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

MHM September 207x300

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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

To view the larger PDF version - click here

coping with ocd1

coping with ocd2

FEARFUL OBSESSIONS BY GLYNIS HORNING Checking that you've locked the door or switched off the lights several times is one thing, but what if your life is ruled by fears that compel you to perform exhausting or disruptive rituals? obseswicierionscan the ni but one at..v fear ost ceafrno of tton contanunn , or by ger arns . _ e all get thoughts stuck in our heads sometimes, or check our bags several times over for keys, passports or other important items. But for some people, irrational fears become overwhelming, and the urge to perform certain rituals to calm them develops into a compulsion that dominates their lives, interfering with their ability to function. ' 'Since primary school I've felt compelled to repeat certain actions just to feel safe:says Odette Kennedy, a 27-year-old Johannesburg aftercare teacher.Td have to touch my body, then take a step forwards and another backwards before walking on. It was embarrassing when other kids noticed, but a little voice in my head was telling me if I didn't do it, something bad would happen'. Later, Odette's bed sheets had to be perfectly smooth: 'I'd just get them right, then I'd have to get out of bed and switch my bedroom light on and off, on and off It was when she began rolling her eyes that her mother decided something was seriously wrong and took her to a doctor and psychologist.They diagnosed obsessive-compulsive disorder (OCD). OCD affects about three percent of us at some stage of our lives, and usually starts in early adulthood, says Cassey Chambers, operations director of the South African Anxiety and Depression Group (SADAG). Obsessions can vary widely, but one of the most common is fear of contamination — by dirt, germs, chemicals, radiation, cancer, sticky substances or AIDS.This can trigger ritualistic cleaning, obsessive hand-washing, or avoidance — always wearing gloves or socks, or opening doors with elbows, says Dr Margaret Nair, a psychiatrist who consults at Life Entabeni Hospital in Durban. Other OCD sufferers fear making a mistake or harming people by poisoning food, spreading illness, even pushing a stranger in front of a car or running over a pedestrian, which can lead them I WI IMAGES GREATSTOCK/CORBIS, SUPPLIED 28 Life AUTUMN 2015 Don't be embarrassed to get help if you think you have OCD - you are in star company: Emily Blunt fixates on things: 'As a kid, I'd get these obsessive moments where I'd be in the car with my dad, and every time we went past a lamppost I'd start clucking six times,' she told an interviewer. Cameron Diaz opens doors with her elbows to avoid touching germ-ridden handles. Megan Fox avoids restaurant silverware. Jim Parsons washes his hands so often they are constantly red. Don't criticise or embarrass them - the anxiety can make symptoms worse, and they may already have a low self-image. Direct them to reputable websites such as www.sadag. org, or download information for them to read. Give encouragement - assure them they are not alone and that treatments today help to significantly reduce symptoms in most people. Suggest they speak to a mental health professional. If they still refuse to admit they have a problem, don't give in, says Cassey Chambers. 'Gently explain that you will not be involved in the OCD, and that your offer to help find a doctor or therapist still stands.' Tell them you will help them resist their compulsions, and support them by reinforcing good behaviours. Recognise gains made in treatment and be flexible during stressful times. Stay positive - OCD is nobody's fault. Contact SADAG: Call 0800 21 22 23, SMS 31393 or visit www. sadag.org. to avoid cooking, driving or going out Still others are terrified they'll set fire to their house or flood it, so they constantly check stoves and taps; or that they'll lose valuables, which leads to them repeatedly checking on these. And some are compelled to constantly organise and arrange things, or hoard them, afraid to throw anything away, however useless, adds Dr Peter Francois Colin, a psychiatrist at Life Wilgers in Pretoria. COMPULSIVE ORIGINS The causes of OCD are still not clear, Dr Colin says, but current theories indicate biological factors contribute. It's been linked to abnormalities in levels of the neurotransmitter serotonin, which may be genetic as there's a tendency for OCD to run in families. Evolutionary theorists have suggested that OCD may have had evolutionary advantages in primitive times, with behaviours such as constantly checking the environment for dangers or hoarding supplies raising the chance of survival. Sometimes OCD can be traced back to a stressful event, such as the death of someone in the family, says Dr Colin. It may follow a medical illness, such as complications from a streptococcal throat infection, which can affect the brain, says Dr Nair. Or it can be secondary to other mental illnesses, such as schizophrenia, anxiety disorders and depression. HIGH COSTS OCD will be diagnosed if individuals have obsessions or compulsions or both, which cause significant distress, take up their time (more than an hour a day) or interfere with their ability to function, socially or at work. 'Families are also often pulled into the compulsions, being forced to participate with the patient's rituals', says Dr Colin. In extreme cases, it can cost the sufferer's job, relationship, and even their life - as in the case of contamination-obsessed former British law student, Samantha Hancox. She eventually spent up to 20 hours a day showering, becoming house-bound and dependent on her elderly parents. She died in 2010 at the age of 40 from dehydration and severe skin infection. Fortunately, Odette's OCD was diagnosed early, and she could begin treatment - which brings significant relief from symptoms in most cases when properly prescribed and adhered to, say Drs Colin and Nair. CURRENT SOLUTIONS  Today medication, usually selective serotonin re-uptake inhibitors (SSR1s) and other serotonic drugs, can be all that it takes to control OCD.'These often need to be continued long term and in higher doses than those used for depression:says Dr Colin. 'Adjunctive medication may also be used to obtain optimal control, such as an antipsychotic,' adds Dr Nair. Medication worked for Odette, but when her condition improved, she stopped taking them - and the symptoms returned. The most effective treatment for OCD may be a combination of medication with cognitive behavioural therapy (CBT) that uses exposure and responsive prevention (ERP). This helps patients resist compulsions through 'habituation'- they're encouraged to gradually expose themselves to whatever they fear, while refraining from the rituals they usually use for relief, until they establish that their fears truly are groundless. Odette began not only straightening her sheets again, but finding she could not go anywhere without'protecting' her hands and feet with skin creams and socks. After a recent bout of severe depression, she was hospitalised and put back on SSR1s, and she is about to start CBT. 'My OCD is manageable but becomes more frequent and controlling when I get stressed:she says. 'I find myself trapped in repetitive thoughts - if someone interrupts me, I have to start from the beginning or else I can't relax: she explains. 'The thing is, I'm married now, and though I'm used to living with OCD, I don't want the man I love to have to live with it too!. Helping hand For psychiatrists, psychologists and other healthcare professionals at Life Healthcare hospitals, email general. information(eulifehealthcare.co.za or fax 086-500-7535. Odette Kennedy was diagnosed with OCD when she was at school

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