Single Step Winter 2016
Transcription
Single Step Winter 2016
Single Step The leading charity for people affected by depression Winter 2016 Suffering in silence Why men find it so hard to talk Feeling better together Friends in Need turns two Keeping a healthy body and soul Dealing with physical and emotional illness Welcome to Single Step A journey of a thousand miles begins with a Single Step In this issue we have contributions from… About us Depression Alliance is the leading charity in the UK for everyone affected by depression. We bring people together to end the loneliness and isolation that so often comes with the condition. Our support network is a friendly and easy way to share understanding, information and friendship through depression and recovery. We also campaign to end the stigma of depression and to raise awareness of what it means to live with it. It’s vital that our friends, family, workplaces and communities are providing the right support to help people get better and stay well. Support us Your support will ensure our vital work continues. • Join our Friends in Need community to connect with others at friendsinneed.co.uk • Join a self help group or meet up in your area, or get help to create a new one • Be part of our national network to change attitudes towards depression and influence national developments Make a donation and become a supporter at www.depressionalliance.org Paul Cornish Illustrator and Science Communicator Nina Jacobs Deputy Editor Joanna Gilkes Freelance writer Jane Christopher Cognative Behavioural Therapist Naomi Martin Occupational Therapist This issue Dear Members, Sadly and with a very heavy heart, we would like to inform you this will be the last copy of a printed version of Single Step. After months of much deliberation and discussion we can no longer deny the inevitable – it is too expensive to produce. We know, having heard from so many of you, how much you value both reading and contributing to the magazine and how much you love to see it dropping on the doormat every quarter. We also know that using computers to find out information and meet people is not everyone’s cup of tea, and so we will continue to provide support for anyone who would like to get a group started locally or needs to know where to find a group to join in their local area. The good news is that Depression Alliance has been grown significantly over the last few years, driven in no small part by our Friends in Need online platform, and today we reach more than 23,000 people. All these people have joined Friends in Need and are part of the great, friendly, warm and caring community, that meet up online and locally. There are lots of local groups and we’re always there to help start new ones. If you would like to know how to use Friends in Need, or just to find out if is there a local group in your area, please do get in touch as we are happy to help. We still need your help to make sure that everyone with depression has someone to talk to all of the time. Alison Lawrence, Chair of Trustees Help fundraise for Depression Awareness Week 18 April 2016 For more information please email [email protected] or check out our website www.depressionalliance.org/get-involved/ We’d love to hear from you! We’re always looking for blogs to add to the Depression Alliance website. If you’d like to contribute please read our guidelines here: www.depressionalliance.org/ get-involved/blog-for-us Disclaimer Depression Alliance has tried to ensure that the contents of this magazine are accurate. Depression Alliance takes no responsibility for the content of articles or adverts reproduced and this should not be taken as an endorsement of any kind. Contacts Depression Alliance 9 Woburn Walk London WC1H 0JE T: 020 7407 7584 E: [email protected] W: www.depressionalliance.org Trustees Chair: Alison Lawrence Company Secretary: Malcolm Johnston Lynsey Conway Kevin Lewis Professor Chris Thompson Staff Chief Executive: Emer O’Neill Finance & IT Coordinator: Michael Beaven Digital Manager: Erin Hedger Friends in Need Team Leader: Liz Duff Fundraising Team: Alex Morgan West London Friends in Need: Stuart Beck, Yvonne Nelson, Whitney Shaw-Dale, Imogen Petit, Christina Bengston Friends in Need Coordinators: Louise Jones, Ansa Khan, Sarah Strong, Della Scully, Tina James, Katie Oliver Community Manager: Seema Inamdar Communications Coordinator: Laura Sacha Finance and Admin Officer: Salvatore La Cognata Volunteers: Julia Cosby and David Mark Thanks Thank you so much to our volunteers across the country, without whose hard work and dedication we would not be able to offer the support, information and understanding that people affected by depression so urgently need and deserve. Credits Editors: Erin Hedger and Nina Jacobs Design: Bananadesign Ltd Printer: Witherbys Contents Winter 2016 8 Suffering in silence Why men find it so hard to talk “Too many men wrongly believe that admitting mental distress makes them weak, and this kind of self-stigma can prevent them from seeking help.” 4 Farewell to Emer 6 Have your say 4 News Catch up with all the news from DA 6 Have your say Can different music impact on wellbeing? 7 Good deed feed Small acts of kindness make a big difference 8 Suffering in silence Why men find it so hard to talk 10 Feeling better when we’re together Friends in Need turns two 12 Keeping a healthy body and soul 10 Friends in Need 12 Healthy bodies Dealing with physical and emotional illness 14 Ask the therapist Our expert offers advice about CBT 15 Better by nature Benefitting from the great outdoors 16 Your reviews 17 Technology time Online tools for your wellbeing 17 Your letters & emails 19 Fundraiser profile & 60 seconds with... Our news 4 Single Step Winter 2016 Going up Almost a billion pounds of investment to enhance mental health services across the country has been announced by the Government. From the funding, nearly £250million will be spent on liaison mental health services in emergency departments. January saw our Friends in Need community grow to more than 23,000 users. Less than a year ago we reported there were around 10,000 users. New research from Oxford University shows people suffering from chronic sleep problems are at double the risk of developing depression. Professor Colin Espie, who co-founded sleep improvement app Sleepio, says such people “have more difficulty recognising and managing emotions”. Rugby league player Ryan Bailey has spoken about his battle with depression that almost ended his sporting career. Thanking charity Sporting Chance for the support they gave him, the Warrington prop said he would never have asked for help because rugby league is a “manly sport”. Four in 10 employees are at risk of depression, a new report by Global Corporate Challenge (GCC) has found. Nearly 15,000 people were surveyed from 34 companies in 67 countries revealing 39 per cent of employees fell into the worse category for psychological wellbeing putting them at risk of depression. ➽ On behalf of everyone at Depression Alliance welcome to the 2016 edition of Single Step. The year is well underway and with it there is much to tell you about. First of all and with sadness we are saying goodbye to our Chief Executive, Emer O’Neill. It will be almost 10 years to the day since Emer walked through the doors of DA – where does the time go? She has, without question, turned DA into a dynamic, modern and welcoming organisation. Her passion and understanding of our goals ensured that DA grew significantly over the years and has taken huge steps forward to achieve our vision. DA services now reach tens of thousands of people across the country – whether it is going along to a local group, building individual networks through Friends in Need, being supported within communities because of the foresight of the NHS and local authorities to make DA services available or using the information online. All this and much more is because of Emer’s leadership and her unique ability to engage people to work with DA. On behalf of us all at DA, a huge thankyou to Emer for everything – her legacy will continue! So how do we continue to build on all that Emer has started? The Trustees have spent much of 2015 asking this question – how can DA reach more and more people? How can we grow quickly, efficiently and with a solid base for the future? The simple answer is that we cannot realise our ambitions alone – we need to work in partnership with organisations and individuals who share our values and vision, like-minded people that will strengthen and transform. So, working with the staff team and volunteers the Trustees are leading a programme to enable us to achieve our goals. 2016 will be an exciting year for DA – we will be looking for new ways of working to build capacity and resources. We want Friends in Need and all our services to be within easy reach. Not a small task and as we set off on this journey we will keep you up to date on developments and achievements. An important aspect of our work is how we communicate with you and our many other supporters. To help us answer this question we need your help. How do you like to hear from DA? What do you want to hear about? How often do you want to hear from us? What format works for you? How easy is it to talk to us and tell us what you need? Email us at reception@ depressionalliance.org Finally on behalf of everyone at DA, enjoy this edition of Single Step and we look forward to hearing from you! ➽ DA Chief Executive bids farewell Going down In brief Rotary funding brings support to Bath Residents in Bath are benefitting from ongoing support services for depression sufferers thanks to the fundraising efforts of the city’s Rotary Club. On our website last year we featured the story of how the Rotary Club of Bath presented Depression Alliance with a cheque for £4,000 to help set up new support networks for those affected by depression. The money was raised by Rotary at its annual golf tournament in September and has enabled Depression Alliance to reach out to more people in need of help. Becky Hughesman, whose job it is to set up peer support groups in Bath, said since starting her post in November she had made links with both health and professional bodies keen to endorse the project. “The feedback was that there are a number of groups in Bath, but nothing specifically for depression,” says Becky. She is advertising Depression Alliance’s new presence in Bath through our Friends in Need (FiN) platform and has so far had an encouraging response. “To date we have five members on FiN, all of whom I have been in direct contact with to encourage their participation and offer support. In addition I designed a poster advertising the groups which resulted in a further five people coming forward.” Becky says the meet ups have been offered weekly since the end of November and include activities ranging from a walk around Victoria Park to meeting at a central café in the city. “It is clear to see that the need for a group exists,” she says. “I’ve already received a lot of positive feedback from the current members.” Peer support Our Side by Side project, which aims to improve mental health through peer support, has already made good progress since its launch in September. DA is now involved in the national evaluation into peer support that is taking place across England. Working alongside Mind and Bipolar UK and funded by the Big Lottery, nine regions have been selected and DA is working in three of them: Northamptonshire, Plymouth and West London. The programme aims to improve the lives of people experiencing mental health problems across England through access to peer support. Side by Side coordinator Louise Jones said: “We have some lovely groups established and we are hoping that, as a result of people coming along and experiencing the benefits of peer support and participating in the evaluation, we will be able to prove that it is a beneficial thing.” Participants are needed for a large study of eye-movement patterns that may help with diagnosis of individuals with common mental illnesses. Anyone interested in taking part in the research being organised by the Clinical Brain Sciences Centre at the University of Edinburgh should contact the Depression Alliance office for more details. Tony Mears certainly took a load off his back after completing a gruelling week-long weight vest challenge to raise more than £230 for Depression Alliance. Tony, who only took off the 30kg vest to wash or sleep, said: “It was super challenging but the reaction and feedback I got from people was far beyond what I was expecting. I’m pleased the money is going to a good cause.” Thank you so much to Rasteen Riyahi-Boni who completed the Leicester Half Marathon in October raising more than £150 for Depression Alliance. Rasteen said: “I got up at 6am every other day to train while working at a camp in America over the summer. I endured some incredibly tiring runs in between my lectures, injured myself, putting me out for a whole season of lacrosse and got bitten by a dog. This is nothing compared to what people with clinical depression fight with every day. I chose DA because mental illness has affected people that are very important to me and I want to make a difference in the lives of the people and their families who suffer the same fate.” Have your say t How does listening to differen llbeing? types of music impact on we t sad or aggressive music A recent study has found tha ious and depressed people. is used as a coping tool by anx g studies and articles claimin The internet is littered with does to our brains, its to explain exactly what music how it helps to release psychological functions and This particular study by a mood-enhancing chemical. t people who listen to sad Danish researchers claims tha iety erience higher levels of anx or aggressive music may exp listen to happier music. or neuroticism than those who wed that certain listening The results of the study sho ects on the brain. styles can have long-term eff be used as a coping tool by Can sad or aggressive music ple? anxious and depressed peo I agree. Every time Ig depressed, et sa music alwa d ys helps me. M usic helps me a lot! Yahwel 6 Single Step Winter 2016 e sion ar s e r p e nd y and d emes a r Anxiet t x e t sic feren the mu s two dif i t i e it just believ k n i h t I I don’t ps. k to hat hel ind bac itself t m e h t cts ings t distra only br s u j s t i and anxiou the now epressive or y md say, an you fro y e h t s ill ts. A pe – I w o c e though m p hat hel d tools t hamme o M . m try the Listen to the music. It helps Someone once asked me to describe happiness, I got into the whole idea of was it about the perfect job, relationship, meal, day or joke. I couldn’t decide because they all made me happy but the actual essence of the pure feeling of happiness that was harder to think or come by. I kept thinking on this for a few days and I realised at one point during the day driving home from work listening to Talking Heads on the radio and singing along that it was music. It had the power to lift me out of any slump even if it was for a five-minute breather before I fell back into the black hole. Nick Hornby wrote in his book 31 Songs that a perfect song should stand alone in its perfection and not evoke any memories of better times or generally not be good for sentimental reasons but simply because it is a good song. I disagree. I firmly believe that music has the power to heal and the power to lift your spirit. Alan d e e f d e e d d o Go upport s d n a s s e of kindn way Small acts g difference to the d a bi e them an t a can make r b e l e c o let’s we feel, s you. say thank Thanks for article on #depressioninworkplace! Excited to talk about this tomorrow @womenoffuture #wof10yrs Jessica Many thanks Yvonne for the information and the opportunity to meet with you today. You have given me the chance to once again get back into life. I had a spring in my step when I left you. So grateful to be involved with Friends in Need – what a wonderful organisation. LS Hi to all of you at the Depression Alliance team. Just to say a big thank you for a super Christmas party at the Piano Bar, Park yed International Hotel. I really enjo had and bers mem r meeting othe nd a lovely evening. I will try to atte to due – r yea this more events nt unforeseen circumstances, I spe in don Lon ide outs a lot of time 2015. Looking forward to seeing tyou all soon. Best wishes for a frui ena Boz 6! 201 y bus ful, happy and When my depressi on gets bad I find it helps to listen to sad music . I can connect wit h it in the moment and, hope fully, sometimes, th ere is a cathartic release of emotion. I tried lis tening to happy and upbe at music, but I foun d it was frustrating that I couldn’t “be happy” an d actually sometimes ended up feeling worse. W he n you suffer severe depr ession, happiness ca n become alien to you. Trying to be and feel som et hing you are not isn’t helpfu l. That’s just my ex pe rience. Cameron It [Royal Albert Hall] was certainl y a most momentous and joyful eve nt and I must deeply thank you personally and your other DA colleagues for organising such a busy event. You and your team worked so competently and delivered an excellent occasion for us to participate in. This I believe is the strength and forte of DA. And this is why I believe that DA is so amazingly successful. With my best wishes to you and the DA team. Dhiraj A huge thank y ou to E everyo mer fro ne at th m e Depre Alliance s s io n team fo r all her dedicat ion and suppor t over th e last 10 year s! Feature Suffering in silence Suicide is the biggest single killer of men aged under 45. Paul Cornish explores why men find it so hard to talk about their depression and get the help they need. hree years ago I was diagnosed with obsessive compulsive disorder. Before that I had no idea why my brain would latch on to disturbing thoughts and ideas and ruminate on them constantly, for days on end. Usually I was able to maintain a veneer of calm and cheerfulness to mask the ugly, repetitive churning going on inside my head. Occasionally however the strain would begin to show. Sometimes I would retreat into a silent depression in order to devote my energy fully to my ruminations. On other occasions I would release my turmoil in the form of tears, hyperventilating, and a lot panicky “confessions” about what an awful T 8 Single Step Winter 2016 person I was, directed at wonderfully patient but confused friends. The reason for these episodes seemed obvious to me. I was just not cut out for the real world. I figured that unlike every other man I had ever met I was weak, childlike, and prone to dramatics, tantrums, and sulking. I had no choice but to “get on with it” alone, like a “real man” should. It turns out I was not quite as alone as I believed. Reluctance A recent poll of 1,500 men by The Huffington Post UK found that 42 per cent of men had suffered from depression and anxiety during their lifetime. When asked if they would open up to anyone about these feelings, almost a quarter (24 per cent) said they wouldn’t. According to the mental health charity Mind only 23 per cent of men would see a GP if they felt low for more than two weeks, compared with 33 per cent of women. I figured that unlike every other man I had ever met I was weak, childlike, and prone to dramatics, tantrums, and sulking. This reluctance to open up about depression and anxiety can have serious consequences for men. According to the Office of National Statistics, suicide was the leading cause of death in England and Wales for men aged between 20 and 34 years of age in 2012, and 76 per cent of suicides in 2012 were men. Male suicide rates The highest suicide rate in 2012 was found in men between 40 and 44 years of age. Mind spokeswoman Beth Murphy has argued that the high suicide rate among men in their 40s is evidence of “scarring” over time by factors such as unemployment and low wages. In 2015 a YouGov Survey of 2,000 men found that more than four in 10 men (42 per cent) say they have had suicidal thoughts, with two fifths (41 per cent) never talking to anyone about their problems. The same poll found that 49 per cent of those who did not seek help “didn’t want people to worry about me”, 32 per cent felt ashamed, 37 per cent did not want to make a fuss and 43 per cent didn’t want to talk about their feelings. Tips for men suffering with depression and anxiety 1 Stay active: The NHS advises that exercise and socialising can improve your mood. Make the effort to keep in touch with friends and family. Take up a sport, join a gym, or ease yourself into exercise by taking a short, 20 minute walk every day. 2 Don’t drink too much alcohol: It could make you feel more depressed and for some people, alcohol can become a problem. 3 Have a routine: Try to get up at your usual time and stick to your routine, for example regular mealtimes, as much as possible. 4 Face your fears: Don’t avoid the things you find difficult. Facing up to them will make them easier to cope with. 5 Know the symptoms: As well as emotional or mental symptoms there are also physical symptoms to depression of which many are unaware. Depression can cause you to have difficulty sleeping, or to have more sleep than usual. You may feel tired, lose your appetite, or eat more than usual. You may have physical aches and pains, and you may find yourself moving more slowly than usual. 6 Talk to someone: If you don’t feel comfortable talking to family and friends there are other ways to reach out for help. Self-stigma Why then, do men find it so difficult to admit to depression and anxiety? Why are men so reluctant to ask for help, to the point where they often consider taking their own life? Many believe the problem to be a fear of being perceived as weak or foolish. Dr John Chisholm, chairman of the Men’s Health Forum (MHF), argues: “Culturally, men are reluctant to admit and talk about personal problems because they see it as embarrassing and a sign of weakness and vulnerability. There’s a reluctance to make a fuss or appear silly, and a feeling that things will get better even if they take no action.” Why are men so reluctant to ask for help, to the point where they often consider taking their own life? Paul Farmer, chief executive of Mind, said: “Sadly, too many men wrongly believe that admitting mental distress makes them weak, and this kind of self-stigma can prevent them from seeking help and ultimately can cost lives.” A further problem, according to Mind and the MHF, is that the symptoms of depression often differ depending on gender. Women often exhibit what are regarded as more “traditional” symptoms, for example sleepless nights, crying, or feeling low. Men on the other hand are more likely to “act out’” by taking drugs, drinking, or being aggressive, which means their problems can be overlooked or misdiagnosed. The issue then seems to be a cultural one. Men are stereotypically viewed as strong and stoic. Men are expected to laugh off or ignore problems, often in the company of other ‘blokes’ down the pub. As journalist Owen Jones put it “stereotypical forms of masculinity – stiff upper lips, laddishness – are killing men.” These arguments certainly match my own experience. I used to joke that I was “far too shallow to feel depressed”. I assumed that I was being a childish “drama queen”, or a “moaner” whenever I would spend all day in bed, or cry and hyperventilate in the toilets at work. I used to look at other men my age seemingly coping and wonder why I was weaker than them. I did not even consider seeking help until these thoughts and feelings had resulted in the end of a long-term relationship and the complete derailing of my career path and life. Even then it was several more years before I felt able to discuss anti-depressant medication and the possibility of OCD with my GP. National awareness Awareness of depression and anxiety among men does seem to be slowly on the rise. Last year, on 19 November, International Men’s Day, the House of Commons debated issues that adversely affect men, such as male suicide, for the first time. Celebrities such as Stephen Fry and politicians such as Labour MP John Woodcock are speaking publicly about their mental health issues. Charities such as Depression Alliance, Mind and CALM continue to campaign to raise awareness of the issue, and offer online information and resources for men affected by depression and anxiety. Real progress will never be made however until there is no longer any shame or stigma in a man asking for help. Journalist Laurie Penny has said: “Asking for help is seen as an affront to masculinity... the rules of masculinity prevent you from asking for help or talking about feelings.” These “rules of masculinity” need to change. Lives are depending on it. Paul Cornish is an illustrator and science communicator from Cardiff. He is currently living in England and can be found online at www.paulgcornish.co.uk Feature Feeling better when we’re together As Friends in Need celebrates its second birthday, Nina Jacobs finds out the secret behind its continuing success. n the two years since it was set up Friends in Need (FiN) has literally helped thousands of isolated and lonely people across the UK – a remarkable achievement that perhaps no one could have predicted given its small beginnings. Seema Inamdar, FiN community manager, describes the online platform’s evolution as “truly staggering” as it marks its birthday celebrations with an impressive 23,000-strong membership. “Launching in November 2013, Friends in Need has gone from a basic and small platform for a few Depression Alliance members to chat to each other to a much more complex organism with thousands of members,” she says. “Friends in Need has taken on a life of its own and the community is thriving and flourishing despite the obstacles that each member faces daily,” she adds. I 10 Single Step Winter 2016 At present there are 920 active groups offering the chance for members to maintain their recovery, meet new people, challenge themselves and share their experiences – either online or face to face. The results were overwhelmingly encouraging as nearly three quarters of respondents said they would recommend FiN to others. Almost half of people who had attended a meet up found it supportive while 43 per cent said they felt less isolated since using FiN. More than 50 per cent said FiN had been beneficial to their health and 26 per cent said they been able to help others through being a member of FiN. Around a third of members (36 per cent) said they used FiN for ‘learning/reading experiences from other people like me’ while 31 per cent became members for support and friendship in the community. Community feedback Scientific evidence base To mark FiN’s second birthday, we carried out our own survey in November of more than 200 members of the FiN community so they could provide us with some feedback. Given what we learnt about the benefits of FiN from our own internal findings it should come as no surprise there is a solid evidence base about the effectiveness of peer support for those suffering from depression. She says users of the platform, which had its official launch at 10 Downing Street, are helping to create new groups on a daily basis which provide a vital lifeline for people to meet up in their local area to share support. Friends in Need has taken on a life of its own and the community is thriving and flourishing. Researchers in Queensland, Australia, writing in the Journal of Affective Disorders, describe how interventions that increase social identification can reduce depression symptoms in community and clinical settings (T. Cruwys et al, 2014). Discussing the use of antidepressant medication for the treatment of depression, they say it can have a compliance rate as low as 45 per cent partly due to common side effects such as drowsiness and weight gain. The majority of patients prefer non-drug treatment but in spite of this therapy is often avoided because it is perceived to be stigmatising. “There is therefore a need for the development of treatment alternatives (particularly in the maintenancephase of treatment) that are costeffective, non-stigmatising, and widely accessible.” Even internet-based support groups, which involved no face-to-face interaction, appear to have potential benefits for patients with depression. They say basic research has shown that social isolation both precipitates and maintains depression. Additionally, the specific trigger for a depressive episode is very often the loss of an important social tie, such as bereavement, divorce or redundancy. “Social isolation can also reduce responsiveness to treatment and is a well-established risk factor for relapse,” they add. Social identification Citing the results of studies which suggest that interventions to facilitate social interaction can effectively alleviate depression, they say “even internet-based support groups, which involved no face-to-face interaction, appear to have potential benefits for patients with depression”. According to a large recent study each social group that a depressed individual joined reduced their risk of relapse four years later by around 24 per cent. “This effect was such that a depressed person who joined no groups was at 41 per cent risk of relapsing four years later, compared to a much lower 15 per cent risk for a person who joined three groups,” they say. The researchers outline the central argument of the current research which is that social activities are effective in reducing depression to the extent that they facilitate social identification, which they argue constitutes the “active ingredient” of groups that gives them the potential to be curative for depression. “The benefits of social identification have previously been demonstrated for a wide-range of health conditions, such as recovering from stroke or trauma. Indeed, studies have found that merely reminding individuals of their group membership serves to increase resilience to stress and tolerance of physical pain.” Effective strategy They conclude that facilitating patients to join social groups that they are likely to value – or to rediscover the value of groups that they are already a part of – is a strategy that is compatible with existing treatment models, particularly interpersonal psychotherapy and behavioural activation strategies in cognitive behavioural therapy. The future If FiN can gain so much ground in terms of membership in just two years, it seems impossible to predict how much more it could grow in the future. Seema says: “We have great plans for Friends in Need but we cannot do this without your support. A big thank you to everyone that has contributed to the site, either through donating, welcoming new members, sharing some advice, a tip on the site or arranging a meet up. “Giving back as well as taking support is what makes Friends in Need a special and unique place for those affected by depression.” From left to right: Chris Thompson, Alison Lawrence, Samantha Cameron, Emer O’Neill, Annali-Joy Thornicroft, Robert Hubbard. What FiN members say Feeling less isolated “This site has been really supportive for me when I was in a really dark place. It’s reassuring to talk to people who understand. So many people don’t understand what depression is like and it’s difficult to get the support you need sometimes. Always talk.” Helping others “Wow, learn something new everyday! I never knew that meditation can help with depression. I will be definitely trying this out. Thanks for the suggestion!” Using FiN for learning/reading experiences From our two-year anniversary survey in reply to: Since using Friends in Need, I feel… “Better informed about anxiety disorders and mental health issues other people have which I don’t have.” “I have spent the last hour or so browsing this site and reading threads, and it has had a calming effect on me, something that I was not expecting.” Support/friendship in the community “Hello everyone. I have been overwhelmed with the amount of support I have received in the last hour after posting the above. I like to say I am feeling much much better as I have found out I am not alone anymore and people do care... I love this group.” Overall benefits to mental health “I must say that finding this site, using it regularly has also played a massive part in how I’ve felt recently. I have never spoken openly about how things are inside for me, by opening up on here and seeking professional help elsewhere, GP, referrals etc. I feel like a massive burden has been lifted.” Feature Keeping a healthy body and soul Mental health problems can often hinder an accurate diagnosis of physical complaints. Bipolar disorder sufferer Joanna Gilkes found out first hand just how hard that can be when she was diagnosed with cancer. have experienced depression since childhood, before I even knew what the term meant. During university, I suffered the bereavement of a close relative and was first prescribed anti-depressants. Luckily, I completed my degree and entered full-time employment after graduation. In hindsight, I should have taken a break after my studies, as just 10 months into my new role, I suffered a major breakdown that necessitated a compulsory hospital admission. I was subsequently diagnosed with bipolar disorder in 2001, at the age of 23. I Recognising different symptoms Of course, anyone who is or has been depressed themselves, or knows someone going through it, will recognise that depression does not have purely mental health symptoms. Depression can and does manifest itself in physical ailments too: weight can be gained, and lost; sleep patterns are affected, and you may find yourself sleeping too much or not being able to sleep much at all. Even your immune system can become weakened, meaning that you may find yourself particularly susceptible to any coughs, colds, or viruses going around. But surely a doctor would be able to differentiate between those physical health symptoms caused by depression and those stemming from something else? Moreover, when presented by such physical symptoms in a person already experiencing depression, surely a doctor would not merely conclude that they were definitely caused by the depression itself, without investigating further? 12 Single Step Winter 2016 A hard lesson to learn Cancer diagnosis Unfortunately, I have recently learnt the hard way that some doctors cannot correctly distinguish between mental and physical ill health. Two years ago, at the age of 35, I found a suspicious lump about the size of a fifty pence piece in my left breast. After a mostly sleepless night, I contacted my GP surgery first thing the next morning and was invited in the same day. Even though the lump had, at this point, visibly changed the outline of my breast, the doctor had trouble finding and feeling it, and I had to guide her examination. When I was finally seen by a breast specialist, I was diagnosed with Grade 3 Invasive Ductal Carcinoma or ‘The Big C’. I had two lumpectomies – operations to remove the lump – but five months after my initial diagnosis, I had to have a mastectomy. I asked my breast consultant whether if the GP I had initially seen hadn’t procrastinated and I had received an earlier referral, would he have been able to remove the cancerous tissue without having to remove my whole breast? He didn’t answer with an outright ‘no’, instead he said “We just don’t know” which could be interpreted as him admitting that there was, at some stage, the possibility of saving my breast. Depression can and does manifest itself in physical ailments too: weight can be gained, and lost; sleep patterns are affected. Before my appointment, I had briefly researched the subject of ‘breast lumps’, so when the doctor wasn’t offering me possible explanations, I asked whether it was a fibroadenoma – or ‘breast mouse?’(a mobile lump that moves position in the breast.) Although the doctor admitted she wasn’t sure about the nature of the lump, she didn’t seek help or a second opinion, and dismissed it as ‘just a cyst’. Current government guidelines state that, if there is any suspicion of cancer, referrals to a specialist must be made within two weeks of the initial appointment. I, however, was turned away a total of three times, over a period of six weeks, before I was eventually referred. Breast cancer and mental health At the time, it did cross my mind that this GP’s inability to correctly diagnose this physical problem of mine was caused by the fact that I also have a mental health diagnosis. But then events overtook me, and I had to put my suspicions about the significance of my bipolar diagnosis to one side in order to concentrate on my recovery. Two years on though, and I decided to research breast cancer and mental health. I discovered a study entitled Breast Cancer Screening In Women With Mental Illness (December 2014, based on research led by the University of Leicester’s Department of Cancer Studies). It queried whether women with a mental health diagnosis were less likely to be screened for breast cancer, than those women who do not experience mental ill health; and whether Tips for managing mental and physical health 1 Find out what works best for you. For me, too much stress and not enough sleep can trigger a relapse. 2 Regular exercise can really help. Alternatively, search charity shops for cheap exercise equipment and DVDs, or check out YouTube for free workout videos. 3 Try to eat healthier, but don’t berate yourself if you fancy a biscuit or two. 4 Take a list of symptoms and someone with you for moral support when you visit your doctor. a mental health diagnosis prejudiced diagnoses of breast cancer, and delayed the offering of a screening mammogram. The study showed there were significantly reduced rates of mammography screening in women with mental illness, depression and severe mental illness such as schizophrenia. I feel vindicated knowing that my suspicions about my existing mental health diagnosis were right: it can affect a doctor’s perception of physical health problems, and have a negative impact on their accurate appraisal and consequent treatment of such problems. I also feel angry – not because I was unfortunate enough to have cancer. After all, breast cancer, like depression, is an ‘equal opportunities’ disease, in that it doesn’t discriminate in terms of age, class, ethnicity, sexual orientation and even gender. No, I feel angry that my cancer wasn’t promptly and properly diagnosed at the earliest opportunity; and I can’t help but wonder if the situation would have turned out to be very different if I didn’t already have, as they say, a history of mental ill health? NICE recommendations The National Institute for Heath and Care Excellence (NICE) understands that caring for both body and mind is of equal importance. It advocates ‘patient-centre care’ – advising that a patient’s needs and preferences should be taken into account when it comes to considering their treatment. NICE also recommends a ‘collaborative care’ approach to health treatment, meaning that all other agencies involved in a patient’s care, work together effectively to deliver a comprehensive service. This service should start with the initial diagnosis, run throughout treatment and be evident in after-treatment support. It is likely that your GP will be your first port of call when physical health problems arise. However I always do a bit of online research beforehand to make sure I’m up to speed. If blood tests or referrals are not offered, I try to pluck up the courage to ask for them. I find it easier to do this by taking someone along with me – so that they can step in and ask if I feel overwhelmed and unable to. Joanna Gilkes is currently based in Hertfordshire, but regularly commutes into London to study again after years of being a carer. She has a keen interest in all things ‘entertainment’ and is also hoping to raise awareness of both mental health and breast cancer by writing about them. Questions ? Ask the therapist Putting your questions to those that know Ree says: “What should I expect when I start CBT? How should I start preparing for the sessions?” Jane Christopher Cognitive Behavioural Therapist “What should I expect when I start CBT? I’ve been referred but it’ll probably be a couple of months before I hear anything. Is there anything I can do to start preparing for it?” Ree, Kent Cognitive Behaviour Therapy (CBT) examines the links between people’s thoughts, feelings and behaviour. This is a really important question and I hope that this response will help in answering it. I will break it down into two parts. What should I expect when I start CBT? Cognitive Behaviour Therapy (CBT) examines the links between people’s thoughts, feelings and behaviour (Westbrook, Kennerley, & Kirk, 2010). It examines how what people think and do can impact on and maintain their feelings. An important part of working with CBT is the collaborative relationship between the therapist and the client. While the therapist is an expert in applying CBT principles, the client is an expert in his or her experiences. TRIGGER THOUGHTS FEELINGS BEHAVIOUR Laying the ground work At the start of working together, you and your therapist will be developing the ground work, an individualised picture (what is known as a “formulation”) that helps with understanding and examines what might be maintaining your difficulties. This helps with making sense of what you might be experiencing and is a central part of guiding treatment. A basic CBT formulation might look like this (see chart left). Managing difficulties CBT aims to help you to become your own therapist and because of this, you will be learning skills in your sessions to help you to break the cycle that you are in. You and your therapist will be like detectives, monitoring your cycle with the aim of helping you to develop alternative ways of managing your difficulties. This will involve practicing what you learn in your sessions in between (homework) which you and your therapist will prepare in advance. This will be reviewed in each session. 14 Single Step Winter 2016 Is there anything I can do to start preparing for it? It sounds like you are keen to prepare for your CBT sessions which is good news. A starting point might be to regularly monitor situations that might be “triggering” off any anxious or depressed thoughts that you may be experiencing. Ask yourself “what is it that triggered this thought or feeling?” This is not always easy but have a go. Pay attention to how your thoughts influence how you feel. Pay attention to what you might be doing to cope and the impact that this has on your mood in the short term and in the long term. Many people find that while their behaviours help in the short term, they are not helpful in the long term. By monitoring your cycle for example in a diary, it will help you and your therapist to develop a picture of what might be happening. Doing this would be a good headstart. It would also be helpful to think about your therapy goals as your therapist will be asking you about this as it will help inform the direction of treatment. Good luck Ree Resources There are lots of basic books and materials available on CBT that can help with getting started. Depending on what you are experiencing, these may be useful guides: Overcoming depression and low mood: A five areas approach by Chris Williams; Overcoming anxiety, stress, and panic: A five areas approach by Chris Williams. These books should be available in most libraries but they are also accessible from Amazon. A useful website that you could visit is from the Centre of Clinical Interventions where you can access reading material and workbooks that may be helpful. See: www.cci.health.wa.gov.au/resources/index.cfm Jane Christopher is a Cognitive Behavioural Therapist based at Croyden IAPT. Wellness Better by nature Getting outdoors and enjoying nature-based activities is an easy and accessible way to improve wellbeing. Naomi Martin Occupational Therapist The use of ecotherapy to improve wellbeing is gaining ground across the UK as evidenced by one Nottingham-based charity which has been successfully offering it to residents experiencing mental health issues. Framework Housing developed its Nature in Mind scheme as a new service from the experience and evidence gathered through four years (2011–2014) of its Gateway to Nature project, which supported people to overcome barriers that had a negative impact on their lives including confidence, social isolation and health problems. Being outdoors has been shown to release more of the ‘good’ hormones and help people to feel less stressed, anxious or angry. The great outdoors Ecotherapy, which is provided to Nature in Mind participants, is a term to describe the use of nature-based activities to improve mental wellbeing. Activities range from gardening, walking, cycling to nature-based arts and crafts, conservation tasks, animal care, bushcraft – basically anything that involves spending time in and interacting with nature. The programme of activities generally takes place in a group setting and can provide a great way of tackling social exclusion and for participants to meet new people. in patients who spent more time outdoors opposed to those who were confined indoors. More recently mental health charity Mind conducted a nationwide study (Ecotherapy: the green agenda for Mental Health, 2007) and found that people who engaged with ‘green exercise’ (physical activity in a natural environment) noted significant improvements in both their mental and physical health. Other studies suggest that simply viewing a pleasant rural landscape can be enough to increase senses of wellbeing (Health effects of viewing landscapes, Velarde et al 2007). mood, as well as benefiting overall physical health. For many people taking part in something that is enjoyable, in a safe and stigma free environment, can be a start to rebuilding lost confidence. For some this can be about confidence in their own abilities to achieve something or develop a new skill. Are you on Friends in Need: why not try setting up your own local ecotherapy meet up? Biophilia There are many different reasons why this sort of activity supports people with mental health problems. The notion of biophilia suggests that we have an innate need to connect with nature as we have evolved to be dependent on it and our health can suffer from the disconnection from nature that modern lifestyles often lead to. Chemically, being outdoors has been shown to release more of the ‘good’ hormones and help people to feel less stressed, anxious or angry. Time spent in a natural environment can aid relaxation and have a restorative effect. Being outside also gives you the opportunity to absorb vitamin D from the sunlight, which has been shown to be effective in reducing low mood. Not ready to join a group? Here’s how you can still enjoy the benefits of ecotherapy • Go for a short walk • Spend some time in the garden • Visit a local park • Watch a nature programme Physical exercise The evidence base The notion of ‘getting outdoors’ as a way of improving overall health is not a new one – physicians during the early part of the last century were documenting the improvements seen Many of the ecotherapy activities involve an element of physical exercise – whether this is a gentle walk around a local park or strenuous digging on an allotment – this will help release endorphins and improve Naomi Martin is an Occupational Therapist who worked in the NHS for six years before moving to Framework in 2015 to work for the Nature in Mind project. Reviews Your reviews Every issue we ask you to tell us what’s on and what’s out there… If you fancy writing a review we’d love to hear from you, so get in touch today! Walking on Sunshine The Danish Girl Rachel Kelly Available on Amazon This book is written by someone who previously suffered with depression and the “steps” she used to help her stay calm and happy. I was unsure about it at first as I didn’t expect someone else’s coping strategies to be of any use to me but I was pleasantly surprised. There were steps on breathing techniques, mindful moments and meditation I found useful as it offered an explanation of how to practice them, also information on useful vitamins to take and then links at the back of the book where you can obtain further information on the topics and also blank pages to make your own notes. My favourite steps were “Habitreleasing” as the thought of changing habits can be quite scary to depression sufferers but a very beneficial thing to do and something I had never thought of before and constructive “Wallowing” where the idea is to indulge your feelings. The steps I found least useful were relating to her hobbies such as “flower power” and “mending” purely because they are not areas that interest me and preferred the more general steps relating to sleep, box sets and overusing mobile phones. There were poems in the book which I didn’t enjoy as it made me feel quite intimidated by the author. While I might not recommend this book to anyone I would definitely recommend some of the steps. Gemma, Birmingham Starring Eddie Redmayne On general release Ah, The Danish Girl – what a delicious film. A small group of four Croydonites treated ourselves to this cinematic experience at the Grants Vue, and were all pleased to have done so. I do the film a grave injustice if I relate to it simply as a retelling of the first known male to female gender reassignment surgery. For one of the film’s many talents is in portraying a truly delightful and poignant story, not of an individual, but of an individual who achieves a deeply rooted wish through persistence and the support of those closest. This is definitely a film worth watching, and discussing, with others – the experience is far greater than the sum of its parts. This is a film with many good attributes: the film quality, photography and scene setting are a visual treat. The acting from the main leads is sublime. The direction successfully takes control of our emotions and imaginations to fully immerse us in a historically transformative experience. The story itself journeys from an enthusiastic young artistic ‘parents to be’ couple, through the coping with a life changing experience, to flourish into the birth of a new individual (and movement). For my money then, there has to be Oscars awaiting for The Danish Girl... prepare to smile with joy and shed a tear while you experience this wonderfully poignant theatrical experience. Sandra, Croydon 16 Single Step Winter 2016 Explaining my Depression to my Mother – a Conversation A poem by Sabina Benaim Available on YouTube I’ve been asked plenty of times to explain how my anxiety feels – I guess you have too. Having watched Sabina perform her poem online, I’m know I’m not alone in feeling that it’s so hard to describe, especially when the person you’re trying to explain it to is someone you love, and possibly someone who can’t understand. And whilst it is hard, Sabina manages to put her feelings into words really effectively. Her description of her depression changing in form, and the fact that she is the host to a party that she doesn’t even want to be at, struck a chord with my own sentiments. Sabina delivers her poem, a dialogue between her and her mother, with such raw emotion that it left me slightly breathless and not a little bit anxious myself. I found it uncomfortable viewing because she displays her feelings with such veracity that I didn’t know what was coming next. Her mother tries to understand, and – presumably with kindness – makes suggestions to try and help her daughter, but in doing so she forces Sabina to realise that her depression is beyond her mother’s comprehension, and possibly also her own. Do our loved ones even want to understand? It seems to me that Sabina’s mum is happier to remain in her ignorance, perhaps because it’s too painful to enter into the world her daughter inhabits. Maybe she’s protecting herself. Nick, Kent Tech talk Technology time Each issue we bring you a selection of online tools, apps and resources to help improve your wellbeing. Nina Jacobs Deputy Editor Memory Star Koko Available for free download from Google Play and the App Store Memory Star is the not-for-sharing app aimed at those suffering from depression and anxiety. When you open the app you are faced with the question, how are you feeling? You then have two options; ‘happy’ or ‘cheer me up’. If you’re feeling happy the app allows you to add a picture and a message that you can then review whenever you need cheering up. These memories create ‘stars’ in a constellation of your personal happiness. I enjoyed this app and would recommend it to anyone with feelings of depression and anxiety; having the visual imagery to look back on reminds us that the skies aren’t always grey. It’s difficult to remember happy memories when you’re feeling down but having a bank of those specific memories at your fingertips makes it simple. Memory Star takes away the anxiety of ‘sharing’ our happy moments for ‘likes’ and holds them for our own personal viewing pleasure. My only suggestion for the Memory Star app is to download it when you’re feeling good about yourself and can immediately add happy moments otherwise there will be no content to cheer you up with. I believe it would also be more beneficial if users were able to upload videos to the app. Seeing yourself and others in these live action memories can help revive those happy feelings. Nevertheless, for anyone looking for a user friendly app that can shine some light on those dark days don’t hesitate to download Memory Star. Madison, London Available for free download from the App Store Anyone who has ever suffered from anxiety or depression will know the feeling of worrying about something that you don’t want to say out loud. ‘What if I say something stupid in the meeting, and everyone laughs at me?’ However irrational a fear may be, we know that keeping our worries to ourselves can give them more power. New tech app Koko aims to change that, in a Facebook style format it asks users, ‘What’s wrong?’ After anonymously posting your worry, other users are encouraged to respond, helping to reassure the person to rationalise the worry that they’re having. Similar to Cognitive Behavioural Therapy (CBT), the app appears to be based on thoughtchallenging, allowing the person to see the objective truth of a situation rather than feeding the anxiety. As someone who has had CBT for depression, I found the app a useful, immediate way of putting thought-challenging into action. Not only does it give you an impartial voice to help alleviate your negative thoughts, but it connects you with other people in a time when you may be feeling very lonely. And the most important bit – it’s all anonymous, so no matter how silly you think your worry may be, you can post it without fear of judgement. Of course like every technology it has its limitations. The potential for trolling on a network which connects vulnerable people means that it needs to be militantly regulated. Despite its effectiveness for every day worries, I think we have to draw the line when posting about serious life problems. Tayana, London Sleepio www.sleepio.com Sleepio is an app that as the name suggests tries to help those who suffer with sleep problems. It is offered as a free trial but there are a range of subscription options for those who wish to continue using it on a regular basis. The app offers help with a number of common sleep problems – struggling to fall asleep, waking up in the night and uneven sleep patterns. After identifying the problem you want to tackle, you run through a series of questions about your habits, daily routine and worries to build up a picture of what issues may be contributing to your sleep problems. The App Professor then uses this information to assess your sleep efficiency and devise an improvement programme. In soft, measured tones, the app talks the user through the reasons for sleep problems occurring and what is going on in the brain. It also tries to explain how we feel when struggling to sleep and suggests techniques to try to control the feelings of anxiety that not being able to sleep can bring. In addition, there are tips on how to establish a good sleep routine and exercises to help the user to overcome their problem and improve sleep efficiency. For someone like me with a mild problem, the app was useful for identifying a few tweaks that I could make to my routine that could help to minimise future bad nights, but I think it would come into its own for someone that is really struggling to sleep well. Des, Surrey Letters Your letters & emails Do you have something to get off your chest? A question or a tip to help other DA members? We love getting your feedback so write or email your thoughts to Depression Alliance. Our letter of the month wins a £15 voucher to spend in Marks & Spencer or Debenhams Letter of the month Good sleep routine I would like to respond to two very interesting articles in the last issue of Single Step (Summer 2015): ‘Being Mindful of Mindfulness’ – like Tanya Simons I find my own moments and methods of mindfulness – bus journeys – especially longer ones, are what I love. No responsibilities, no “catch-up chores”, nothing to sort out, just sitting relaxing, observing, to the point of almost sublime calmness. I can literally feel as if I’m gradually being consumed gently by an inner peace. I also agree 100 per cent that no one should ever be made to feel they should be able to cope without medication. I have tried many different therapies and courses, and each has helped me in its own way at the time but it’s my medication which keeps me well and mentally healthy. Kaitlyn, whose blog was published on the Letters page, touched upon the importance of sleep hygiene. Speaking as someone who for most of my life (even as a child) could not sleep until the dawn chorus lulled me to sleep – I have at last developed my own technique to ease myself to sleep. When I first settle down I lie on my back and then I allow all intrusive thoughts to flit around noisily in my head like a colony of bats. But I observe them, rather than be controlled and disturbed by them. I accept the chaos but have created a distance between myself and it. After a certain time, perhaps 15 to 30mins I feel I am ready to turn away from the chaos, leave it behind and I then turn onto my left side and a new feeling of relaxation wraps around me, which I sink into, my breathing now naturally slower. When I am ready to embrace sleep I then turn over onto my right side, breathing now naturally more deeply and sleep – now my friend embraces me. This technique can be tweaked according to individual needs, ideas, so don’t let the night demons control you, take control and run them out of town. Mary, London 18 Single Step Winter 2016 One of our Friends in Need members has written this poem which we would like to share among readers of Single Step. Today I feel alone, tomorrow I will too ‘No’ it whispers in my head ‘I’m depression, I’m with you’ It says it is my friend, it tells me what to do As I shut the door and curtains and hide myself from view The tears they sting my eyes whilst depression holds me close Whilst in its grip I cry I can’t release its force It’s been with me for years, we’ve been through thick and thin ‘I know you best of all’, as it looks at me and grins Sometimes we lose contact, it’s busy so it seems But not too far down the line, ‘I’m back!’ it yells and screams It follows me around, it hates to see me smile It says it feels left out, I feel guilty for a while It likes to see me sad, it says it understands ‘Come walk with me again’, it cries, ‘I will hold your hand’ At night away from view, when alone and scared It shares with me the razor blade, equipped and well prepared Close by in the background, urging me to harm It compliments with insults, all part of its charm ‘Why are you ungrateful, there is no better friend? I’ve been with you forever, I’ll stay until the end’ Sometimes it really pushes me, encouragement it says ‘Haven’t you had enough yet, I can lead the way Why be here anyway, no one loves or even cares’ It often loses patience, ‘Come on, let’s climb the stairs’ It is my bestest friend I guess, it knows me inside out But for some unknown reason, its intentions I somewhat doubt For I have another friend, I don’t see it much I don’t know its name, I can’t feel its touch It follows me around, it doesn’t say a thing But I often feel its presence from underneath its wing Its voice is faint and distant, is it even there I have to strain to listen, ‘I’m here and I care’ I can’t accept those words, I’m being bossed around Depression isn’t happy, of hope that’s now been found It says I must forget it, it says ‘it isn’t real There is no friendship stronger than ours, I am the real deal I tell you all the truths, I shelter you from lies I guide you through the bad times, be thankful I’m your life’ I sit with it again, once more in its embrace ‘See depression is always here for you’ the smile lines its face My heart feels low and heavy, my tears fall to my frown My eyes all black and weathered, my mind so very down I’m still in search of happiness, that great and golden catch That brilliance of wonder is that my perfect match? I’ll cast my line and hope that one day I will surely find That little fish called happiness who can swim around my mind Until that very day when I escape these tears I’ll never be alone, depression is all I hear Lauren Snaith Fundraiser profile Tony Mears, Leeds Wore a 30kg weighted vest for a week “My partner and I moved to Leeds but we didn’t know anyone and over the months a combination of stress and other factors led my partner to develop anxiety and depression. She eventually sought medical help and it occurred to me that had I known about Depression Alliance sooner she might not have struggled so much. The reason I chose to wear the vest was that my partner described dealing with depression, and sometimes anxiety, as like carrying a weight. It was an extremely difficult concept for me to grasp – and I imagine even harder for those not living with a loved one that suffers with depression. The vest was 30kg – broadly the same as a goat, a seven-year-old child or 30 bags of sugar. I took it off to sleep, and to shower, otherwise I was in it the whole time. Sitting wasn’t a rest as the stress was over the shoulders, walking was like climbing a mountain, and I nearly passed out when I tried to keep up in a boxing session! After the challenge the feedback I got from friends, whom I had no idea were battling depression, was incredible. I like to think people who hadn’t thought about how hard depression can be were provoked to think deeper.” 60 seconds with... Christina Bengston Our Marketing Coordinator for Friends in Need What does a Marketing Coordinator for Friends in Need do? It’s my job to make sure that people know about Friends in Need. I give presentations and information to doctors, therapists, pharmacists and most importantly, members of the public, to let them know the help that is available to them. Why Depression Alliance? Mental health and wellbeing is hugely important to me. I have been affected by anxiety and a sound sensitivity condition known as misophonia for all of my adult life but it wasn’t until my early 30s that a very good friend gave me the courage to ask for the help I needed. What do you enjoy most about your job? Coming up with ideas and planning new ways to market Friends in Need. I also really enjoy getting out and about at events. We have regular information stalls at libraries and other local venues and it feels amazing when you meet someone who tells you that Friends in Need is exactly what they’ve been looking for. What are your wellbeing essentials? I find looking after my body is so important. Getting outside and doing some exercise always makes me feel so much better. I like to go for long runs along the canal. It gives me a chance to clear my head, look around at the wildlife (I’m a big fan of herons) and get those endorphins flowing. What are you most looking forward to at DA in the coming months? I’m most looking forward to reaching out to even more people who might benefit from Friends in Need. There’s still not enough awareness of Depression Alliance among GPs and so that’s one area I want to work on and improve next year. Get your runners on! Help fundraise for Depression Awareness Week 18 April 2016 For more information please email [email protected] or check out our website www.depressionalliance.org/get-involved/