Microsoft word - an fcn response to depression.doc

An FCN’s Response to Depression
1:5 Australians will suffer depression in their lifetime. More than 10 million prescriptions for antidepressants were written in Australia in 2003. As the incidence of depression in our society continues to rise the World Health Organisation has predicted that by 2020 depression will be the highest cause of debilitating illness in the western world, second only to heart disease. Depression is a mood disorder that results in ongoing feelings of sadness and hopelessness, that can affect a person’s ability to reach their full potential and at times even everyday life functioning is affected. If left unchecked it may become seriously debilitating and even life-threatening if suicidal ideation develops. The US Food and Drug Administration have put warning labels on antidepressant drugs (AD) saying they may cause suicidal ideation in children and adolescents. Australia is unlikely to follow suit. This is because ‘none of the SSRI’s (Serotonin Reuptake Inhibitors) and indeed no antidepressant is currently approved in Australia for the treatment of MDD (Major Depressive Disorder) in children and adolescents. Two of the SSRI’s, ‘Fluvoxamine’ and ‘Sertraline’ are approved in Australia for children and adolescents with obsessive compulsive disorder. The media recently highlighted the number of Australian children who are on antidepressants which raised questions from the public regarding the overall safety of antidepressants at any age level. This topic is worth considering because depression is an illness that FCN frequently encounter in their practice and one which clients often ask about. Concern is expressed as to the safety and the effectiveness of mood-altering chemicals. People want to know how the illness can be diagnosed and what treatment is available. Depression is a multi-faceted condition and it can be considered from many angles. Depression is recognised by the medical profession as an illness that is caused primarily by depletion in certain brain chemicals. As such it can be remedied by the use of anti-depressant medication to correct this imbalance. Patients may be hospitalised and benefit from in-patient therapy services. In severe cases, Elector Convulsive Therapy may be used to manage the depression. There is definitely a degree of effectiveness with medical treatments, but there are also additional options that clients may want to know about. The FCN is able to look at the condition holistically and address the ‘whole person needs’. Social circumstances, negative experiences, possible abuse, relationships with other people, work and financial pressures, physical health and what is most often overlooked, the spiritual dimension, which all impact on depression. Dr. Gregory L. Jantz, PhD is the author of a new book called ‘Moving beyond depression – A whole person approach to healing’. Published by Shaw Books: Colorado, 2003. The author recognises all dimensions of the individual’s life and offers positive and realistic suggestions to move forward. He expertly recognises the components of a depressive illness and gently challenges the reader to begin to address the areas of emotional wellness, environmental balance, relational healing, physical health and spiritual renewal. The book concludes with a 12 week program that covers these areas. Another book that can be highly recommended is ‘New light on depression: Help, hope and answers for the depressed and those who love them’ by Biebel D.B. and Koenig H.G., Zondervan: Grand Rapids, Michigan, 2004. The authors of this book sees depression as a whole person disorder and offer a comprehensive look at current treatment modalities and offering insights into how they can be utilised to obtain maximum benefit. It is sensitively and wisely written and again recognises the complexities of this illness. There are many helpful websites on the topic of depression on the internet. It is important to recognise that some are sponsored by pharmaceutical companies and as such will have a distinct bias toward medical treatment. Another useful website with practical guidelines can be found at You
can click on learning path email guide to subscribe to a free coach by email to lead you through the
learning path over 18 days. They provide regular email contact to enable you to gain effective
strategies to overcome depression.
Susannah Warner RN, RMHN,
FCN - Connections Church of Christ, Croydon Vic. (2005)

Other useful resources for the person with depression and her/his carer/s

Psychologist Todd Zemek, (2004) has written a book ‘Shopping for a shrink’ Wakefield Press (8362
8800) which discusses practical advice, step by step suggestions, and answers to popular questions
on depression and seeking the right help. He suggests we check for changes in sleep pattern, lack of
appetite, weight loss, lack of energy, loss of interest in exercise and activity, trouble concentrating,
mood changes, change in libido, change in general outlook and appearance as possible signs of
The website ‘Beyond Blue’ has fact sheets you can print off and use with clients. I have used ‘Stress and anxiety reduction strategies’ and ‘Sleep-wake cycle
management’ for client handouts. They have an excellent ‘Physical activity management plan’ that
FCNs can use to encourage a person who has lost interest in activity to recommence exercise to
alter their body chemistry naturally. When you combine this with counselling, prayer, supportive
encouragement, compassionate care, and appropriate medication most people can work themselves
out of clinical depression.
An excellent booklet is available called ‘Growing up with young people’ and it covers adolescent
mental health issues for families. I recommend a you keep a few copies on hand for your practice to
give out as needed. Http://
Antonia van Loon RN PhD
FCN Blackwood Hills Baptist Church South Australia

Self-management of Depression Using Alternative Treatments
It is true that many people with depression try to self-manage their condition. This is to be applauded
if the management strategies they use are helpful. Sadly alcohol, drugs, smoking are common
strategies that are seldom helpful in the longer term. The ‘Beyond Blue’
website has compiled an “evidence-based” list of alternative treatments for depression and anxiety,
based on scientific research.
The ones they consider to have ‘good evidence’ base for treating depression include: physical
exercise, light therapy (for ‘winter blues’) and St John’s Wort (note you should not take this if you are
on anti hypertension medication) self-help cognitive behavioural therapy books. Those with ‘some
evidence’ include: acupuncture, light therapy, massage therapy, relaxation therapy, Folate
supplements, Yoga breathing exercises. There is ‘poor evidence’ for ginseng, colour therapy, lemon
balm, vervain, pain killers, chocolate and prayer. One must wonder about the latter inclusion
because there are many testimonials to the power of prayer that may not fit the rigours of “evidence-
based research”.

The ones they consider to have ‘good evidence’ base for treating anxiety include: exercise, Kava,
relaxation therapy, bibliotherapy. There is ‘some evidence’ for acupuncture, music, autogenic training
(self relaxation), meditation, Inositol, dance/movement therapy, avoiding alcohol. There is ‘poor
evidence’ for Bach flower remedies, Berocca, ginger, Gotu Kola, herbal remedies, homeopathy,
lemongrass, liquorice, magnesium, passionflower, St John’s Wort, Valerian, Vitamin C,
Aromatherapy, Hydrotherapy, massage/touch therapy, humour, yoga, caffeine reduction, nicotine
avoidance, and PRAYER.
I know that I am frequently asked about these therapies and their effect/side effects, and safety from
clients. This website has link to the Medical Journal of Australia articles that may provide you with
more information.

FCN Blackwood Hills Baptist Church South Australia


Microsoft word - capitulo3.doc

G U I A L A B O R A L Y F I S C A L 2 0 1 2 : T R A B A J A R C O M O I N G E N I E R O 2. ASPECTOS BÁSICOS DE LAS FORMAS JURÍDICAS MÁS RELEVANTES QUE LA EMPRESA PUEDE ADOPTAR. TRÁMITES DE CONSTITUCIÓN 2.1. LA COMUNIDAD DE BIENES Y LA SOCIEDAD CIVIL 2.1.a. Comunidad de bienes La normativa que la regula es el Código Civil. Concepto Existe una comunidad de bienes cuando la

Efca forum 2005

Efficiency, effectiveness and integrity questions relating to Service Contracts Procurement for EC External Actions Stanhope Hotel, Rue du Commerce 9, 1000 Brussels Opening remarks Panos Panagopoulos, EFCA President Koos Richelle, EuropeAid Director General Session 1 – Service procurement for EC external actions: policy and implementation Agneta Lindqvist, Euro

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