in the New York Times

The advertising industry’s “Council for Research Excellence” commissioned a report into media usage, which found that the average American watches 61 minutes of advertising and promotions a day. A senior researcher at Turner Broadcasting says that the data is “actually quite comforting” for the TV industry.

The New York Times reports it with a straight bat, which is a pity. Next time they might point to the effects of so much screen time.

Click to read more of the New York Times article.

I spent 16 hours in a row to get an animated graphic to work properly on a website. That’s very sad. I’m a perfectionist, and on that occasion I was out of control.

Perfectionism is tricky. A little bit can make you strive hard; too much and you’re susceptible to stress, anxiety and even depression. Where is the line between the two?

Here is a comparison from the University of Texas Counseling and Mental Health Center.

A perfectionist:
- sets standards beyond reach and reason
- is never satisfied by less than perfection
- becomes dysfunctionally depressed when experiences failure
- is preoccupied with fear of failure and disapproval
- sees mistakes as evidence of unworthiness
- becomes overly defensive when criticized

A healthy striver:
- sets high standards, just beyond reach
- enjoys the process as well as the outcome
- bounces back from failure and disappointment quickly and with energy
- keeps normal anxiety and fear of failure and disapproval within normal bounds
- sees mistakes as opportunities for growth and learning
- reacts positively to helpful criticism.

Perfectionism is destructive and people seek and receive treatment for it. CBT is the norm. To me the hardest thing is seeing when aiming high is getting out of hand and becoming destructive.

Writing this post is a good case in point. I should have a stopwatch on.

There are questionnaires at the BBC and Discovery Health that can give you an indication of where you lie on the scale. If you do just one then I think the shorter Discovery Health is better.

If you want to rationalize then the place to start is your goals and values. What is really important to you? How are you going to spend your allotted time on earth?

In my view “simplifying” is synonomous with “removing clutter”, and there are 3 kinds that I take to.

1. Physical clutter

When I buy something it owns me, not the other way around. My time, energy and effort goes into looking after it. What can I throw out instead? If this is you, then ask yourself what something will do for you every time you’re about to buy. Will it add to your life somehow? Or will it quickly become obsolete and a burden?

2. Lifestyle clutter

Are you committed to so many activities that you rush from one to the next, often running late and feeling stressed? Do you work back each night, bearing more and more of the workload? Do you find it hard to say no to new committments? Busyness is the new disease of the western world, but we, especially we, need to wake up and smell the roses. The stress of a rushed life is much harder for us mentally ill people to bear. We need to straighten our priorities, learn to say no, set reasonable schedules and not feel guilty about it.

Over the last few years I’ve learned the beauty and power of the word “No”. It’s OK to say no, and I’ve found that it actually garners respect. Everyone has to set boundaries on their life, but boundaries are only respected if you hold firmly to them. We need to focus on the most important things in our lives, like key relationships or spiritual growth.

3. Mental Clutter

I often have lots of things buzzing around in my head, but nothing gets my full attention, and nothing gets finished. (No doubt my love of strong, locally grown coffee is partly to blame.) When I start to feel overwhelmed I ask my wife to help me gain perspective. We work out the things that I actually need to do, not just things I’ve compulsively collected in a real or imagined to-do list over the previous fortnight. Some of the things are so menial, but they get put on a list and find a corner of my cluttered mind in a weak or manic moment. All of these have to go, so I can feel in control again. This has a wider application, as many depressed people have the same feeling of loss of control. I know that my very worst depressive episodes have been accompanied by this. Putting my mind into some kind of order, or decluttering, is a great help.

More reading:
http://zenhabits.net/2007/08/peaceful-simplicity
http://zenhabits.net/2007/09/simple-living-simplified
http://www.slowdownnow.org/

The Bureau of Labor Statistics recently published the Time Use Survey for the U.S. in 2006. The chart for leisure time on an average day, for ages 15 and over, appears above.

The most striking thing about the chart is its neat division down the center. Just over half of all leisure time is spent consuming TV. TV makes up more than all of the other leisure activities combined. If you add in use of the computer for leisure, then total “screen” time is getting close to 60% of the pie.

I posted recently about the rubbish being shown on TV. It is full of stress and negative energy. Good news and happy endings just don’t sell. TV is especially unhelpful for us people with mood disorders.

My wife Anna told me tonight that the type of TV program that I watch has a big impact on my mood. A movie that is very violent, dark or disturbing can trigger or worsen a depressive episode. Even the nightly news can trigger symptoms like anger and irritability. At the same time relaxing in front of a comedy or light, airy movie can be helpful. It took Anna about 5 years to figure this out. Longer for me.

In your life, how much time do you spend on the right hand side of the pie? How much can you move across to the left, and what other categories of leisure can you add in that will benefit your health?

On a slight tangent, I’m interested to hear how other parents manage leisure time for their kids.

I’m not saying that I’ve sorted it all out, but for the moment I like the rules in place for our 3 kids (ages 4, 7 and 9). Firstly we don’t distinguish between TV, DVDs, Nintendo, etc. We let them have 45 minutes of “screen time” on Wednesdays, Thursdays and Fridays, and 1 hour 20 minutes on Saturdays and Sundays. Mondays and Tuesdays are “screen free days”. The exceptions are schoolwork and “typing tutor” (which is gathering dust).

Looking at the above chart I can see that we are strict parents, but it’s fair to say that the kids have a good balance of leisure activities. Much better than I do! And of course, if I’m alone at home with the kids and I’m ill, the screen rules disappear.

One of her important points is that it takes an awful lot of work to get better and then stay well. I agree wholeheartedly. It seems that those who actively participate in their treatments have the most success in returning to and maintaining good health. They are active in learning about the illness, in locating resources, in finding the right treatments, and they are determined to pull things around. It doesn’t help to be passive about depression.

Therese’s experience of nearly giving up on traditional medicine rings true. For the first few years of being treated my family doctor experimented with various drugs with little success. I was fortunate to find a great psychiatrist on my first attempt, but it involved a good dose of my own research. When my doctor suggested a psychiatrist I declined and asked him to refer me to the one I had chosen. I know that most people don’t have the time or inclination to do this, but it was important for me as the point in which I became active in my treatment. I had been labeled “treatment resistant” for too long.

I would point out that when medicines are used it is not just about finding the right drug or mix of drugs, but also making the right diagnosis in the first place. This sounds very basic but misdiagnoses are very common. It is awful being treated for the wrong mood disorder.

Therese has developed her system very purposefully. Remaining healthy requires a plan; much more than passive acceptance. I definitely suggest you try her 12 steps, with some shaping to suit.

The type and amount of care that you can give will depend on your relationship with the person, but here are some ideas.

1. Understand the illness.

Learn all that you can about depression. The better you grasp the illness, the more effective you will be in giving your care and understanding. It will help you to understand why the person behaves the way they do, and better equip you to respond appropriately.

2. Seek Appropriate Treatment

This is such a far-reaching, wide-ranging topic that I would be foolish to give advice. Suffice to say that it will be helpful for you to explore the treatment options available in your area and suggest to the person that they need professional help. It might be helpful for them if you go along to the first or subsequent appointments.

If he or she won’t admit their illness then explain why you are concerned and perhaps provide them with some helpful written information to chew over.

3. Provide Emotional Support

Your partner or friend needs patience, care and understanding. They have a real illness, and just like someone with cancer they can’t just “snap out of it”. If they could, they would. Saying things that show ignorance about the illness is counterproductive and will reinforce their negative thinking.

The best way to communicate is to empathize, listen more than talk, and ask questions like “How can I support you?” or “How can I help?”

4. Keep the Illness Separate

The illness and the person suffering the illness are not the same thing, so keep them separate. When they express pessimism, anger, frustration, or sadness, it is the illness talking not the person. If you separate the two you will find it easier to cope emotionally. It will help you to be a more effective caregiver.

5. Listen Non-Judgmentally

Don’t try to talk a depressed person out of their feelings, no matter how irrational they sound. This is likely to compound the problem. It is better to remain neutral and say something like “You are obviously really suffering with this. What can I do to help you feel better?” Keep your suggestions, solutions and advice for another time.

6. Make a Plan

Help the person to make a plan for coping with depression. Identify things that trigger or worsen the depression and things that make it better. Think through and list the ideas formally on paper. Help them to put this plan into action. Some positive, helpful things to include are getting to bed early, having adequate sleep, exercising regularly, drinking plenty of water and eating healthy foods.

7. Look after yourself

As a caregiver you are likely to be under stress. You need to care for yourself by taking time out and recharging your batteries. Find other friends or relatives who you can talk to and rely on at a pinch. Sometimes you will need a sounding-board to keep things in perspective. Make sure you continue to live your own life as well, and spend time doing things you enjoy.

There are services that provide education and support for caregivers. Through information sessions and support groups, you can talk to people who are in a similar position.

8. Organize their medicines

If your partner or friend is taking medicine for depression then it is crucial for them to follow their prescription. Too many people go on and off their anti-depressants depending on how they feel. This all but eliminates their effectiveness.

I take medicine at night without any problems, but if it wasn’t for my wife handing the pills to me I would never take them in the mornings. She also fills my scripts and tells me when to go to the doctor for more. It’s not laziness; it’s just the nature of depression. More than once I have spent hours in bed staring at my pills, but not had the mental energy to actually take them. If your partner or friend is not complying with their prescription, try to find out how you can help.

9. Support network.

Introduce the idea of joining a support network for depression. This will give them an outlet for discussing their problems and receiving input, and help them to discover that there are other (normal) people experiencing similar problems. There are depression support groups everywhere. Make sure that you find one that is positive and focused on recovery. Inward looking, pessimistic groups can be unhelpful.

10. Get out and About

One of the most therapeutic things that a depressed person can do is step out the front door. Natural light is very beneficial, especially early in the day. Exercise also has proven benefits. Something as simple as taking a walk or gardening should lift the person’s mood. Anything low-key that involves going out can also help; seeing a movie, meeting friends, or going out to eat, just to name a few ideas.

11. Help with daily tasks

When your body is heavy and your mind is dark, there is nothing harder than the burdens of everyday life. Something that seems minor to you may be an insurmountable task to your friend or partner. Ease their burden by helping with the daily load – running errands, doing the shopping, cooking, taking the kids out for a couple of hours. You may be surprised to find that helping with a very simple chore could relieve them of a lot of stress.

12. Spend normal time together

Just spending time with the person lets them know that you care and want to understand their problems. Enjoy the reasons for being their companion in the first place. It’s important that they live as normal a life as possible. Help them to do this by carrying on your relationship with them in a normal fashion. Don’t let everything get dark and serious. Find some positive things and try to enjoy them together.

The points above are very general by necessity. I realize that they don’t fit all circumstances, but I hope that you find at least a few helpful ideas.

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Are you looking for ways to help someone with depression?

Our electronic mood charts are very effective in helping people work out the triggers of their depression, the early warning signs of new episodes, and the most effective strategies, specific to them, that they can adopt to stay well.

In a nutshell, they give people the tools to be proactive with their mental health.

Please take a look at our mood chart apps, and consider purchasing a license for the person you care for.

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“HR Executives Rank Mental Illness #1 for Effect on Indirect Costs”
Innerworkings: A Look at Mental Health in Today’s Workplace Survey, May 2007

A 2006 study published in the American Journal of Psychiatry found that an employee with depression averaged 27.2 lost workdays per annum from absence or poor functioning on the job, and an employee with bipolar disorder averaged 65.5 days.

It is clear that mental illness has a huge impact on employers. It costs them billions of dollars each year from decreased productivity and lost work days.

In the “Innerworkings” survey nearly two-thirds of the Human Resources respondents estimated that at any given time, 3% or less of their employees suffer from a mental illness, and one-quarter said less than 1%.”

From the American Journal of Psychiatry study the number is actually closer to 8.2%. The Innerworkings respondents are well off the mark.

What effect does this have? Clearly CEOs and Human Resources Managers need to focus more of their attention on this immense need. It is in everyone’s best interests.

If you need to convince an employer about the problem then a good way to do it is to point to the bottom line. A tool reserved just for this purpose is the Productivity Impact Model developed by the HSM Group.

The purpose of the model, or calculator, is to give a realistic picture of how depression impacts on a company’s profitability. It takes just a few steps to calculate the amount of time and money lost, and the great thing is that the assumptions underlying the model are based on prior research studies. It’s not wild, ballpark guessing.

How does it work?

Using a company’s size, industry, location, and age / gender breakdown, it estimates the number of people in the company with depression. Then by taking a range of values for workdays missed, total wages and benefits, and additional medical costs, it provides output for days lost across the company over a year, total “replacement” costs to cater for those lost days, and total extra direct medical costs.

The output is persuasive, and it would surely get the ball rolling if placed in the right hands.

Why have I posted this list? Not to glorify depression and other mood disorders.

I’m a fan of a few of these stars, but not all. However I salute them as people who have a public profile, which is the worst thing that can happen to anyone, while also coping with such a dreadful illness. I’m thankful that I can cope with my illness in anonymity.

On Saturday 31 March more than 2 million Sydney businesses and residents enjoyed Earth Hour, by turning off all of their lights and appliances between 7.30 p.m. and 8.30 p.m. Earth Hour signaled the start of a campaign that aims to reduce Sydney’s greenhouse gas emissions by 5% in 2007.

We enjoyed a great family time that night, and we all went to bed early (and happily).

Have you ever wondered how important light is to your state of mind?

Our brains respond to light and dark by ramping up or ramping down the activities of our vital bodily systems. Our bodies are designed to work in cycles of 24 hours, in tune with our natural world. If we don’t have our internal cycles matching our external ones, then psychologically and physiologically we are worse off. It is especially difficult to find a balance for people working shifts, airline staff and others with variable or unusual work hours.

Insufficient exposure to sunlight is a big contributor to the type of depression known as Seasonal Affective Disorder. SAD normally occurs in autumn and winter, with the shorter daylight hours. The most common treatment for SAD is light therapy, where the person spends a set amount of time each day, normally in the morning, sitting close to a special fluoroescent light device.

Some studies have shown that light therapy can help with the more common forms of depression, although the evidence is inconclusive. Irrespective of this, one of the easiest ways to lift your mood is to get exposure to natural light early in the day.

Why not try this easy experiment to see if it helps you?

• Set your alarm for a bit earlier in the morning than normal and spend some time outside

• Make sure that you enjoy at least 40 minutes outside during the day

• If you can manage some exercise at the same time then all the better

• Monitor your mood state over 3 weeks or more, and observe the changes. Hopefully you will have a new strategy that makes an big difference to you!