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Stress, Anxiety and Depression. Presentation for Youthnet, Cottage Boardroom, Nov 16, 2005. Michael Cheng, Psychiatrist http://www.drcheng.ca. This presentation is protected under a Creative Commons Deed ( http://creativecommons.org/licenses/by-nc-sa/2.0/

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stress anxiety and depression

Stress, Anxiety and Depression

Presentation for Youthnet, Cottage Boardroom, Nov 16, 2005

Michael Cheng, Psychiatrist

http://www.drcheng.ca

slide2
This presentation is protected under a Creative Commons Deed (http://creativecommons.org/licenses/by-nc-sa/2.0/
  • You are free to copy, distribute, display and perform this work, as long as this work is not used for commercial purposes
goals
Goals
  • An overview about stress, anxiety and depression in youth
  • What is it
  • What causes it
  • What can you do about it
  • Where to get help (in Ottawa)
top questions from youthnet facilitators
Top Questions from Youthnet Facilitators
  • What is the meaning of life?
  • What is bipolar?
  • Common causes of teenage depression?
  • What to do when having an anxiety attack?
  • Where to refer someone with mood/anxiety problems (in Ottawa)?
everyone needs a healthy body mind spirit
Everyone needs a healthy body, mind, spirit

Body

  • Body (Physical, Biological Self)
  • Mind (Psychological, Emotional Self)
  • Spirit (Spiritual Self)

Note: Overlap, e.g. psychological interventions can cause biological changes, and vice versa

Mind

Spirit

the triple a
The Triple A

Agency / Autonomy / Achievement

Activity (as opposed to

passivity)

Affiliation (Relationships)

the triple c
The Triple C

Control

“Chipper” (or being active)

Connections with Others

three p s
Three P’s

Power

Proactive

People

slide11

Point A

Point B

(Goals)

slide12

Obstacles such as stress (at home, school, work), depression, anxiety

Point A

Point B

(Goals)

typical stresses in our modern society
Typical stresses in our modern society
  • Body
    • Medical / physical illness
    • Lack of sunlight / Drug Use
  • Mind / Social
    • School / Work
    • Classmates / co-workers
    • Family
    • Friends
    • Boyfriends/girlfriends
  • Spirit
life is a balance between coping and stress
Life is a balance between coping and stress

Demands /

Expectations /

Stresses

Coping Ability

problems if demands expectations or stresses outweigh coping
Problems if demands, expectations or stresses outweigh coping

Coping Ability

Demands /

Expectations /

Stresses

there are two solutions to restore the balance
There are two solutions to restore the balance...

 Coping Ability

Demands /

Expectations /

Stresses

stress can lead to
Stress can lead to:
  • Physical problems
  • Emotional or mood problems such as
    • Depression
    • Anxiety
    • Eating Disorders
    • OCD
    • Any problems with mood/coping...
mood disorders what is it
Mood Disorders: What is It?
  • Everyone gets sad from time to time
  • Just enough sadness is good because it alerts people to do something to change their situation
  • Mood disorders are when people’s moods are so extreme that it gets in the way of life
  • It is not normal, and is not something that someone can easily ‘snap out of’
mood disorders to diagnosis or not to diagnosis
Mood Disorders: To Diagnosis or Not to Diagnosis?
  • Classified according to the DSM-IV
  • For formal DSM-IV criteria for disorders, visit www.mentalhealth.com
  • Although imperfect, the DSM-IV nonetheless reflects an improvement from the past, when there was no common language in talking about what was, or was not a mental condition
  • Each version of the DSM gives us a greater understanding of mental conditions
mood disorders to diagnosis or not to diagnosis1
Mood Disorders: To Diagnosis or Not to Diagnosis?
  • Pros
    • Gives us a common language
    • Allows people to learn and get support about their condition or problems
  • Cons
    • Being ‘labelled’ may carry a stigma (perhaps stigma is the true problem?)
    • The fact that people may misuse a diagnosis to avoid responsibility for a problem
    • Being put into a box
my personal bias
My personal bias...
  • Appropriate use of a ‘diagnosis’ in the right situation can be helpful
example of how to use a diagnosis
Example of How To Use a Diagnosis
  • “You’ve told me that before having these problems with your mood, you were always a happy, high achieving, outgoing person.”
  • “You’ve mentioned having problems with your mood, sleep, appetite, concentration and energy, and that you’ve been feeling hopeless.”
  • It sounds like you may have a medical condition called depression. The good news is that this condition is very treatable and we can help you feel better again.”
example of how to use a diagnosis cont d
Example of How To Use a Diagnosis (Cont’d)
  • “You are not responsible for causing this condition.”
  • “However, it is mainly up to you to get better.”
  • “But the good news is that you are not alone – we will support you in overcoming the depression.”
mood disorders types
Mood Disorders: Types
  • Major Depression (aka Clinical Depression, Major Depressive Episode)
  • Dysthymic Disorder (aka low grade depression)
  • Adjustment Disorder (mood problems following a stress, but not severe enough to be major depression
  • Bipolar Disorder
major depression
Major Depression
  • Problems with mood (sad, angry, irritable), PLUS
  • Physical problems with
    • Sleep, Energy, Appetite, Concentration
  • May also have problems with
    • Thoughts
      • Low self-esteem
      • Hopelessness / Suicidal thoughts
    • Behaviors
      • Social withdrawal, loss of function
dysthymic disorder
Dysthymic Disorder
  • Problems with mood (sad, angry, irritable), PLUS
  • Some physical problems
  • Some problems with
    • Thoughts
    • Behaviors
  • BUT is not as severe as Major Depression
adjustment disorder
Adjustment Disorder
  • Problems with mood (which are not severe enough to meet for depression or dysthymic disorder) following a stress
  • Does not involve significant changes
bipolar disorder
Bipolar Disorder
  • A condition with severe highs and lows where one’s moods are like a roller coaster, to the point it causes problems
  • During highs
    • Mood high or irritable, excessive energy, less need for sleep, excess talking, excess activities
  • During lows
    • No energy, depressed mood, more need to sleep, i.e. essentially like being depressed
anxiety disorders
Anxiety Disorders
  • Everybody has worries and gets anxious from time to time
  • Just enough anxiety is helpful because it keeps us cautious and safe
  • Anxiety Disorders are when one has so many worries that they get in the way of life
types of anxiety disorders or conditions
Types of Anxiety Disorders (or Conditions)
  • Generalized Anxiety Disorder
    • Constant worries with physical symptoms that cause problems
  • Panic Disorder
    • Out of the blue feelings of panic that cause problems
  • Obsessive Compulsive Disorder
    • Repetitive thoughts or behaviors that cause problems
  • Social Anxiety Disorder
    • Extreme shyness that causes problems
a general approach to helping others
A General Approach to Helping Others
  • Figure out the person’s goals
    • “What would you like to get from coming here to see me/us?”
  • Figure out what to do to get to that goal
    • “What do you think we need to do to get to your goal?”
a general approach to helping others1
A General Approach to Helping Others
  • Figure out what stress is causing (or contributing to) the anxiety or depression
    • Usual stresses include
      • School
      • Family
      • Friends
  • Problem-solve and find ways to deal with that stress
approach to conflicts
Approach to Conflicts
  • Conflict is when two parties want or expect different things
  • Solution
    • Figure out what each party wants or expects from the other
    • Ensure it is reasonable
    • For things that each party wants in common, great!
    • For things that each party disagrees on, negotiate and compromise
everyone needs a healthy body mind spirit1
Everyone needs a healthy body, mind, spirit

Body

  • Body (Physical, Biological Self)
  • Mind (Psychological, Emotional Self)
  • Spirit (Spiritual Self)

Note: Overlap, e.g. psychological interventions can cause biological changes, and vice versa

Mind

Spirit

slide38
Body
  • Ensure healthy amounts of
    • Sleep
    • Diet/nutrition
    • Exercise
      • Individual exercise
      • Group / social exercise
      • Yoga / Martial Arts
    • Sunlight (in the case of winter depression)
slide39
Body
  • Medications may be a helpful ‘body’ or physical intervention in certain circumstances
  • For anxiety and depression, in general
    • Non-medication strategies are tried first
    • Medications are used if non-medication strategies are unsuccessful
slide40
Body
  • Common types of ‘self-medication’
    • Sweets, carbohydrates, chocolates
      • May possibly be a way of getting serotonin
    • Exercise
      • May be a way of getting adrenaline / dopamine
    • Caffeine
      • May be a way of getting adrenaline / dopamine
    • Street drugs
slide41
Mind
  • Ensure good coping strategies and ways to deal with stress
    • School / work
    • Family
    • Friends and
    • Boyfriends/girlfriends
slide42
Mind
  • Psychotherapy such as cognitive behavior therapy
    • Anxiety or depression is caused by cognitive distortions
    • Fixing cognitive distortions will overcome the anxiety or depression
spirit
Spirit
  • Figure out what gives meaning to the person’s life
  • Ensure those things are in the person’s life
types of help for anxiety and depression
Types of Help for Anxiety and Depression
  • Speaking with friends
  • Speaking with family
  • Speaking with religious supports (e.g. chaplain, priest, rabbi, iman, etc.)
types of professional help for anxiety and depression
Types of Professional Help for Anxiety and Depression
  • School personnel (teachers, guidance counselors, vice-principal, social workers, coach, etc.)
  • Medical Doctors (family physicians, pediatricians, psychiatrist)
  • Psychologists
  • Counselors
  • Social Workers