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Understanding Depression


  Webcast presented by the National Council for
Community Behavioral Healthcare in observance of
          May is Mental Health Month

 Program content based upon Mental Health First Aid USA
Meena Dayak
Vice President, Marketing & Communications
 National Council for Community Behavioral
                 Healthcare




                                             2
Overview
  Understanding Depression & Mood Disorders
       Signs & Symptoms
       Risk factors


  How to Help

       Suicidal Behavior
       Depressive Symptoms
       Non-Suicidal Self-Injury


                                               3
www.TheNationalCouncil.org
  Not-for-profit association

  Represent 1,700 behavioral
   healthcare organizations
  Member organizations treat and care
   for six million adults and children with
   mental and addiction disorders

                                              4
What Is a Mental Disorder?

A mental disorder or mental illness is a diagnosable
illness that:

  Affects a person’s thinking, emotional state, and
   behavior
  Disrupts the person’s ability to
       Work
       Carry out daily activities
       Engage in satisfying relationships


                                                       5
U.S. Adults with a Mental Disorder in
Any One Year

             Type of Mental Disorder   % Adults

 Anxiety disorder                         18.1    .

 Major depressive disorder                 6.7    .

 Substance use disorder                    3.8    .

 Bipolar disorder                          2.6    .

 Eating disorders                          2.1    .

 Schizophrenia                             1.1    .

 Any mental disorder                      26.2    .


                                                  6
The Facts

  Mental health problems are common.

  Stigma is associated with mental health problems.

  Many people are not well informed about mental
   health problems.
  Professional help is not always on hand.

  People often do not know how to respond.
  People with mental health problems often do not
   seek help.
                                                       7
Recovery from Mental Illness
“Recovery is the process in which people are able to
live, work, learn, and participate fully in their
communities.”

“For some, this is the ability to live a fulfilling and
productive life despite a disability.”

“For others, recovery implies the reduction or complete
remission of symptoms.”

                — President’s New Freedom Commission on Mental Health, 2003


                                                                         8
What Is Mental Health First Aid?

Mental Health First Aid is the help offered to a
person developing a mental health problem or
experiencing a mental health crisis. The first aid
is given until appropriate treatment and support
are received or until the crisis resolves.




                                                     9
The Mental Health First Aid Action Plan


  Assess for risk of suicide or harm
  Listen nonjudgmentally
  Give reassurance and information
  Encourage appropriate professional help
  Encourage self-help and other support strategies




                                                      10
Marie Dudek
 American Foundation for Suicide
Prevention, Central Florida Chapter
      & Creating Today, Inc.



                                      11
What Is Depression?

  Everyday blues, sadness or a short-term depressed
   mood is common
  Many individuals may cope with these feelings
   without significant impact on their everyday life.
  Episodes of major depressive disorder last for at
   least 2 weeks and affect a person’s
       Emotions, thinking, behavior, and physical well-being
       Ability to work and have satisfying relationships



                                                                12
Signs and Symptoms of Depression
Emotions
  Sadness
  Anxiety
  Guilt
  Anger
  Mood swings
  Lack of emotional responsiveness
  Feelings of helplessness/hopelessness
  Irritability

                                           
                                           13
Signs and Symptoms of Depression
Thoughts
  Frequent self-criticism
  Self-blame
  Pessimism
  Impaired memory and concentration
  Indecisiveness and confusion
  Tendency to believe others see one in a negative
   light
  Thoughts of death and suicide

                                                  
                                                      14
Signs and Symptoms of Depression
Behaviors
  Crying spells
  Withdrawal from others
  Neglect of responsibilities
  Loss of interest in personal appearance
  Loss of motivation
  Slow movement
  Use of drugs and alcohol



                                             
                                                 15
Signs and Symptoms of Depression
Physical
  Fatigue/lack of energy
  Sleeping too much or too little
  Overeating or loss of appetite
  Weight loss or gain
  Constipation
  Headaches
  Irregular menstrual cycle
  Loss of sexual desire
  Unexplained aches and pains
                                      16
Depression in the Workplace
  Decreased productivity

  Morale problems

  Lack of cooperation

  Safety problems, accidents

  Absenteeism or presenteeism

  Being tired all the time

  Complaints of unexplained aches and pains

  Alcohol or other drug misuse
                                               17
Types of Mood Disorders

  Major depressive disorder


  Bipolar disorder


  Postpartum depression


  Seasonal depression




                               18
Risk Factors for Depression
  Distressing and uncontrollable event
  Exposure to stressful life events
  Difficult childhood
  Ongoing stress and anxiety
  Another mental illness
  Previous episode of depression
  Family history
  More sensitive emotional nature
                                          
                                              19
Risk Factors for Depression
  Illness that is life threatening, chronic, or
   associated with pain
  Medical conditions
  Side effects of medication
  Recent childbirth
  Premenstrual changes in hormone levels
  Lack of exposure to bright light in winter
  Chemical (neurotransmitter) imbalance
  Substance misuse
                                                    20
How to Help
The most common crises to assess for with
depressive symptoms are:

  Suicidal thoughts and behaviors
  Nonsuicidal self-injury




                                            21
Suicide Risk Assessment
  Gender

  Age

  Chronic physical illness

  Mental illness

  Use of alcohol or other substances

  Less social support

  Previous attempt

  Organized plan
                                        22
Warning Signs of Suicide
  Threatening to hurt or kill oneself
  Seeking access to means
  Talking or writing about death, dying, or suicide
  Feeling hopeless
  Feeling worthless or a lack of purpose
  Acting recklessly or engaging in risky activities
  Feeling trapped
  Increasing alcohol or drug use
  Withdrawing from family, friends, or society
  Demonstrating rage and anger or seeking revenge
  Appearing agitated
  Having a dramatic change in mood
                                                       23
How to Help a Person
Who May be Suicidal
  Have a conversation: discuss your concerns, ask
   them directly whether they are suicidal and whether
   they have a plan
       “Are you having thoughts of suicide?”
       “How are you thinking of harming yourself?”
  Ensure your safety and their safety
       Do not leave an actively suicidal person alone
  Try to involve them in decision making about
   connecting to professional help or other supports
  If you have serious concerns, call 911 or the
   National Suicide Prevention Lifeline at 1-800-273-
                                                         24
   TALK.
How to Help: Non-Suicidal Self Injury
  Assist the person by letting him or her know you
     are concerned and are willing to help.
    Recognize that self-injury is usually a symptom of
     serious psychological distress.
    Let the person know that treatment is available for
     this distress.
    Ensure that the person knows where professional
     mental health care is available.
    Encourage, but do not force, the person to seek
     professional treatment.
                                                           25
How to Help: Treatments Available
  Supportive counseling
       Providing emotional support & teaching problem-
        solving skills.
  Psychological Therapies
       Cognitive behavioral therapy, stress management,
        interpersonal psychotherapy
  Medical Treatment
       Medication, electroconvulsive therapy (ECT)
  Peer & Community support
       Friends, family, faith networks, support groups
  Self-Help strategies
       Exercise, CBT based books, relaxation therapy, light
        therapy                                            26
Questions on Depression & Suicide?




                   ?
                                     27
Mental Health First Aid in your
Community
  Visit www.MentalHealthFirstAid.org for further
   information on the course and to find an instructor
   near you.
  Become a fan of Mental Health First Aid USA on
   Facebook & get updates and information on a
   variety of mental health topics.
  For any further questions, contact Bryan Gibb at
   bryang@thenationalcouncil.org or Susan Partain at
   susanp@thenationalcouncil.org or 202.684.3732.


                                                         28
More in the Understanding Mental
Illness Webcast Series
  Visit www.MentalHealthFirstAid.org for an audio
  recording and Powerpoint of today’s webcast.

  May 12     Understanding Anxiety Disorders
  May 19     Understanding Psychosis
  May 26     Understanding Substance Use Disorders
  5 – 6 pm Eastern; 4 – 5 pm Central; 3 – 4 pm
  Mountain; 2 – 3 pm Pacific
  Today’s attendees are not required to register again
  for these webcasts.
                                                      29

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Understanding depression 5 3 10

  • 1. Understanding Depression Webcast presented by the National Council for Community Behavioral Healthcare in observance of May is Mental Health Month Program content based upon Mental Health First Aid USA
  • 2. Meena Dayak Vice President, Marketing & Communications National Council for Community Behavioral Healthcare 2
  • 3. Overview   Understanding Depression & Mood Disorders   Signs & Symptoms   Risk factors   How to Help   Suicidal Behavior   Depressive Symptoms   Non-Suicidal Self-Injury 3
  • 4. www.TheNationalCouncil.org   Not-for-profit association   Represent 1,700 behavioral healthcare organizations   Member organizations treat and care for six million adults and children with mental and addiction disorders 4
  • 5. What Is a Mental Disorder? A mental disorder or mental illness is a diagnosable illness that:   Affects a person’s thinking, emotional state, and behavior   Disrupts the person’s ability to   Work   Carry out daily activities   Engage in satisfying relationships 5
  • 6. U.S. Adults with a Mental Disorder in Any One Year Type of Mental Disorder % Adults Anxiety disorder 18.1 . Major depressive disorder 6.7 . Substance use disorder 3.8 . Bipolar disorder 2.6 . Eating disorders 2.1 . Schizophrenia 1.1 . Any mental disorder 26.2 . 6
  • 7. The Facts   Mental health problems are common.   Stigma is associated with mental health problems.   Many people are not well informed about mental health problems.   Professional help is not always on hand.   People often do not know how to respond.   People with mental health problems often do not seek help. 7
  • 8. Recovery from Mental Illness “Recovery is the process in which people are able to live, work, learn, and participate fully in their communities.” “For some, this is the ability to live a fulfilling and productive life despite a disability.” “For others, recovery implies the reduction or complete remission of symptoms.” — President’s New Freedom Commission on Mental Health, 2003 8
  • 9. What Is Mental Health First Aid? Mental Health First Aid is the help offered to a person developing a mental health problem or experiencing a mental health crisis. The first aid is given until appropriate treatment and support are received or until the crisis resolves. 9
  • 10. The Mental Health First Aid Action Plan   Assess for risk of suicide or harm   Listen nonjudgmentally   Give reassurance and information   Encourage appropriate professional help   Encourage self-help and other support strategies 10
  • 11. Marie Dudek American Foundation for Suicide Prevention, Central Florida Chapter & Creating Today, Inc. 11
  • 12. What Is Depression?   Everyday blues, sadness or a short-term depressed mood is common   Many individuals may cope with these feelings without significant impact on their everyday life.   Episodes of major depressive disorder last for at least 2 weeks and affect a person’s   Emotions, thinking, behavior, and physical well-being   Ability to work and have satisfying relationships 12
  • 13. Signs and Symptoms of Depression Emotions   Sadness   Anxiety   Guilt   Anger   Mood swings   Lack of emotional responsiveness   Feelings of helplessness/hopelessness   Irritability  13
  • 14. Signs and Symptoms of Depression Thoughts   Frequent self-criticism   Self-blame   Pessimism   Impaired memory and concentration   Indecisiveness and confusion   Tendency to believe others see one in a negative light   Thoughts of death and suicide  14
  • 15. Signs and Symptoms of Depression Behaviors   Crying spells   Withdrawal from others   Neglect of responsibilities   Loss of interest in personal appearance   Loss of motivation   Slow movement   Use of drugs and alcohol  15
  • 16. Signs and Symptoms of Depression Physical   Fatigue/lack of energy   Sleeping too much or too little   Overeating or loss of appetite   Weight loss or gain   Constipation   Headaches   Irregular menstrual cycle   Loss of sexual desire   Unexplained aches and pains  16
  • 17. Depression in the Workplace   Decreased productivity   Morale problems   Lack of cooperation   Safety problems, accidents   Absenteeism or presenteeism   Being tired all the time   Complaints of unexplained aches and pains   Alcohol or other drug misuse 17
  • 18. Types of Mood Disorders   Major depressive disorder   Bipolar disorder   Postpartum depression   Seasonal depression 18
  • 19. Risk Factors for Depression   Distressing and uncontrollable event   Exposure to stressful life events   Difficult childhood   Ongoing stress and anxiety   Another mental illness   Previous episode of depression   Family history   More sensitive emotional nature  19
  • 20. Risk Factors for Depression   Illness that is life threatening, chronic, or associated with pain   Medical conditions   Side effects of medication   Recent childbirth   Premenstrual changes in hormone levels   Lack of exposure to bright light in winter   Chemical (neurotransmitter) imbalance   Substance misuse  20
  • 21. How to Help The most common crises to assess for with depressive symptoms are:   Suicidal thoughts and behaviors   Nonsuicidal self-injury 21
  • 22. Suicide Risk Assessment   Gender   Age   Chronic physical illness   Mental illness   Use of alcohol or other substances   Less social support   Previous attempt   Organized plan 22
  • 23. Warning Signs of Suicide   Threatening to hurt or kill oneself   Seeking access to means   Talking or writing about death, dying, or suicide   Feeling hopeless   Feeling worthless or a lack of purpose   Acting recklessly or engaging in risky activities   Feeling trapped   Increasing alcohol or drug use   Withdrawing from family, friends, or society   Demonstrating rage and anger or seeking revenge   Appearing agitated   Having a dramatic change in mood 23
  • 24. How to Help a Person Who May be Suicidal   Have a conversation: discuss your concerns, ask them directly whether they are suicidal and whether they have a plan   “Are you having thoughts of suicide?”   “How are you thinking of harming yourself?”   Ensure your safety and their safety   Do not leave an actively suicidal person alone   Try to involve them in decision making about connecting to professional help or other supports   If you have serious concerns, call 911 or the National Suicide Prevention Lifeline at 1-800-273- 24 TALK.
  • 25. How to Help: Non-Suicidal Self Injury   Assist the person by letting him or her know you are concerned and are willing to help.   Recognize that self-injury is usually a symptom of serious psychological distress.   Let the person know that treatment is available for this distress.   Ensure that the person knows where professional mental health care is available.   Encourage, but do not force, the person to seek professional treatment. 25
  • 26. How to Help: Treatments Available   Supportive counseling   Providing emotional support & teaching problem- solving skills.   Psychological Therapies   Cognitive behavioral therapy, stress management, interpersonal psychotherapy   Medical Treatment   Medication, electroconvulsive therapy (ECT)   Peer & Community support   Friends, family, faith networks, support groups   Self-Help strategies   Exercise, CBT based books, relaxation therapy, light therapy 26
  • 27. Questions on Depression & Suicide? ? 27
  • 28. Mental Health First Aid in your Community   Visit www.MentalHealthFirstAid.org for further information on the course and to find an instructor near you.   Become a fan of Mental Health First Aid USA on Facebook & get updates and information on a variety of mental health topics.   For any further questions, contact Bryan Gibb at bryang@thenationalcouncil.org or Susan Partain at susanp@thenationalcouncil.org or 202.684.3732. 28
  • 29. More in the Understanding Mental Illness Webcast Series Visit www.MentalHealthFirstAid.org for an audio recording and Powerpoint of today’s webcast.   May 12 Understanding Anxiety Disorders   May 19 Understanding Psychosis   May 26 Understanding Substance Use Disorders 5 – 6 pm Eastern; 4 – 5 pm Central; 3 – 4 pm Mountain; 2 – 3 pm Pacific Today’s attendees are not required to register again for these webcasts. 29