Working with people experiencing depression and anxiety disorders MHBiz 10 February 2016 Working with people experiencing depression and anxiety disorders Dr. Leanne Craze, Sydney, Australia

What we will cover today What are depressive and anxiety Common types How many Australians? Some important facts Care, support & treatment Relevance to working with customers Skills & strategies for Hume staff Helpful resources

What is depression? Short-term depressed mood – short term and often recovery without professional assistance Major depressive disorder – lasts longer than two weeks and significantly affects a person’s daily life Symptoms are physical, psychological and behavioural

Depression – physical symptoms Key symptoms include: Fatigue Lack of energy Sleep disturbance Change in appetite Weight change Headaches and unexplained aches and pains Loss of sexual drive Low immunity and string of sickness

Depression – psychological Sadness Anxiety Anger and irritability Mood swings Feelings of guilt, hopelessness and helplessness Self criticism and self blame Loss of sense of pleasure Difficulty in concentrating and making decisions Thoughts of suicide and self harm

Depression – behavioural changes Crying Withdrawal Loss of interest in appearance and self care Loss of motivation Slow Using alcohol ad drugs Absenteeism

Depression - checklist For more than two weeks: Felt sad, down or miserable for most of the time? Lost interest or pleasure in usual activities? If yes to either…

Depression check list continued Lost or gained a lot of weight or had increased or decreased appetite? Sleep disturbance? Felt slowed down, restless or excessively busy? Felt tire or had not energy Felt worthless? Guilty? Had poor concentration, thinking difficulties or indecisive Recurrent thoughts of death

Depression checklist cont. 4 or less items – unlikely to have a depressive illness 5 or more – likely to have a depressive illness

Common types of depressive disorders? Major depressive disorder Perinatal depression Bi-polar Seasonal affective disorder Often occurs with anxiety disorders and other mental disorders Depression can accompany physical conditions

How many Australians? 6.2% of people aged 18-85 in any one year More woman than men Median age of onset is 25 years

Group Exercise 1 What do you think might be some of the major risk factors for depression? What do you think might be some of the toughest aspects of living with depression?

What helps Psychological therapies – CBT, mindfulness, interpersonal therapy, psychodynamic therapy, problem solving therapy, behavioural activation Counselling support Medical treatments – antidepressants, anti- psychotic medication, mood stabilisers, ECT Lifestyle – exercise, diet/nutrition, managing stress

Anxiety disorders One in four Australians aged 16-85 experience an anxiety disorder at some stage of their lives 14.4% of Australians each year Anxiety disorders frequently commence in childhood

Anxiety disorders are tricky People can’t figure out what’s going Most distressing symptoms are physical People think they are about to die Because its so physical, people think the answer comes in the form of a tablet

Some common types of anxiety disorders Generalised anxiety disorder Phobia e.g. social phobia, agoraphobia, specific phobias Obsessive compulsive disorder Post traumatic stress disorder Panic disorder Hoarding disorder

What helps with anxiety disorders Psychological therapies e.g. CBT, behaviour or exposure therapy Stress management and relaxation training Lifestyle changes Medical treatments – antidepressant medication and other medications

Group Exercise 2: Understanding the impact of anxiety Film: Fight or flight? What types of things do Sharon and Wayne experience? What did they find most difficult? What would you find most difficult?

Group Exercise 3: Understanding how anxiety can be overcome Film: Fight or flight? What does CBT aim to help people do? Why is it important? Information and self-monitoring – what info, monitoring what and why? Why is learning how to control one’s breathing important? What does realistic thinking aim to help people do and why is it important? Internal and external exposure – what are they?

Discussion: so what for Hume? If a customer has depression what aspects of their tenancy and their interactions with Hume might they find most difficult? If a customer has anxiety disorder what aspects of tenancy and their interactions with Hume might they find difficult?

Discussion: skills and strategies for Hume Could any of the strategies outlined in the film be drawn upon to help customers? What skills would be using? How might staff as well as the organisation assist customers with depression and anxiety disorder?

Getting help – getting started Better Access One to one therapy Group-based therapy Self-management

Helpful e-resources for depression and anxiety Beyondblue - https://www.beyondblue.org.au/ Mind Health Connect - http://www.mindhealthconnect.org.au/ eCentreClinic - https://www.ecentreclinic.org/ E-couch – https://ecouch.anu.edu.au MoodGym - https://moodgym.anu.edu.au Blue pages - http://bluepages.anu.edu.au/ Mindspot - https://mindspot.org.au/ Mental Health online - https://www.mentalhealthonline.org.au/

Helpful e-resources for depression and anxiety cont. My Compass - https://www.mycompass.org.au/ This way up - https://thiswayup.org.au/ Blackdog Institute - http://www.blackdoginstitute.org.au/ CRUfAD - https://adc.crufad.org/

Helpful books & films for depression and anxiety Me depressed? Don’t make me laugh! Fight or Flight I think they think Books Beating the Blues – Tanner & Ball Taming the Black Dog – Aisbett Living with it – Aisbett Letting it go - Aisbett