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New Research on Depression in the Workplace.

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Mental Health Matters Journal for Psychiatrists & GP's

MHM Volume5 Issue5

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depression speaking book

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

Fearful of being labelled a failure, high achiever Amy Singer hid her depression for nearly 20 years, accepting treatment secretly, but losing friends and career opportunities along the way. Until a chance meeting put her on the road to recovery. This is her story... The nights are the worst. I wake up three to four hours after falling asleep, often crying, and my mind filled with black thoughts and dread. Mostly about how I don't want to exist, how life is empty and meaningless and how alone I am. And at that hour, I am. There is no-one with whom I can share my despair. And so I lie there, immobile. Night after night. Week after week. Time ticks on, slowly, with the same thoughts spiralling around my head.

There is no space for rational thought. Ending it all is a repetitive theme. If I'm lucky I sleep again. And then it is always a deep sleep. So when the alarm goes off, I am in a fog. It is only rote behaviour that gets me out of bed and to the office - at least on the good days. Often I cannot face people - particularly those who will see through my fragile defences, and then the habit of getting out of bed fails. All I want is to be alone, in the dark. Yet I also want someone to help me. When first diagnosed with major depression, I was 25 and working in the media industry. My dark clothes, relatively uncombed appearance and negative outlook were not really at odds with the culture of the newsroom. But the lethargy that goes with a serious depressive episode is all powerful and cannot easily be hidden. It consumes your mind, body, soul and upsets your general rhythm. You could see it in my defeated posture, hear it in my tired voice, and spot the dark rings under my eyes. I believed my failings and weaknesses were visible to everyone - which were not congruent . with the high achiever I was.

So I became quieter and guieter, believing everyone was out to trip me up. If I did not engage, I would not risk the tears which punctuated any conversation about my welfare. Caffeine, sugar, chocolates and alcohol provided a quick energy boost and temporary respite, particularly at work. But of course, the downside was harsh. The weight gain, for example, exacerbated my bad self-image. One night at a very low point of this cycle, I reached for a kitchen knife and tried to cut my wrists. Fortunately the knife was blunt and I did not inflict significant wounds. But in the light of day my behaviour shocked me into going to see my GP. He prescribed an anti-depressant and sleeping tablets, booked me off work and convinced me to go away on a restful recovery holiday where I could swim in warm water and feel the sun on my skin. Thereafter began a process of therapy - and what turned out to be very long-term relationships with a psychologist, a psychiatrist and prescription drugs. Inevitably though, as soon as I felt stronger, I would convince myself that I did not need the medication and its horrid side effects. So I would stop taking it and then the depression hit again, and again, and again, and again.

The journey of changing drugs to find one that would make me feel OK was filled with lows. With my psychiatrist's guidance I tried Prozac, Edronax, Cipramil, Cymbalta, Paxil, Zoloft, Tofranil, Triptyline, and at some points with anti-anxiety drugs, mood stabilisers and sleeping tablets. In each case, my mood improved somewhat, but the side effects were vicious and I hated that constant feeling of being unwell. With my sense of reality questionable, it was never easy to know which ailments were drug related, which were psychosomatic and which were physiological. An example was when I was diagnosed as having fibro-myalgia - I am a sceptic and was convinced the constant muscle and joint pain was a result of the drugs, but the psychiatrist aligned it to the depression. I was also convinced that hot, visible flushing in the face and constantly dry, bloodshot eyes was drug related - not an autoimmune illness as was suggested. And so I would convince myself that I was better off without a daily happy pill. In retrospect, I see that I had my first major depressive episode at 17, ignited by anxiety and a deep gulf between how others saw me - head girl, high achiever and natural leader - and how I saw myself.

The repetitive themes throughout my illness have been my own self-doubt and anxiety, and when they combined, my mood could accelerate downward with a speed that no amount of rational intervention could influence. During this process I was unable to accept positive input or any questioning of my skewed views about myself. I cut out most of the "pull-yourself-together" brigade who - through my own doing - had no insight into what was driving me down. There's little worse for someone in the depths of soul-sapping depression to be told just to "get over it", or to be asked what is so bad about one's ' life to justify such a state, when others all over the world are at greater and real • disadvantage. Instead, this was a battle I waged pri- vately. Only my doctors, the psychologist and a handful of really good friends - who themselves had experienced depression or had insight into the illnesses - knew the extent of my misery. I also chose not to divulge the details to my family, something many people criticise me for as I have a large and very supportive family. But my own place in the clan, for reasons of a difficult family history, was guided by a deep-seated belief that I should be of minimal burden to everyone. In fact, despite my sense of being weak by giving into the depression, I was often one of the mainstays of the family.

Writing now, I can see how odd this is - but my attitude still runs very deep. At work, colleagues mostly accepted that I did not offer much about my personal life. When dealing with the tasks of the day, I was competent. In fact, that is an under- There's little worse for someone in the depths of soul-sapping depression to be told "get over it", or. to be asked what is so bad about one's life to justify such a state, when others all over the. world are at greater and real disadvantage statement. I was a high achiever who took responsibility easily and was good at managing people and processes. I climbed the corporate ladder quickly and managed to excel at each level. I often wonder how I did it, for.when the dark days hit, most of "my energy was spent trying to stay on an even keel in the office. I would not risk telling anyone about the depression at work. I feared I would have been labelled and that it would have affected my career ride. I still believe this. But the strain was immense. During a down cycle, I would go home and disintegrate. When depressed, I would avoid seeing friends who might judge me, or probe too closely my state of mind. Some close work relationships deteriorated - as I was seen as elusive and evasive - when in fact going inwards was the only way I could avoid revealing my deep despair. "Romantically it was no better.

The complex mix of issues that undermined" my self-confidence meant sexual relationships were comple'te disasters that would just feed my depression and further erode my seltimage. When the strain of trying to hold things together started to show at work, I would take Igave, but even this strategy could "not work forever. "Then I was put forward for a major promotion, but had to compete with a colleague for tne position. Suddenly I could no longer contain my anxiety - it showed in my face and jaw, which started pulling spontaneously; in my demeanour and in my frequent tears, which merely heightened my


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