BLACK DOG INSTITUTE

Black Dog Institute

Kerrie Eyers Consultant

BLACK DOG INSTITUTE

Ageing Gracefully

Maintaining health and wellbeing

as we grow older

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MOODS AND FEELINGS

• Renew your brain

• Recognise depression

• Helping someone who might be depressed

• Strategies for maintaining a positive outlook

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BLACK DOG INSTITUTE

RENEW YOUR BRAIN

Tools that help our brain to renew

• meditation

• relaxation

• yoga

• mindfulness

Tracking our emotions…. aim to lower

• blood pressure

• stress reactions

• anxiety

RECOGNISE DEPRESSION

When is depression an illness (‘clinical’ depression)?

– a severe ‘down’ / (or may feel emotionally frozen)

– present for 2 weeks or more without a break

– preventing normal functioning.

Symptoms; the person may feel…

– pessimistic

– worthless and guilty

– hopeless and helpless

– irritable, thin-skinned, touchy

– withdrawn, giving up on friends, activities and interests.

Depression can be more difficult to recognise in older people (65+)

Symptoms can be similar to the problems of ageing.

Seek assessment from a professional accustomed to older people.

Symptoms in older people can include unexplained physical aches and pains,

memory loss, anxiety and various behavioural changes.

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HELPING SOMEONE WHO MIGHT BE DEPRESSED

First, do they really need professional help?

Get some advice for yourself initially – maybe from your GP

How do you bring up the subject with your relative/ friend?

When might be a good time to talk?

What might you say to them?

Good communication needs….

What will professional assessment achieve?

Why not just ‘wait it out’?

If the need for assessment is accepted, what then?

If the person appears suicidal, seek help from a mental health professional

or ring Lifeline on 13 11 14.

Don't try to rescue the person or take over responsibility: guide them to

professional help.

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STRATEGIES FOR MAINTAINING A POSITIVE OUTLOOK

Research indicates the value of cultivating the following habits:

o Practice optimism.

o Avoid chewing over 'wrongs’.

o Beware comparing yourself to others.

o Studies indicate that we should be grateful.

o If you can, make a community commitment.

o Live in the here and now.

o Adopt big changes little by little.

o We can increase our resilience.

o Contentment is associated with gratitude, forgiveness, compassion, generosity of spirit

and considering others.

o Keep your side of the fence clean.

[Adapted from Sophie Scott’s book, Road Testing Happiness.]

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HOW AND WHERE TO FIND SUPPORT

• Where to go / who to ask for help

• What to expect from a mental health consultation

• Types of treatment and support

o Physical

o Psychological

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WHERE TO GO / WHO TO ASK FOR HELP

Untreated depression or anxiety may last for months or become worse.

Seek help early, so you can recover sooner.

A mental health problem is not your fault BUT it is your responsibility.

Start by talking to a/your General Practitioner (GP)

o Different types of depression or anxiety respond to different kinds of treatments. You

need a thorough check from a health professional to assess what’s happening.

The GP can then give you a referral to a psychiatrist or a psychologist if needed.

o A GP can prepare a mental health treatment plan with you and discuss whether you

might be able to get a Medicare rebate for psychology treatments.

Some GPs have a strong interest and extra training in mental health issues.

To find one, try calling some general practices near you.

Beyond Blue lists health practitioners with an interest in treating depression, bipolar

disorder and anxiety states. See:

https://www.beyondblue.org.au/get-support/find-a-professional

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WHAT TO EXPECT FROM A MENTAL HEALTH CONSULTATION

Black Dog Institute (www.blackdoginstitute.org.au) has online fact sheets about all

aspects of mood and anxiety disorders, including types of treatment and support.

Take a trusted relative or friend to your appointment if it helps you.

When you consult a mental health professional, you should expect confidentiality,

empathy, understanding and enough time to express your thoughts and feelings.

He or she might ask about:

the features of your disorder and how much it is affecting your life;

the risk of any self-harm or harm to others;

any previous episodes; any triggers for your current symptoms;

any family history of mental health problems;

Information about your family and friendship supports;

your childhood experiences, and your parents;

your drug and alcohol history;

any medical problems and allergies, any medications you are taking;

your satisfaction with work, or retirement;

your views about your illness, and any treatment preferences.

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WHAT TO EXPECT FROM A MENTAL HEALTH CONSULTATION

After the assessment you should have an idea about your likely diagnosis, the

possible triggers for your current symptoms, a strategy for managing the

disorder, and a schedule for further treatment and support.

IF more than one professional is involved, check who is in charge of managing

your treatment.

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TYPES OF TREATMENT AND SUPPORT 1 We are all individuals with different contributing factors, and we each respond differently to

treatment so usually a combination of treatments is most effective.

Types of treatments for anxiety / depression / bipolar disorder

• Psychological

• Physical

• Self-help and alternative therapies

1. Psychological treatments include

cognitive behaviour therapy (CBT)

e-mental health programs (online therapies)

interpersonal psychotherapy (IPT)

mindfulness-based cognitive therapy

positive psychology

psychotherapies

counselling

narrative therapy

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TYPES OF TREATMENT AND SUPPORT 2

2. Physical treatments

The type/combinations of medications is specific and depends on your symptoms.

For anxiety disorders

• Benzodiazepines (addictive!)

• Beta blockers

• Antidepressants relevant to anxiety

For depressive disorders

• Antidepressants

• Mood stabilisers

• Tranquillisers

Other treatments for depression include

• repetitive transcranial magnetic stimulation (rTMS)

• electroconvulsive therapy (ECT) (for severe depression)

For bipolar disorders

• mood stabilisers (such as lithium)

• antidepressants (the type suited to bipolar disorder)

• Antipsychotics (for severe mania or bipolar depression)

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ATTUNING TO GROWING OLDER

• What helps us find meaning as we age?

• The benefits of joining in

• Attune: listen to feedback from our body, surroundings,

others

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WHAT HELPS US FIND MEANING AS WE AGE?

Interviews identify two main themes: being decent and being of use.

Make adjustments to enable you to play to your strengths.

Being decent

This is linked with achievements. Being a good....

—worker, provider, good husband or wife, mother/ son/ friend.

Associated values included...

being independent, working hard, helping others, making a contribution,

not complaining and not being a burden.

Being of use

Loss of function and independence poses a threat to the pride of making a contribution

and helping others.

Some people are more inventive about finding ways to be of use.

There is also pride to be derived from remembering, recording and talking about our life

and our achievements.

Having someone to listen who values these stories is affirming.

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THE BENEFITS OF JOINING IN

Being connected with others helps the immune system to work better, lowers

stress hormone levels, makes you more alert and has psychological benefits

• Collect friends – and connections with relatives, neighbors and children

• Avoid – people who bring you down

• Seek access – to services and supports

• Get a companion animal – a pet gives a sense of purpose; a dog gives you exercise!

• Participate – in organised social activities: reduce isolation and get a sense of

proportion

• Volunteer – this can give you purpose and structure

• Link in – via technology: do a local course on email, Skype, phone apps...

• Structure your time – make each day a bit unique

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THE BENEFITS OF JOINING IN

Being connected with others helps the immune system to work better, lowers stress

hormone levels, makes you more alert and has psychological benefits

• The tele – select your favourite TV programs, don't watch endlessly

• The radio – pick your favourites (warning: talk-back radio can depress/anger you)

• The library – borrow an audio book; give your eyes a rest and your ears some work

• Get outside – get out of the house first thing, go for a walk, take your tea into the back

yard, plant something, or attract some birds with seed if you've got a bit of space

• Other occupations – a camera, a tape recorder, a CD player, a video player open new

worlds

• Hobbies – subscribe to a magazine that covers an area that interests you

• Family – cook meals for your family or spend time with a grandchild on a regular basis

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ATTUNING: LISTENING TO FEEDBACK FROM OUR

BODIES, SURROUNDINGS AND OTHERS

“I now see in myself the signs of age that I used to observe in my parents”

We're more long-winded

Our reaction time is slower

We're not as 'up' with the latest technologies

Our balance is not as steady: it can be improved

Some of our get up and go /has got up and left: don’t overextend yourself

There's more 'brain fog' (need 5 people to dig up the name of the film/actor!)

The medications we take have some side-effects (on driving capacity too)

Don't overdo the New Year's resolutions; makes both injury and failing to follow through

more likely

For the travelers: Try not to travel beyond your capacity: mitigate risks – take

appropriate meds with you, cut down on luggage, ensure it's maneuverable, take the

best transport you can afford, check local risks and scams ahead of time, spend the

extra money to make up any shortfalls

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BLACK DOG INSTITUTE