Feedback on Dr Tom Brown's February talk on helping people suffering from depression: click here

Additional information noted at the November talk not already touched on in the February notes: click here

Resources recommended by Dr Tom Brown: click here

The sequence of those three items above now starts here:

Just under 60 gathered in the offices of the law firm Burness for the February talk and were treated to excellent fare - our thanks to Burness for their hospitality. OASIS had a huge waiting list and we are greatly indebted to Dr Tom Brown for agreeing to offer this talk again in November and to Scottish Widows for hosting the re-run which attracted over 100 people.

Here are two quotes from people who attended the February talk:

C of Newton Investment Group:

"Dr Tom Brown of the Western Infirmary in Glasgow was a reassuringly straightforward and down-to-earth speaker.

He began his talk with a comprehensive list of the many symptoms of depression. As someone who has suffered from depression myself, these symptoms were almost all familiar to me. For anyone in the audience who hasn't suffered, I'm sure this was a helpful starting point.

Dr Brown went on to provide some startling statistics about the prevalence of depression - 10% of men and 15% of women will suffer a depressive illness in their lifetime. Again, depression is a very isolating illness and it is sad to think how many people go through the experience, all of them feeling they are suffering alone.

Dr Brown gave some simple examples of things we can do for colleagues who are suffering from depression. It isn't an illness one recovers from quickly though, so 'being there' is perhaps one of the hardest, but most important, things we can do."

E of Standard Life:

"I really did get a lot out of it as I have a colleague who is going through a depressive event at the moment. I thought the way it was split into the 3 main areas i.e. symptoms, causes and help was really useful and it was pitched at just the right level for us to understand.

I was amazed that it kind of confirmed what I knew already about depression (certainly the symptoms) and it was good for me that there were simple things I could do to help, such as listening, being accepting etc. I always thought there was something more I should be doing.

The sheet of useful reading material and websites was a great idea. We could have discussed the subject all afternoon - it was a pity we had to come back to work!"

Now some Notes from a listener at the February talk

(Disclaimer: this is what a listener thought he heard, not a 100% accurate account of what Dr Tom Brown may have said!)

1. What depression is:

"Melancholia", depressive illness; low mood - ongoing, pervasive; not enjoying what used to; waking very early, or the opposite; losing weight; inability to concentrate; social withdrawal; irritability; indecisiveness; hopelessness; sucidial thoughts; physical aches and pains; delusional thoughts; false beliefs.

It affects one's work, one's relationships, and social functioning.

10% of men and 15% of women will experience it in their lifetime.

2.What causes depression

No one thing. Certain things can predispose you to getting depression:

genetic make-up; personality; low self-esteem. Also events: financial loss; a bereavement. Environment. Drugs. Alcohol.

3. How depression is treated:

NB. 70 - 80% of people who have a major episode get better.

Can recur.

Mild cases: counselling and self-help groups.

More pronounced cases: under the ongoing care of a doctor and often on antidepressants. Also psychological treatments like CBT (not Computer Based Technology in this instance but Cognitive Behavioural Therapy!)

4. How to be helpful to someone with depression:

Listen, be accepting of the person; accept depression as an illness.

Facilitate seeking of help.

If a person is in treatment, encourage to keep taking the treatment.

Encourage the person to do things they used to enjoy.

Encourage them to try to adopt a normal sleep pattern, also to cut down on alcohol and to avoid cannabis.

Don't ignore or sweep aside any references to suicidal thoughts: hear the person out and talk about their comments. Reassure them that treatment is available.

Some further information noted at the November talk and not already touched on above:

Astonishing fact: depressive illnesses are the fourth most prevalent determinant of global disease! So say the World Health Organisation and the World Bank.

Depression often presents with physical symptoms.

Typical symptoms: disturbances of sleep and appetite.
But 15% of cases see people oversleeping and overeating.

Some people get a physical illness and then get depressed.
For some people it is the other way round, and depression has been found to be a risk factor for serious heart disease.

Predisposing things include genetic factors and personality type.

Precipitating factors can be change of boss, change of role at work, financial loss, inadequate training for the job we are expected to do, and un-negotiated changes in our job.

As for treatments, Dr Brown was sceptical about counselling except in mild cases of depression.

Self-help: one of the books on his list is full of exercises and - very usefully and unusually - may be photocopied.

See a doctor - this may seem obvious but it isn't to everyone: one reason for this is that the depression may be being caused by something physical, eg an underactive thyroid.

Drug treatments: people often stop their course of treatment too early, either thinking "It's not working, so I'll stop, or thinking "I'm OK now, so I can stop."

CBT (Cognitive Behaviour Therapy): this can be very effective, as can interpersonal psychotherapy. The difficulty is accessing the people with the right skills.

For moderate to severe depression: ECT (Electro-convulsive treatment) may be just right. NB: This treatment method is not controversial in psychiatric circles.

How can we "lay people" help? One way is by becoming more aware of depression ourselves, also arousing awareness in others, and reducing the stigma society still attaches to depression.

Another way is: Be available to listen, offer a listening ear and validate the person's experience.

Specifically at work: we can ensure appropriate training is given to people when there is any job change. We can also identify interpersonal relational issues early and deal with them.

When people have been off for some time and want to return to work: does your employer have a policy in place to cope with cases of mental illness as opposed to physical illness? How flexible is your company / office? It needs to be. [This writer is aware of a leading financial services employer in Edinburgh which has respected that one returning employee can only manage 2 hours of work a day - and they have negotiated a package for this person. Both parties appear very happy with the arrangement.]

Resources:

BOOK LIST

1) Lewis Wolpert: Malignant Sadness: New York, Free Press 1999

2) William Styron: Darkness Visible: London, Jonathan Cape 1991

3) Andrew Solomon: The Noonday Demon: Vintage Press 2001

4) John White: The Masks of Melancholy: Inter Varsity Press, Leicester

SELF-HELP BOOKS

1) Chris Williams: Overcoming Depression: Arnold 2001

2) Chris Williams: I'm not supposed to feel like this: Hodder and Stoughton 2001

3) Dennis Greenberger & Christine Padesky: Mind over Mood: Guilford Press, New York 11)1)

WEB SITES

http://www .psycom.net/depression.central (Dr Ivan's Depression Central)

http://www.blarg.net/~charlatn/depression/Depression.html (Andrew's depression site)

http://b1uepages.anu.edu.au/

http://www.rcpsych.ac.uk (Royal College of Psychiatrists)
(Click on Mental Health Information for Factsheets and Leaflets for the public)

http://www.psych.org (American Psychiatric Association)
(Click on Public Information for Factsheets and Pamphlets)

PROFESSIONAL HELP (Private Sector)

Edinburgh Clinical Psychology Consultants, 21-23 Hill Street, 0131 624 4021 - provide psychological treatment for a variety of disorders including depression.

PS. OASIS have one or two useful leaflets and addresses in Edinburgh and Scotland.

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