Routine depression screening for adults not recommended

CBC.ca

Family doctors don't need to screen for depression in adults who aren't showing symptoms, new Canadian guidelines recommend.

On Monday, the Canadian Task Force on Preventive Health Care updated its 2005 guidelines.

Marc Fignon, left, director of the film The Great Depression, hands out flyers for his film to festival patrons at the Sundance Film Festival. New Canadian screening recommendations do not apply to people with known depression. (Chris Pizzello/Invision/Associated Press)

"Our recommendations highlight the lack of evidence about the benefits and harms of routinely screening for depression in adults," Dr. Michael Joffres, chair of the group's depression guidelines writing group and his co-authors concluded in the Canadian Medical Association Journal. Joffres is also a member of the Faculty of Health Sciences at Simon Fraser University, in Burnaby, B.C.

"In the absence of a demonstrated benefit of screening, and in consideration of the potential harms, we recommend not routinely screening for depression in primary care settings, either in adults at average risk or in those with characteristics that may increase their risk of depression."

It's estimated one in every eight adults meets the criteria for major depression at some point during their lifetime and one in 20 aged 15 or older had in the past 12 months, according to the 2002 Canadian Community Health Survey.

The value of screening didn't hold up for milder cases, the panel said.

They suggested that clinicians stay alert to the possibility of depression, especially in patients that may increase their risk, and to look for it when there are clinical clues such as insomnia, low mood, diminished interest or pleasure in activities and suicidal thoughts.

The recommendations do not apply to people with known depression, with a history of depression or who are receiving treatment for depression.

To read the full article:  http://www.cbc.ca/news/health/story/2013/05/13/depression-screening.html

Mental Health Week

By Gail Packwood

The Canadian Mental Health Association (CMHA) declared May 6 to 12, 2013 Mental Health Week. 1 in 5 Canadians will experience some sort of mental health issue in their lifetime and it is something that can affect people at any age or stage of their life.

Initiatives like Mental Health Week aim to help reduce the stigma that is often attached to mental health issues. This year CMHA hopes to engage people in a discussion on practical ways to maintain and improve their mental health and to support the recovery of those who are living with mental illness.  Mental health is “more than the absence of mental illness. It’s a state of well-being”. Finding coping strategies to deal with the pace and stresses of modern living is critical to maintaining good mental health.

Some signs that what you are dealing with may be more serious than stress are:

• Insomnia. If you can’t sleep because you cannot stop thinking or worrying.
• If you struggle with doing everyday tasks – getting dressed, showering, going to work – seem impossible.
• If you cannot “let go”.  You stay angry, sad or upset about something, unable to forgive or forget the issue or situation (this could be big or small issues).
• If you can’t work.  The idea of a “mental health day” but very real.  You cannot get up the energy or will power to go to work.
• If you feel unattractive physically and unworthy of love, positive attention or friendships.

Often those living with a mental illness, their family and friends may feel overwhelmed and unsure of what resources and services are available and where to turn to for help.  But help is available – and according to CMHA, all mental illness is treatable.  Mental illness can take many forms, from anxiety disorders, depression, and schizophrenia to bipolar disorder, eating disorders and gambling addictions.  Each form may require different treatment options and timelines for recovery.

Many factors may affect our ability to maintain a balance in our mental health – physical changes and illness, bereavement, loneliness and lifestyle changes like retirement, can all lead us to suffer from mental health issues like anxiety and depression. The CMHA website offers three quizzes that you can do to check on your mental health. These non-scientific tests may give you some insight to your own current situation and where your mental health might benefit from making positive lifestyle changes or different choices.

Those in Ontario can contact the Mental Health Helpline 24 hours a day for confidential, free and anonymous assistance. 1-866-531-2600 or www.MentalHealthHelpline.ca

Very often the first call for information comes from concerned friends or family of a loved one who they feel needs help.  Do not be afraid to ask questions and seek advice. Treatment is available.

For more information on Mental Health Week, CMHA and to find services and resources in your area, visit http://mentalhealthweek.cmha.ca/

We need to talk more, not less about suicide

Yehudit Silverman, Montreal Gazette

MONTREAL - Every 40 seconds, a life is lost to suicide. Around the world, between 20 million and 100 million people attempt suicide every year, and more than a million succeed. At this very moment, thousands of people are contemplating taking their own life to end the torment of depression, chronic pain, anxiety or unbearable shame.

As we mark Canadian Mental Health Week this week, it’s instructive to recall that suicide is the second-leading cause of death among teens, and a common cause of death among elderly people. And yet in spite of the magnitude of the problem, suicide remains entrapped in a culture of shame and taboo. As a result, it tends to be shrouded in silence. We have to end that silence.

There is a pervasive myth that talking about suicide encourages it. Media outlets have developed policies governing their coverage of suicides, based on this myth. And yet research, including my own, indicates we need to talk more, not less, about suicide. Let me explain.

A person contemplating suicide commonly feels disconnected and hopeless. One of the most important things we can do, when faced with someone who is struggling with severe depression, pain, anxiety or shame, is to ask them the question, simply and directly: “Are you contemplating suicide?”

Leading questions such as “You’re not suicidal, are you?” or “You’re not thinking of doing something crazy?” carry judgments, and signal that the questioner is reluctant to hear a truthful answer. Ending silence also involves listening openly.

To read the full article: http://www.montrealgazette.com/news/Opinion+need+talk+more+less+about+suicide/8344517/story.html#ixzz2Sd2EbH9V

Social Isolation – the “Modern Plague”

By Gail Packwood

A new study shows that those with a larger social network and closer relationships tend to be both mentally and physically healthier.

Dr. Mike Evans’ podcast “Importance of Strong Emotional Relationships to Your Health” talks about loneliness as being a huge factor in a person’s overall health (you can listen to his podcasts through his website - http://www.myfavouritemedicine.com )

Not surprisingly, people in happy relationships tend to see life with more optimism, purpose and increased self-esteem.  All these feelings have a positive affect on your health.  People who are married or in a common law relationship tend to engage in positive lifestyle choices as such as eating more meals at home.  These choices have an affect on your overall health.

Also not surprisingly, people who have suffered bereavement experience an increased illness and mortality rate – especially in the first weeks and months following the bereavement.  While not a cure for everything that ails us, companionship and social interactions appear to play a key role in keeping us healthy.  Leaning on friends and family can help you overcome loss.

Modern western society isolates us in many ways.  Longer commute times – either alone in our vehicles or on public transit with headphones – prevents us from participating in some social interactions because we simply don’t have the time.  Internet relationships are often used to replace in person ones – we email instead of telephone for instance.  Dr. Evans does not see the Internet as entirely harmful however.  He says it “accentuates who we already are”, so if you are a loner, you may use the Internet to avoid interactions with people.  If you are naturally social, it may help or enhance your social activities.  However, virtual friends and relationships do not replace the benefits of real ones.

11% of Canadians claim they are lonely with no friends at all beyond family members.  The larger your social network is, the healthier your psychological well-being.  Isolation may lead to various forms of depression or even certain harmful addictions.

How can we avoid becoming socially isolated, especially as we age?

• It is important to reach out to friends and family members.  Call someone to say hello or invite them over (social interactions do not have to cost money!).  Perhaps you know someone else in a situation similar to yours?  They would probably appreciate a telephone call or visit as well.
• Join a group.  Is there an activity you enjoy or a subject you are interested in?  There are many groups available in your community – everything from walking groups to bridge and curling clubs.  Check with your local library, seniors’ centre or community centre and see what they have to offer.  Many groups are free and accept new members on an on-going basis.
• Volunteer!  Helping others helps us feel good about ourselves.  Also, if you make a commitment to help out somewhere at a specific time, it is good motivation to get out of the house. Most charities need help.  Think of a cause you believe in and give them a call.  Larger organizations will have a staff member dedicated to volunteer recruitment.

It is important to realize if we are becoming more isolated than may be healthy and to pay attention to our friends and loved ones who we may not have seen out and about in awhile.  Remember, it takes a village to keep each of us healthy!

Mental Health – Let’s Talk

By Gail Packwood

You may have noticed Bell’s current advertising campaign aimed at promoting awareness of mental health issues in Canada.  1 in 5 people in this country will suffer from some form of mental health issue in their lifetime.   On February 12^th, Bell will donate 5¢ towards mental health initiatives for every text message and long distance call made on their network, as well as for every tweet using the #BellLetsTalk hashtag.  All of this goes a long way towards reducing the stigma that often faces people who are dealing with a mental health concern.

The Canadian Mental Health Association (www.cmha.ca) has been working to promote awareness and provide assistance and support to those living with mental illness for almost 100 years.

As we age and our life circumstances change – our health may deteriorate, our bodies change, we retire, people close to us pass away – we may experience increased stress and loneliness which in turn can lead to mental health issues.

There are ways to cope with these changes.  One way is to expect and plan for change – what would you like to do once you retire for instance? By thinking about it before the time comes, we can be more prepared and less shocked when the inevitable happens.  Having a positive attitude that helps you stay interested and involved in life and the world around you is also a great coping strategy.

The CMHA website offers these other suggestions on how to deal with these changes:

Physical Changes:

• Accept that the changes are happening.
• Stay positive.  You are not alone in this experience.
• See your doctor regularly.  It is the best step in dealing with issues that may require medical attention or be improved with medication.

Dealing with Loss:

• Look for support from family and friends and in turn offer your support.
• Allow yourself to grieve.
• Talk about your loved one.

Dealing with Loneliness:

• Stay active and look for new social activities.
• Reach out to friends and family members.
• Spend time with grandchildren and other younger family members.

Retirement:

• Renew your interest in a hobby or activity that you enjoy but haven’t had enough time for.
• Make a list of your skills.  You likely have experience that could be invaluable to a charity in your neighbourhood.
• Maintain contact with old friends.
• Travel!  If you can afford it, there are likely many places you have wanted to visit.  If finances don’t allow you to go very far, look at finding group outings for day trips in your local area.  The “stay-cation” can be equally rewarding.

For more information, visit the CMHA website www.cmha.ca.

The iPod Project

By Gail Packwood

The past which is not recoverable in any other way is embedded, as if in amber, in the music, and people can regain a sense of identity. . . — Oliver Sacks

January marks Alzheimer’s Awareness Month in Canada.  According to the Canadian Institute of Health Research, 747 000 Canadians currently live with dementia and its most common form, Alzheimer’s disease.

There remains a stigma attached to a diagnosis of dementia and a fear of forever losing the person behind the disease by their loved ones.  40% of those who are diagnosed with the disease report feeling distanced from friends and loved ones when they first reveal their diagnosis.  Those with dementia lose personal memories – the individual is still there but they won’t necessarily be able to recall who loved ones are, locations, what they did for a living etc.  They essentially lose their story – the story of their life.

There have been many studies on how music affects brain function and mood (one of the better known is Dr. Oliver Sacks’ book Musicophilia: Tales of Music and the Brain).  The results from music and creative therapy can be quite remarkable, unlocking, if only briefly, emotions and memory that had been lost.

Two months ago, the Alzheimer’s Society of Toronto started the iPod Project.  The concept is simple.  The society gives iPods to people living with the disease that have been loaded with music that is meaningful to the individual – perhaps songs from their youth or what they first learned to play on piano. They help the family member or primary care giver set up music playlists and train them on its general use – how to download more music etc.

To participate in the program, you have to have received a formal diagnosis of Alzheimer’s disease, and still be living in the community (not in a long term care facility) within the GTA.

The results so far have been striking.  Hearing music from their past has generated responses from those who were primarily unresponsive, relieved anxiety and nervousness in situations that ordinarily caused both and generally helped to calm and relax the patient.  Many have been noted to start singing along or even dance with their iPod.  For someone who had been trapped outside of their memories, to recapture something of who they used to be, even for a few hours is wonderful.

Personalized music has the power to release memories and help the individual regain some sense of their identity, regardless of their music aptitude (they don’t have to have played a musical instrument for instance).  While the results are not permanent, they seem to be apparent in even very severe cases of the disease.  The respite is equally heartening for the family and friends of the Alzheimer’s patient as they get to see their loved one being a little bit of who they once were.

The concept of using iPods originated in New York City with the Music and Memories Project in 2011 (musicandmemories.org) and similar programs are now starting in Kansas and the Maritimes.  With such a simple idea and such positive results, hopefully the program will spread even further in the future.  Of course, anyone with access to an iPod or MP3 player could easily set up something similar for their own loved one.

In Toronto, the Alzheimer’s Society is still looking for participants! For more information about the Toronto iPod Project, visit the Alzheimer’s Society of Toronto’s website: www.alzheimertoronto.org.