I recently found an article in our local Sydney Morning Herald that made for some sad reading.

Professor Cummins from Deakin University has been researching the well-being of different societal groups for the last 6 years. The studies measure the degree to which different people are satisfied with their lives.

In the most recent study (October 2007) 3,750 carers were asked questions about health, relationships, safety and community involvement. A carer was defined as someone who looks after a frail, disabled or mentally ill relative.

According to the study carers have the lowest level of well-being of any group in the community. Further, the rate of moderately depressed carers was found to be 56% (general population is 6%), while almost 40% exhibited severe or extremely severe depression. As you can imagine the typical carer suffers a high level of dissatisfaction with life. And this is even in the presence of mitigating factors like a high income or being in a relationship.

This is tragic stuff. It really highlights to me the importance of looking after yourself as a carer. Have boundaries, have breaks without feeling guilty, maintain some part of your life that is separate from the person you’re caring for, build a support network (formal or informal), or join a support network, and find somewhere to fit in a bit of fun.

As a carer you need to stop yourself falling in a heap. You need to be resilient to mental illness, and you are far more effective in giving care to another if you remain healthy yourself.

This is the 5th and last post in a series by Anna on “Being a Carer”. Earlier posts are The Depression Dialog , Know the Enemy , Trigger Unhappy and Keeping Your Mind Together.

I’ve written a lot about being a carer in my last 4 posts, but in this one I’d like to share with you the book that really saved my own sanity. It is “Loving Someone with Bipolar Disorder” by Julie A. Fast and John D. Preston.

In the first few months after James’ diagnosis I read a lot of material to educate myself. The problem was that most of it was factual information on depression and bipolar, but it didn’t tell me how to manage practical things like James’ irritability. The info simply described the symptom without ideas for its management.

From pages 1 to 2: “This book can provide you with the tools you need to be a resource and support for your partner instead of a crisis manager and constant caretaker.” This is exactly what I needed!

The book was written specifically for carers. Julie Fast has bipolar disorder, as does her partner of 10 years, and the result is a book with real insight.

At its heart is the idea of creating a holistic treatment plan.

The first aim is to develop a symptom list that you can use to identify when your partner’s behavior starts to change. Once that has been worked out the second aim is to create a “what works list” to treat those symptoms before they progress to a full blown episode. The third step is to work out what triggers the symptoms in the first place. These are often outside events, situations or behaviors that once modified or eliminated really make your partner far more stable. Once you understand the triggers well, then the goal is to stop the mood swing from starting in the first place. If it does start then the “what works list” comes into play.

Of course this strategy requires recording your partner’s behavior over time e.g. by keeping a journal.

The rest of the book focuses on the needs of the carer. (Obviously your partner achieving greater stability is already a significant help).

The chapter on “Your Emotional Response” starts you on the road of looking after your own needs. It discusses issues like anger, grief, guilt and feeling trapped. For me, it was almost a springboard for seeing a counselor.

The chapters on work, money and sex cover practical issues that cause distress. They were all helpful chapters, but for me the chapter “The Hard Truths” had more impact. This chapter really lays it on the line and forces you to face the reality of your relationship. Are you prepared to stay with your partner if things don’t change? Tough reading.

My favorite chapter is “The Bipolar Conversation”, which teaches you how to avoid pointless fights when you partner is baiting you. The book ends with “Laughter and Joy”, an inspiration to leading a normal life again. From this I learned to structure in happy times in our lives.

A brilliant book. It may be about bipolar, but the application is much wider and relevant to all mood disorders. It would greatly help any carer living with a depressed partner.

Here is the link to the book on Amazon (not an affiliate link).

Today is Blog Action Day, with almost 15,000 bloggers committed to writing about the same topic - the environment. For my contribution I’ve collected some articles that discuss different links between the environment and mental health. These articles are a timely reminder to me that every aspect of my environment impacts my state of mind - with powerful implications. I hope you also find some helpful food for thought.

A Little Therapy from Nature
“It’s not just about creating an aesthetically beautiful, productive, harmonic space…we all must face ourselves in this environment and that is definitely therapeutic. My dream is not only for a sustainable planet -  it’s for a happy population.”

How Gardening Could Cure Depression
“Getting dirty might help lift our spirits, according to a new study which reveals that common soil bacteria could act like antidepressant drugs.”

Green Peace of Mind
“The outdoors as a cure has been overlooked…because “psychologists, like everyone else, have been stuck in their offices.”

What on Earth is Ecotherapy?
(Previous Post)
“Mind sees ecotherapy as an important part of the future for mental health. It’s a credible, clinically-valid treatment option and needs to be prescribed by GPs, especially when for many people access to treatments other than antidepressants is extremely limited.”

Creating Healthy Communities, Healthy Homes, Healthy People
“Mounting evidence suggests physical and mental health problems relate to the built environment, including human-modified places such as homes, schools, workplaces, parks, industrial areas, farms, roads and highways…the sparse research on sustainable communities suggests that diligent planning is needed to create an environment that is conducive to the mental and physical well-being of humans as well as the natural environment.”

The Healing Qualities of Nature
“Nature can become a place of refuge for difficult times. When life stresses start closing in, one can escape to the wilderness physically or mentally. Being in nature helps to clear one’s head of life’s demands and disruptive thoughts. This clarity of thought may lead to finding answers to life’s questions and discovering insights to life problems.”

I recently came across a personality survey hiding in the backwoods of the Black Dog Institute website.

It seems intuitive that personality plays a part in whether a person develops depression. There is a huge gap between someone who is optimistic and active in making their situation better, and another who feels helpless and passive about their circumstances.

It follows that analysis of your personality may give you a better understanding of the causes of your depression, to the extent that it is caused by personality factors. And understanding these causes will help you to more effectively treat your illness.

The Black Dog survey examines 8 personality categories relevant to depression - anxious worrying, irritability, social avoidance, personal reserve, self-criticism, perfectionism, interpersonal sensitivity and self-focus.

My score on irritability was high, which I expected. Thankfully there were no other areas of concern, but admittedly when I took the survey I had been stable for a while. As a check I asked Anna to repeat the survey based on how she sees me. The scores were very close, which gives me comfort. It seems that I view myself in a similar way to others, which surprises me.

The survey would suit anyone willing to look in the mirror and make changes for the better. It was designed as a depression tool, but I think anyone could make good use of it.

For more background information about the survey download the news release or go directly to the start page.