Coping With Stress and Depression

Coping with Stress and Depression

Presented by

Zaza Sakhat, LICSW & Susan Weinstein

Agenda

•  How to identify signs of stress •  What are ways to reduce stress •  What is mindfulness-based stress reduction •  How to identify when it�s more than stress •  What are anxiety and depression •  How and where to get help

  Consider: What causes you the most stress?   Stress is a fact of life, but it can be managed

Viewer Activity

Stress is your body's way of responding to any kind of demand. It comes from the strains of day-to-day life or acute events.

Definition of stress

Acute Stress—How does it feel ?

You are driving You see a dog in the road You slam on the brakes What happens to your body?

Signs of Stress

  Digestive problems   Tense muscles and aches   Racing heartbeat and

restlessness, sweating   Skin problems   Getting sick more frequently   Irritability, quick temper   Worried, anxious thoughts   Forgetfulness, problems

concentrating   Less interest in sex   Menstrual or fertility problems   Drinking more alcohol,

smoking more often

How stress impacts the body

You have a �fight or flight� response   Adrenaline and other body chemicals are

released   Good for short spurts, not long term   Chronic stress without healthy release has

long-term consequences to physical and emotional health

Chronic stress can take a toll

Increased vulnerability to  Infections, viruses  Sleep problems  Anxiety  Depression  GI problems

 Heart conditions  Weight gain or loss  Infertility  Compromised glucose

control (diabetes)

Take the Holmes and Rahe stress test at www.stresstips.com/lifeevents.htm

  Healthy ways and unhealthy ways

How do you cope with stress?

Strategies for coping with stress

  Relax deliberately and breathe deeply

  Eat well, with a healthy, balanced variety of foods

  Stop smoking   Limit coffee and alcohol   Exercise and move your body   Sleep long enough to feel rested   Set limits   Spend time with others   Laugh and sing   Practice spirituality   Focus on your goals

Rationale for reframing

Reframing negative thoughts can help us: •  Turn them into positive possibilities •  Reduce stress and improve mood

Reframing

What nourishes you?

Inventory your personal attributes

Reframing

Practice gratefulness

  I recognize

  I acknowledge

  I appreciate

Mindfulness-Based Stress Reduction (MBSR)

Mindfulness means paying attention in a particular way—deliberately, in the present moment, and without judgment

  Decreases the negative effects of stress   Some success easing other health

problems   MBSR is a lifestyle change, more

effective in the long run

Benefits of MBSR

The MBSR program was founded in 1979 by Dr. Jon Kabat-Zinn, U-Mass Medical Center; now offered at centers and clinics nationwide

Citations: Carmody & Baer, Relationships between mindfulness practice and levels of mindfulness, etc., J Behav Med, Feb 2008; Marchand, Mindfulness-based stress reduction … for depression, anxiety, pain, and psychological distress, J Psychiatr Pract, Jul 2012

Ways to practice MBSR

  Meditation   Yoga   Tai chi   Other body-centered meditative

approaches

By increasing awareness in a conscious way, you can work through your stress

Commit to reducing stress

For your eyes only, jot down one or two things you can do starting tomorrow (maybe even tonight?) to help manage your stress—at home and at work. �I commit to:

 [doing what?]  [by when?].�

Remember to breathe!

Beyond Stress

Anxiety or clinical depression

Do you know someone who is anxious or depressed?

These are medical conditions

Clinical depression and anxiety:   Affect people of any age, gender, race, income level   Are treatable medical conditions

  80% of people improve with treatment   Are often biologically based

  Like diabetes or heart disease

What is anxiety?

Excessive dread, fear, or worry that is intense and ongoing

Who has anxiety?

Anxiety is very common: •  40 million adults in the U.S.

suffer from anxiety disorders*

*Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 2005 Jun;62(6):617-27

Signs of anxiety disorders

•  Irrational feelings of fear, uneasiness, dread

•  Excessive worry •  Impaired concentration or

selective attention •  Feeling restless or on edge •  Heart palpitations or racing

heartbeat •  Avoiding activities or people •  Easily startled or jumpy •  Bothered by normal

surrounding noise or conversation

•  Irritability •  Sweating •  Fatigue •  Headaches and stomach

problems •  Insomnia •  Repetitive/compulsive

behaviors (checking, counting, washing)

•  Nervousness

What is clinical depression?

  A treatable medical condition

  Affects people regardless of gender, race, income level, age

  More than sadness or “the blues”

Who has clinical depression?

Common •  14.8 million American adults in a given year1

•  About 7% of American adults are depressed1 •  20% of teens will experience depression by adulthood2

If untreated, can lead to suicide •  30% attempt suicide, and half of those take their lives3

1: Archives of General Psychiatry, 2005 Jun; 62(6): 617-27

2: American Academy of Child and Adolescent Psychiatry,

Facts for Families, The Depressed Child, 2008

3: National Center for Health Statistics, 2007.

Depression—what others notice

•  Talking very negatively •  Acting without concern

for others •  Abusing alcohol or drugs •  Picking fights, being

irritable, critical, or mean •  Withdrawing from people •  Having trouble at work

•  Talking suddenly about separation or divorce

•  Complaining of medically unexplained aches and pains

•  Eating or sleeping too much or too little

•  Behaving unusually or uncharacteristically

Abusing alcohol and drugs

Common sign

9% of full-time workers—about 12.7 million people—have problems with alcohol consumption.*

*2011 National Survey on Drug Use and Health, Substance Abuse and Mental Health Services Administration

Markers of depression

For at least 2 weeks: •  Feeling miserable,

depressed, sad, empty, or irritable

•  Losing interest or pleasure in most activities

Thinking of death or suicide - Seek help immediately

Help and Resources

Where to go for help

•  Employee Assistance Program at your company •  Your doctor (get a referral) •  Mental health clinician (e.g., psychiatrist, psychologist,

social worker, psychiatric nurse, family therapist) •  Complete an online screening, give to your clinician to

get a full evaluation   Depression and Bipolar Test: www.familyaware.org, click �Tools�   Massachusetts residents: www.stopmysadness.com   Outside Massachusetts: www.helpyourselfhelpothers.org

Nonprofit organization helping families recognize and cope with depression and bipolar disorder to get people well and prevent suicides Visit Families for Depression Awareness at www.familyaware.org

Learn More, Get Support

Audio Podcast Series

Depression in the Family

•  Signs of Depressive Disorders

•  Diagnosis and Treatment

•  Helping a Family Member

•  Caregiver Burnout

•  Family Communication

•  How to Find and Pay for Treatment

•  Family History

Depression Test

•  Anonymous, confidential •  Available at

www.familyaware.org •  Print out results, take to

clinician

Mental Health Family Tree

Depression Wellness Analyzer

Computer-based tool to monitor treatment. Download at www.familyaware.org

Care for Your Mind

Bringing people with mood disorders and their families into a conversation about mental health care system and how to fix it

•  Collaboration with Depression and Bipolar Support Alliance

•  www.CareForYourMind.org

Coping with Stress Training

  Stress is top health concern among employees

  Depression training helps employers reduce the cost of untreated or poorly treated depression

We can present a company-specific webinar or in-person workshop to employees

We also have a Coping with Stress Workshop,

including Facilitator’s Guide, so you can present the workshop to your company, community group, or other organization

Massachusetts Department of Public Health

The Massachusetts Workplace Mental Health Initiative

Stay Engaged With Us

•  Sign up for our email newsletter (go to homepage at www.familyaware.org)

•  Volunteer or share your story (go to www.familyaware.org and click �Volunteer� tab)

•  Participate on www.CareForYourMind.org

Special Thanks

Zaza Sakhat, LICSW, today’s presenter

Educational grant support from: •  Massachusetts Department of

Public Health •  Takeda and Lundbeck •  AstraZeneca •  Forest Laboratories and contributions from individuals like you!

Next Steps

•  Please complete the online evaluation to receive your free Coping with Stress brochure and reframing handout: https://www.surveymonkey.com/s/HV3DY9Z

•  Implement your commitments to reducing stress

•  Visit www.familyaware.org to learn more, volunteer, and/or donate to Families for Depression Awareness

Thank you!