1. Working with People with Depression and Anxiety

2. Overview What is depression?What is depression? What is anxiety?What is anxiety? Depression / Anxiety and FrailtyDepression / Anxiety and Frailty Helping people using the ‘Recovery Approach’Helping people using the ‘Recovery Approach’

3. Depression What are the signs that someone is depressed?What are the signs that someone is depressed? Spend five minutes talking to the people next to you about what you may notice if a service user you are working with is suffering from depressionSpend five minutes talking to the people next to you about what you may notice if a service user you are working with is suffering from depression

4. Symptoms of Depression It is important to remember that depression can have lots of physical signsIt is important to remember that depression can have lots of physical signs Negative thoughts are often about: -Negative thoughts are often about: - - yourself (eg ‘worthless’) - the world around you (eg ‘unfair’) - the future (eg ‘future is hopeless’) Depression may be mild, moderate or severe and different treatments are available depending on the severity and cause of the depressionDepression may be mild, moderate or severe and different treatments are available depending on the severity and cause of the depression

5. Anxiety What are the signs that someone is suffering from anxiety?What are the signs that someone is suffering from anxiety? Spend five minutes talking to the people next to you about what you may notice if a service user you are working with is suffering from anxietySpend five minutes talking to the people next to you about what you may notice if a service user you are working with is suffering from anxiety

6. Understanding Anxiety Anxiety includes physical and emotional symptomsAnxiety includes physical and emotional symptoms The physical sensations are caused by the body’s fight or flight response to fearThe physical sensations are caused by the body’s fight or flight response to fear A panic attack is when anxiety rapidly builds and the physical sensations are very powerfulA panic attack is when anxiety rapidly builds and the physical sensations are very powerful Avoiding the things that make us anxious increases our anxiety…Avoiding the things that make us anxious increases our anxiety…

7. Depression, Anxiety and Frailty It is common for people to suffer from depression and anxiety at the same timeIt is common for people to suffer from depression and anxiety at the same time It is sometimes difficult to know whether anxiety has led into depression or vice versaIt is sometimes difficult to know whether anxiety has led into depression or vice versa People become depressed and anxious when they are stressedPeople become depressed and anxious when they are stressed

8. Frailty service users are more likely to be suffering from depression and anxiety than other people in the community, because of stresses associated with physical health problems and later life (eg loss of spouse):Frailty service users are more likely to be suffering from depression and anxiety than other people in the community, because of stresses associated with physical health problems and later life (eg loss of spouse): –1 in 4 older people have symptoms of depression that require treatment – Depression is over 7 times more common in people with two or more chronic physical conditions

9. Depression and anxiety may have a big affect on how service users manage and cope. For example:Depression and anxiety may have a big affect on how service users manage and cope. For example: –Feeling confident about managing independently when you have been in hospital –Anxiety can make the symptoms of COPD much worse –Engaging with rehab programs can be affected by motivation problems caused by depression or worries

10. How can you help? If you think that a service user or carer may be depressed or anxious, inform the care co- ordinatorIf you think that a service user or carer may be depressed or anxious, inform the care co- ordinator There will be a mental health worker in every CRT to offer adviceThere will be a mental health worker in every CRT to offer advice Being supportive and encouraging can be very helpful to people with mild depression and anxiety problemsBeing supportive and encouraging can be very helpful to people with mild depression and anxiety problems Listen to how the person is feeling – being able to talk about our problems often helps us allListen to how the person is feeling – being able to talk about our problems often helps us all

11. Relaxation is a very useful way to help people who are anxious (see handout)Relaxation is a very useful way to help people who are anxious (see handout) Having more positive thoughts can help people to worry less, feel more confident and less down (see handout)Having more positive thoughts can help people to worry less, feel more confident and less down (see handout) Supporting people to make the most of their lives is often the best way to help – we call this the ‘Recovery Approach’….Supporting people to make the most of their lives is often the best way to help – we call this the ‘Recovery Approach’…. ( Break)