of depression are worse than usual and don't seem to get any better. • When your feelings of depression affect your work, interests and feelings towards your family and friends. • If you find yourself feeling that life is not worth living, or that other people would be better off without you.

11. Professional help Most people with depression are treated by their GP. Depending on your symptoms, the severity of the depression and the circumstances, your doctor may suggest: • self-help • talking treatments • antidepressant tablets

12. Guided self help This can include: • Self-help leaflets or books, using Cognitive Behavioural Therapy (CBT) principles • Self help computer programmes or the internet • Exercise - 3 sessions per week for 45 minutes to 1 hour, for between 10 and 12 weeks

13. Cognitive Behavioural Therapy “Focuses on the way people think and act in order to help them overcome their emotional and behavioural problems”

14. CBT exercise

15. Talking treatments • Cognitive Behavioural Therapy • Psychotherapy • Counselling And more • Problem-solving therapy • Couple therapy • Support groups • Bereavement counselling • Group therapy

16. Talking treatments • Talking about things can bring up bad memories from the past and this can make you feel worse for a while. • Others have reported that therapy can change their outlook and the way they relate to friends and family. • Make sure that you can trust your therapist and that they have the necessary training. • Unfortunately, talking treatments are still in short supply. In some areas, you may have to wait for several months.

17. How do antidepressants work? The brain is made up of millions of cells which transmit messages from one to another using tiny amounts of chemical substances called neurotransmitters. It is thought that in depression, two of these neurotransmitters are particularly affected – Serotonin, sometimes referred to as 5HT, and Noradrenaline. Antidepressants increase concentrations of these two chemicals at nerve endings and so seem to boost the function of those parts of the brain that use Serotonin and Noradrenaline.

18. Antidepressants • Do not ‘cure’, but may help individual to feel and cope better • It takes time to feel the effects • They may have side effects • Rarely addictive – although sudden stop may cause withdrawal • The most effective intervention is TALKING + ANTIDEPRESSANTS

19. Further help • Your GP may refer you to a specialist mental heath professional, such as a psychiatrist, psychologist or mental health nurse, who can review your treatment so far. They may suggest a different medication, or a combination of drugs or of treatments.  • Community Mental Health Teams (CMHTs) are often the most easily accessible service for people with mental health problems. They can provide support for people living in their own homes. The CMHTs are multi-disciplinary teams, which may include a psychiatrist, community psychiatric nurses (CPNs), social workers and support workers, among others.

20. Questions?

21. Break

22. My personal journey When I’m depressed… • My feelings • My thoughts • My body/physical effects • My behaviour

23. Escaping depression • Look at your surroundings • Safe space inside • Go outside • Sunlight or light box • Don’t ignore your physical health • Avoid stimulants and depressants • Omega 3 fish oils • Stabilise your blood sugar • Food affects mood

24. Escaping depression • Examine your relationships • Focus your energy on people who are positive for you • You can’t change anyone, only how you react to them • Tell people how their actions effect you • Talk • Your knowledge • Positive self talk • Cognitive Behavioural Therapy – look at your negative thoughts • Everything is temporary

25. Don't keep it to yourself • If you've had some bad news, or a major upset, tell someone close to you -  tell them how you feel. This is part of the mind's natural way of healing. Accept • You can’t change the past, but you can change the future Forgive • Holding feelings of anger and hate only hurt us Gratitude • Start small • Hope

26. Know yourself – my personal coping strategy • Do I understand and listen to my own feelings? • Be a scientist, not a manager… • What triggers my depression, what makes me feel better

27. What things do I find difficult? • What small action could I try and test out my ability? • Remember- be a scientist not a manager!

28. Mood MappingDr Liz Miller

30. Case study A close friend or family member is suffering from depression • How could they help themselves?

31. Helping others • Listen. This can be harder than it sounds. You may have to hear the same thing over and over again. It's usually best not to offer advice unless it's asked for, even if the answer seems perfectly clear to you. • Make sure that they are buying enough food and eating enough. • Help them to stay away from alcohol. • Encourage them to accept help. Don't discourage them from taking medication, or seeing a counsellor or psychotherapist. • If they are getting worse and start to talk of not wanting to live or even hinting at harming themselves, take them seriously. Make sure that they tell their doctor.

32. Do you treat yourself this way? Never do or say anything to yourself that you wouldn’t to a good friend Criticism is allowed, but it must be constructive Respect and value yourself If you are rude, apologise to yourself

33. Self esteem Nothing bad has happened to me. There’s no reason why I should be depressed. It must be my fault” “Other people can cope with their lives without getting depressed. I should just be able to pull my socks up. I must be weak.” “Why should I take medication? It won’t help. It can’t change the things that are making me depressed”

34. Seeing the positive (even if it’s small!) • Creating a more positive view of yourself…. • See yourself through the eyes of love and acceptance

35. Break

36. Stigma of mental health Open Secret DVD

37. Living with stigma Stigma isolates people People often find it hard to tell others about a mental health problem they have, because they fear the reaction. And when they do speak up, the overwhelming majority say they are misunderstood by family members, shunned and ignored by friends, work colleagues and professionals or called names or worse by neighbours.Psychiatric patients are four times more likely than the average not to have a close friend and more than a third say they have no one to turn to for help.

38. Living with stigma It excludes people from day-to-day activities Everyday activities like going shopping, going to the pub, going on holiday or joining a club are far harder for people with mental health problems.What’s more, about a quarter of people with a mental illness have been refused by insurance or finance companies, making it hard to travel, own property or run a business.

39. Living with stigma It stops people getting and keeping jobs People with mental health problems have the highest ‘want to work’ rate of any disability group – but have the lowest in-work rate.One third report having been dismissed or forced to resign from their job and 70% have been put off applying for jobs, fearing unfair treatment.

40. Living with stigma It prevents people seeking help We know that when people first experience a mental health problem they tend not to seek help early and tend to come into contact with mental health services only when a crisis has developed. This also means there are many people with mental health problems who receive no treatment or care. It delays treatment and impairs recovery Not seeking help early means that recovery can be more difficult. People with mental health problems often report that they are not listened to by health professionals and feel unable to request changes to their treatment. 

41. Living with stigma It has a negative impact on physical health We know that people with mental health problems tend to have poorer than average physical health and, as a result, people with the most severe mental health problems die on average ten years younger. Almost half of people with mental health problems report discrimination from GPs who think physical problems are being imagined or made up.

42. Have you experienced stigma or discrimination?How did it make you feel?What was the outcome?

43. Time to Change 80% people experience stigma and discrimination

44. Stigma and discrimination • http://www.youtube.com/watch?v=4tiYbhVBjTk

45. 0203 513 3404