Depression, drought & mental health help. Bush Remedies – You and your mental health.

Here is the last in the Bush Remedies : You and Your Mental Health ABC New England North West Radio series for 2013. This year I have presented six mental health topics in Bush Remedies – all with a focus on rural people and place. This last one for the year features a discussion about drought and depression. I hope there are some useful tips as we approach summer in Australia for my fellow rural people. 

Times are changing again in northern NSW with the shades of brown closing in on us and drought looming….

The health of the land and the climate has a big impact on the mental health of the people who live in rural drought zones. The changes in mental health can be slow and insidious. Mental health doesn’t usually just ‘snap’ or ‘break’ like a football broken leg injury, it happens slowly the same way that wrinkles and grey hair develop…. One day you notice that you have aged… but you don’t notice it every day. It is the accumulations of grey hairs over a long period of time…. And mental illness is a bit like that – especially depression. But in our rural case…. It is the slow shift from green pastures to brown bare ground that is reminiscent of depression. Mood, thoughts and senses all seem to slowly lose their flexibility and capacity for resilience.

It is not surprising that mental health is less robust in times of drought, and its impact is felt widely across the region. Drought is a chronic natural disaster… is slowly builds to a point where the impact is profound, and we know that people are vulnerable to those chronic changes – it is just plain human. Depression is not a weakness of character. Rather there are very clear explanations for why it should develop in the face of major decline of the health of the total environment, of which people are a part.

An interesting research study was done in Western Australia where there are some salinity problems. Salinity creeping to agricultural lands has devastating impacts for people, place and livelihoods, and it is very hard to turn back that clock… if at all. In this case, researchers compared maps of the land and salinity with population data and data about how many people in that region were discharged from hospital after treatment for depression. They found that there were significant increases in people requiring hospital treatment for depression who came from the salinity affected areas compared with the wider population. Drought might have similar impacts… those studies still need to be done, but there are lessons we can learn from the salinity impacts in Western Australia. (Here is the reference if you want to find out more – sorry there will be a pay wall for that one: Speldewinde, P. C., Cook, A., Davies, P., & Weinstein, P. (2009). A relationship between environmnetal degradation and mental health in rural Western Australia. Health & Place, 15, 880-887. )

So, Drought proofing our mental health…what can be done?

We can predict that depression will accompany drought – and will last slightly longer then the drought. Recovery takes time… for the land and for minds and emotions.

We know it is coming, so it makes good sense to make some plans to drought proof and depression proof at the same time. Perhaps we can’t take away all of the pain, but we might be able to minimize it, and reduce the impact by getting in early. Here are some tips:

• Mental health first aid – learn the basics about mental health and what to do if someone you know needs some mental health help in a crisis, and how to get them to expert help if and when it is needed.
• Consider doing a mental health first aid course – either you, or someone in your workplace or community…just the same way people do for physical first aid. Make sure there are enough people around in your rural community who have done mental health first aid so that someone knows how to get expert mental health help if and when it is needed.
• Look for opportunities to find the glass half full – not everything is bad all the time, but when your mood is low, it is harder to see the good, because the bad just seems to close in. Fight for that little glimmer of hope – don’t let go.
• Actively seek at least one thing that is deeply satisfying everyday-it can be something simple and that doesn’t cost money… there will be one thing! If you can’t find one thing every day – that is an urgent sign to see a health professional and get some help with your mental health. Don’t put off that appointment.
• Rural people sometimes equate being healthy with being able to work, so when they feel a bit low they counter that with trying to work harder (because if you can work hard, you prove to yourself that you are well). But it is a trap we rural people set up for ourselves…. If you struggle to be motivated, can’t remember the last time you felt happiness, not sleeping, and grumpy with the people you love the most…. Then working harder won’t fix it – BUT a visit with a mental health clinician might!
• Don’t work too hard. If you have put in a full day, then you have done your best. Be satisfied with your effort, rather than damming that you couldn’t do more. Drought is an endurance race…. The work that goes with it will be like a marathon – but tackle it one leg at a time. Don’t try to race to the finish line without stopping to catch your breath and recharge your emotional batteries. Take a day off – or a half day off if you need to. Look after your mind, so IT can look after you longer!
• Sleep – you need about eight hours a night…. Try and get yourself into a healthy sleeping routine. (See a blog or two ago for more about this!)
• Eat and drink well – that means not too much alcohol (it is a depressant drug itself – so don’t double dip into depression), plenty of water, fresh foods – not too much processed food. And, then eat slowly and mindfully – enjoy every mouthful, give it a moment longer in your mouth to relish flavor and be mentally and nutritionally satisfied.
• Talk… talk to others about how they are travelling… it might be that others are feeling the same way you are, ‘a problem shared is a problem halved….’ Bottling up emotions doesn’t work well – and eventually it explodes (like homemade gingerbeer… messy!).
• If you are not travelling too well – see a mental health worker sooner rather than later… there are no prizes for being stoic. It just doesn’t work!

If you do need some help – this is where to look:

• Local hospital (accident and emergency – if it is urgent), community health service or multipurpose health facility will know how to get you linked up with some help.
• Local GP – again, they will know where to point you in the right direction.
• NSW Health have a 24 hour Mental Health Line 1800001511 (free from landline – charges from a mobile). Call them anytime and speak with a mental health clinician. Calling this number it is the best way to access public free mental health care. You can call for yourself, to get information for a friend, or even ask them to do a welfare check if you are worried about someone else (eg you are worried about whether they might be thinking about suicide).
• There are a range of non government organizations – I have listed a few of them in previous blog posts…. Scroll back through some blogs.
• NSW Department of Primary Industries have The Rural Womens Network  http://www.dpi.nsw.gov.au/rwn/support
• NSW Rural Assistance Authority have some practical supports that are worth checking out – some of which include rural financial counselors. Here are some handy links to them:
  • http://www.raa.nsw.gov.au/home
  • http://www.raa.nsw.gov.au/rfc
  • http://www.raa.nsw.gov.au/__data/assets/pdf_file/0004/352885/RFC-Contact-List-26-September-2013.pdf

We can’t stop the drought – but we can take the steps needed early to make sure that the impact on our mental health is reduced. The more aware rural people are of the early warning signs the earlier mental health help can be started, the better. The sooner help starts the less the impact. If it is left a long time before getting help – the harder it is to shift; and the longer the recovery. Depression proof – get in early!

Some first signs that depression is developing:

• Talking about dying, wanting to die, or musing that it would be better off if you/they were dead
• Changes in eating-  no appetite, or craving for processed and oil saturated foods
• Drinking more alcohol than usual; drinking to get to sleep at night
• Not sleeping restfully throughout the night; finding it hard to get up in the morning.
• Anxious- an little more on edge then usual.
• Finding it hard to concentrate.
• Can’t recall being happy in recent times.
• Low flat mood, without any modulations. Just low all the time, never seem to have moments of joy.
• Unhappy.
• Grumpy with others; angry, a short fuse.

Any, some, or all of these feelings (above) are worth further investigation. Make an appointment to see a health professional to get back on track with your mental health. A health professional will be able to make a plan with you for your recovery; it mightn’t be a big deal, it mightn’t take too much effort (especially if you get in early) and it might just be worth the awkward moments of reaching beyond any stigma or small town talk to get back to emotionally-normal-for-you as soon as you can. That way you will be better positioned to cope and you’ll be more resilience to the blows that accompany riding thorough drought times.