Goals: share tips, traps & tools; introduce the healthcare maze; focus on recovery.
 
Objectives: provide teaching tales, clarify expectations, monitor progress, suggest that depressed people seek second opinions. Patients can read to learn about their illness and the basic steps for diagnosis and treatment. They can ask their health professionals about the practice guidelines of psychiatry, (i.e. which recommend taking histories, testing blood sugar, thyroid, hormones and other biochemicals, diagnosing medical or metabolic conditions, planning safe and effective treatments, monitoring progress, asking about suicidal thoughts).

Note: Several factors can cause or contribute to episodes of depression, anxiety, psychosis or dependence (on meds, alcohol or sugar). Depression, a low-fuel ‘signal’, can occur when the brain runs low on fuel. Anxiety signals danger or something going wrong, even with brain metabolism. When a person feels unwell, it takes effort to cope during episodes, much less identify the root cause(s) of symptoms, assess the competency of their health professionals and negotiate for better care, such as restorative treatments.

Limits: Depression coaching can complement but does not replace medical care. Each person decides when and how to apply ideas, books, tips and tools. The best results come after people accept their diagnosis, consider the range of possible treatments, learn which treatments help, find better quality care, monitor their progress and shift toward recovery.

Some people choose to rely on meds or talk therapy; easy to understand why sick people might prefer not to read about practice guidelines or their diagnoses. Even so, I coach patients to proceed and succeed rather than watch them stay sick, suffer and deteriorate.

As a peer advocate, I do not have all the answers to peoples’ health problems, issues or relationships. I am not a health professional, therapist or support group facilitator. I do not continue if my input interferes with medical advice or therapy sessions. If my information is not useful, I step back. It does not make sense to go over the same topics if people do not listen, do not want to learn or cannot process new information.

As a self-employed accountant-consultant, from October to May, I have to focus on billable work for paying clients. The Spring, tax-time, gets busy.

Who will benefit? With a bit of coaching, many people can learn to help themselves. However, if their treatments are not effective, some people stay sick; others lose hope. Some people, desperate for help, eventually do start to listen and learn. They choose when to search for better quality care, request medical records, ask for second opinions and seek guideline-quality care: histories, diagnostic tests, safe and effective treatments.

Please accept my best wishes for your recovery. One day at a time, you can do it!

Consulting the experts: As each patient searches for help, over the first 6 months (or so), they typically consult a series of health professionals: family physician, psychiatrist, specialists (blood or hormone disorders), naturopath, mental health nurse, addiction counsellor, psychologist or talk therapist. Support group(s) may be enlightening.

Each health professional has practice guidelines, diagnostic methods and treatment recommendations. Eventually most patients find helpful medical advice. Some patients have family members and friends who can offer encouragement and support and watch for signs of a pending crisis.

Recovery and relapse: Even after years of episodes, illness, confusion, fear and frustration, depressed people can recover. There can be set-backs and relapses, and if so, health professionals are trained to monitor, diagnose and treat. I do not need to hear details of confidential information that patients discuss with their doctors, i.e. about their symptoms, diagnoses and treatments. I also do not need to hear about personal matters that patients discuss with their family or friends. A brief overview is sufficient.

      Months 1 to 6: please summarize your progress once a month.

      Months 9 to 24: please E-mail your progress report quarterly.

Quarterly updates can outline your efforts to: (1) understand standard treatments (meds and talk therapy) and review what you learned by (2) reading about diagnosis and treatments, (3) asking for second opinions, (4) getting better quality care and
(5) complementing standard treatments with ‘restorative’ programs.

WRAP self-help: Some people benefit from Wellness Recovery Action Planning (W.R.A.P), a self-help system developed by Mary Ellen Copeland, PhD. As a patient, Mary Ellen researched and wrote books and a web site. She developed facilitator training materials and courses. She teaches patients to identify trigger factors, monitor their progress and, in the event of relapse, take action to restore and maintain their mental health. She explains why wellness recovery action plans and individual toolkits can help patients keep themselves calm during episodes, so they can stabilize and recover. www.copelandcenter.com   (book store, newsletter, WRAP training courses)

Restorative care: The content of a ‘restorative’ program will depend on each patient’s diagnosis, biochemical individuality, circumstances, relationships and other variables. Competent health professionals consistently follow their practice guidelines. They know how to test depressed and anxious patients for medical and metabolic disorders and how to identify other factors which can cause or contribute to episodes. They know when to recommend safe and effective treatments which can complement medications and talk therapy. Their depressed and anxious patients recover and live well.

For instance, some patients may have a thyroid disorder as well as depression. Even a mild thyroid deficiency can cause or contribute to ‘depression’ symptoms. Those patients may benefit by adding thyroid treatments or other supplements such as iodine (a trace mineral which the body uses to make thyroid hormones) or vitamins (co-factors which the body uses for metabolism i.e. enzyme-based reactions). Not every depressed and anxious patient has a thyroid deficiency, but some people may find thyroid testing useful. After testing and diagnosis by a health professional (who knows about disorders of metabolism), those patients may benefit from treatments for hypothyroidism.

Therapy: Rebuilding relationships is part of the recovery process but as a peer advocate, I do not have the education, experience or qualifications of a therapist. I recommend that people discuss relationship issues with their therapists.

Journaling: Some people find it useful to write brief daily entries in a personal journal. The process of writing can help people acknowledge their issues, clarify their thoughts, consider possibilities, express their feelings, identify their patterns and encourage themselves to proceed and succeed. As patients think and write about their situations, they can help themselves to improve their self-analysis and mindfulness skills.

Summary:

As a recovered-patient turned author-consultant-coach, I encourage patients to find the keys to their depression ‘puzzles’, consider adding a restorative program to their other treatments, proceed with their personal recovery work and restore their mental health.

Depression coaching can help depressed and anxious people find quality care so they can solve their depression puzzles, recover and live well.

A brief quarterly progress report would be welcome. Every few months, you may wish to outline, in an e-mail, three ways you are progressing with your personal recovery work.