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Research on Depression in the Workplace.

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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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"Aint no sunshine when she's gone, only darkness everyday"… although the words weren't written about money, they hold so true for this most necessary of evils. As South Africa's economy flounders in the wave of a global crisis, so our citizens are feeling the pinch, not only in their wallets but their emotions as well. As many as 3 in 10 people in any given workplace experiences symptoms of depression. Look at managers and it's 1 in 3. If your colleagues seem grumpier than usual, they may be losing sleep over the global financial crisis.

According to an online survey conducted by Chicago-based ComPsych Corp (an employee assistance programme supplier), ninety-two percent of respondents said the economic turmoil is keeping them awake at night. Of those, a third said their biggest worry was the cost of living, another third cited credit card debt as their major concern. One in six said their biggest worry was their mortgage payment, while for others it was concern over their retirement funds.

While not all sectors of the economy are equally affected, rising food prices, petrol costs and increasing interest rates affect all of us to some degree. "I had just bought a new car, had house payments and school fees, not to mention all my kids' extra mural expenses, when I was told the contract position I had been counting on wasn't available anymore", says 45-year-old business consultant Derek*. "I lay awake every night, worry eating me. I couldn't tell my family what had happened – how could I?"

Many South African men are struggling with emotional issues but, as they are often socialised to be 'strong', and not express emotion or sadness, and they often have no outlet or support system. Men are under enormous pressure to perform in the competitive workplace and are frequently judged on their occupational and wealth status. "Recent economic hardship, unemployment and the financial crisis are all reasons that men have more stress to contend with, and an increased incidence of depression", says Johannesburg psychiatrist Dr Dora Wynchank.

"It was so much easier to just stay in bed or lie on the couch and sleep", says Derek as his drive and determination started to falter. He began withdrawing from friends and family, fought regularly with his wife and become increasingly distant from his children because, he believed, he couldn't share his problems and would be judged as "weak and pathetic" if he admitted he wasn't coping emotionally – never mind financially.

His story is an all too familiar one. Grant*, 41, is married with three young children. He is well qualified with both a degree and two diplomas but recently lost his job and cannot find another one. He has no money or savings to draw on and his medical aid and cellphone have been cancelled. "Grant saw a psychologist very briefly three years ago for what he called 'burnout'. It didn't last long, he thought it made him weak", says his sister who believes that he's been depressed for a long time. "He refuses to admit or acknowledge his feelings – he's so worried about what people will think and how they will treat him." Grant's family is in dire financial straights. His wife is trying to work from home but with a small baby, is finding it very difficult and their marriage is taking severe strain.

There has been a recent increase in businessman seeking psychological help because of financial problems. "We are receiving more calls now than ever before from men who are really battling to cope, men who need help, support and advise", says chief executive of the South African Depression and Anxiety Group, Elizabeth Matare. "Many men are not coping financially or emotionally and close up to their families. This means that their one support system isn't there."

"Traditionally, the business community find it difficult to cope, and stress-related psychological problems spill over into family relationships", says Dr Wynchank. According to her, divorced, widowed or single men in their 50s or older are the highest risk group in South Africa for completed suicides – and the tendency of men to 'self-medicate' with alcohol is another reason why their depression may go unnoticed.

"When I lost the contract, I'd stay home, drink beer and feel sorry for myself. Even when I was offered work, I found reasons not to do it because I'd totally lost faith in myself and my abilities. I tumbled into the big black hole of self-pity that I had heard about but always thought happened to other people", says Derek.

Derek and Grant aren't the only ones experiencing this slide into depression. Many men interviewed said they are more fatigued, irritable or angry, compared with last year and many say they lie awake at night due to stress. A disturbing number of those interviewed admit to using alcohol to manage their stress and too many report they have thought about suicide on more than one occasion. Depression is twice as common in adult women as it is in men; however, many men suffering from depression are not diagnosed or treated and may attempt suicide. It's well recognised that men's suicide attempts are more successful than women's and 5 men die by suicide to every one woman who succeeds. "Men tend to use more violent means like shooting, hanging, and gassing than women which are more likely to succeed", says psychologist Michael Sissison. "Men rarely survive their attempts." New research by the Medical Research Council indicates that suicide rates are highest in Johannesburg, at 14 per 100 000 people.

According to Dr Wynchank, interpersonal problems, marital problems, partner-relational problems, family problems, financial problems, stress, and feelings of loss of support because of family change as causes of depression have increased recently. "In this context suicidal behaviour is sometimes used as an inappropriate method of communication and a problem-solving technique and increasingly being employed as a first-line, crisis-management strategy", says Dr Wynchank. In South Africa's present financial situation, chronic and acute stress as a result of financial pressures, are critical considerations in suicidal behaviour.

Social isolation and not being able to ask for the support of those closest to you is a serious risk factor. Grant is currently helping a friend with his business that requires him to travel a lot and be away from home a couple of nights a week. This means that he is alone and isolated from friends and family – most of whom are unaware of his situation. His sister is very worried. "He's all alone, in a dingey hotel, with no-one to talk to. I know he has started drinking more and I worry that one night, it'll all become too much for him and he'll take his life."

"I had 'Carte Blanch syndrome' really badly", laughs Trevor*, 35-year-old suicide survivor. "Sunday nights, when I heard the Carte Blanche theme song, I'd panic. I was terrified of facing a new week, terrified of what Monday morning would bring. It got to a point where I wouldn't sleep – I'd stay up worrying, pacing – and often not even go in on Monday morning." The more Trevor missed work, the worse his anxiety and panic became. "The more I avoided work, the more I needed to avoid work."

Research conducted by AIC Insurance on absenteeism in South Africa confirms that it is reaching staggeringly high levels, and could be costing the country's economy as much as R12 billion per year. In the average company approximately 4,5% of the workforce is absent on any given day. In certain companies this figure is as high as 18%. Most disturbing is that many South African companies don't do anything about absenteeism as, it seems, and there is widespread acceptance that not much can be done. Surely we cannot afford the luxury of such passive views any longer.

"Employers need to take a long, hard look at why their employees are absent – and do something about it", says HR Manager Loretta Pillay. "Many employees are struggling with debt and financial issues that lower their motivation and performance at work. We need to offer counselling and pro-active services to help people manage debt before it becomes a life- threatening problem." According to many HR Managers and EAP Consultants, the focus needs to be on the health, wealth and happiness of employees. "A healthy workforce is absent less often and has improved productivity – something we can all understand."

"My HR Manager saved my life – really!", says Trevor. After missing more and more work days and becoming increasingly unproductive when he was there, his manager called him in for a talk. "She asked me what was going on. She seemed really concerned. I guess it had all become too much – I was so tired of pretending – I don't know, I just broke down and told her everything." Trevor admitted to having attempted suicide the weekend before and said he wasn't coping with the financial pressures and strain of work. His recent promotion and increase has resulted in him spending too much "on silly luxuries" and now he was in debt. His manager put him in contact with a debt counsellor as well as a psychologist. "It saved my life. I learned knew skills and new ways to cope – in a healthy way. I got to the point that I didn't care what people thought – I just needed help."

"Depression in men is responsive to treatment and the lives of these men can be saved", says Dr Wynchank. "Effective, affordable, well tolerated medication, support groups and psychotherapy are there to heal and to improve quality of life." The South African Depression and Anxiety Group has an extensive list of resources throughout the country. They can be contacted seven days a week from 8am to 8pm on 011 262 6396.

"Take a step back from the world you're in", says wellness trainer and coach Janine Shamos. "Turn off the news, put the newspaper away a couple of hours before bed. Do something that reconnects you with the positive aspects of your life – walk in nature, listen to music, talk to the people you love."
A break from all that intensity may be just what you need. Read a fashion magazine or a funny book—something to make you laugh and get your mind off money and the news. And look at how you're handling stress - if you're turning to substances, it's time to talk to a professional.

Warning Signs of Depression:
· Changes in eating and sleeping habits
· Withdrawal from friends and family
· Loss of interest in pleasurable activities
· Moodiness
· Talk of death or suicide
· Working slowly
· Making mistakes more often
· Inability to concentrate or make decisions
· Being frequently late or absent from work
· Working or trying to work too hard
· Increased use of drugs and/or alcohol

With the help of his sister, Grant began seeing a psychologist and is on the road to mental and emotional health. "His financial problems haven't just disappeared but at least he is better able to handle the stresses and strains of life right now. He can talk to us and he feels more motivated – and hopeful that he'll get out of this mess in one piece", says his sister.

Whether you're over-worked, out of work or thinking about working - relax before you settle into bed, go to bed and wake up at regular times, and try not think about things that are worrying you as you lie awake at 3am. The good news is that according to the US National Bureau of Economic Research, recessions last an average of 11 months while upturns tend to last for 6 years, so this too shall pass.

Where to get help:
· SADAG 011 262 6396 / 0800 567 567
· SADAG Substance Abuse line 0800 12 13 14
· Employee Wellbeing Programme 0800 006 068
· FAMSA 011 975 7106
· Debt Counselling 0861 663 328


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