Wednesday, February 3, 2010
Understanding Depression Moving Forward
When I woke up on Australia Day to see Professor Patrick McGorry was made Australian of the Year for his dedication on the work he has done on Mental Illness, it was divine timing with our BE OPEN TO DEPRESSION AND SHOW YOUR SUPPORT Campaign that Amanda Cox and I are putting together. On the same day ironically my sister’s friend (who suffered from Depression) sadly Commit Suicide on that very day.
If we are going to combat Depression we ALL need to come together with a realistic and clear approach. Here are a few facts for you to think about-
Deaths due to Mental Illness is in the TOP 4 of Medical related deaths
Each one of these Epidemic Illnesses has Specialists in their field.
1. Heart Disease- General Cardiologists and Cardiac Surgeons
2. Arthritis & Musculoskeletal conditions- Rheumatologists
3. Cancer- Oncologists
4. Mental Illness- NOTHING. OK they have General Practitioners
5. Diabetes- Endocrinologist
Now I do not want to get into a GP debate however there is such a shortage of any GP’s let alone a good one. GP’s just don’t have the time or the knowledge to configure the right course of action for someone with Depression, so instead they put them on Antidepressants and organise no testing to see if it is Biological or Physiological (this determines that the right medication is prescribed) or no referrals to a Psychologist or any follow up.
According to new studies men and people who live in the Country are most at risk for being undiagnosed, so where do we go from here?
The Government needs to-
• Educate ALL GP’s through out the Country have a CLEAR protocol in which GP’s have to follow. With testing, referrals and follow ups.
• They already have the Rebates BUT
I don’t know about you but I have a hard time trying to get my head around what is available and what they have or should do, LET ALONE IF I ACTUALLY HAD DEPRESSION. It’s too confusing, especially if your mind is UNABLE to process information. They will put it in the too hard basket and too be honest I wouldn’t blame them.
If you have cancer-
• You have tests
• You see a Specialist
• You receive treatment
• You are closely monitored
It’s kept really simply because when you ARE SICK you do not need any other stress. You mind should be focusing on getting better, yes?
What I find the most frustrating is Mental Illness is totally treatable and those 48 million people who will commit suicide due to Mental Illness DO NOT HAVE TO DIE! It gives me shivers, it brings tears to my eyes and it makes me sick to my stomach. That it just DOESN’T have to be this way.
PLEASE, PLEASE, PLEASE EDUCATE EDUCATE EDUCATE
Disclaimer: This article was written from a personal opinion and I am NOT a qualified in psychology or counselling. If you do need assistance with emotions or mental health, to seek assistance from your GP immediately.
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20 comments:
Just wanted to raise a couple of points from your post that would benefit from clarification.
In fact Mental Illness has a range of specialist medical practitioners with the most notable being psychiatrists. According to the Royal Australian and New Zealand College of Psychiatrists "a pyschiatrist is a qualified medical doctor who has obtained additional qualifications to become a specialist in the diagnosis, treatment and prevention of mental illness and emotional problems".
In addition to psychiatrists there are clinial pyschologists, general psychologists, counsellors and social workers, along with general practitioners, all who have a role in the support and treatment of people with depression.
Just like your example of cancer and the 4 points of treatment/support you raised, each of those points are also offered to a person with a mental illness (including depression).
There IS a clear process for treatment of anyone in need of medical support, whether that be for physical or pyschological illness. GPs or hospital emergency rooms are the first line of support regardless of the medical condition. When it comes to depression the process is the same. A GP or hospital ER doctor will then refer a patient on to other appropriate services for treatment and follow up.
The challenge is getting a person, any person, to the doctor in the 1st place. Just as many people with diabetes, broken bones, SDTs or other treatable diseases don't approach their GP, people with depression as avoid the medicos.
I'm also curious on your quotation of "48 million people who will commit suicide". That is a large number and it could not be representative of Australia unless it was over a very long period of time.
The other myth that I will challenge is that people who commit suicide have a mental illness or are depressed. This is not always the case and at this point in time there has been no way of determining that all suicides are depression related.
I congratulate you on starting your dialogue on depression and mental illness. I would also suggest that you include information and insight from those that have been through depression/mental illness and/or medical practitioners that regularly treat this illness.
I have suffered depression for over 20yrs and although Leah has stated that there are professionals to support people with mental illness the understanding and compassion is not there with so many. Unless you really go off the deep end and make a scene no one really cares. I have never been tested physically but my diagnosis was give after a short questionnaire, I don't see the same test done for any other disease! I've had a GP tell me just to be happy and a psychiatrist tell me to basically get over it. So in the midst of depression it is almost impossible to find the strength to go on let alone beg for someone in the medical profession to help and care. When I was pregnant I saw a hospital psychologist who was helping me but once I had the baby I was dumped (because I was no longer in the care of the maternity dept), left to fight alone again. People don't commit suicide for fun, Leah saying that people committing suicide do not have a mental illness or are depressed just shows a lack of understanding, but you will never know!
Hi Leah, Thank you so much for sharing your thoughts. I know there are a variety of specialists available for Depression and when they are referred to them it is fantastic and the progress is amazing. However personally what I have found upon my research is that they are not always getting the referrals they need. Not always but it does happen alot.
The 48 million was based on the statistics from Australia and USA and that information is from SANE. That number is not based on all suicides.
My last 2 posts have been from Experts and 1 from someone who has suffered from Depression, I will be publishing more posts from people who have/do suffered from Mental Illness. So please feel free to read those.
Thanks Again
Renee xx
Anonymous (I would prefer to address you by name but respect your right to anonymity) - it is unfortunate that your experience over the past 20 years with medicos and depression has been less than positive. In the 30+ years that I have been dealing with both depressed and manic moments in my life I have found both both positive and negative experiences. With that experience I found it interesting Anonymous that you made the reference "but you will never know".
In fact I know all to well - 3 family members or friends that have comitted suicide, 2 of which were teenagers that "did if for kicks just to see" without any indication of depression.
We all have a different story about depression and we all handle it in different ways. Just as there are differences in the way that it shows up in individuals so to there are different ways to approach treatment.
Even when people try to understand, unless they have truely walked with that black dog at their side it is hard to REALLY understand. For that reason we cannot just expect our medical professionals to understand (even with all their training), we must help them help us. When a person, whether they be GP, psychiatrist or friend, says "just be happy" or "get over it" then it is time to find someone who understands. There are more people genuinely willing to help than to just "put a smile on your face".
As Renee has started to do, the main thing we need to do is talk about it with each other, step out of the shadows, stop hiding, start listening and start trusting.
Thank you guys, I cherish both of your opinions. I find that sometimes it has alot to do with where you live. If you/re in the Country then they just do not have the resources that are available in the city. There is such a stigma around it that isn't around any other illness but the more we talk and open up the more we can combat it.
Leah, you just gave me an idea for the next photoshoot with a black dog! Ooooo that's good :)
Thank you for sharing :) xxxxxxxxxxxxxxxxx
Thanks Leah I appreciate you view and I am anonymous because of the stigma, the shame and thats how I feel "anonymous".
I just want to clarify what I meant when I said "but you will never know", I meant we will never know the real reasons for people suiciding because they aren't here to tell us (I am truly sorry for the lose of your family and friends). I in no way think I'm the only one who is experience this horrible disease, however I do feel very alone in it.
Hi Anonymous... I respect also your privacy... but isn't that Renee's main aim to as you say to get away from the feeling of stigma, and shame... it is about opening the can of worms and owning your condition... I for one have suffered depression,due to my Parkinson's and a crisis in my life as well... In my darkest hour, I did try and commit suicide.. and they is very few doctors to help with terminally ill patients... no one wanted to know me or care for me including my husband at the time.. it was left to my children..... but my friends got me through.... I am not ashamed,and never was and I have never have felt stigma....Depression is a part of many people's life and it was a part of mine.... but I refuse to lay down with the black dog.... You are not alone Anonymous in your plight...if you need an ear.. I will listen... Louise.
Hey Renee... I have the best song ever called "the Black Dog" he is Aussie Musician and the Cd is called the "blame train"... his name is Mick Wilson... he is great.. the song even better... not sure how to get it to you.. I could scan the words... my son is good with that computer side of things... if you are interested let me know... I think Mick lives in Queensland. Louise
Thanks Louise! You sound like you have a great group of friends and a great attitude. I wish you all the best for the future.
I guess I'm not brave enough yet to open my can of worms to the world, maybe one day.....I do support what Renee is doing and that is why I have left comments, I hope they help in some way.
renee
i am sorry but i take offense to you saying there are no services available for the mentally ill. leah is right, there are services but people don't want to see the specialists because of their costs, embarrassment to talk to their doctor about issues (that one was mine - i had a dark secret that i only told my psychiatrist at my last hospital admission in 2008). i have had some tests to see how sick i have been and at the time i was so sick i have lost my job of nearly 23 years because i was so sick.
you are right that the country lacks the services that the cities have but that is in every medical profession and not just mental health. i find it very harsh to say it is just the mental health system that is lacking in the country. every illness is lacking in the country and then there is the add on effect that people need to see doctors at hospitals and the referral lists increase.
leah i fully agree with you about suicide - not always related to depression and you are so right about the teenagers being so gun ho to try it out and think they will be ok and they unfortunately die as a result. those that are unwell, are likely to leave some sort of note to let their loved ones know what has driven them to take this action. i have tried oding twice and it isn't nice. the ed staff were worked off their feet and i got forgotten because of other priorities but hey the hospital systems are so bad, we expect our new trained doctors to know everything and we have found out this week this is not the case. the catt team at the hospital saw me both times before i was allowed to go home and they did a very good assessment of me and have followed me up at home - i think that is a great service given the hospital/doctor system. 48 million should not be quoted when most of that would be coming from the usa. our mental health sites would have up to date figures on suicide.
there are web sites people can access for help, discuss their mental illness and it is great that such services help people. one in particular, offers counselling services which might be good for those in the country, can't access a service provider.
i have been dealing with my mental illness since 1996 so i know there are good doctors around and there are crap doctors around. it is a matter of shopping for a person you feel understands your illness/need and you are comfortable talking to about your issues. i have had to change psychiatrists last year after seeing my other one since 1996 and it has been hard to build the rapport, tell him what has happened.
sometimes gp's have to get a person on meds asap because they are so depressed/in need of medications to help them. like all other services there are good gp's and bad gps. my old psychiatrist never ever sent any information to my gp about my mental illness in all the time i have seen him. now that isn't good because it is causing issues as she is writing my scripts for my medications and she doesn't have a full story of my mental history.
robyn
Hi Robyn,
Thank you for your honesty. Please do not take offense to what I stated. My main aim is too eliminate the stigma around Depression not attack the GP's or anyone else because you're right there are some great Professionals out the and people have good and bad experiences. To think that someone with a Mental Illness has to shop around because it is my fear that if they have a couple of bad experiences they won't hang in there long enough to find a good one and go untreated or worse, that is my biggest fear.
I had to include the USA statistics because I have alot of Americans emailing me about the issue and they also read my blog. However the number in Australia is approx 330,000 and that is a statistic sourced from SANE and the ABS all information produced was from the most recent studies.
There are so many great websites that people can go to. However it is my aim is for people who don't have Depression to get a better understanding of it and reduce the stigma. So if we all ban together we can't really do something about this.
Lou- Thank you for your lovely words :)
Renee xx
Hi Everyone,
I have worked as a GP with a special interest in mental health for the past 10 years. It is an enormous problem and certainly one that cannot be solved in the 15 minute standard consult. The government has been trying to address the issue with the introduction of the mental heath plans that when completed by the GP allow patients access to the cheaper (sometimes free) consultations with a psychologist. Mental Health needs a team approach as Louise said and fortunately times are changing and people are able to access these services. If the GP you see isn't interested in mental health, then change doctors...ask around and find one that is. Also there are no biochemical test for depression We will sometimes do other tests o exclude conditions that mimic depression like thyroid disease and B12 deficiency, but there are no specific tests. I cannot stress this point enough. The diagnosis is a clinical diagnosis based on the patients symptoms and presentation. That's it. Medications are often prescribed depending on the severity of the disease .Sure if its mild then some counselling and cognitive behavioral therapy can work but moderate to severe mental illness needs medications, just pneumonia does, just like asthma does and just like heart disease does.
Hi all,
I work as a volunteer telephone support counsellor at PANDA, which is the Post and Antental Depression Association - so I will talk about PND in particular. We have a number of GPs, psychologists, psychiatrists, etc, on our database who have a specific interest in depression, particularly PND. If you know of any health professionals you can recommend, please contact PANDA. We're a national service and the telephone support workers at PANDA have all had PND of differing severity, so have 'walked in your shoes'. In July 2010 it will become a 24 hour helpline. Well done for opening this discussion to educate people!
Thank you Dr Lucy & Lisa,
I spoke to a Psychologist and they informed me that there is a test involved to determine whether it is Biological or not? I will look into this further. Wouldn't it be great if the person "team" could be the ones responsible for phoning around GP's to find one that has an interest in Mental Illness..... Mmmm?
Lisa, PANDA do such a great job and I applaud you guys.
Just discussing it with you guys in this post gives me a better understanding and clarity so I am sure it does for many others as well and that is what it is all about. Thank you xxx
Renee xx
ok, so how do you "know" if you are depressed?
i got home from the doctor an hour ago. After finally deciding to seek some help for feeling a bit down and having a few problems with my partner i worked up the corage that I would ask the doctor for a referral to "talk" to somebody. the appointment was made for me and kids to get some immunisations etc and i decided to ask while there. it was embarrassing and i was so nervous and didnt get the help i was looking for. The doctor was rushed for time and said "are you depressed?" I said "no, well i dont think so" and she said well if its just for relationship counselling it will cost $130- so i said i can't afford that dont worry about it.
so should i have said yeah im depressed?! i dont know if i am... i dont think so, i dont WANT to be depressed but somethings not quite right. its not PND and im scared thats what people will think, but i have no problems with my baby and never did with my older child.... but whats the point of asking am i depressed??? your the doctor, you tell me..... so now i feel stupid for even asking the doctor and i dont want to go back to her because ill feel stupid.
so after all that,
how do you know if you are depresseD?
Hi Anonymous,
I am so sorry that you didn't get right diagnosis, questions, doctor, empathy or respect for that matter. It is the hardest step to ask for help like that then to have that happen just makes my skin turn.
If you have been feeling "off" for 2 weeks or more then you do need to talk to someone and the first port of call is a GP then they can refer you onto the right person.
If you are in Australia there are subsidies in place that help with the cost. Go to this link http://info.beyondblue.org.au/MAHP.html and type in your postcode and it will come up with a list of GP's that actually specialise in Depression.
Good luck and if you need anything please don't hesitate to ask.
You can email me on renee@braqueen.com.au
Renee xx
Hi,
I suffer from depression too and have been battling it for a long time through various therapies. I'm lucky that I am in a better place at the moment and have had help along the way. Depression is different for everyone, impossible at times and not everyone is lucky enough to have access to help.
So, we have set up a not for profit organisation called Building Resilience which is running courses to help those going through a hard time to make informed choices about their health, together with trained therapists and professionals.
The next course is starting on the 27th July in Brisbane so please do have a look through our site for more info. www.buildingresilience.net.au
Life should not be so hard.
Thanks for reading.
Nadine
Hi annonymous,
Congratulations for taking that first step. I'm sorry you didn't get the help that you needed.
Don't feel embarrassed about how you're feeling. You'd be amazed at how many of us in the world are feeling the same way.
Good luck.
Em.
Hi Anonymous,
I battled with depression for most of my adolescence and all of my adult life. I was not diagnosed until I was 31. And that's after years of seeing GPs for various ailments including migraines, stress and muscular tension. Nobody, until 1999, put it all together and gave me a diagnosis.
I'm now more educated about depression, about myself and about how I can manage it. But I am not "cured". It is something I live with, something I manage - with medication, with lifestyle changes, with learning to follow my heart.
I am extremely lucky in now having a fantastic GP and a team of professionals who look after me. But it has taken me 12 years to get here after being diagnosed. So don't give up hope! If you don't feel right, then you're not.... Keep asking for help. Eventually you will find it, I promise....
Thank you all so much for showing such great support!
Rxx
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