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New research from Professor Andrew Oswald, an economist at the University of Warwick has established that there is a peak risk of depression in middle age. Professor Oswald is known for his interest in the interface between Psychology and Economics. Previously research had suggested that the risk of unhappiness and depression stays relatively constant throughout life. The latest finding – of a peak risk in middle age – was consistent around the globe, and in all types of people.

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We have been looking round for online “Help yourself get better” resources. Some of them could be a bit superficial (does answering a lot of questions get anyone well?), some have access barriers (CD-ROMs, DVDs, $$$) or like Beating the Blues™ are only available through a health care professional. Another, Depression Relief is £20 for a lifetime subscription. Restoring the Balance (£25 (single-user)) is a self-help CD-rom is based on cognitive behaviour therapy techniques. It includes interactive exercises and is designed for people experiencing mild to moderate anxiety or depression. It is written in HTML and Javascript so should run on all Windows and Macintosh computers with a web browser.

Living Life to the Full (Flash) was pretty comprehensive (after a slightly weighty sign-up). It promotes itself as a “self-help website using cognitive behaviour therapy to help tackle a range of problems including negative self-image, anxiety, sleep problems”. There are short TV programmes (lovely Scottish accents, the site is party funded by the Depression Alliance Scotland) each lasting last about 8-12mins that have key facts, hints & tips and useful summaries.

I thought the MoodGYM, (Flash again) another CBT site, was pretty good with its cute avatars each with their different approaches. Again you do need to sign up, but the process is quite easy. Also, being Australian, a bit closer culturally.

MoodGYM (Flash) is an interactive program designed to help you:

  • identify whether you are having problems with emotions like anxiety and depression
  • overcome these problems, develop good coping skills for the future

MoodGYM is based on two programs which are successful in preventing and treating depression and anxiety. These are: cognitive behaviour therapy and interpersonal therapy.

See our earlier post for information about a trail for a NZ based resource: OMS Helping People with Depression

  • Learn about depression so you will have a better understanding of what is happening
  • Try to be supportive, loving and empathic
  • Offer kindness and attention, even if it is not reciprocated
  • Keep reaching out, calling, and letting the person know you care – even if they don’t respond to
  • your invitations
  • Don’t be hostile or sarcastic when the person makes meager attempts to be responsive – accept
  • their efforts as the best they have to offer at that time
  • Offer assistance with chores
  • Don’t make promises you can’t keep
  • Don’t take over things that the other person CAN handle, as this will further erode self-
  • confidence
  • Focus on the positive aspects of the other person and the relationship
  • Listen non-judgmentally
  • Encourage them to be active and eat healthily
  • Don’t push the other person’s buttons
  • Don’t abandon him/her if you can find ways to help without creating your own health issues
  • Remind the person that this is an illness, that they are not to blame for feeling “down”
  • Don’t lie or make excuses for their behaviour – this may only delay getting assistance
  • Insist that the person get a complete medical examination to rule out any organic source of
  • depression (such as a thyroid or endocrine imbalance)
  • Encourage the person to get professional assistance – for both of your sakes
  • Accompany the person to a doctor’s appointment as a way of facilitating getting professional
  • help. Take notes, as the person’s concentration and recall are likely to be affected by depression
  • Be patient – treatment for depression takes time
  • At a time when your loved one is less depressed, try to reach agreement with them that outlines
  • ways you can be helpful when depression sets in
  • Take suicidal comments seriously
  • Continue to offer reassurance that things will get better with time and help
  • Leave depression recovery articles lying around
  • Keep curtains open, letting plenty of light into the house

The following are some of the recovery goals that people in support groups have set for themselves:

  • Exercise
  • Diet ( healthy & eating regularly )
  • Attending DSN and/or other groups ( stickability )
  • Counselor ( to unearth hidden stuff )
  • Retrain our brain to think positively
  • Start a new hobby or interest /Creativity
  • Set a travel goal
  • Once a month meeting a new or an old friend ( get over any bitterness )
  • Journal
  • Random act of kindness
  • Baking or gardening
  • Create a stress free day every week
  • Manage disappointments in a healthy way
  • Stop putting actions off for another day
  • Keep in touch with my family
  • Better myself in a particular way
  • Work on my low self esteem
  • Look at little things around me, appreciate them – e.g. Flowers
  • Plan respite care in advance
  • Educate myself about depression, e.g. Depression Awareness Course, internet, books etc.
  • Create a list of phone numbers of support people
  • Take one day at a time
  • Do things I like!
  • Keep on going regardless
  • Learning to live for the now
  • Learning to forgive, forget & let go!
  • Pace myself more, take breaks when I need to
  • Stay healthy and positive
  • Set money goals & stick to them
  • Be more honest about how I am feeling
  • Remind myself I’m not the only one feeling this way
  • Stop stressing about small stuff
  • Be nice to myself, especially in my head
  • Find some supports so I don’t go it alone
  • Make the effort to help others
  • Plan a mental health day
  • Don’t be afraid to share my feelings with those close to me
  • Find God again, reconnect spiritually
  • Walk fast 3 times a week & diary it
  • Join a Latin dance class to exercise & meet people

Sleep. Whats enough sleep or too much? What is ‘Normal’ Sleep’ ? No one person is the same. And its not just about how much sleep, its what kind of sleep you get. The The University of Maryland Sleep Disorders Center has a comprehensive approach. There is heaps of research and a holistic, practical response to what can be a major problem for depressed people.

They talk quite a bit about what they are do on the their website. Below are some of things I thought were useful (given you probably aren’t going to go to Maryland for treatment):

What they are saying:

Normal Sleep

Contrary to what you may think, sleep is an active, organized process. How and when we sleep is governed by a number of factors. These include factors under our control, such as whether or not we are sleep deprived, and factors beyond our control, including our internal biologic clock that regulates our biologic rhythm (also called a circadian rhythm) over a 24-hour period.

How Much Sleep Do I Need?

There is, in fact, a wide range of sleep time that is considered “normal.” While the average normal amount of sleep is around 7.5 hours per night, there are some people who do just fine on 5 hours per night, and some who require as much as 9 hours per night. The key is to find the right amount for you. The best way to tell is by seeing how you function during the day. For example, if after 6 hours of sleep you feel refreshed in the morning and awake during your daylight hours, then you don’t need more than that. If, on the other hand, you need 9 hours a night to feel refreshed and to function well during the day, then that is what your individual requirement is and sleeping the “normal” amount of 7.5 hours per night will actually leave you sleep deprived. If you are getting what you consider to be an adequate amount of sleep and are still unrefeshed and sleepy, then you might have an organic sleep disorder …

Copyright 2005 The University of Maryland All rights reserved.

Depression Awareness Courses for the early part of 2008 are being run at Hillmorton High (February) and at the Mental Health Education and Resource Centre (April).

From Sunday Star Times November 25, 2007

There are few conditions for which the causes and treatments remain as misunderstood as those for depression. The recent reporting of high rates of “depression” in New Zealand men (November 18) also quoted two high-profile New Zealanders who had no useful response to antidepressants: “Drugs not only failed to help, they stifled his creativity…” and “They dull you down and dumb you down…”

It sounds like the wrong treatment but, unfortunately, this sends a message that adds yet another barrier for those people for whom anti-depressants are not only life-saving, but life-transforming and even miraculous.

The problem is that there is a widely held misconception that depression is one illness, with one treatment. In reality, there is no illness that as fully displays the full range of genetic, environmental, social, psychological, nutritional and biochemical complexities as depression.

How then can we judge a single treatment modality? The weighty prejudice at times carried by anti-depressant medication should not be added to because it was the wrong key to an individual lock.

Assuming that anti-depressants are the right treatment for all depression is like saying antibiotics are appropriate for all infections (they only work against bacteria, not viruses or fungi), or that radiotherapy is the only treatment for cancer (it is highly effective in some forms of cancer, useless in others).

Depression is a condition with multiple causes, some or all of which may be at play in any given person suffering from its symptoms. Unfortunately, as antidepressants are the only freely available and funded intervention for treating depression, they can at times be overused relative to other therapeutic modalities.

Let’s not make it even harder for people suffering from this debilitating condition to seek help and treatment.
William Ferguson, gen. practitioner
Kumeu Village Medical Centre
David Codyre, psychiatrist
ProCare Primary Mental Health Programme

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