A global perspective on A global perspective on depressiondepression

Ragnar Asker, Jennifer Bezaire, Rebecca Bond, Ragnar Asker, Jennifer Bezaire, Rebecca Bond,

Kelly LangfordKelly Langford

The World Health Organization (WHO) The World Health Organization (WHO) defines depression as “a common mental defines depression as “a common mental disorder that presents with depressed mood, disorder that presents with depressed mood, loss of interest or pleasure, feelings of guilt or loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low low self-worth, disturbed sleep or appetite, low energy, and poor concentration” (WHO, energy, and poor concentration” (WHO, 2006). 2006).

What is Depression?What is Depression?

Now, depression is the 6th largest burden of Now, depression is the 6th largest burden of disease across the globe, for all ages and sexes. disease across the globe, for all ages and sexes.

By 2020…???By 2020…???

Have A Guess…Have A Guess…

OUR FOCUS:OUR FOCUS:

DEVELOPEDDEVELOPED

Australia, Sweden Australia, Sweden

& Canada& Canada

v.s.v.s.

DEVELOPINGDEVELOPING

India & UgandaIndia & Uganda

Global Mental Health ResourcesGlobal Mental Health Resources

Community care in mental health (MH), By Country, Total, 2005Source: Mental Health Atlas 2005

Psychiatric nurses / 100,000 (MH), By Country, Total, 2005Source: Mental Health Atlas 2005

COMMON THERAPIESCOMMON THERAPIES

In Australia, Sweden and Canada:In Australia, Sweden and Canada:

Anti-depressant medications Anti-depressant medications

Psychotherapy,Psychotherapy,

Cognitive behavioural therapy, Cognitive behavioural therapy,

Interpersonal therapy, Interpersonal therapy, andand

Family therapy Family therapy

Population of Population of 1,103,371,0001,103,371,000 In 2001, for every 100,000 In 2001, for every 100,000

people in India there were;people in India there were; 0.4 psychiatrists, 0.4 psychiatrists, 0.04 psychiatric nurses, 0.04 psychiatric nurses, 0.02 psychologists, and 0.02 psychologists, and 2.5 psychiatric beds 2.5 psychiatric beds

INDIAINDIA

UGANDAUGANDA

Population of 24,700,000 Population of 24,700,000 For every For every 100,000 persons 100,000 persons

there are said to be;there are said to be; 0.05 psychiatrists (12 0.05 psychiatrists (12

psychiatrists in total), psychiatrists in total), andand 346 traditional healers346 traditional healers

In Uganda & India:In Uganda & India:

Traditional Healing is the most common Traditional Healing is the most common treatment modality:treatment modality: Lack of access to western psychological treatmentLack of access to western psychological treatment Belief systemsBelief systems

Causes of depressionCauses of depression Methods of TreatmentMethods of Treatment StigmaStigma

Economic reasonsEconomic reasons

What you didn’t know about What you didn’t know about Depression …Depression …

CausesCauses Mobile Phones & SMS?Mobile Phones & SMS? Consumerism?Consumerism?

Success rates for medication are not what they seemSuccess rates for medication are not what they seem Standard ’talk’ therapies have a high relapse rate.Standard ’talk’ therapies have a high relapse rate. CausesCauses

Childhood TraumaChildhood Trauma Dysfunctional RelationshipsDysfunctional Relationships Severe stressSevere stress

What’s the Alternative?What’s the Alternative?

Animal therapyAnimal therapy

VNS TherapyVNS Therapy

Nutritional TherapiesNutritional Therapies

Self Help?Self Help? Self Asessment OnlineSelf Asessment Online

http://www.mayoclinic.com/health/depression/MH00103_Dhttp://www.mayoclinic.com/health/depression/MH00103_D Mood Gym Mood Gym http://moodgym.anu.edu.au/http://moodgym.anu.edu.au/

EVIDENCE-BASE OF ALTERNATIVE TREATMENTS FOR EVIDENCE-BASE OF ALTERNATIVE TREATMENTS FOR

DEPRESSION in AustraliaDEPRESSION in Australia GOOD EVIDENCEGOOD EVIDENCE St John’s Wort (herb)St John’s Wort (herb) Physical exercisePhysical exercise Self-help books involving CognitiveSelf-help books involving Cognitive Behaviour TherapyBehaviour Therapy Light therapy (for winter or seasonalLight therapy (for winter or seasonal depression)depression)

SOME EVIDENCESOME EVIDENCE AcupunctureAcupuncture Light therapy (for non-seasonalLight therapy (for non-seasonal depression)depression) Massage therapyMassage therapy Negative air ionisation (for winterNegative air ionisation (for winter depression)depression) Relaxation therapyRelaxation therapy S-AdenosylmethionineS-Adenosylmethionine FolateFolate Yoga breathing exercisesYoga breathing exercises

POOR EVIDENCEPOOR EVIDENCE GinsengGinseng Lemon balmLemon balm PainkillersPainkillers VervainVervain Colour therapyColour therapy PrayerPrayer ChocolateChocolate

What’s the Answer?What’s the Answer?

Attitudes and BeliefsAttitudes and Beliefs Open-minded treatmentOpen-minded treatment Collaborative approach globallyCollaborative approach globally

Utopia or DystopiaUtopia or Dystopia

Is the choice betweenIs the choice between

homo roboticushomo roboticus vs.vs. homo holisticushomo holisticus ??????

?????