Hi everyone,

As part of Mental Health Week, we will be hosting another live chat here on Thursday 8 October, 1-2pm with Dr Stephen Carbone, beyondblue’s Policy, Evaluation and Research Leader.

Stephen worked for many years as a General Practitioner. A few years ago, Stephen decided to hang up his stethoscope and to move into the area of mental health promotion. He is now working at beyondblue where he is working with others to find ways to promote mental wellbeing, prevent depression, anxiety and suicide and ensure people affected with these mental health conditions have the opportunity to get the supports and services that are right for them - at the right time.

Our live chat will be focussed on tips for staying mentally healthy, and also how you can get the best out of your relationship with your doctor.

See also the BB resource What are my options?

PLEASE NOTE as per our community rules, Stephen won't be able to answer questions about medications, these are best discussed offline directly with your mental health professional. 

So bookmark this thread, get your questions ready, and we'll see you back here next Thursday afternoon when this thread will be unlocked and Stephen will be here to chat.

Hi everyone, Dr Steve is here and our chat is now open.

I'll start off with the first question - thinking back to seeing patients, what would you do in consultations to check that people you saw were looking after their mental health as well as their physical health?

dear Stephen, I want to thank you for giving us the time to be able to do this, it's a great initiative by Beyond Blue.

I am sorry but I have asked a a few questions.

You must have had a great deal of patients who were depressed for you to decide to change, but I don't want to get too involved in this.

My first question is that I seemed to changed 360 degrees to be able to overcome my depression, so did I do this by choice or was it because my old life wasn't what I wanted to go to, actually that's the same question, however it's very difficult when talking to someone on the forum that they need to change direction, they don't believe me or don't want to, so if they don't want to then their depression is not going to improve, unless they get enormous help to do so.

Why do people who have relapses like I have, last for only a couple of weeks or days rather another person who still struggles with it for a long time, and is it because I have changed 360 to them that haven't.

However by changing direction I have to start all over again, because my depression was not a place where I wanted to be, so my principles, values in life and what I do have all changed, but then could be open to a new set up to new ways of getting depressed, because I have never been there before.

Dear Chris, thanks for your question.

For me, mental health is just as important as physical health and I think as a GP I like to make sure that I encourage people to look after their mental health.  Some of the steps people can take relate to their lifestyle, regular physical activity, healthy diet, and getting enough sound sleep are just as helpful for mental wellbeing as they are for physical wellbeing.  There's also various other things we can talk about during this chat that can promote mental wellbeing.

When someone comes to me, I like to ask them generally how things are going, check on their mood, and check if they feel that they're coping well.

Dear Geoff, thanks very much for your questions.

I think everyone's journey through depression and recovery is going to be different, as are the circumstances that led to their condition in the first place.  We know that there's no one single factor that causes depression and/or anxiety, but rather a mix of individual and environmental factors that contribute.  For some people, they may feel they need to change their life quite substantially, for others it's about fine tuning and learning new relaxation and coping skills, as well as understanding their condition and seeing it for what it is - a health condition rather than a personal flaw or failing.

You're quite right, some people experience one episode and are well from then on, but others may have symptoms on and off, or more enduring. Everyone's different, and treatment needs to be tailored to the individual's preferences, needs and circumstances.

Hi Dr Steve

Interesting move from a GP to promoting mental health. Can you think back and pinpoint the main driver for the change?

Hi.  I have PTSD, & wondering if its normal to wake up in the morning some times feeling like you have been crying for a week? Like your head feels like it & your eyes & nose & throat feel like that.  Please get back to me. 

Jadeala

Hi Dr Steve,

Thanks for joining us and coming on during Mental Health Week.

One of the questions that I find we get asked a lot is 'can depression or anxiety be cured'?  My initial thought was that we couldn't cure it yet but we could find ways to manage it and get it under control.  What are your thoughts?

Dear Geoff, thanks again! 

Beyondblue encourages everyone who is interested to get involved in the forums. We know that people use them in different ways. Some people like to read what others have to say, which helps them, others want to post comments and get involved. We want people to do what works best for them.  It's a bit like general practice, people will have their own preference with how often they come to see a doctor, how much they are willing to say about their situation. We make sure the door is always open, so people come and talk to us at their own pace.

With regard to your second question, I couldn't agree more, I think it's important that there is good communication between the person, their family (if that's what the person wants), and any health professional or other professional providing assistance. That way everyone's on the same page, there's less confusion, and we're doing what the person is wanting from us.

I apologise for not referring to your title.

There must be many people who come and see you and don't believe that their depression can ever be cured, and I was one of those people, so this may make you frustrated, perhaps annoyed, and you feel as though you have been treating this person for quite awhile and they don't believe you.

Hi jadealaB, thanks for your willingness to share your experience and participate in the forum.  

PTSD is quite a common mental health condition, and typically has 4 main characteristics:

1. People feel very wound up, tense, anxious, on-edge.

2. They often have flashbacks or re-experience the trauma that led to the condition.

3. They tend to want to avoid anything that reminds them of that situation that led to the condition.

4. They can often feel numb, irritable, angry, and find it hard mixing with people socially.

They are conditions that can really affect people's wellbeing, and relationships with others.  However, there are treatments available. The main treatment is a type of counselling called Trauma Based Cognitive Behaviour Therapy.  But there are other treatments as well.

The symptoms you discuss could be related to PTSD, but possibly other conditions as well, as it is very common for people with PTSD to also experience, for example, depression and other anxiety conditions. If you're not sure and would like to talk to someone about this, you can call our support service or talk to a GP that you trust. It sounds like this is really distressing for you, and I encourage you to reach out for help through those avenues.

Hi Dr Steve,

I have been diagnosed with anxiety/dysthymia/depression. Is it possible for mood to change over the course of a day with depression? Sometimes I am upbeat and energetic and then in the same day I withdraw and feel down.
I thought I may have bipolar but looking at the Changing Minds documentary on ABC last night I can draw no comparisons to the behaviour of the bipolar patients in a high mood. I don't talk fast, not sleep, have pressured speech etc.

 Thanks.

Hi romantic_thi3f, great question.

I guess it depends what we mean by cure.  As mentioned, some people may only experience one period or episode of depression or an anxiety condition, and with the right treatment and support, they recover completely and are well from then on.  For other people, it may be about managing the condition which may come and go.

Doctors try to help people get on top of the symptoms.  Even if people can't completely get symptoms under control, it is still very important to assist them to get back into their day to day life, whether that's studying, working, mixing with others and participating in life regardless.  Recovery is about feeling included and doing the things that are good for you.

Hi Dr Steve,

Thanks for being on the forum today :)

Here's my question: when you were a practising GP, did you feel that people were more forthright and proactive about discussing certain types of mental illness and symptoms, but not others?

Hi Geoff, GPs see people from all walks of life, with all sorts of health and mental health conditions. I see my job to diagnose conditions where I can, and provide information to people about their health conditions, explain their options to them, listen to their questions and together work out a plan of attack. I'm here to provide advice and guidance, but it's a collaboration and people will work out what they think is best for them.  

GPs are obviously human, and obviously there are times when we might feel a little bit miffed or frustrated, but really we are professionals and we think we try to do our best and not let these sorts of personal feelings get in the way.

How long does PTSD last for?? Ive had it for years now & ive had alot of help for it. When does the night mares stop??

 Jadeala

Dear MisterM, thanks for your question.

It's not uncommon for some people with depression to experience changes in their mood within the same day. There is a technical name for it called diurnal variation - this can be part of depression and not necessarily a symptom of bipolar disorder. 

Bipolar is different in that people can experience episodes of either persisting depression, or persisting elevated mood (a high, hypomanic, manic).  Usually each episode of low mood or elevated mood would last days to weeks.  Without getting too technical, there are some people with bipolar disorder who cycle quite rapidly between low mood and elevated mood, but my impression is that your changes are part of your dysthymia/depression, but you might wish to discuss this with your doctor or psychologist.

That's a great question SM.

Mostly I think it was just that different people may have been more comfortable about talking about mental health conditions than others. It's probably not going to come as a surprise to you for me to say that females were often more prepared to discuss these things than men.  However, I did see a lot of men who came to me for their mental health condition, whether that was because I was a male GP or some other reason i don't know.  But I also agree that there is still, unfortunately, somewhat more stigma attached to some conditions compared to others.  

I think people are more willing nowadays to discuss depression and anxiety, but maybe less prepared to discuss other conditions like schizophrenia.  I think this is a shame and our community needs more information and education so people are not reluctant to talk about any mental health condition.

It's important to remember GPs have heard it all, seen it all, and accept it all, and you shouldn't feel embarrassed or afraid to discuss any condition with them.

Dear Plain Jane, thanks for your question.

Agoraphobia can be distressing because it makes you fearful of going out. Agoraphobia is a type of anxiety condition, often connected with panic disorder. The treatments that work for other anxiety conditions are also suitable for agoraphobia, like Cognitive Behaviour Therapy (CBT), Exposure Therapy, and sometimes medication.

While often these treatments are provided by doctors or psychologists face to face, nowadays there are also telephone or online based treatment programmes. We call them e-mental health programmes. One that you might like to look into is Mindspot, but there are others. Mindspot combines telephone counselling with internet modules that can teach you about anxiety and strategies to manage it. Once the agoraphobia is more under control, you may then decide to try a face to face treatment as well, or instead.

Great question, Geoff.  It is important to distinguish between sadness, which is a normal human emotion, and depression, which is a significant health condition. 

Sadness often is related to an obvious event, is typically milder than depression, and doesn't last as long.  If you split up with someone, or you fail to get a job that you're keen on, you are bound to feel sad.

Depression is not always related to an obvious event, is usually more severe, can give you physical and psychological symptoms, and more of them, and is more enduring. While depression includes persistent low mood, it is more than that. It includes changes in your thinking, becoming more self-critical and negative, as well as physical changes like insomnia, loss of appetite. Depression also impacts on your ability to do things day to day, whereas sadness usually does not.  

It's sometimes a question of degree, but they are quite different.

Hi Joannie, thanks for your question. I acknowledge how difficult it's been for you.

Yes, treating depression and anxiety is very individual, and the way people recover also is quite individual. I think the main thing is to continue to talk about and look for options that will work for you. Doctors and psychologists are important, but so are other things that can help anyone and everyone.

Social relationships are a big part of this, and that is why we encourage people to use the forums here, or to look for mental health organisations that provide opportunities to be with others and do enjoyable things. 

There are also some clinics that do research that look for new ways of trying to assist people with depression and anxiety, particularly people who feel that they're not getting better. You may have heard of some new treatments like TMS - I am familiar with two organisations doing research in this area, one in Melbourne called Monash Alfred Psychiatric Research Centre and one in Sydney called the Black Dog Institute, but there are others.

Perhaps it might be useful for you to look at their websites and see if you are eligible to participate in some of the research they're doing. I encourage you to not give up hope and continue to look for those things that might help, please feel free to contact our support service if you need to talk to someone in more detail.

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