Stress Anxiety and Depression Presentation for Youthnet Cottage

Stress, Anxiety and Depression Presentation for Youthnet, Cottage Boardroom, Nov 16, 2005 Michael Cheng, Psychiatrist http: //www. drcheng. ca

This presentation is protected under a Creative Commons Deed (http: //creativecommons. org/licenses /by-nc-sa/2. 0/ v You are free to copy, distribute, display and perform this work, as long as this work is not used for commercial purposes v

Goals An overview about stress, anxiety and depression in youth v What is it v What causes it v What can you do about it v Where to get help (in Ottawa) v

Top Questions from Youthnet Facilitators What is the meaning of life? v What is bipolar? v Common causes of teenage depression? v What to do when having an anxiety attack? v Where to refer someone with mood/anxiety problems (in Ottawa)? v

It’s All About Balance

Q. What do normal people need in life?

Everyone needs a healthy body, mind, spirit 1. 2. 3. Body (Physical, Biological Self) Mind (Psychological, Emotional Self) Spirit (Spiritual Self) Note: Overlap, e. g. psychological interventions can cause biological changes, and vice versa Mind Body Spirit

The Triple A Agency / Autonomy / Achievement Activity (as opposed to passivity) Affiliation (Relationships)

The Triple C Control “Chipper” (or being active) Connections with Others

Three P’s Power Proactive People

Point A Point B (Goals)

Obstacles such as stress (at home, school, work), depression, anxiety Point A Point B (Goals)

Life is full of things that cause imbalance (in mind, body, spirit)

Typical stresses in our modern society v Body – Medical / physical illness – Lack of sunlight / Drug Use v Mind / Social – – – v School / Work Classmates / co-workers Family Friends Boyfriends/girlfriends Spirit

Life is a balance between coping and stress Coping Ability Demands / Expectations / Stresses

Problems if demands, expectations or stresses outweigh coping Coping Ability Demands / Expectations / Stresses

There are two solutions to restore the balance. . . Coping Ability Demands / Expectations / Stresses

Stress can lead to: Physical problems v Emotional or mood problems such as v – – – Depression Anxiety Eating Disorders OCD Any problems with mood/coping. . .

Prevalence of Mental Disorders in Children and Adolescents in Canada (Stats Can, 2002, age 0 -19) Anxiety Disorder 6. 5% ADHD 3. 3% Depressive Disorder 2. 1% Substance Abuse 0. 8% Schizophrenia 0. 1% Bipolar Disorder 0. 1% Eating Disorder 0. 1% Etc. . . ANY DISORDER 15%

Mood Disorders: What is It? Everyone gets sad from time to time v Just enough sadness is good because it alerts people to do something to change their situation v Mood disorders are when people’s moods are so extreme that it gets in the way of life v It is not normal, and is not something that someone can easily ‘snap out of’ v

Mood Disorders: To Diagnosis or Not to Diagnosis? v v Classified according to the DSM-IV For formal DSM-IV criteria for disorders, visit www. mentalhealth. com Although imperfect, the DSM-IV nonetheless reflects an improvement from the past, when there was no common language in talking about what was, or was not a mental condition Each version of the DSM gives us a greater understanding of mental conditions

Mood Disorders: To Diagnosis or Not to Diagnosis? v Pros – Gives us a common language – Allows people to learn and get support about their condition or problems v Cons – Being ‘labelled’ may carry a stigma (perhaps stigma is the true problem? ) – The fact that people may misuse a diagnosis to avoid responsibility for a problem – Being put into a box

My personal bias. . . v Appropriate use of a ‘diagnosis’ in the right situation can be helpful

Example of How To Use a Diagnosis v v v “You’ve told me that before having these problems with your mood, you were always a happy, high achieving, outgoing person. ” “You’ve mentioned having problems with your mood, sleep, appetite, concentration and energy, and that you’ve been feeling hopeless. ” It sounds like you may have a medical condition called depression. The good news is that this condition is very treatable and we can help you feel better again. ”

Example of How To Use a Diagnosis (Cont’d) “You are not responsible for causing this condition. ” v “However, it is mainly up to you to get better. ” v “But the good news is that you are not alone – we will support you in overcoming the depression. ” v

Mood Disorders: Types Major Depression (aka Clinical Depression, Major Depressive Episode) v Dysthymic Disorder (aka low grade depression) v Adjustment Disorder (mood problems following a stress, but not severe enough to be major depression v Bipolar Disorder v

Major Depression Problems with mood (sad, angry, irritable), PLUS v Physical problems with v – Sleep, Energy, Appetite, Concentration v May also have problems with – Thoughts • Low self-esteem • Hopelessness / Suicidal thoughts – Behaviors • Social withdrawal, loss of function

Dysthymic Disorder Problems with mood (sad, angry, irritable), PLUS v Some physical problems v Some problems with v – Thoughts – Behaviors v BUT is not as severe as Major Depression

Adjustment Disorder Problems with mood (which are not severe enough to meet for depression or dysthymic disorder) following a stress v Does not involve significant changes v

Bipolar Disorder v v A condition with severe highs and lows where one’s moods are like a roller coaster, to the point it causes problems During highs – Mood high or irritable, excessive energy, less need for sleep, excess talking, excess activities v During lows – No energy, depressed mood, more need to sleep, i. e. essentially like being depressed

Anxiety Disorders Everybody has worries and gets anxious from time to time v Just enough anxiety is helpful because it keeps us cautious and safe v Anxiety Disorders are when one has so many worries that they get in the way of life v

Types of Anxiety Disorders (or Conditions) v Generalized Anxiety Disorder – Constant worries with physical symptoms that cause problems v Panic Disorder – Out of the blue feelings of panic that cause problems v Obsessive Compulsive Disorder – Repetitive thoughts or behaviors that cause problems v Social Anxiety Disorder – Extreme shyness that causes problems

Restoring the Balance

A General Approach to Helping Others v Figure out the person’s goals – “What would you like to get from coming here to see me/us? ” v Figure out what to do to get to that goal – “What do you think we need to do to get to your goal? ”

A General Approach to Helping Others v Figure out what stress is causing (or contributing to) the anxiety or depression – Usual stresses include • School • Family • Friends v Problem-solve and find ways to deal with that stress

Approach to Conflicts Conflict is when two parties want or expect different things v Solution v – Figure out what each party wants or expects from the other – Ensure it is reasonable – For things that each party wants in common, great! – For things that each party disagrees on, negotiate and compromise

Everyone needs a healthy body, mind, spirit 1. 2. 3. Body (Physical, Biological Self) Mind (Psychological, Emotional Self) Spirit (Spiritual Self) Note: Overlap, e. g. psychological interventions can cause biological changes, and vice versa Mind Body Spirit

Body v Ensure healthy amounts of – Sleep – Diet/nutrition – Exercise • Individual exercise • Group / social exercise • Yoga / Martial Arts – Sunlight (in the case of winter depression)

Body Medications may be a helpful ‘body’ or physical intervention in certain circumstances v For anxiety and depression, in general v – Non-medication strategies are tried first – Medications are used if non-medication strategies are unsuccessful

Body v Common types of ‘self-medication’ – Sweets, carbohydrates, chocolates • May possibly be a way of getting serotonin – Exercise • May be a way of getting adrenaline / dopamine – Caffeine • May be a way of getting adrenaline / dopamine – Street drugs

Mind v Ensure good coping strategies and ways to deal with stress – – School / work Family Friends and Boyfriends/girlfriends

Mind v Psychotherapy such as cognitive behavior therapy – Anxiety or depression is caused by cognitive distortions – Fixing cognitive distortions will overcome the anxiety or depression

Thoughts

Spirit Figure out what gives meaning to the person’s life v Ensure those things are in the person’s life v

Types of Help for Anxiety and Depression Speaking with friends v Speaking with family v Speaking with religious supports (e. g. chaplain, priest, rabbi, iman, etc. ) v

Types of Professional Help for Anxiety and Depression School personnel (teachers, guidance counselors, vice-principal, social workers, coach, etc. ) v Medical Doctors (family physicians, pediatricians, psychiatrist) v Psychologists v Counselors v Social Workers v

Questions?