Caring for the carer

I'm not entirely sure why I found the short piece, The perfect husband I am not, by Tom Becker, resonating with me. Perhaps it's his sheer honesty about how difficult it is to be continually sympathetic to someone who has a chronic illness. His piece is a good reminder that carers need care too...

Here's how it starts.

My wife’s depression pours light on my own sins. I’m stoic, unsympathetic and critical of her in every way. I’m quick to declare fix-its for her occasional panic episodes. Ever since she was diagnosed with anxiety-induced depression 14 years into our marriage, I’ve waged my own war against the demon of selfishness and, in moments of failure, self-worthlessness.

God and Suicide

Chris Erdman preached a sermon on the Second Sunday of Lent this year, which focused to a great extent on the suicide of a close friend, Jamie Evans [photo] three days earlier.

The sermon needs to be read in full, but in this post I'd like just to quote three extracts relating to the way in which we continue to regard those who have a mental illness, by which I mean, and Erdman means, not necessarily those who wander the streets talking to themselves, or those who inhabit psychiatric hospitals sometimes for years on end, but those who live amongst us in the community and are suffering daily from the difficulties of (often severe) depression.

First, we must work to remove the stigma of mental illness, a stigma that keeps mental illness secret and hidden and dangerous.
Look, there’s no more shame in mental struggle, mental anguish, and mental illness than there is in high cholesterol or high blood pressure. We readily recognize our need for help in other areas of our lives. For God’s sake, why then do we consign people whose minds are troubled to the secret and lonely life of walking the road of clinical depression alone? We must end this secrecy! We must throw open the windows of our lives to the fact that to one degree or another we are all troubled, some of us more than others. In fact, there are more reasons to be struggling mentally, emotionally, and spiritually today than there are reasons not to. Let’s get that into our heads and learn to live more honestly and compassionately toward others as well as toward ourselves.

Second, self-care is not an option. We all need to learn to practice some kind of vulnerability, some kind of internal awareness of what's going on on the inside of our lives. There are many ways to do this.

Third, those who are in great mental and emotional pain need community.

We must become more educated about the signs of mental illness, and more able to recognize those signs in those around us, as well as in ourselves. Let’s face it; we’re not very aware of what’s going inside the skin of others, let alone ourselves. Our faces are buried in our cell phones; we’re glued to computer and TV screens. Our minds are fixated on the thought parade that never ceases to march through our brains. The noise of this modern world drowns out true awareness. We look but cannot see; we hear but do not listen; we walk the paths of daily life but aren’t very aware of what’s really going on around us.

When you’re aware, truly aware, you slow down. You listen. You see things others, in their busyness and distraction, do not see. You sense what others cannot sense. Awareness is the ability to see beneath the surface, to detect the subtle changes in the emotional climate within you and within those around you. You see it in their eyes. You hear it in the tone of voice. You sense it in their touch.

Awareness is a particularly Christian virtue—a way to be fully here, to be completely in this present moment because you know God holds all things, you know God loves this world, and you know God is at work to bring about the goodness we all seek. Awareness is necessary for community. You cannot build a community when you’re distracted.

Erdman discusses the way in which he believes God looks after those who've committed suicide. For decades the church labelled them as people who'd committed an unforgivable sin. Erdman, (and I suspect, Jesus Christ) doesn't think that's the case.

RID website

Two years ago researchers from the University of Otago's Injury Prevention Research Unit set up the University of Otago depression website Rid - Recovery via the Internet from Depression . It started to accept participants about a year ago.

The site offers people a series of interactive exercises and mental health surveys, as well as information on where to access face-to-face or telephone counselling, and other mental health services.

The lead researcher, Dr Shyamala Nada-Raja said that researchers were happy with the number of participants enrolled so far, but the trial still needed a total of 700 participants to be statistically valid. 660 were enrolled so far, and she hoped to have another 40 within the next couple of weeks, after which enrolments would be closed.

660 people enrolled so far
Participants range in age from 18-70
30% of participants men; 20% new migrants 16% of participants live in rural areas
14% of participants have a physical disability
About 50% of participants are also receiving treatment elsewhere for anxiety or depression
About 50% of participants say their anxiety or depression relates to an underlying physical problem such as chronic pain

adapted from an article in the Otago Daily Times, Tuesday Oct 6th, 2009

Suicide and Recession

In an article in the latest SPINZ (Suicide Prevention Information NZ) newsletter, Dr Sunny Collings writes:

Recent articles in the media have suggested that the recession is having an impact on suicide rates. For example, in the UK a death by suicide was reported as being the ‘first suicide due to the economic downturn’. Irrespective of the details of the individual case, this claim is an oversimplification. The causes of suicide are complex and both individual level factors and societal/cultural factors are important.

Suicide rates rose in New Zealand during the Great Depression with a peak in 1930. The international rise in suicide rates during the Depression was probably due to the rise in unemployment. Evidence of a link between unemployment and suicide has been shown in New Zealand, with an odds ratio of about 2.5, meaning that people who are unemployed are more likely to complete suicide.

However, mental disorder was estimated as accounting for about half of the increased risk.

Dr Collings discusses the connections - or lack of them - further in the article, which is available online. Basically, unemployment - particularly for men - can add hugely to stress in a person's life, but it's usually only when it's added to an existing state of unwellness that the risk of suicide increases.

And it's no different here

Figures from a survey of 300 Canadian pastors came out in the February 2009 edition of Presbyterian Record, as a sidebar to an article entitled: Breaking the Silence - the mental health of our clergy. The issue of wellness, or the lack of it, amongst clergy has tended to be covered up for decades, because clergy are expected to be so 'holy,' 'capable,' 'fit and healthy' that they never need be sick or off-duty. The situation in New Zealand is little different. There are times when it seems as though ministers have little to do all day except write the weekly sermon and visit a few elderly ladies in the parish. But the truth of the matter is, of course, that most ministers are frantically busy, overloaded to such an extent that they don't have nearly enough time for their families, nearly enough time to relax, or virtually any time to just sit and listen to what the Lord is saying to them.
There are many reasons for this, including:
Ministers working a minimum of 50 hours a week, and often more than that;
Not having the days off to which they're entitled;
Feeling as though they have to be perfect when they're often under huge stress to perform;
Feeling empty, going through the motions, in terms of prayer, worship, Bible reading, spiritual life in general;
Lacking someone who can counsel or mentor or come alongside them;
Suffering depression or burn-out or panic attacks and having to live with it.

The Canadian situation only confirms what is known in New Zealand. This is what the National Mission Office has been working on for several years: finding ways to help ministers avoid breakdowns and depression.

The full report can be found at the Caring for Clergy site - click on Current Research and then on 'Clergy Well-Being - Seeking Wholeness with Integrity'.

More on TheLowdown.co.nz

The New Zealand Ministry of Health won a gold EFFIE in the SOCIAL MARKETING / PUBLIC SERVICE category for TheLowdown.co.nz website, which is part of its National Depression Initiative created to help young New Zealanders understand and recover from depression.

The aim of the website is to reduce the impact of depression on youth by encouraging them to seek help. Young people are notorious for not going to GPs or using other support services. They are difficult to engage, even with issues that interest them, let alone with an issue that they don’t understand and that still carries a social stigma.

One in seven young Kiwis will experience serious depression over the next 12 months, a condition closely linked to suicidal behaviour.

TheLowdown.co.nz is a leading edge multimedia website where musicians and celebrities shared their experiences of depression. A place where youth can learn about depression, take a self-test, listen to NZ music, talk to their peers via a message board and receive professional support via free text messaging and email support services.

Brian van den Hurk, DraftFCB General Manager, says, “With the sobering statistics for youth depression and suicide it is crucial that we help young people to deal with and recover from depression. TheLowdown.co.nz has been created for them to get help as quickly as possible. If they can develop their skills in coping with what life throws at them, they can have more control over their future."

Details from a Scoop report

Men and Depression

One of the areas National Mission Office has been concerned with is the health of Presbyterian ministers around the country. Ministers can suffer from burn-out, depression and the symptoms that go with these. And often they feel forced to keep on keeping on because ministers are supposed to be capable people.

Male depression is only just beginning to be regarded as a prime source of suicide amongst men in mid-life - as recent tv ads will have indicated.

Via an article in the magazine, Grapevine, I've just become aware of a site called MenAlive.com. It focuses on depression, mid-life crises, irritable male syndrome (that's right, no typo there), and other related issues.

It's an American site, but it has a links page that is global in its range. And quite apart from that, depression is common to mankind (and womankind, or course!)

SANE advertising

This effective 'road' sign comes from a campaign being run by SANE Australia. There's a brief video ad on the site from a campaign focusing on mental health. One of the main messages SANE is promoting is that often close family members see the signs even before the person who's having mental health problems. This leads to them needing to encourage the person to get help. The campaign is similar to the one shown in NZ in regard to depression.
It's an importantpoint to note that:

The 2005-2006 data shows that the rate of suicide is higher for Mâori (17.9 per 100,000) than non-Mâori (12.0 per 100,000). This disparity has increased over the past nine years.
While fewer Mâori people died by suicide in 2005 than in 2004, the three year moving average rates - a more robust measure of what’s happening over time – show the Mâori suicide rate has increased by 5.2 percent from 2002-2004 to 2003-2005.

Addressing the needs of Mâori is particularly important because Mâori also have poorer outcomes in other areas relating to suicide. For example, depression is a major risk factor for suicide. Te Rau Hinengaro: The New Zealand Mental Health Survey shows that Mâori report higher rates of depression than all other ethnic groups, and, with the exception of Pacific peoples, are less likely to access services for a mental health problem.