We all have mental health and there is no health without mental health. As part of Mental Health Awareness Week 2017, I have presented a series of articles covering a variety of mental health subjects to increase our knowledge.  These have so far covered:

  1. What is Mental Health?”
  2. The Impact of Mental Ill-Health
  3. When is a mental health problem a problem
  4. Balancing the Risks around Mental Ill Health
  5. Stress
  6. Anxiety

The final article in the series, this one, looks at depression.  We may all have a down day, but what is depression and how do I gauge that this is a down day (or few days) and that is depression? Do remember the third article in the series about “When is a problem a problem? (Answer: When it’s a problem).

Thoughts and reading around depression have led me to a formula:

S + A + T = D

In this formula, S is stress, A = anxiety, T = time and D = depression. If we live with stress we can develop anxiety and over a period of time, these can turn into depression. As a rule of thumb, depression is identified when we have suffered the symptoms for at least two weeks. The symptoms to look for include:

  • Persistent sadness
  • Numbness, a lack of feeling
  • Mood swings, anger to complacency
  • Feelings of hopelessness and helplessness
  • Affects ability to study, concentrate and enjoy relationships/ socializing
  • Global thinking, for example, everything is always against me or I am always wrong
  • Anxiety and guilt
  • Loss of libido
  • Self-criticism, pessimism
  • Unexplained aches and pains
  • Fatigue and sleep issues (insomnia, poor quality of sleep or sleeping too much)
  • Appetite issues (either undereating or overeating)

Depression affects up to 10% of people in England in their lifetime. It can re-occur, if you have been depressed once you can go back there (but as you are more aware of it should be able to get help sooner). Depression can co-occur with other health and mental health issues. As an example, it is probably not a surprise to realize that someone diagnosed with a long-term chronic medical condition (let’s say fibromyalgia or chronic fatigue syndrome or cystic fibrosis) may also become depressed. Or a person diagnosed with generalized anxiety disorder may go on to develop depression also.

Depression in the Workplace

 Depression in the workplace may be challenging to recognize but the cost to the individual, the company, and the economy is significant. 1 in 6 employees may have enough symptoms to be diagnosed with a mental health condition at any one time. Stress, anxiety, and depression are the most commonly recognized mental health issues at work. The HR specialists tell me that a middle manager being signed off due to a mental health issue may cost the company in excess of £30 000.

Depression in the workplace may present as a combination of all or some of the following:

  • Decreased productivity
  • Morale problems
  • Lack of co-operation
  • Safety problems (risk-taking behavior including driving at speed and not using PPE)
  • Timekeeping issues
  • Absenteeism – call in sick when not
  • Presenteeism – going to work when ill, or being there but not actually doing work
  • Frequent complaints of being tired all the time
  • Alcohol and/or other drug use

It goes without being said, but I’ll say it anyway, that if the symptoms described affect you perhaps it is time to write them down and go for a chat with your GP.

Balancing the Risks around Mental Ill Health

Balancing the Risks around Mental Ill Health

We all have mental health and there is no health without mental health. As part of Mental Health Awareness Week 2017, I am presenting a series of articles covering a variety of issues on mental health subjects to increase our knowledge. The first article answered the question “What is Mental Health?” The second explored “The Impact of Mental Ill-Health” and the third posed the question of when is a mental health problem a problem. Before we look at some of the individual mental illnesses let’s try and get a balancing perspective. Are there risk factors that presuppose mental ill health?  Can it affect anyone?

There are a variety of risk factors around mental health and if we have enough of them, if their impact on us is more than we can cope with and if they affect several areas of our life we may be set up for mental illness at some point.

We all have several areas in our life. For example, I have my work area, my social area, and my family. You may have other areas that are important to you and could include looking after elderly family members, or if you are in a formal learning environment there is the area of your education, or you may be a volunteer at a charity that is important to you or the organizer of a local sports event. These are all important parts of our life and overlap in a give and take as we place more or less emphasis on them at different times. Sometimes the overlap between the areas may be slight, at other times it may be significant.

Let’s now consider what may be risk factors for mental ill health.

* Nature – We cannot choose our genetics and on occasion, our genes give us a nod in a particular direction. There is no particular one gene for any one mental illness. The genetics of mental disorders is complex involving many genes and these can be directly affected by our environment.

* Nurture – or the environment we live in and how we were raised, what’s around us; our non-genetic factors are also important to the occurrence of mental illness. Timing has to be included in the mix as a certain mix of nature and nurture may result in mental illness in one person but not another.

* Gender – not being sexist, but I think we can accept that women may present more often with mixed anxiety and depression and men, on the other hand, may present with more alcohol and drug dependence. These are generalizations and not cast iron specifics.   

* Temperament – our nature, disposition, character or personality.

* Childhood experiences – what we learn as children from life events and how they are handled/treated/supported may determine how we respond to events in later life.

* Socio-economic factors – according to the Oxford Dictionary this relates to or is concerned with the interaction of social (our society and its organization) and economic factors (sources of finance, disposable income, type, quality and quantity of goods purchased, housing, etc).

* Being a long-term carer – it should come as no surprise that being a long-term carer for a chronically ill or disabled parent or child can be a factor in our own mental health.

* Some medications – the side effects of some medications may include, for example, depression or paranoia.

* Some medical conditions – having one mental illness can presuppose another; having a long-term medical condition may presuppose a mental illness. For example, someone affected by OCD (obsessive-compulsive disorder) may also be diagnosed with depression or someone confined to a wheelchair may be affected by anxiety.

* Trauma – a deeply distressing or disturbing experience, particularly as a child, may lead to mental illness in later life, particularly if inadequately treated or supported originally.

* Adverse life events including: separation, divorce, bereavement, moving house, changing job, childbirth, accident, or witnessing a traumatic event, etc.


Now a person may have good coping mechanisms in all areas of their life but if overwhelmed by a number of (risk) factors become unable to cope and develop mental illness. Similarly, a person may not have very good coping mechanisms and anyone risk factor could be too much for them. This explains why the comments sometimes used “Pull yourself together” or “Snap out of it” have no meaning and do not help. The overwhelmed person is just that, overwhelmed, not coping and quite unable to pull themselves together nor snap out of it. Similarly, a person coping well may develop bad coping mechanisms due to the stress in their life, become increasing unable to cope and become ill. Another person may cope remarkably well with a strong risk factor at home as long as work is going well. But should things at work take a downturn they cease coping altogether.


The rest of this series we will be looking at various mental health illnesses and what symptoms to look for. The first will be stress.