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Depression can be extremely debilitating, especially when we feel at rock-bottom and, when we reach that point, daily life can be pretty bleak. Gone is the ability to get out of bed, attend to our personal hygiene, eat breakfast, take the children to school, go to work, or whatever it is that gives us a sense of purpose. Our existence tends to be a reactive one; we shut down and withdraw from activity that keeps us feeling good about life.

It's true to say that depression often has a remitting and relapsing course. It may have no obvious cause, or it can be related to physical problems or various life events. Most people with depression will get better without treatment, although getting better may take several months or even longer. Living with symptoms in the meantime can have a heavy impact on the whole of our lives: relationships can suffer, our working life may be put at risk, together with our ability to pay the rent or the mortgage. I paint a bleak picture, I know, but such is the trauma that depression creates.

If we find ourselves in this situation, it can be very difficult to admit that we have a problem; our ego may well send us into denial, after all, who wants to be seen as weak? Of course, the first step to getting better is to acknowledge that we are ill and that we do need support to get well again. This acknowledgement is actually a sign of strength; it takes great strength to be honest about our vulnerability.



It is also helpful to talk to the GP; medication may well be suggested, especially if the depression is moderate to severe. This can be supplemented with counselling and it is thought that a combination of medication and counselling can be more effective than either treatment on its own. Given time, it is hoped that we will be fully functioning again and able to go about our daily lives in a more balanced way.

But it seems to me that the optimal time to manage our response to depression is when we are well. Counselling can actually be more helpful at this stage, simply because we have the headspace to be able to reflect around those issues that depress us. We have the opportunity to equip ourselves with strategies for managing our response to depression more effectively, becoming more proactive in the process.

I have found that one of the simplest and most effective tools we can use to prevent ourselves from slipping into the abyss is a mood diary. Producing our own journal can be both therapeutic and creative. But, more than anything, it is a practical tool that can alert us to changes in our mood and give us the opportunity to address any issues, before they spiral out of control.

Daily writing is recommended, particularly as it helps us keep the momentum going and it creates a daily habit. It can be helpful to write at the end of the day, which gives us the opportunity to reflect on what has been good about the day, what has been less helpful, whether we could have done things differently and whether there are lessons to be learned from it. Scaling our mood from 1-10 can also help us to think about what action we may need to take to prevent us from slipping down the scale. This could be something as simple as spending time with others, going for a walk, or simply relaxing in the bath with a nice candle and our favourite music.

Having said all of that, depression has a habit of coming back to bite us when we least expect it. Staying well is no easy task; it requires discipline and determination. Writing can be part of that discipline and persisting with it can ensure that we don't take our eye off the ball, as far as monitoring our mood is concerned. So, good luck with your "pen and paper" and I wish you a healthy future!

1. It feels like we are now living in an “always on” world. What can we all do to help manage our work life balance?
In seeking to establish a balanced home and working life, two key words spring to mind and they are expectations and priorities. On a professional level the Contract, Job Description and Person Specification are good starting points. A comprehensive Induction Process that defines mutual expectations and boundaries within the role is an essential part of the process. Issues like working hours and priorities should be clearly understood and regular Appraisals are a good indicator of whether key objectives are being met in this area. But life is not all about work and our personal lives are equally important. Those two key words are just as important as we navigate our way through expectations and priorities in our relationships. I’m always keen to encourage people to consider prioritising time for themselves, their partner and their family. We all have 24 hours in a day, and it is important to ensure that we use them wisely. 

2. What’s your best tip for time management at work? 
At the beginning of the working week it is so important to assess priorities for the week ahead. If you run a diary, plan it carefully and don’t forget to review it on a daily basis, things change, and this also applies to our priorities. If you don’t run a diary, maybe now is the time to start. If you don’t require a diary, think about ways in which the completion of tasks is being monitored and evaluated. And… in the middle of it all… don’t forget to take time to breathe. In other words, take a break!
 
3. If you are leading teams, how can you help staff understand how to be able to manage their time effectively?
Children live what they learn; this is something I often find myself saying to parents of young children when they are desperately trying to do the right thing as parents. This saying translates equally well into the workplace: The best piece of advice I would offer a Team Leader is to model behaviour that you hope team members will want to emulate. On a practical level, a regular one to one meeting with staff members is a good way of discerning whether any issues are arising and may well allow for a conversation around how they might be best addressed. 

4. Stress is a frequently used word. How can you identify if a colleague is stressed at work and what is your advice on how to support them.
Identifying whether a colleague is stressed is not always easy, particularly if the individual does not acknowledge it, which is often the case. Common symptoms might include irritability, mood swings, anxiety, low energy and problems with concentration. Behavioural difficulties might include hostility or simply withdrawing from interacting with others. There may be physical symptoms too, including headaches, aches and pains and symptoms of panic, including breathing difficulties, chest pains and a sense of terror. They may fail to attend work, either because of repeated minor infections or because they might be struggling to function well emotionally. Performance may have dropped, and mistakes might be more common. Sensitivity is key in addressing the issues, especially if the colleague feels ashamed and struggling to acknowledge the difficulties.  Colleagues would do well to check in with the individual, offering gentle support, emotionally and practically; expressing concern for their wellbeing without attempting to take control. Managers might want to complete a Stress Risk Assessment and this can be found at www.hse.gov.uk/stress/standards This allows for the opportunity to put in place a supportive plan, which can be reviewed periodically. If the organisation has access to an Employee Assistance Programme, make the individual aware of this, particularly as some short-term counselling may well address and resolve the issues.

5. What’s your favourite motivational quote and why?
 That’s a difficult question, when I have so many of them! The one that is my absolute favourite though goes like this: “The journey of a thousand miles begins with one small step”. (Lao Tzu) Life can be difficult and we can be overwhelmed by issues that crop up in all areas of our daily life. Taking a positive step back from those difficulties and breaking them down into manageable pieces is so important. We can’t control what happens in the future, but we can take control of what is happening today. Addressing issues we face today may well inform what happens in the future.

​Mental Health Awareness Week 13-19th May 2019

Do you know, it thrills me when I see the various campaigns out there and especially when they are about raising awareness around mental health. It’s not before time that we are really engaging with the subject, especially as, believe it or not, it applies to our universal human condition.
 
I was shocked, if not a little confused, to hear someone say: “I don’t have mental health”, when I was talking to them about this very subject. What the individual actually meant was that she didn’t have mental ill-health. Of course, as I was speaking to her in my professional capacity, it was my duty to correct her and reassure her that she did indeed have mental health; whether that had been compromised in some way was a matter for the assessment I was undertaking.
 
It’s interesting, I think, that as soon as the word “mental” is used, some people automatically think that this is a slur on their character, even today, when we are so much better at communicating the importance of health generally. So, what I’m trying to communicate is that we all have a mental health, which is intrinsically linked to our physical and spiritual health. So, what we know is that if one area of our wellbeing has been compromised, then it is likely that another area will be compromised as a result. For example, break a leg and I may feel pretty fed up mentally as I’m prevented from going about my well organised and busy life.
 
So what is mental health? Well, it is a state of being that affects how we think, feel and act. It is a state of well-being that enables us to live and work fruitfully within our various relationships and communities, enables us to maximise our full potential and helps us to cope with the normal stresses of everyday life. But, as human beings, our mental health fluctuates throughout our lives, just as our physical health does. Complex beings that we are means that we are often exposed to difficulties along the way that have the potential to challenge our coping mechanisms and leave us pretty isolated if we do not draw the support that we need. But, our capacity to draw that support will depend on a number of factors.
 
As a counsellor, I’m fascinated by human behaviour and human development. I’m mindful that the way in which we function as adults is borne out of our formative experience. If our childhood experiences had not been supportive or affirming, then we may be less likely to reach out to others for support as adults. Fear of being ridiculed or labelled is often a stumbling block, especially among the men I see in my counselling room. I’m mindful too that cultural issues may also inform our capacity to draw support. Common features might include a “stiff upper lip” mentality that does allow for the expression of vulnerability.
 
The shocking truth is that in 2017, 5,821 suicides were recorded in Great Britain. Of these, 75% were male and 25% were female. Suicide is the most common cause of death for men aged 20-49 years in England and Wales. Less extreme, it is estimated that 1 in 6 adults experiences a common mental health problem, such as anxiety or depression and 1 in 5 adults has considered taking their own life at some point.
 
So I wonder, where are you in all of this? What was your early experience? How easy is it for you to open up about difficulties you are struggling to address? Well, if I only have one message, then it is this:
 

• Admitting you have a problem is not a weakness and, if anything, it takes great strength to acknowledge it and to share it.
• Asking others for help is acceptable, not everyone is going to be unsympathetic.
• If you struggle to trust those in your personal life then it is essential to seek professional help: speak to your GP or other authorised mental health practitioner.
• Remember, relationships and engaging with others is key to our mental health; take that first step, it may be the hardest, but it may well save your life.

 
 Best wishes, Jan