Dr Grant Blashki – When to seek support for depression and anxiety

Well, mental health problems as all
of us know are extremely common in the community. I mean these are the sorts of issues that
you really know about either from your network of friends or family and they cause a lot
of disability and distress in the community. Some of our survey suggests that, you know
in one year about five per cent of people get what we call a depressive disorder, about
seven per cent get an anxiety disorder, and about another seven per cent get a substance
abuse problem, so problems like drinking alcohol or using drugs. So these are incredibly common
problems. One of the things about these illnesses
is a lot people just put up with it. We know from our research studies, that only about
half of people go and get any professional help at all, and that’s such a shame because
we’ve got treatments that work. She mentioned to me that you wanted
to come talk to me but… Yeah. What’s going on? Yeah. Well, it was her idea that I come
and speak to you. It’s quite hard for people to decide
when should they seek help, because a lot of the symptoms of mental health problems
are really normal. I mean all of us sometimes have sleep problems or sometimes get a bit
down about something. So that’s just normal life. I guess the question of when do you
actually go and get some professional help, there’s not a single right answer, but the
sorts of things that you should think about are, “How long has this been going on for?”
I mean if you’ve had weeks, or in some patients it’s been months, where things haven’t been
right its very important to go and get that assessed. The other thing to think about is the
severity of symptoms. So if you’re having lots of trouble sleeping or have become really
demotivated or in terms of anxiety you’ve got really quite paralysing worry, that’s
important to pay attention to that and get some help. A third issue to look at is how is it
affecting your day-to-day life? If you find you’re missing work or it’s impacting on your
relationships or your usual sort of day-to-day role, that’s another good sign that, “Hey,
this is not normal, this is something more serious, I think I’ll go and have a chat with
my doctor about this and see what’s going on” GPs have a really important role as
part of our mental health system. Firstly, they often know you quite well and often they
know the families or the local culture and that can be really helpful. The other thing
is GPs are really well placed to look at the mental health side of things and at the same
time look at the physical side of things and often mental health problems are very linked
in with physical problems and I’ll give you an example. So, it wouldn’t be uncommon in
general practice for a patient to come in initially worried about, lets say, chest pains
or palpitations, who actually their main problem is anxiety. So in that setting the GPs got
a great opportunity to look at the case, make sure they’re not having a heart attack or
not having some major physical disease that we ought to check, and at the same time, you
know, when results come back normal to have a chat with the patient about, ‘Well, what
else could be causing these symptoms?’ so in medical terms we often call that somatization
and it’s very common in general practice. The other reason why GPs are very helpful
in this situation is some physical diseases can cause mental health problems. So I’ll
give you an example; a classic is a disease called thyrotoxicosis, so your thyroid gland
is in your neck and sometimes it makes too much hormone and over the last 10 years of
clinical practice I’ve had two patients, who everyone thought their main problem was anxiety
but no one had actually checked their thyroid. So the GP is in a really good place to say,
“Maybe there’s something physical causing this”. The other possibility is medications.
Now medications for all sorts of other problems can sometimes have the side-effect of upsetting
people’s mental health and that’s another thing that your GP can actually look at which
is very helpful.

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