THE SOUTH AFRICAN
DEPRESSION AND ANXIETY
GROUP

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IN THE WORKPLACE

New Research on Depression in the Workplace.

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JOURNAL

Mental Health Matters Journal for Psychiatrists & GP's

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SPEAKING BOOKS

suicide book

Literacy is a luxury that many of us take for granted.  We depend on written communication for information, guidance, and access to heath care information That is why SADAG created SPEAKING BOOKS and revolutionized the way information is delivered to low literacy communities. It's exactly what it sounds like.a book that talks to the reader in his or her local  language, delivering critical information in an interactive, and educational way.

The customizable 16-page book, accompanied by local celebrity audio recordings, ensures that vital health and social messages can be seen, heard, read and understood..

We started with books on Teen Suicide prevention , HIV, AIDS and Depression, Understanding Mental Health and have developed over 30 titles, such as TB, Malaria, Polio, Vaccines for over 30 countries.

depression book

Tips on managing ADHD symptoms in the workplace.

The attention deficit hyperactivity disorder, when untreated, typically amounts to a life of chaos, both at home and at work.  It’s a chronic, lifelong disorder, with the early indications sometimes apparent from infancy, and extending well into the sunset years of life.  It affects every waking moment of the day, every day.  Not limited to that, it can also cause a disrupted pattern of sleep, with a typically delayed onset of sleep, followed by possibly a restless sleep with several awakenings, or with a shorter than average overall duration of sleep.  It’s really never ending.

Have a look at this email I received from a concerned employer, regarding a young man working for him.

"It has been an ongoing problem since I can remember, his working and living environment is a physical mess.  He gets edgy and angry when you talk to him about his life and working style, he is very disorganised, with meetings and phone calls missed all the time. He fails to keep promises with customers and must always keep his hands busy. Sometimes he can work up until the early hours of the morning in the workshop doing welding and mechanical work then fails to report to work the next day. And even then, he focuses on unnecessary details. "

ADHD is a neuropsychological disorder, the major characteristics of which are as follows.  

1.Hyperactivity.  This is a pattern of physical restlessness, often present from infancy, which very often tends to diminish in intensity during adolescence, with vestiges persisting into adulthood.  I have the impression that it can be best understood as a feeling of physical discomfort which is relieved by virtually persistent motion of some part of the body.  It leads to the person, preferring to be "on the go" in some or other manner.  Hyperactive persons rarely sit still for extended periods of time.

2.Impulsivity.  Impulsive persons tend to react without forethought.  Decisions are made hastily and without serious reflection of the consequences of such decisions.  Hence the decision making often amounts to being thoughtless.  They could be considered to be the "man of the moment" mostly this moment.  They find it extremely difficult to delay their actions.  They like to have it their way, straight away.  Any change of plan or a delay, which is beyond their control, frequently leads to feelings of intense frustration, which have the capacity to result in verbal or sometimes physical assault.  This pattern of behaviour, can seriously compromise effective social relationships, both at home and at work.

3.Attention Deficit.  This particular problem can seriously impair work performance.  Simply getting started could take an inordinate amount of time.  A lot of time is actually wasted. It can amount to tasks either taking far too long to complete, or sometimes not completed at all.  They often shift from one incomplete task to another to alleviate a sense of boredom. It contributes to forgetfulness, and a tendency to misplace or lose things.  Procrastination is a very common characteristic, with tasks being left to the very last minute, and typically rushed or incomplete.

4.  Organisation and planning.  This is usually of poor quality.  One aspect of this problem is poor time management, with frequently too little time allowed to adequately complete a task.

I have however noticed that where plans have been prepared, it’s the implementation of which proved to be the problem.  This disorder is not so much due to a lack of knowledge, but rather due to a lack of performance.  ‘Getting it done’ can sometimes be an almost insuperable challenge.

5..Interpersonal Hypersensitivity.  I find that many ADHD sufferers are emotionally very vulnerable and oversensitive to rejection from others, either real or imagined.  They are highly dependent on favourable feedback from other significant people, such as colleagues or their employer.  Such feedback could be considered essential to ensure their motivation for optimal performance.  This problem could be summarised as one of either threat or neglect.  They feel intensely threatened when facing disapproval or criticism, or heartily dismayed or resentful when neglected or unappreciated.

Some simple questions which could be put to the patient, which may suggest the presence of ADHD, would be to enquire:

1.    Whether there were any problems encountered at any stage of their education?
2.    Whether they disliked studying?
3.    Whether they were socially cautious or shy in their relationships to others?
4.    Whether they have problems with a concentration?  

A response to these questions in the positive would provide sufficient grounds to consider immediate intervention or a referral to a specialist for a comprehensive evaluation.

Therapeutic intervention.

From a treatment perspective, it’s helpful to view, this disorder as having two fairly discreet aetiological categories Genetically & Neurological factors and Psychologically/Environmentally determined factors based on life experiences.  Both of which benefit from an attention.  

Firstly.  Neurological/physical

1.  ADHD is primarily a neurological disorder which responds most favourably to the introduction of psychostimulant medication.  I would consider it the sine qua non.  I find it has the capacity to normalise patterns of behaviour in persons with ADHD.  Methylphenidate, in its various formulations is my drug of choice.  It needs to be introduced with caution and on the lowest possible dose, to avoid or minimise transient side effects. If need be, an adequate pattern of sleep, could be facilitated with a trial of melatonin, or clonidine, taken an hour or two prior to the planned onset of sleep.

2.  Following a holistic approach to the management of this disorder, in my view, it is imperative.  I like to ensure my clients have an adequate night's rest, are engaged in regular brief daily vigorous exercise, and follow a healthy diet, excluding refined carbohydrates.  These three simple steps can make a significant difference to rehabilitation.

Secondly.  Psychological/educational

3.  I find the most effective form of psychological intervention consists of both psycho education, including cognitive behavioural therapy with a focus on skills development.

Dealing effectively with this troublesome disorder requires a radical life change on the part of the patient to ensure an adequate quality of life.  Management should be regarded as long-term.

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