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Prevention is Intervention

Denise Kan, MSW, LMSW, RSW

Richmond Hospital

June 6, 2015

2015 MENTAL WELLNESS SCREENING, EDUCATION DAY, &

CHINESE SOCIAL SERVICE EXHIBITION

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DEPRESSION

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11 MYTHS ABOUT DEPRESSION

• Depression and Sadness are one and the same

• Depression is a sign of weakness

• Depression isn’t a real illness

• Depression is all in your head

• Depression is always brought on by traumatic life events

• Depression is contagious

• If your parents have it, you will, too

• Real men don’t get depressed

• An antidepressant is all you need to feel better

• You will need medication for the rest of your life

• Talking about depression only makes it worse

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WHAT IS DEPRESSION?

• Depression is a common mental disorder

• Characterized by sadness, loss of interest or pleasure

• Feelings of guilt of low self-worth

• Disturbed sleep or appetite

• Feelings of tiredness and poor concentration

• Impairing a person’s ability to function at work or at school, or cope of daily life

• In severe cases, depression can lead to suicide

• Depression often starts at a young age

- Definition by WHO

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DIFFERENT TYPES OF DEPRESSION

• Major Depressive Disorder

• Dysthymic Disorder

• Postpartum Depression

• Seasonal Affective Disorder (SAD)

• Substance/Medication Induced Depressive Disorder

• Premenstrual Dysphoric Disorder (New to DSM 5)

• Disruptive Mood Dysregulation Disorder (New to DSM 5)

• Bipolar Disorder (New category on its own in DSM 5)

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COMMON SYMPTOMS OF DEPRESSION

PHYSICAL :

• Tiredness or Fatigue

• Disturbed sleep

• Disturbed appetite

• Change in weight

• Muscle pain

• Gastrointestinal problems

• Headache

• Loss of sexual desire

• And more……..

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BEHAVIORAL:

• Isolation

• Loss of interest in hobbies and activities

• Neglecting responsibilities

• Restlessness

• Psychomotor impairment

• Engage in addictive/dangerous activities, e.g. gambling, drinking, illegal drugs….

• Suicidal attempts

• And more……

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EMOTIONAL:

• Persistent sad, anxious, or “empty” feelings

• Feelings of hopelessness or pessimism

• Feelings of guilt, worthlessness, or helplessness

• Irritability

• Restlessness

• Numbness

• Loneliness

• And more……

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COGNITIVE:

• Difficulty concentrating

• Difficulty remembering details

• Difficulty making decisions

• Racing thoughts

• Psychomotor impairment

• Suicidal thoughts

• And more………

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CAUSES OF DEPRESSION

SITUATION:

• Major loss in life, e.g. death of loved one, divorce, moving, immigration, job loss, war

• Isolation

• Relationship conflicts

• Chronic stress, e.g. health problem, unemployment, parenting issues

• And more…….

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THOUGHTS:

• Negative thinking habits

• Harsh self-criticism

• Biases and Distortion

• And more…..

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ACTION:

• Poor self care

• No rewarding activities

• Socially withdrawal

• Too much responsibility

• And more……..

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EMOTION:

• Discouragement

• Despair

• Sadness

• Anxiety

• Numbness

• And more……

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PHYSIOLOGY:

• Chronic disease

• Altered sleep

• Changes in brain chemistry

• Addiction

• And more……

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TREATMENT AND CARE

MEDICATION:

• What kind of medication works for me?

• How does medication work for me?

• Side effects?

• Dosages?

• How long do I need to take this medication?

• Conflicts with my other medication(s)?

• NEVER STOP taking medication suddenly

• Different medications work for different people

• Certain people benefit from taking medication for a long time

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PSYCHOTHERAPY:

• Is an effective treatment on clinical depression

• For severe depression, it needs to work with medication and self care activities

• Reduces stress in your life

• Gives you a new perspective on problem and your depression

• Makes it easier to stick to your treatment

• Helps to catch early signs that your depression is getting worse

• E.g. CT, CBT, Psychodynamic Therapy, EMDR, MBSR, Satir Therapy, Art Therapy, Group Therapy

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LIFESTYLE CHANGES:

• Sleep

• Diet, e.g. balanced nutrition, reduce caffeine

• Exercise

• Thinking patterns, e.g. be realistic, open-minded, let it go, praising and acknowledging yourself

• Social Support

• Stress Reduction, e.g. reduce obligations, plan ahead, get support, KEEP UP SELF-CARE

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• Exercise

• Balanced diet

• Beware alcohol and drugs

• Sleep

• Self-compassion

• Connection with community

• Connection with animals

• Humor

• Gratitude / Accepting / Love

• Think “bigger”

• Learning

• Sun

• Nature

• Play

• Prayer

• Meditation

• Yoga

• Tai Chi

• Music

• Aesthetics, e.g. arts, beauty

• Aroma Therapy

• Volunteering

• Reading / Writing

• Curiosity

• And more……

SELF-HELP TIPS TO IMPROVE DEPRESSION

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ANXIETY DISORDER

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9 MYTHS ABOUT ANXIETY DISORDER

• Anxiety isn’t a real illness

• Avoiding anxiety-provoking situations is helpful

• Anxiety will get better over time if I just wait it out

• The only people who get anxiety are just naturally nervous

• If you are having panic attack, just get used to it

• A panic attack can make you loss control or pass out

• Someone with anxiety just need a stiff drink and they will be alright

• People who have anxiety just need to relax

• It can take a lifetime to see the results from treatment for anxiety

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WHAT IS ANXIETY DISORDER?

• Anxiety disorder involves more than temporary worry or fear

• The anxiety does not go away and can get worse over time

• The anxiety feelings can interfere with daily activities such as job performance, school work, and relationships.

- Definition by National Institution of Mental Health

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DIFFERENT TYPES OF ANXIETY DISORDER

• Panic Disorder

• Agoraphobia

• Phobia (Specific)

• Social Anxiety Disorder (Social Phobia)

• Generalized Anxiety Disorder (GAD)

• Obsessive Compulsive Disorder (OCD)

(New category on its own in DSM 5)

• Post-traumatic Stress Disorder (PTSD)

(New category on its own in DSM 5)

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RESPONSE TO ANXIETY

THOUGHTS:

• I am in danger

• The worst possible scenario is going to happen

• I won’t be able to cope with it

• And more……

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PHYSICAL SENSATIONS – The Adrenaline Response:

• Heart racing

• Breathing gets faster

• Muscles tense

• Sweating

• Pupils dilate

• Digestive system slows down

• More alert

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BEHAVIORS:

• Avoid people or places

• Not going out

• Going to certain places at certain time

• Only going with someone else

• Escape, leave early

• Go to the feared situation, but use coping behaviors like self talk, smoking, avoiding eye contact, medication…etc. to get through the situation

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WHO DOES ANXIETY DISORDER AFFECT?

• Gender

- Women to Men 2:1

• Age

- Most often appear in youth

• Personal factors

- Shy, perfectionists are more prone to anxiety disorder

• Family history

• Social factors

• Occupational risks

- e.g. Emergency personnel, military personnel

• Chronic illnesses

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COMMON SYMPTOMS OF ANXIETY DISORDERPHYSICAL:

• Muscle tension

• Hot or cold flushes

• Sweating

• Tightening of the chest

• Chest pain

• Racing heart

• Shortness of breath

• Dizziness

• Dry mouth

• Nausea

• Gastrointestinal problems

• Disturbed sleep

• Fatigue

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BEHAVIORAL:

• Avoidance

• Restlessness

• Compulsive behaviors

• Hypervigilance

• Self-medication

• Addiction

• And more……

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EMOTIONAL:

• Excessive worry or fear

• Irritable

• Shame

• Shyness

• Embarrassment

• Angry

• And more……

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THINKING:

• Trouble concentrating

• Poor memory

• Hard to make decisions

• Racing thoughts

• Obsessive thoughts

• Anticipating the worst

• Feeling like your mind goes blank

• Nightmare

• Suicidal thoughts

• And more……

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TREATMENT AND CARE

MEDICATION:

• What kind of medication works for me?

• How does medication work for me?

• Side effects?

• Dosages?

• How long do I need to take this medication?

• Conflicts with my other medication(s)?

• NEVER STOP taking medication suddenly

• Different medications work for different people

• Certain people benefit from taking medication for a long time

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PSYCHOTHERAPY:

• Is an effective treatment on anxiety disorder

• For severe anxiety disorder, it needs to work with medication and self care activities

• Reduces stress in your life

• Gives you a new perspective on problem and your anxiety disorder

• Makes it easier to stick to your treatment

• Helps to catch early signs that your anxiety disorder is getting worse

• E.g. CBT, Exposure Therapy, EMDR, MBSR, ACT, Satir Therapy, Art Therapy, Group Therapy

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LIFESTYLE CHANGES:

• Sleep

• Diet, e.g. balanced nutrition, reduce caffeine

• Exercise

• Relaxation exercise, e.g. progressive muscle relaxation, meditation

• Thinking patterns, e.g. be realistic, open-minded, let it go, praising and acknowledging yourself

• Social Support

• Stress Reduction, e.g. reduce obligations, plan ahead, get support, KEEP UP SELF-CARE

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• Exercise

• Balanced diet

• Beware alcohol and drugs

• Sleep

• Self-compassion

• Connection with community

• Connection with animals

• Humor

• Gratitude / Accepting / Love

• Think “bigger”

• Learning

• Sun

• Nature

• Play

• Prayer

• Meditation

• Yoga

• Tai Chi

• Music

• Aesthetics, e.g. arts, beauty

• Aroma Therapy

• Volunteering

• Reading / Writing

• Curiosity

• And more……

SELF-HELP TIPS TO IMPROVE ANXIETY DISORDER

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Denise Kan, MSW, LMSW, RSW

Phone: 778-865-7710

Email: denise.DKCounselling.com

Web: DKCounselling.com

THANK YOU