Mind Yourself - coping with stress and depression
Depression and stress are two big factors in the lives of Irish people today. There are many myths about both which need to be dispelled. Studies suggest that there is a superficial awareness of the circumstances that can contribute to the onset of depression and doctors also report some frustration in depression management. At times, when people begin to feel better after taking antidepressants, they stop taking the medication.
A recent public meeting in Dublin on depression, stress and suicide, chaired by this author, attracted a massive gathering – an indication of the level of public desire for better information. The meeting heard that around 300,000 people are affected by depression in Ireland at any one time. Unfortunately, less than one in four people get adequate help. Chemical changes take place in the brain which cause depression – key molecules called neurotransmitters do not work correctly or they are present in the wrong amounts. It is not something to feel guilty or embarrassed about.
According to Prof Patricia Casey, consultant psychiatrist, Mater Hospital in Dublin, sometimes there is no trigger for depression, something which can add to the guilt people affected feel because they believe they should have a reason for the illness.
“Around 50% of people do not have a trigger or risk factors for depressive illness”, she said. “The outcome for those who get treatment is very good. It is also important to be aware too that antidepressants are not addictive”. The newer antidepressants also begin working much faster, within days, compared with older treatments. These medicines also help ‘re-wire’ the brain so that thinking processes work better.
Dr Casey said that there are many misconceptions surrounding mental health and barriers need to be broken to encourage more people to seek treatment.
Depression often requires medical and psychological treatment. Unlike feeling ‘a bit down’, clinical depression can be very disabling, affecting the simplest of everyday activities such as getting up in the morning, shopping or cooking meals. Depression is an illness that lasts for a period of time and is not about advising someone affected to pull themselves together.
The treatment may involve cognitive therapy. This is a form of psychotherapy aimed at helping people see the world differently. A depressed patent may have come to see him or herself as powerless to change. The therapy helps people spot false thinking and find ways to cope better.
Recent surveys show that three quarters of Irish people believe that life in Ireland has become more stressful in the last five years. Most people accept stress as a normal part of living and are able to cope with it in various ways. However, for around 300,000 people – workplace stress affects family life and 13% of the population suffer from anxiety. When you are stressed, you find yourself becoming irritable and tired.
Some coping mechanisms can be very harmful, including increased smoking, and increased alcohol intake. The problem with excessive alcohol use is that over time it has a physical devastating effect on the brain– something which can easily be shown using Magnetic Resonance Imaging (MRI) scans of the brain.
Just one in ten people have sought professional help for stress related ailments, most of these going to a GP.
According to Prof Casey, depression occurs mainly in young women and it is important to be aware that it is not associated with the menopause. Depression can occur in children as young as five years. Some people have a chemical predisposition to depression.
In relation to stress, the meeting heard that the top three causes at home are financial and health concerns, and transport problems in urban areas. At work, the top three causes are too heavy a workload, being responsible for others at work and the physical workplace environment.
“Moving house is the second most stressful event – the first is going to prison”, Prof Casey said.
People have different coping systems. It also depends on how you view pressures – as problems or as challenges. People who have good social supports and strong religious beliefs seem to cope better.
For people suffering from depression, having a shoulder to cry on can be helpful, but only up to a point, Prof Casey explained. She said that this might offer short-term assistance as people may feel positive after talking about their problems. However, it is not a long-term solution and neither is going on a holiday.
The subject of suicide is a very distressing one, especially for those affected by it. Worldwide, around one million people take their own lives each year. It is now the principle cause of death in young people, exceeding accidents and cancer. Over 400 people commit suicide in Ireland each year.
According to Dr John Connolly, consultant psychiatrist, St Mary’s Hospital, Mayo there is truly no health without mental health. For those who contemplate suicide, most want to end pain rather than end their lives, he said. But he also warned that even ‘minor’ suicide attempts must be taken seriously.
The danger signs are: severe depression; people talking about suicide; a preoccupation with death; hopelessness; self-destructive behaviour and even a sudden calmness or happiness after a period of deep depression. This may reflect the fact that a person has decided to end their life, has put their affairs in order and is now calm with the decision.
Dr Connolly said that if the level of alcohol consumption could be cut, suicide levels would also fall. In countries where there has been a major decrease in alcohol consumption, so too has the suicide rate fallen, especially youth suicide.
No single cause
It is important to remember that there is no clear single cause for suicide. It is a mix of factors. For young people, youth hopelessness is a factor and ‘copycat’ cases account for up to 10% of all suicides. Bullying is also a factor as well as illness and poor parenting. However, Dr Connolly said that a link with exams and stress has not been shown. Suicide is seen mostly in males, in young people (15-24 years) and also in older people who perhaps live alone and feel little left in life to live for.
Sadly, suicide is notoriously difficult to predict – doctors are likely to be wrong many more times than they are right. But certainly recognising and dealing with depression earlier and moderation in alcohol consumption are two of the big challenges ahead.
The seminar held in Dublin was hosted by Lundbeck Ireland. The AWARE organisation helps people with depression and their families. You can contact them at: Dublin 6617208. If you are suffering from stress or depression, please talk to your GP.
* Fergal Bowers is the editor of irishhealth.com
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