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Research on Depression in the Workplace.

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Mental Health Matters Journal for Psychiatrists & GP's

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Literacy is a luxury that many of us take for granted. That is why SADAG created SPEAKING BOOKS and revolutionized the way healthcare information is delivered to low literacy communities.

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

We started with books on Teen Suicide prevention , HIV, AIDS and Depression, Understanding Mental Health and have developed over 100+ titles, such as TB, Malaria, Polio, Vaccines for over 45 countries.

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Surviving a traumatic event means more than just living to tell the tale. It means seeking out the help that's available and dealing with the experience, so that the aftermath doesn't derail your life.


When I was hijacked outside my home, I remember being so relieved at first that I had not been physically hurt, raped, or worse. Everyone who knew me said they couldn't believe how well I handled it. But months later, I had become someone I did not recognise,' says 32-year-old Linda*, who was held up at gunpoint in the driveway of her Bryanston home three years ago. 'I was easily startled, and if I heard an unexpected loud noise my breathing would get shallow, I'd start to shake uncontrollably and feet clammy all over. I started to have panic attacks that happened anywhere: at work, in the supermarket, in my home; and I also had nightmares. I stopped going out on my own, and I would wake up about 10 times a night. It affected every part of my life: my career, my relationship, and my friendships..?

Eventually Linda went to see a psychologist and was diagnosed with Post Traumatic Stress Syndrome (PTSD) two years ago, after living with its full-blown, incapacitating symptoms for over a year. And she is just one of countless South Africans affected by PTSD.

Any survivor of a traumatic event in which serious physical harm was threatened or happened may develop PTSD, says Fourways psychiatrist, Dr Shadi Motlana. Traumas that could bring on PTSD are multiple, including natural disasters, child abuse, being kidnapped, violent assault, hijacking, armed robbery, military combat or an accident. What's more, just THOSE WITH PTSD TEND TO STARTLE EASILY, LOSE INTEREST IN LIFE, MAY BE VIOLENT, AND IRRITABLE OR AGGRESSIVE witnessing such trauma may trigger the syndrome. 'A person need only witness or be confronted with an event that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others,' explains Dr Motlana. 'The person's response involves intense fear, helplessness or horror.'

Symptoms usually start within three months of the incident, but may still be present years later.

They need to be present for at least a month for a PTSD diagnosis to be made. Those with PTSD tend to startle easily, lose interest in life, may be violent, irritable or aggressive, and can become emotionally numb. They also tend to avoid reminders of the event, and frequently find anniversaries of the event very difficult times. They often 're-live' the incident in their minds and have nightmares about it, and these 'flashbacks' are usually triggered by ordinary events reminiscent of the incident (for example, a car backfiring may recreate a combat situation or the sound of gunfire).

According to Pretoria clinical psychologist Kobus du Plooi, 'Some people suffering from PTSD may also try to self-medicate the painful emotions by abusing alcohol or other substances, which further wreaks havoc on every aspect of their Lives. Others may develop major depression, causing symptoms such as insomnia, a persistent depressed mood, impaired concentration, and Low levels of energy, all of which impact on day-to-day functioning.'

Du Plooi says that although there are no available statistics on the rate of PTSD in South Africa, it is fairly safe to assume that, given our high crime rate, 'there is probably a higilet prevalence of PTSU here than in other countries with lower crime rates.'

Of all of his private practice patients, he estimates that as many as 40 percent are in treatment for 'exposure to trauma'. 'I would also say that about 60 to 70 percent of my clients report that they have been exposed to a traumatic incident at some point in their Lives, although they might not present with these symptoms for treatment, but might be presenting with something else, like marital difficulties or major depression,' he adds. He notes that those who have experienced trauma in the past, and who have not resolved it, are among the most likely to present with PTSD. "

What is vital is that anyone presenting with the symptoms of PTSD for more than one month seek help urgently. Treatment is available, sensitive to the individual, and, as Linda discovered, it does work. 'Because each human being is unique, so psychotherapeutic treatment needs to be tailored for every individual,' explains Du Plooi. 'It may involve therapy that allows the client to face the traumatic event again and to The Bankmed Personal Stress Assessment (PSA) can help you assess your mental health status. Bankmed Vitality members can earn up to 5 000 points for completing the PSA. The Bankmed Special Care Programme for depression offers support and guidance to members diagnosed with depression. For more information, phone 0800- BANKMED (0800-226-5633). develop effective coping procedures as well as a corrective emotional experience in order to overcome the debilitating effects of the condition. It may, in addition, also involve pharmacotherapy, with the use of prescription of drugs.'

And, just as treatment is unique, so is recovery. 'Some people may learn to cope, but never fully recover from the effects of PTSD, but most of the clients I have worked with do not forget the incident but do make a full recovery in terms of no longer experiencing the symptoms or effects of the condition,' says Du Plooi.

'I still have the occasional panic attack, and I still sometimes have nightmares,' admits Linda, 'but they grow less and less frequent the longer I continue with my therapy. I am much more balanced now, and only wish that I had sought help sooner than I did.'


Pat Bosman, therapeutic reflexologist at Sandton's Anxiety and Trauma Clinic, says that the best way to handle PTSD is to help yourself: keep your life as normal as possible and get back to your usual. routine talk about what happened to someone you trust go for counselling with the right psychologist who specialises in treating PTSD as soon as possible after the incident. It is advisable for family members to attend counselling as well go for group counselling as there you will be able to see that you are not alone. 'The best way to treat PTSD is for the person affected to acknowledge that there is a problem and to accept full responsibility for the recovery - otherwise they will become reliant on other people. In some cases, there is full recovery but unfortunately, in other cases, it stays for life, and depending on the age at the time of the incident, it can cause major problems in Later life,' she says.

* Name has been changed.

USEFUL CONTACTS South African Depression and Anxiety Group (SADAG): 0800-567-567; SMS 31393; Mental health hotline: 011-783-1474; www.sadag.coza Mental Health Information Centre of South Africa: 021 938 9229; www.mentathealthsa.coza Trauma Clinic: 011-403-5102/3 Anxiety and Trauma Clinic: 011-883-4552


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