World Mental Health Day and the global crisis of depression

Today, 10 October, is World Mental Health Day. This day, sanctioned by the World Health Organisation, raises public awareness about mental health issues. The aim is to stimulate open discussion of mental disorders and to promote investment into treatment and prevention services.

The theme for 2012 is “Depression: A Global Crisis”. In support of this, the World Federation for Mental Health (WFMH) has compiled a highly informative PDF document on World Mental Health Day and on depression in particular – well worth a read.

Depression – a mental disorder that involves depressed mood, loss of interest, decreased energy, feelings of guilt and reduced self-esteem, disturbed sleep, suppressed appetite, reduced concentration and heightened anxiety – is indeed a crisis of global proportions, with a reported number of 350 million people worldwide suffering from some form of depression. That’s almost 1 in 20 people worldwide.

While various forms of treatment exist – including basic psychosocial support combined with antidepressant medication or psychotherapy such as cognitive behaviour therapy, interpersonal psychotherapy or problem-solving treatment – depression is often not correctly diagnosed and access to treatment remains a problem, especially in the developing world. It is estimated that in some areas less than 10% of depression sufferers receive treatment.

Bipolar affective disorder, a severe form of depression, involves disruptive mood swings between frenzied manic states and episodes of deep depression.
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In a way we are faced with polar opposite problems in the developed and developing world when it comes to treating depression. In the developing world, the disease is often not correctly diagnosed, and the necessary medication is not available, or there aren’t suitably trained caregivers to assist with the required therapy.  In the developed world, on the other hand, I personally think we tend to ‘grab the pills’ way to quickly. While antidepressant medication is a key component in the treatment of severe depression, what is worrying is the extent to which it is willy-nilly dished out to anyone and everyone who feels a bit down. Almost like the injudicious prescription of antibiotics for anything from a mild flu, when all that’s needed is some rest and recovery time, we are becoming a population popping ‘happy pills’ when the problem could be solved successfully, and with less side-effects, through therapy and even self-help approaches including regular exercise, maintaining a healthy diet, relaxation techniques, a regular sleeping routine, creating a stable daily routine, etc. As reported by the WFMH, “Innovative approaches involving self-help books or internet-based self-help programs have been shown to help reduce or treat depression in numerous studies in Western countries.”

While antidepressant medication is an important component in the treatment of moderate to severe depression, milder forms of the disease can be effectively treated through self-help treatments including regular exercise and healthy eating.
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On this day, spare a thought for the millions of people suffering from depression, and do what you can to be there and to support those needing our help.  If you feel you may be suffering from the disease, don’t hesitate to seek help – it can be treated. And make sure to get an informed opinion before necessarily opting for medication – there are many potentially less harmful alternative treatments out there.

To quote the WFMH, “On an individual, community, and national level, it is time to educate ourselves about depression and support those who are suffering from this mental disorder.”

Positive Thinking Day – Accentuate the positive (but acknowledge the negative…)

Today is Positive Thinking Day. The day reminding you that if you can think it, you can do it. That if you smile and focus on positive thoughts, you will feel better. That you need to visualise success in order to achieve it.

Yeah right…

The ‘power of positive thinking’ has been one of the most jumped-upon bandwagons ever in motivational pop-psychology – so simple, such a positive message. Try a Google or Amazon search for ‘positive thinking’ and you will be inundated with self-help books, courses, motivational posters, famous quotes, you name it.

“Happiness is evolution’s way of saying, go out and discover new things. Go play, go explore” – Adam Anderson Canada Research Chair in Affective Neuroscience at the University of Toronto.
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It all started as a legitimate new field of psychology in the 90’s, known as Positive Psychology, led by the likes of psychologist Martin Seligman. Where much of the the focus in psychology had historically been rather negative (mental illness, addiction, etc), the idea behind positive psychology was to explore and better understand positive aspects such as happiness, virtue, resilience and optimism. The idea was never, however, to advocate indiscriminate, mindless optimism  – even Seligman long ago expressed the warning that optimism “may sometimes keep us from seeing reality with the necessary clarity”.

Many aspects of positive psychology struck an obvious chord with motivational speakers, self-help authors and the like, and soon positive thinking went from one weapon in the psychologist’s arsenal to the silver bullet to solve all the world’s problems.

As such it’s not surprising that there has been a bit of a backlash from the scientific community to the magical magnificence of positive thinking. For example, some of the literature showing the correlation between a positive attitude and good health, may have stretched things a bit by using this relationship to support the claim that a positive attitude will result in improved health. Yes, there seems to be a clear correlation between attitude and health, but little prove of causality. Does positive thinking cause good health, or does good health result in a positive attitude? Or can it be that there is no causative relation between health and attitude at all, and that it is just that a specific subset of people in society (perhaps those with, for example, naturally high energy levels) happen to exhibit both good health and a generally positive attitude.

A healthy dose of pessimism or negativity may also help us identify potential challenges we face in pursuing our goals, which may help us better prepare for these eventualities, thereby actually increasing our chances of success.

Researchers at Wellesley College have found that forcing people out of their natural attitudinal state may have a detrimental effect on their performance – a group of defensive pessimists who were forced to try and change their attitude and ‘cheer up’ actually performed worse at subsequent tasks. A 2001 study by Seligman and Isaacowitz, involving participants from an elderly community, also found that the pessimists in the group were less likely than the optimists to fall into depression after experiencing negative life events such as the death of a partner or good friend.

Recent years have seen a resurgence in the field of positive psychology, with psychologists like Canadian Jamie Gruman, co-founder of the new Canadian Positive Psychology Association, again promoting the study of human well-being and happiness and emphasizing strengths rather than ailments. The new proponents of the field are careful, however, not to be seen as just another ‘lollipops-and-rainbows’ approach, but rather to promote a balanced approach to living a positive life.

So, I guess the message on Positive Thinking day should be to think as positively as you feel comfortable doing. Even if positive thinking may not necessarily be the magical prescription for good health and a long happy life, I am at least not aware of any studies showing that being positive may actually be bad for your health.

Except of course if you go happily venturing down dodgy, dark and dangerous alleyways because of your unshakably optimistic belief in the goodness of your fellow man…  Or if your unflinching positivity starts driving your less flowery fellow workers to physical violence…

Whichever way you roll, here’s a little song (a wonderful new version of an old classic) to brighten your day. Happy Positive Thinking Day everyone…

Can Positive Thinking Be Negative? Scientific American.
Canadian social psychologist proposes science of positive thinking. The Vancouver Sun.