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Research on Depression in the Workplace.

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Mental Health Matters Journal for Psychiatrists & GP's

MHM Volume 8 Issue1

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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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When Vani*, 41, a shopkeeper in Phoenix. Durban, began hearing voices, she was terrified. Then I thought I was God and I was swearing and shouting at people! It took all my family's strength to get me to hospital.' Schizophrenia is associated with violence and aggression, but the person most at risk is the sufferer, says Amoore, as suicide is a real risk. Schizophrenia is not a split in personality, as many people think, it's a split from reality. Incidence About one percent of the population.
Symptoms Hallucinations (visual or hearing voices), delusions (sufferers believe they're being spied on, cheated on, persecuted or controlled by other powers, or that they're another being), disorganised thoughts, memory problems, emotional flatness, unpredictable agitation, inability to respond to things around you or function socially, and behaviour that is bizarre to others. Causes These are not yet known and are different for everyone, says Amoore.
They can include genetics, brain damage during pregnancy or a difficult birth, and environmental stressors. Triggers A traumatic event like a hijacking, stress at work or exams, street drugs like ecstasy, tik, crack, LSD and dagga, or alcohol. Treatments Get assessed and start treatment at once, says Amoore. You may need to be booked into a hospital or clinic.
Medication is vital as certain antipsychotics can reduce delusions and hallucinations and help you think clearly and live independently. CBT, counselling and family therapy help too. Help yourself Learn to spot the early warning signs, such as feeling anxious or suspicious. Also avoid stressful situations, drugs and alcohol, and eat well, exercise regularly and learn relaxation techniques. Control your voices by staying busy, spending time with people, and reminding yourself that the voices can't hurt you - that you're in control, says Amoore. 'Most importantly, join a support group!'
When my husband died, I was the only support for my three tads,' says Phindi*, a 36-year-old Durban office worker. 'I missed him so much. Everyone said it would get easier, but four months later, I could hardly get out of bed in the mornings. I wasn't eating or sleeping and had no energy or hope. I would have lost my job, but the HR head got me counselling for depression. It saved me and my family!' Everyone feels blue at times, but when it goes on for more than a few weeks, and is severe enough to interfere with your work or home life, you need to get professional help.
Incidence About five or six percent of the population has a depressive disorder. Symptoms Persistent feelings of sadness, anxiety, emptiness, hopelessness, worthlessness or guilt, loss of energy and interest in things that you used to enjoy, eating or sleeping too much or too little, irritability, restlessness, difficulty concentrating or remembering, headaches and digestive problems Causes Clinical depression is a medical condition caused by an imbalance of chemicals in the brain, but there is also a genetic link. Stressful living or working conditions and relationship, financial or health problems can make depression worse. HIV sufferers are especially prone, as the virus and some ARVs can chemically affect your mood, plus stigma and lack of support add to the problem. Triggers Unexpected life events like a death, a break-up, an accident or an assault. Treatments As for panic disorder. If you're HTV-positive, speak up: depression can be treated separately from your condition, says Amoore.
Help yourself The same as for panic disorder. BANKMED'S SPECIAL CARE PROGRAMME Bankmed offers support to members and dependents diagnosed with bipolar mood disorder and depression, through our Special Care Programmes. Visit www.bankmed.co.za or call Bankmed's customer call centre on 0800-BANKMED (0800-226-5633). BIPOLAR DISORDER 'When I'm up, I'm so high, I feel nothing can touch me,' says Maureen*. 37, who works in advertising in Johannesburg. Then I come down so low that, if it weren't for my meds, I'd have ended it long ago.' Bipolar disorder or 'manic depression' is a brain disorder that causes extreme swings in mood, energy and activity levels. We all have ups and downs but these are so severe that they interfere with your ability to do everyday tasks and can harm relationships and work performance. Left untreated, bipolar disorder can lead to suicide.
Incidence About one percent of the population. Symptoms These may be hard to spot at first as they can seem like separate, unrelated problems. 'You experience a sudden, dramatic shift in the extremes of emotions that have little to do with external situations,' says Amoore. In the manic or 'high' phase you're not simply happy, you're ecstatic, with racing thoughts, bursts of energy, extreme optimism and grandiose delusions - nothing can stop you, nothing can go wrong. You spend money like water, sex is great and you can't get enough. Judgment and caution aso disappear. You may also speak so loudly and so fast, others can't follow you, and you get furious if someone suggests you are unreasonable. In the low, depressive phase, your self-esteem plummets, you lose interest in things you used to enjoy, sleep or eat too little or too much, cry, withdraw, and feel helpless, hopeless, guilty and flat.
Causes Unknown, but thought to be a combination of chemical imbalances in the brain, genetics and psychological stress, says Amoore. People who are HIV-positive are at special risk of bipolar mood disorder and other serious mental illnesses (SMIs), including major depression, says Durban-based psychiatrist and researcher, Dr Dinesh Singh, as the virus can attack the brain and this, along with certain ARVs, can affect mood. Triggers Traumatic life events like the loss of a loved one, a job or a relationship can set off a bipolar episode, as can hormone or sleep changes or changes in seasons, Treatments Bipolar disorder has no cure but can be very successfully managed with a combination of psychotherapy and medication, says Amoore. CBT can help change your pessimistic or overoptimistic thoughts and beliefs, and interpersonal therapy can reduce the strain the disorder puts on relationships. But these can't replace long-term, preventative treatment with medication.
Help yourself Eat a balanced diet and exercise regularly as both can affect brain-chemical levels. Be careful with alcohol, caffeine and over-the-counter medications. Try to reduce stress at work, schedule downtime, regulate your life, go to bed and get up around the same time daily, and join a support group.:)
* Not their real names. SADAG, 0800-567-567. SMS 31393, www.sadag.co.za. Bipolar Helpline, 0800-70-80-90. ~~ Suicide Crisis Line, 0800-567-567. • Substance Abuse Helpline, 0800-12-13-14. • Mental Health Information Centre, 021-938-9229. • Lifeline, 0861-322-322.

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