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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.  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.

suicide speaking book

Questions and Answers

Q: How serious is social anxiety disorder - isn't it just a form of shyness?

A: Social anxiety disorder is an extreme pathological anxiety and is distinct from the common shyness experienced by many people. Shyness is typically not disabling or distressing, and is part of the spectrum of human personalities, which does not require treatment. In contrast, social anxiety disorder is characterized by a marked and persistent fear of social situations, which causes intense suffering to the patient and interferes with their daily functioning. It is a common condition that is estimated to affect 2-5% of the general population at some point in their lives, yet it is under-recognised by both patients and physicians.

Psychiatrist, Dr Annemarie Potgieter, says: "Someone who is shy can be considered an introvert, and although they do feel slightly awkward in social situations, after a while they get used to the situation and relax. They do not experience the same extreme fear of embarrassment in a social situation that people suffering from social phobia do. Although social phobia can be present in all social situations, it is usually non-generalized, in that the person fears a few specific situations e.g. school or parties. What distinguishes people with social phobia from those who are merely shy are three factors: their extreme, negative reaction to criticism, their negative thoughts and reactions about how others are going to judge them, and their severe physical reactions such as panic attacks and blushing, either in the situation or in anticipation of it. This leads the person to either avoid these situations or to endure them with great amounts of distress."

Q: Why do patients rarely seek treatment for their condition?

A: Patients rarely present to their physicians for their social phobia symptoms, because they do not recognise that they are suffering from a chronic medical condition. Public awareness of the existence of social anxiety disorder is very low, which has resulted in patients and their families believing it is a personal problem that they must deal with. Patients feel that they would be wasting their physician's time and would not be taken seriously. They are also unaware that there are treatment options available. According to Dr Annemarie Potgieter, people are not aware that what they are suffering from has a treatable diagnosis, and that this is where the media has an important educational role.

Q: If social phobia is so common, why is it under-diagnosed?

A: The principal reason for social anxiety disorder being under-recognised is lack of awareness among physicians about the nature of the condition and its associated disability. Some physicians are uncertain of the existence of the disorder and believe it to be an extreme form of shyness, or a symptom of another anxiety disorder. Further reasons for under-recognition include the following:

§ Combined psychiatric disorders are common in sufferers of social phobia and they may mask the condition

§ The coping strategies that patients invent to help them endure their symptoms may disguise the disorder and make diagnosis difficult

§ Fear of visiting the doctor may be an inherent feature of the disorder

Q: What are the consequences of patients not receiving treatment for their condition?

A: Social phobia typically occurs during adolescence - a time when social skills are developed and when educational achievement is important. Obstruction of social development through fear and avoidance can lead to long-term disability and affect work, social and family lives. In addition, the symptoms endured by social phobia sufferers can trigger comorbid conditions such as depression and substance abuse, leading to a marked reduction in their quality of life.

Q: What is the best treatment for social anxiety disorder - medication or therapy?

A: Both medication and therapy such as cognitive behavioral therapy (CBT) have proved to be effective in the treatment of social anxiety disorder. Of the pharmacological treatments, both selective serotonin reuptake inhibitors (Aropax) and MAOIs (Aurorix) are recommended as the drugs of first choice. There is good evidence that exposure-based strategies of CBT are helpful in social anxiety disorder and their use may improve the chances of sustained remission. However CBT is not available throughout South Africa. There is some benefit to combining the pharmacological and psychological strategies though controlled data examining the usefulness of this approach are lacking.

Q: How long should patients continue treatment?

A: There is a lack of information on the length of treatment required for social anxiety disorder. However, a number of trials have suggested that relapse rates can be high if treatment is discontinued too early. Dr Annemarie Potgieter states: "There have been no formal long-term studies done, but the recommended period of treatment is usually about a year. It depends largely on how severely the patient is affected, whether symptoms reappear when treatment is discontinued and on complications that may occur due to other comorbid illnesses. It is important to remember though that the medications used in the treatment of social phobia are non-habit forming, and that when medication is discontinued it should be done slowly." The studies indicate that therapy periods of up to one year can maintain patients' improvement and minimize the risk of relapse. In some instances, patients may require treatment for longer than one year. For example cases where:

§ The symptoms are still present

§ The patient has an additional condition

§ The patient has a history of relapse

§ The social anxiety disorder started very young in life

Q: Can patients with mild forms of social phobia be treated as successfully as those with a severe form of the illness?

A: There is a common misconception that treatment only works for the more severe forms of social phobia. In fact, therapy works equally well in milder cases of the condition. It must be remembered that even when patients are suffering from mild symptoms of social anxiety disorder, they still experience social fear and/or avoidance that causes them great distress. Research suggests that many sufferers of the disorder, who could benefit from treatment, either never seek help or endure their symptoms for prolonged periods before they finally go to the doctor.





8 a.m. – 1 p.m.




2:30 p.m. – 5 p.m.

DurbanWednesday, 27th October 1999

DurbanWednesday, 27th October 1999

Venue: The Durban Light Infantry Hall, Greyville Racecourse

JohannesburgFriday, 29th October 1999

JohannesburgFriday, 29th October 1999

Venue: The AGFA Theatre on the Square,
Sandton Square
, Sandton

Cape TownTuesday, 2nd November 1999

Cape TownTuesday, 2nd November 1999

Venue: The Breakwater Lodge,
Portswood Road
, V & A Waterfront


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