An honest conversation about depression
Jonathan Hill
Before we start !
We don’t always know each others stories so please – ! •Be sensitive to each others views and feelings •It’s ok to slip out if you need some space •Please talk to or pray with someone afterwards if this session raises any sensitive issue
How many people are estimated to have a form of depression at any one time?
a) b) c) d) e)
1 1 1 1 1
in in in in in
10 25 50 100 500
What are the chances have serious depression in a life time? Women a)1 in 4 b)1 in 8 c)1 in 10 d)1 in 15
Men a)1 in 4 b)1 in 8 c)1 in 10 d)1 in 15
More people die from suicide than road accidents? !
True or False ? ! !
Answer True
Why do people get depressed?
How we were intended
Initial concept Dr Nick Land ‘Psychiatry and Christianity - Poles apart?’ Nucleus - July 2002 (pp13-19) Christian Medical Fellowship
How we were are
Pastoral Care
Prayer Ministry
Befriending
Medication*
Family Work* Physical Care Mentoring Practical support
Social Work* Occupational Therapy*
Prayer counselling
Professional Counselling*
Esteem / confidence building
Vocation / work support *
Stress Vulnerability 

+Ve
-Ve
More details on the model see - Understanding Stress, Family Doctor Publications/ BMA 1996 Full detailed version see - Stuart S, Sundeen S, Principals & Practice of Psychiatric Nursing 1995 Mosby
Stress Vulnerability
Demands
Internal needs & Values
Personality & Coping Style
External Support
Stability
Commit ments
Respons ibilities
Long term condition
Health
speration
Conflict
Partner/ Spouse
speration
Conflict
Parents Health
Church
Pain
Family
Physical Health
Children
Life limiting Education
moveing
Suitability
Housing
Demands
Repair Locality
Finances Debt
Security
Job
Bills Mortgage Changes
stress No job
Blended family
Upbringing Need for relationship
How I like to be seen How I like to do things
How I like to be rewarded
The things I value about my self
Internal needs & Values
The things I believe about myself The things I think are important
History / personal journey
family
Friends
External Support Professi onals
commun ity
Church Colleag ues
Calm / considered
Half full
Personality & Coping Style
Personality Half empty
Upbringing Sit down & plan
History / personal journey
How manage stress
Self manage
Bottle it up
Seek help
Stress Vulnerability
! ! ! ! ! ! ! ! ! ! !
+Ve
-Ve
Can you name the common symptoms of depression? Low Mood Tiredness Tearfulness Disturbed sleep Changes to appetite (loose or gain weight) Physical aches and pain Lack of energy or motivation Irritability and intolerance Feelings of guilt Loss of concentration Change mood patterns through out the day
What’s Actually Happening? The highest you normally feel
Normal
The lowest you normally feel
Depression
Hopelessness
Lethargy/ Catatonia
Weeks
What’s Actually Happening?
Normal
Depression
Hopelessness
Lethargy/ Catatonia
Mood changes constantly, can be affected by tiredness, stress, weather
Normal
What’s Actually Happening?
Normal
Depression
Hopelessness
Lethargy/ Catatonia
In response to bad news mood will often go below normal
What’s Actually Happening?
Normal
Depression
Hopelessness
Lethargy/ Catatonia
It becomes depression when mood stays below normal for more than 2 weeks
lf
tu Fu re
World
Se
Beck’s Negative Triangle
Beck, Aaron T; Rush, A. John; Shaw, Brian F.; Emery, Gary. (1979). Cognitive Therapy of Depression. New York: The Guilford Press. pp. 11
What’s Actually Happening?
Normal
Depression
Hopelessness
Lethargy/ Catatonia
If remaining in this zone for any length of time, there is a change in the physical working of the brain leading to becoming more depressed!
What’s Actually Happening?
Normal
If you become low enough you enter an area of hopelessness where suicide becomes an option as it will appear there is no hope
Depression
Hopelessness
Lethargy/ Catatonia
What’s Actually Happening?
Normal
As they get better they begin to have enough energy to realise how bad they feel and re enter the zone of hopelessness!!
Depression
A large number of people attempt to harm them selves here! Hopelessness
Lethargy/ Catatonia
women
men
Upbringing Need for relationship
How I like to be seen How I like to do things
How I like to be rewarded
The things I value about my self
Calm / considered
Internal needs & Values
Half full
Personality & Coping Style
Personality Half empty
Upbringing Sit down & plan
History / personal journey
How manage stress
Self manage
The things I believe about myself The things I think are important
Bottle it up
Seek help
History / personal journey
Professional Treatment Counselling / therapy – •
Trigger problem
•
Negative thoughts
•
Underlying insecurities
Medication Must only be started & STOPPED by a doctor Antidepressants take 15 – 21 days before they begin to work & stop working Should be taken for 6-9 months, stop to soon likely to become unwell again but this time for longer
The Wider Effects Depression
?
John’s Story
How to help & when to get more support
Specialist professional help. Maintain pastoral support. May need to discuss with care team how you can best help
At every step it is important to know when to refer onwards for help, but it is also important to maintain general support when they are getting help at the next level
Person >
Prayer / Pastoral Support
< Carer
Personal interests Respect Empathy Relationship Care
Practical needs (think stress adaption) Attainable goals Checking up on progress
Avoid â&#x20AC;&#x2DC;counsellingâ&#x20AC;&#x2122;â&#x20AC;&#x2122; !
Be patient, (it may have taken 6-12 months to get depressed it may take just as long to recover)
!
Be encouraging & supportive !
Don't give in to negative thinking! !!
Encourage to seek proper help
Remember the persons family / ‘Carer’ !
Think how you can offer support ! !
Be very care full of! and ‘I am healed’! stories ! ! !
Be aware of our own needs & limitations !
Donâ&#x20AC;&#x2122;t be afraid to get support for your self !
For long term complex needs, consider a support group to share to support !
Keeping Well - Early Warning Signs Green
Amber
• What you are like when you are well
• Signs that you might be becoming unwell
Red
• When you are becoming unwell
Plan in advance in involve people who might be able to help
Keeping Well - Green
• What are you like when you are well? !
• Are there things that help you keep well? Diet, exercise, routines, small group prayer, listening to music etc !
• Are there things that are not good for you? Alcohol, late nights, working to much. !
• How can you help manage these?
Keeping Well – Amber
• Are there any signs that you may becoming unwell? !
• Are there things that can help with these? !
• Who can help you?
Keeping Well – Red
• You have now become unwell !
• Is there anything that has helped before? !
• What needs to happen to help you? Who can help you? !
• What needs to happen to look after your family/ pets etc?
If you have any concerns over your or someone's else's safety seek immediate professional help
On the web•Mind •Depression Alliance •NHS Choices Phone – NHS Choices dial - 111