Helping someone with Depression

About Depression

What can you do to help?
For people affected by depression, discussing their condition with family and friends, and asking them for their help, can be very daunting. They may feel too scared, ashamed or overwhelmed to admit how they are feeling. Tackling depression may seem an impossible challenge. This is when the encouragement and support of a friend is vital to help them feel less isolated and more motivated to actively work on overcoming depression.


By being a supportive friend, you can encourage someone affected by depression to seek help, receive a correct diagnosis and agree on a treatment with their doctor. But how do you approach this subject with them? You may feel that you need some advice to take the first step. Here are some top tips to start the communication:

Talking about depression with your friend
Some of the symptoms of depression (low mood, irritability and fatigue) can make it difficult for someone affected by depression to maintain friendships. Often someone affected by depression may withdraw from social contacts and may not actively seek to address their problem with their friends. And as mental health conditions are still often associated with a stigma in society, both parties may feel uncomfortable addressing the issue. This is why you as a friend may have to take the first step.

If you suspect your friend may be affected by depression, then you should seek positive ways to show your support and reassure them that you will take them seriously and that you will be there for them to lean on.

You could do this by saying:
You are important to me
You're not alone in this and I'm here for you
You don't have to feel guilty or ashamed, this isn't your fault
I can't really understand what you are feeling, but I can offer my compassion and be a friend to you
I'm going to be there for you to lean on. I'm not going to leave you or abandon you
When all this is over, I'll still be here for you
I'm sorry that you're in so much pain. I am going to take care of myself, so you don't need to worry that your pain might hurt me. You're not alone and neither am I
I love you (if you mean it)
Also consider offering them a hug if you feel comfortable with this.

Try to avoid saying negative things such as:

• Pull yourself together.
• No one ever said that life was easy.
• Stop feeling sorry for yourself. Get a grip.
• So, you're depressed. Aren't you always?
• There's always someone worse off than you are.
• Just try not to be so depressed.
• It's your own fault.

Believe me, I know how you feel. I feel depressed sometimes too.
Once you have approached the subject with your friend, encourage them to visit their doctor (if they haven't done this yet), and ensure that they take any prescribed medication as directed and follow any other therapies recommended by their doctor. Besides the professional support your friend will need, there are also ways in which you as a friend can help them get better.


Some lifestyle changes can help people cope with depression. You can help by encouraging your friend to:
Go outside for some fresh air and sunlight every day – why not invite them for a walk or do some gardening if they don't feel like facing the world?

Take regular moderate exercise – you can suggest you do the exercise together. Encourage them to participate in the exercise by reminding them how good they usually feel afterwards.
Avoid being self-critical – you can help by recognising their accomplishments, however small, and making positive comments whenever possible, e.g. remind them that last week they had three good days and the week before they had two – they're getting better all the time.
Eat a healthy, balanced diet – suggest cooking together or invite your friend over for a meal.
Be aware that your friend may just need to rest – offer practical support like shopping and cleaning the house. Try to balance motivating them without asking them to do more than they are ready for. If your friend has stopped taking care of themselves you could try bringing round some nice soap or bubble bath. It will help them relax and improve their self-esteem.


You can also help them by:
Staying in touch on the phone and/or by e-mail.
Avoiding activities where too much alcohol is consumed as drinking can make symptoms worse.
Making time for activities that you can enjoy together.
Generally, you should motivate your friend to learn about depression and depression treatments. This will encourage them to follow their course of treatment as instructed by their doctor and seek help if something doesn't work for them. They will also see that recovery is possible. You may find it useful to learn about depression together as your friend's concentration and memory might be affected. Audio books are a great way to absorb information if your friend finds it difficult to concentrate on written information.


If your friend is talking about or has attempted suicide
Thoughts of suicide and death can be a major symptom of depression, and should be taken very seriously. If a friend expresses suicidal ideas, reassure them that their life is important to you and many other people and that the appropriate treatment will help them to get better. No matter how hard it may seem to look after someone with suicidal thoughts, it is important to show that you care.


If your friend has suicidal thoughts, talk to other professionals (e.g. GP, emergency services, social services) for advice on how you can help them to stay safe, and encourage your friend to access help and support too. Keeping contact details for support helplines close to hand is also important e.g. Aware loCall Helpline 1890 303 302; Samaritans 1850 60 90 90; 1Life 1800 24 7 100.

Anxiety and relaxation techniques

Everyone gets anxious from time to time: there's public speaking, job interviews, the dentist and all the rest. For about one in six of us this will cross over into what psychologists term a disorder at some point in our lives. This is when people are almost continuously anxious and find it difficult to concentrate, have trouble sleeping and become irritable and restless. Women are roughly twice as likely as men to suffer from an anxiety disorder.

For the rest of us anxiety will come and go as part of the normal human condition. Whether it's a constant or occasional affliction, dealing with anxiety effectively is important. People are often prescribed drugs for anxiety but these are less effective in the long-term and have side-effects so relaxation training is often preferred. Relaxation training comes in a variety of flavours, but the five methods which have much in common and the most evidence to support them are (Manzoni et al., 2005):

1. Progressive relaxation The most commonly studied type of relaxation therapy may be familiar to you. It involves mentally going around the muscle groups in your body, first tensing then relaxing each one. It's as simple as that. And with practice it becomes easier to spot when you are becoming anxious and muscles are becoming tense as, oddly, people often don't notice the first physical signs of anxiety. This is based on the idea that the mind follows body. When you relax your body, the mind also clears.

2. Applied relaxation Applied relaxation builds on progressive relaxation. First you learn to relax you muscle groups one after the other. The next stage is to cut out the tensing phase and move straight to relaxing each muscle. Next you learn to associate a certain cue, say thinking 'serenity now!' (hello Seinfeld fans!) with a relaxed state. You then learn to relax really quickly. Finally you practise your relaxation technique in real-world anxiety-provoking situations. Once again, mostly this is about mind following the body.

3. Autogenic training Goes back to the 1930s and is another technique for progressively relaxing the muscles. To help you do this it has a mantra which you repeat to yourself as you go around major muscle groups: "my right arm is very heavy" and so on. A second stage involves inducing a feeling of warmth in the muscles. Once they feel 'heavy' from the first stage, you follow another mantra about warmth: "my right arm is very warm" and so on.

Further stages involve calming the heart and the abdomen and cooling the brow in much the same way. Once again, you'll notice that this is all about the mind following a calm body. As before practitioners recommend daily practice so that you can relax more and more quickly. With practice the simple intention to start the training will be enough to cause the body to become relaxed and warm.

4. Meditation Here's our old friend meditation which has so many different benefits.
If you've been reading PsyBlog for a while you'll have seen this come up in numerous contexts. There is certainly evidence that it can work for people who experience anxiety as well. I describe the basics of mindfulness meditation in this article about attention and meditation. Be aware that meditation is quite difficult and the drop-out rates are high from studies which investigate it (Krisanaprakornkit et al., 2006). This suggests some people don't find it particularly acceptable. For people who can manage it, though, the results are often better than the other techniques (Manzoni et al., 2005). Notice that this technique is much more actively related to the mind than the first three methods. It doesn't just target the body and wait for the mind to follow, instead it's about the way attention is focused. This may be partly why people find it harder. Still, it probably won't do any harm to try.

5. Cognitive behaviour therapy
Finally cognitive behaviour therapy, or CBT, targets both mind and body. As it's primarily a talking therapy you normally have to go to a psychologist who will help you target unhelpful thinking patterns. But there are books available that explain how it works (I mention a few here:

6 Self-Help Books for Depression Recommended by Experts). However these don't specifically target anxiety, they're mostly for mild depression. All together now And there's no reason why you should stick to only one approach. When Manzoni et al. looked at studies which used multi-modal techniques, they found these were effective as well.

If you need to relax—for whatever reason and at whatever time—then try one or more of these different methods. As you'll have noticed the effective techniques share a lot in common. Regular practice is the key and, if you give it a chance, the mind really will follow the body.

Police Work Undermines Heart Health

BUFFALO, N.Y. --

It is well documented that police officers have a higher risk of developing heart disease:
The question is why.

In the most recent results coming out of one of the few long-term studies being conducted within this tightly knit society, University at Buffalo researchers have determined that underlying the higher incidence of subclinical atherosclerosis -- arterial thickening that precedes a heart attack or stroke -- may be the stress of police work.

"We took lifestyle factors that generally are associated with atherosclerosis, such as exercise, smoking, diet, etc., into account in our comparison between citizens and the police officers," said John Violanti, Ph.D., UB associate professor of social and preventive medicine, who has been studying the police force in Buffalo, N.Y., for 10 years.

"These lifestyle factors were statistically controlled for in the analysis. This led to the conclusion that it is not the 'usual' heart-disease-related risk factors that increase the risk in police officers. It is something else. We believe that 'something else' is the occupation of policing.

"Results of the study appear in the June issue of the Journal of Occupational and Environmental Medicine.

Violanti and colleagues have been studying the role of cortisol, known as the "stress hormone," in these police officers to determine if stress is associated with physiological risk factors that can lead to serious health problems such as diabetes and cardiovascular disease.

In a study accepted for publication in Psychiatry Research that looked at the male-female differences in stress and signs of heart disease, Violanti found that female police officers had higher levels of cortisol when they awoke, and the levels remained high throughout the day. Cortisol normally is highest in the morning and decreases to its lowest point in the evening. The constantly high cortisol levels were associated with less arterial elasticity, a risk factor for heart disease, Violanti noted.

"When cortisol becomes dysregulated due to chronic stress, it opens a person to disease," he said. "The body becomes physiologically unbalanced, organs are attacked and the immune system is compromised as well. It's unfortunate, but that's what stress does to us."Results showed that police work was associated with increased subclinical cardiovascular disease -- there was more plaque build-up in the carotid artery -- compared to the general population that could not be explained by those conventional heart disease risk factors.Subclinical atherosclerosis means that the disease shows progression but does not qualify yet as overt heart disease.

"In this case we examined the thickness of the carotid artery as an indicator of increasing risk for atherosclerosis," noted Violanti.

"The plaque buildup was greater in police than the citizen population."In future work, we will measure the carotid artery thickness again to see how much it has increased. At some point in time, the thickness may reach a stage of possible blockage, which will require medical intervention and treatment. We think that police officers will likely reach that stage quicker than the general population.

"P. Nedra Joseph, Ph.D., a former postdoctoral researcher at UB, now at the Centers for Disease Control and Prevention (CDC), is first author on the study. Additional contributors to the study were: from UB -- Richard Donahue, Ph.D., and Joan Dorn, Ph.D., from the UB School of Public Health and Health Professions; Michael E. Andrew, Ph.D., and Cecil M. Burchfiel, from the CDC; and Maurizio Trevisan, M.D., formerly of UB, now head of the University of Nevada Health Sciences System.

The University at Buffalo is a premier research-intensive public university, a flagship institution in the State University of New York system and its largest and most comprehensive campus.

Symptoms of Trauma

Symptoms of trauma

How does trauma develop?

In the days and weeks after a traumatic event, most people experience trauma and stress reactions. These reactions are the result of normal and adaptive survival mechanisms. They can contain elements of post-traumatic stress, depression, anxiety, anger, and grief.

Trauma reactions often appear quickly – in the hours, days, and weeks after the event. However, delayed trauma reactions also can occur anywhere from several weeks or months to years later. Delayed trauma reactions are sometimes sparked by something that reminds the individual of the original traumatic event.

Trauma reactions tend to change in intensity and character over time and usually subside gradually during the first weeks and months after a traumatic event. Most people who have experienced a traumatic event will return to a healthy state of functioning eventually but may have a lasting vulnerability. For example, if you experience a bank robbery, you are likely to think of that event when you enter a bank, and you may experience some temporary anxiety when something reminds you of that event.

Approximately 25% of people who experience a traumatic event go on to experience lasting trauma-related difficulties. These long-term reactions can include elements of PTSD, depression, anxiety, and/or substance abuse. If this has happened to you, it doesn’t mean that you are weak. It may mean that the traumatic event was so powerful that it pushed you far past your normal coping strategies. It also means that you might benefit from working with a counselor or mental health professional who understands trauma.

Common symptoms of trauma

Individuals exposed to a traumatic event can experience a wide variety of trauma reactions after the event. However, some trauma reactions are more common than others. Given the likelihood that humanitarian workers will experience some degree of trauma as a result of their work, it is important for you to be familiar with.

The signs that you (or someone else) are experiencing an unusually intense trauma reaction and should seek support from a mental health professional.
The following table outlines some common symptoms of trauma. Many more general symptoms of stress can also be present after a traumatic event.

COMMON SYMPTOMS OF TRAUMA

Intrusive symptoms

Persistently re-experiencing the event in thoughts, images, recollections, daydreams, and/or nightmares

Feeling upset, distressed and/or anxious in the presence of reminders of the event

Avoidance symptoms

Avoiding places, thoughts, conversations and/or people associated with the event
Problems recalling some aspects of the event

Losing interest in formerly enjoyable and important activities of life
Feeling “removed” from other people
Feeling numb

Arousal symptoms

Being on the alert for danger

Being jumpy and easily startled

Experiencing sleep disturbances (such as not being able to get to sleep, waking up often, or having vivid dreams or nightmares)

Difficulty concentrating

Irritability or angry outbursts

(Adapted from the Diagnostic and Statistical Manual for Mental Disorders IV-TR, 2000)

Experiencing some of these symptoms in the first days and weeks after a traumatic event is quite common, and their intensity will probably subside gradually. However, if the symptoms are severe enough to cause you significant distress, interfere with your daily routine and functioning, or last for more than a month, you may be suffering from post-traumatic stress disorder (PTSD). If you are worried about trauma reactions you have been experiencing please see links on the side of this page or contact me.

Spiritual symptoms of trauma

In addition to the symptoms listed above, there are some common spiritual symptoms of trauma. Spirituality is a core component of human nature. It shapes and informs our sense of meaning, purpose, hope, and faith. It is a foundation, guide, and motivation for morality, personal growth, and service to others. Whether due to an explicit belief in a deity, a more diffuse sense of transcendence or connectedness with nature or a life force, or a faith in human nature and solidarity, most people believe that to be fully human involves more than simply the physical dimensions of existence.

Traumatic events are usually sudden, unexpected, and very frightening. They can cause us to feel unsafe, out of control, isolated, “damaged”, or “dirty”, and/or to lose trust in other people. It’s not surprising that traumatic events may also cause us to question the fundamental beliefs and assumptions that are connected to our deepest sense of meaning and purpose in life – to our spirituality.

Common spiritual symptoms of trauma include:

Altered worldview. Your view of God, who you are in relationship to God, and how the world works, can change after exposure to a traumatic event. For example, trauma may cause you to question assumptions about the world – such as “bad things don’t happen to good people” – that you weren’t even fully aware that you held.

Troubling existential questions. Traumatic events can cause you to struggle with questions and issues related to suffering, evil, forgiveness, fairness, hope, justice, purpose, and divine order.

A loss of a sense of meaning and coherence in life. Traumatic events often raise personal questions related to what life is all about and what’s really important to you. It’s not uncommon to doubt your deepest beliefs, feel empty, and/or feel that life has lost its meaning and coherence.

A sense of discouragement and loss of hope. This can express itself through feelings of depression, painful questioning, and/or cynicism.

Alienation and a loss of a sense of connection. You can feel isolated, or have a sense of being cut off from the connection you feel to the source of your deepest sense of meaning and purpose (whether that be God, nature, a life-force, or other people).

Symptoms of intense trauma reactions

Sometimes individuals experience more severe trauma reactions. When this occurs, they should be monitored and supported by a mental health professional. Symptoms and reactions of a severe trauma reaction include:
Severe dissociation: Feelings of enduring disconnection from your body or surroundings, derealization (feeling as if you or the world is not “real”), and depersonalization (feeling as if you are losing your identity or adopting a new identity). Dissociation may also involve “losing time” or experiencing amnesia regarding significant periods of or the entire traumatic event.

Repeated intrusive “re-experiencing” of the event: Re-experiencing occurs when some facet of the trauma (perhaps a sight, smell, or noise) triggers significant emotional distress and feelings of terror and vulnerability. In its most vivid form, re-experiencing can include flashbacks (feeling as if you are experiencing the event all over again), recurrent and terrifying nightmares, and repetitive and automatic re-enactments related to the event (such as acting out parts of the event over and over again).

Extreme withdrawal: Extreme withdrawal from normal and supportive social networks, drastic relationship changes, and/or compulsive avoidance of other people.

Extreme hyperarousal: Experiencing panic attacks (e.g., times when you hyperventilate, your heart beats very fast, and you think you are going crazy or dying), feeling unable to concentrate on anything, and/or difficulty controlling violent impulses.

Debilitating anxiety: Severe phobias or obsessions, and paralyzing anxiety attacks.

Severe depression: Feeling a constant lack of happiness and pleasure in life, and/or constant feelings of worthlessness and self-blame.

Problematic substance abuse: Prolonged and excessive use of alcohol or drugs to numb distress and aid coping.

Impaired self-care: Diminished capacity for self-care behaviors related to nourishment, hygiene, and rest.

If you, or someone you know, is experiencing severe trauma reactions, click on the links on the left to learn how to find professional help and support.

For personal reflection…

Reading through the possible trauma reactions in this section of the module may have stirred up some uncomfortable memories and feelings in you. Take a moment to “check in” with how you are feeling and decide whether you need to take a break from this study and do something else for a while. If that’s the case, think about what you feel like doing – something fun, distracting, creative, productive.

Taking care of yourself after traumatic events, and try some of the suggestions listed there.

Stress Reactions in Policing (An Garda Siochana)

Published Garda Review in 2007.

The members of the Grada Representative Association (GRA) and its CEC work tirelessly on behalf of all rank and file members of An Garda Siochana to bring about positive and lasting change in relation to Health, Safety and Welfare within the force. http://www.gra.cc/

INTRO
We need a certain amount of stress to function; but what actually is it?
Stress is experienced regularly. We require a certain amount of it to get through tasks, keep us focused and motivated. The problems occur when our body and mind is subjected to high levels of stress for extended periods of time. This is further heightened if we perceive certain situations to be life threatening, harmful to our health or to our sense of self.

These incidences may lead to distress, a natural defence mechanism designed for our bodies to respond to such perceived times of danger; known as ‘flight or fight’. At such times our body creates high levels of stress hormones such as epinephrine (adrenaline), norepinephrine (noradrenaline) dopamine and cortisol, which has harmful effects; that contribute to increases in blood pressure and blood sugar levels and may cause infertility in women. It suppresses the immune system as well as damaging long term memory.

DEVASTATING

The overall hormonal reaction can wear down both body and subsequently emotions; people under distress can often become emotional, irritable, anxious, have difficulty making decisions and even suffer from symptoms of depression and insomnia. If that weren’t enough, sufferers can also expect biological stress-related illnesses and conditions such as weight loss, lethargy, stomach complaints, high blood pressure and even heart attacks. These issues have devastating effects.

It’s obvious why the World Health Organisation’s experts in health and welfare consider policing to be one of the most stress-inducing professions.
Garda work is challenging; traumatic events such as death from violence, accident or suicide, as well as witnessing, securing and reporting such incidences the job then expects that the member informs family members of the tragedy.

Within policing many different aspects provide extremely stress-inducing incidences and strains that can deeply affect both the life of the Garda and their families. Members involved in routine duties potentially face harrowing, challenging and dangerous situations throughout a shift. Other specialist units dealing with such areas as child abuse and child-related areas are not only challenged by the inherent dangers associated with front line duties but also the challenges they face to their own attitudes, cultural beliefs and personal values.

Criminality and social disorder is a side of society most don’t see.Members can be immersed into aspects of society deemed as depraved and violent yet are then expected to finish a shift and enter back into ‘normal’ society; back to family and friends with little opportunity to address the challenges faced on each shift.

FALSE ALLEGATIONS

The operational aspects of policing can be difficult, but when a policeman or policewoman is investigated for their role in carrying out their jobs they can find themselves to be completely isolated and alone to face endless possibilities that may affect them and their families for the rest of their lives.
I have worked with individuals on the wrong end of false allegations arising directly from stress-filled working environments and the level of damage to all aspects of one’s life is immense and devastating. The area of disciplinary procedures is an area that requires high levels of support, communication, understanding and pro-active research to address the needs of individuals under investigation.

Within an organisation the issues of stress are far reaching and are experienced at every level from the new recruit trying to fit in, to the most senior of management positions charged with the operational duties and the responsibilities to each member.

The culture of police work is insular and strong; issues of stress are still, sadly and naively, considered by some to be issues of weakness that are best not discussed or addressed. The truth is simple: the negative affects of stress are very real and will be a major factor in low morale, health and productivity if they are not addressed effectively.

The most serious problems faced by the Force may have stress-related roots. Serious aspects of stress are often a symptom of poor employment relations and have serious implications for the individual and the organization. Those that may suffer from the negative affects of stress at senior levels may find it hard if not impossible to change with the times, as change can be very difficult for most to accept and requires individuals to leave their safe comfort zones.

OLD RULES

A symptom of such for those in a leadership role maybe to compensate by enforcing ill conceived and old rules to the letter of the law in order to keep an internal sense of achievement, while shying away from making adaptations that will add to the process of change, it's easier at times to not challenge and fight for change in an environment that may be negative towards you for doing so. Such issues can result in a breakdown in communication, a dividing of opinion, frustration, anger and a lack of open transparent communication resulting in many more problems.

Within such environments the right of the individuals to have their own opinions can be lost and censored. The right of people to change their minds can be seen as a weakness and the right to ask for help can be seen as an inability to do ones job. Fear to challenging such issues can also be great as there is a very real openly reported sense within AGS that to challenge such concerns will lead to you being “gotten” in the future, either by impacting on your promotion options or added and undue pressure to conform or leave the service.

This too adds to the overall stress levels, frustration and low moral of the workforce. So for some it’s easier not to make decisions, not to raise your head above that parapet. This way of doing things however understandable not only diminishes an individual’s rights but burdens those prepared to challenge the system for the right reasons to be isolated and ridiculed.

The negative effects of stress affect all levels of the organisation and will continue to do so if not addressed. If addressed properly however with acceptance and openness the benefits will be great.

Another area not discussed in regard to stress both for the individual and the organisation is the damage it has on one’s sense of self or one’s ‘self concept’. This is one’s understanding of who you are or an organization’s understanding of what it is. We form our self concept through introspection (looking inward at oneself) and through feedback back from others (the Force has had considerable negative feedback through the press).
An example of this conflict might be when individuals choose to drink or smoke to excess in order to attempt to cope with such things as stress. They know that this is both unhealthy and does not help, yet tend to justify it in order to try and elevate the sense of inner conflict. This spirals into a cycle of further unhappiness.

POSE A REAL THREAT

The World Health Organisation states that up to half of workers in industrialized countries experience psychological stress. Environmental stressors such as hazardous conditions are one cause, but occupational stress also results from work organization -workload, lack of autonomy and control over work, shift work, wage scales and routine, repetitive work. Stress associated with work has been shown to contribute to cardiovascular disease, musculoskeletal problems and other conditions.”

The International Labour Committee reviewed a study of potential sources of stress among Scottish police officers which indicated that the stressors stemming from organizational aspects, such as perceived staff shortages, inadequate resources, time pressures and lack of communication were more significant than those relating to police work. It found that “officers under stress could pose a real threat to their own safety and that of others”.
Coping mechanisms to avoid thinking or dealing with such conditions include over working, using alcohol, self medicating or ‘just getting on with it’. This in part I believe extends from the culture of police work which covertly dictates that signs of genuine stress and difficulty are considered to be signs of weakness, yet for someone to acknowledge their sense of stress and difficulty is a sign of great strength and personal awareness.

The role of a Garda requires emotional health and well being. People with good emotional health are in control of their thoughts, feelings, and behaviours. They feel good about themselves and have good relationships. They can keep problems in perspective and act with clarity and insight. Good mental health is a key piece of equipment, the one ‘dependent variable’ that you rely on daily. Stability of thought allows you to make quick, appropriate decisions and deal with difficulties as they arise. Without this stability the frustrations and stressors of the job may make the decision process difficult and may result in doing things based on stress and frustration arising from the day to day duties associated with the job.

STRONG MIND

The management of stress and providing counselling is a key issue for emergency services workers. Many can be seriously psychologically affected by incidents of trauma specifically related to death, injury, contracting diseases and life-threatening situations. For those who have survived and got through such incidents there can be often times of avoidance and difficulty accepting that they may have been affected, followed by periods of stress or even acute and post-traumatic stress disorders. A study carried out on emergency service workers in New South Wales reported that about “30% of respondents had experienced stress severe enough to seek help, but 39% of these did not seek help for various reasons. Only 9% reported that the information on the availability of such help was given to them during initial training.

There are many things that cannot be done to make the job of policing easier but there are the basics that can be in place; more professionally-trained support officers by way of a better supported EAP Service, proper and up to date equipment, more pro-active training in the areas of stress management and communications and proper working conditions. For An Garda Siochana there is an essential requirement and need for an Internal Garda Specific Unit of Trained non member Psychologists/Therapists providing individual Confidential Therapeutic Support designed to care for Police Officers and their families in complete confidence, to attend where possibly scenes of trauma and crisis to support members and to advise on policy in order to support the future requirements of all members in need.

Employers have a duty of care to their staff to assess the risk of stress related ill health and to control that risk, this requires the identification of risk at source which has been raised in research carried out by myself, health and safety research carried out by Dr Garavan of Limerick University and other work such as research carried out Prof. Cary Cooper in which he confirms that “stress at work does exist” and that one in five people are stressed at work.

It is important to note that a Garda Specif Confidential Therapeutic Support Service for which I support will not counteract the full extent of problems faced, but it will go a long way to establishing change and supporting those that need it. However, the focus should never be removed from the responsibilities of the organisation to deal with their duty of care and the fundamental issues of the emotional health and welfare of their employees. Although, if in place it should be madatory for members who experience trauma during their working shift to have to attend therapy as a matter of course, in this regard the stigma of seeing a therapist is removed completly.

The areas of unhappiness, workplace stress and the need of people to seek support should not be seen as an individual problem but as an area that needs to be addressed as an organisational issue. These are not disciplinary issues or issues to be ignored, it takes a strong mind to know when to ask for support and it takes a committed and caring organisation to embrace change and offer the most effective support possible knowing that it will continue to enhance the overall and exceptional service offered.

By Mark Reddy

Editor: Neil Ward Garda Review

http://www.worklifebalance.ie/

This is a link to an article on Debriefing and PTSD that should be reviewed by all involved in the Emergency Services LINK

Please see the related articles in regard to Stress and Policing and Stress and the Emergency Services by either clicking here or looking under November. Contact me or leave your comments in regard to any issues raised.

HELP

Taking Care of Others after Trauma

People often worry about how to help others after something traumatic has happened to them. If you happen to be “on the scene” at a traumatic event, you may feel that you don’t know what to do to help others. If someone you know is going through a hard time after a traumatic event, you might worry that you are just “getting in the way” and “intruding”, or that you will say the “wrong thing”.

As a general guide, think about what you would need or want from a friend after a similar traumatic event. How would you want someone to treat your brother or sister if this had happened to them? This may help you figure out how to best support others. Two important things to remember are:

You are not responsible for taking away their pain.
You are not responsible for having the “right answer” to any questions they may ask about the event, why it happened, or what it means.
Generally, people will appreciate your caring presence and your good intentions. Here are some ideas you may find useful if you are trying to help and support someone else after they have experienced trauma.

Do…

If you are on the scene and don’t know the person involved, introduce yourself and offer to assist.

Determine their role in the disaster/traumatic event. Were they a witness, a victim, a relative, or a friend? Are they injured and do they need immediate medical attention? Are they missing a loved one who was involved in the disaster?
If it is safe and appropriate, remove the person from the direct vicinity of a stressful situation and protect them from curious bystanders and the media.
Offer to contact a friend or loved one for them. If appropriate, let that person know where they can meet you.

If you leave a highly distressed person, make sure someone else is there to stay with them. If possible, connect them with a mental health professional on the scene.
If appropriate, inquire about what happened and how they’re doing. Allow them to talk about their experiences, concerns, and feelings if they wish. Don’t force them to do so.

When appropriate, discuss normal stress reactions. Review what you know about normal physical, mental, emotional, spiritual, and behavioral symptoms of trauma. Reassure them that any stress reactions they experience may be normal and will probably pass in time. Recognize that the victim may be shaken and shocked, especially during the first 24 hours after the event. He or she may have trouble concentrating on what you’re saying, so keep anything you say fairly short and simple.

Discuss coping strategies and practical plans for the next 24-48 hours. Help the person focus on this immediate time period. Think about how they are going to do simple things like get home, prepare food and eat, and soothe themselves. Determine who will be with them and who they can call if they feel upset or scared. This can be especially important for people who live alone.

Assist the person in making decisions, if necessary. You may need to make decisions for them. More often it is enough to be with them and provide a rational sounding-board while they make decisions about things like medical insurance, statements to the police, who should be contacted, and what they should be told. Simply being a sensible and calming presence can be an invaluable gift to individuals who are shaken and distressed and who are not sure that they’re doing or saying the right things.

Listen carefully. If it’s someone you know well, don’t be afraid to ask what you can do to be helpful and take your cues from them.

Assist with practical tasks. Help with everyday tasks like cooking, cleaning, and supervising children. These activities can help relieve some of the burden for people who are feeling overwhelmed by life. However, beware of walking in and “taking over” in these areas. Sometimes people who have been through a traumatic event will find things like cooking or spending time with their children the best way to care for themselves.
Don’t…

Don’t assume that the person who’s just experienced a traumatic event is unaffected and thinking clearly simply because they appear calm.
Don’t say something like, “you’re lucky it wasn’t worse”. If the victim expresses this sentiment it’s generally safe to agree with him or her. But remember that some people will feel hurt and annoyed by this statement. Instead, you can express support by simply saying things like, “I’m so sorry this has happened to you,” and “you’re safe now”.

Don’t take their anger or other feelings personally. People who have just experienced a traumatic event may feel overwhelmed by intense emotions, including anger. Sometimes that anger can be directed towards you, even when it seems irrational. This can be hurtful and difficult, but try to stay calm and remember not to take it personally.

If you have been helping someone involved in a traumatic event, don’t forget that you will be impacted by hearing the details of their experiences and being a close witness to their pain, grief, and confusion. Do not forget to review your own coping strategies, and take time to care for yourself after you have spent time caring for other people. For more on this topic see our online training module on Vicarious Trauma.


For personal reflection…

What are some other ways to support someone who has been through a traumatic event, either at the scene or in the days and weeks after the event? Write down a list of specific things that might be appropriate.
What do you find hardest about supporting people who are going through a difficult time? What feelings and thoughts does it stir up in you?
What are some helpful ways you typically deal with these thoughts and feelings? What else might help you after you’ve spent time caring for someone who is traumatized or grieving?

Workplace Stress 'Article'

What is Workplace Stress?

Workplace stress is the harmful physical and emotional responses that occur when the requirements of the job do not match the capabilities, resources, or needs of the worker. Workplace stress can lead to poor health and even injury.
The concept of workplace stress is often confused with challenge, but these concepts are not the same. Challenge energizes us psychologically and physically, and it motivates us to learn new skills and master our jobs. When a challenge is met, we feel relaxed and satisfied. Thus, challenge is an important ingredient for healthy and productive work. The importance of challenge in our work lives is probably what people are referring to when they say "a little bit of stress is good for you.

Workplace stress is also referred to as job stress.
What Causes Workplace Stress?

Most people agree that workplace stress results from the interaction of the worker and the conditions of work. Views differ, however, on the importance of worker characteristics versus working conditions as the primary cause of workplace stress. These differing viewpoints are important because they suggest different ways to prevent stress at work.

According to one school of thought, differences in individual characteristics such as personality and coping style are most important in predicting whether certain job conditions will result in stress. In other words, what is stressful for one person may not be a problem for someone else. This viewpoint leads to prevention strategies that focus on workers and ways to help them cope with demanding job conditions.

Although the importance of individual differences cannot be ignored, scientific evidence suggests that certain working conditions are stressful to most people.

Job Conditions That May Lead to Stress
The Design of Tasks.
Heavy workload,
infrequent rest breaks,
long work hours and shiftwork;
hectic and routine tasks that have little inherent meaning, do not utilize workers' skills, and provide little sense of control.

Management Style.
Lack of participation by workers in decision- making,
poor communication in the organization,
lack of family-friendly policies.

Interpersonal Relationships.
Poor social environment and lack of support or help from coworkers and supervisors.
Work Roles.
Conflicting or uncertain job expectations,
too much responsibility.

Career Concerns.
Job insecurity and lack of opportunity for growth,
advancement, or promotion;
rapid changes for which workers are unprepared.

Environmental Conditions.
Unpleasant or dangerous physical conditions such as crowding, noise, air pollution, or ergonomic problems.

Workplace Stress Statistics (American Institute of Stress)
"(Job stress is "the 20th Century Disease")" United Nations National Report
75-90% of visits to primary care physicians are for stress related problems
1 million employees are absent on an average workday due to stress related problems

Less than 25% of Americans find their jobs extremely satisfying today.
78% describe their jobs as being stressful.

Stress costs $200 - $300 billion annually, as assessed by absenteeism, diminished productivity, employee turnover, accidents, direct medical, legal, and insurance fees, Worker's Compensation etc. That is equal to the total net profit of the fortune 500 companies.

60-80% of accidents on the job are stress related.

PLEASE TAKE YOUR TIME TO WORK THROUGH THE RELATED ARTICLES AND LINKS AS THEY WILL PROVIDE YOU WITH ALL OF YOUR WORK RELATED ANSWERS.

Types of Medication

A Brief Overview of the Types of Medication prescribed to those in need.

The drugs, which are prescribed medically, have been selected because of their power to relieve the symptoms of mental illness and stabilise the condition – the main groups are anti-depressants, tranquillisers and mood stabilisers.

Anti-depressants
Low levels of serotonin are thought to be a cause of depression and other related conditions. Medication like anti-depressants can bring the levels of this chemical back to normal. Anti-depressant medication may take two/three weeks before full benefit is experienced. It is important to take medication even when you feel completely well as early discontinuation may precipitate relapse. Some people may need more than one course of treatment.One group of anti-depressant drugs, the monoamine oxidase inhibitors (MAOI) requires patients to avoid certain foods, drinks and medicines. Patients on these drugs are given a warning card listing these by their doctor.

Tranquillisers
Tranquillisers or neuroleptic medications are used to treat major illnesses like schizophrenia and psychotic depression. These drugs suppress a chemical, dopamine, thought to be over produced in people with schizophrenia.Like other drugs used in the treatment of mental illness, this medication may need to be taken over a long period of time. Early discontinuation may precipitate relapse.A relative or friend can play an important role in reminding or encouraging you to take your medication. Make them aware of possible side effects. Read the information leaflets and discuss the information with your doctor or Community Psychiatric Nurse.There may be some side effects to treatment with major tranquillisers – if you experience any of the following, you should inform your doctor:* stiffness, restlessness and shakiness known as extra-pyramidal effects* Sensitivity to light – you should be careful in bright sunlight – use a sunblock cream* some people feel tired, dizzy or may be prone to weight gain.

Mood Stabilisers
Mood stabilisers are drugs used in the treatment of excessively “high” moods, irritability, increased energy and activity. Drugs & AlcoholAs with all types of prescribed medication, it is best to avoid alcohol as it interacts with neuroleptic medicines and increases drowsiness.

Please See Related Articles for advice and support. Always seek medical advice and attention before embarking on a course of medication. Support is always there for anyone who asks from professional and support services please use the links attached to find the most appropriate support you require.

HELP

Setting Boundares and Saying NO

We are constantly bombarded daily with requests for our time. While helping others can be very rewarding, at the same time we can feel distraught about constantly obligating ourselves to others while not fulfilling our own needs. We can feel distressed about constant commitments to do things we simply don’t have the time, energy or desire to do.

At times, we may immediately feel the urge to say no, but instead lose our nerve. the question is why?

Is it because:
You fear you won’t be liked or feel a strong need to please everyone
You have to always keep the calendar full so you feel needed and important
You undervalue the need for down time and forget simply not wanting to do anything is a legitimate reason to say no or you would rather not deal with the consequences of saying no and all the feelings that come with it.

Setting boundaries and saying no is taking personal responsibility for your well-being. This requires you to clearly speak up, and specifically ask for what you want. Your decision to say no to requests from family, friends, and co-workers doesn’t have to be filled with feelings of uneasiness and guilt. It fact, it’s important you remember the decision to say no is strictly a personal choice – yours!

Whether at work, with family, or friends, you can say no with diplomacy, tact, and respect. Here are some ways you can take charge and assert your right to say no.

Be sure you have all the facts
Before making a commitment, be sure you have a complete understanding of exactly what’s being asked of you. You may feel confused because you just don’t have enough information to make a decision. You have the right to ask as many questions as necessary.

Ask yourself “Is this a unreasonable request?”
When someone makes a request, he or she is usually tuned into “WIIFM” (What’s In It For Me). People are not necessarily concerned with whether or not a request is in your best interest. If you feel hesitant, trapped or otherwise uncomfortable – go with your gut and say no. These uneasy feelings probably indicate saying yes isn’t best.

Take Your Time
There is no law that says you have to immediately obligate yourself to someone when asked. Take your time before you make a final decision. Simply say “I need time to think about this. I’ll get back to you.”

Set goals
Setting your goals will make it easier to say no. Establishing priorities makes it easy to decide how much time you can devote to others without sacrificing your own needs. You will be more comfortable declining requests that conflict with your priorities.

Speak up - without excuses or apologies
When you have all the facts and decide say no, say no calmly and firmly. An assertive tone of voice, body language, and eye contact lets others know you are serious and definite in your decision.

Don’t be meek.
Say no directly without excuses. Excuses make you appear as if you aren’t in control of your decisions. If you say “I’m sorry but…” this only weakens your stand. If you have decided saying yes is not in your best interest, no apology is necessary.

What if they won’t take no for an answer?
If someone won’t take no for an answer, repeat your position. Maintain your stand and don’t allow yourself to be manipulated or strong armed. No means no and you have the right to stand by your choice.

Feel good about your decision to say no
Feel calm, confident, and comfortable with your decision to say no. Be secure knowing it’s enough to say no simply because you just don’t want to.
Remember, learn how to say no is a win-win situation for everyone.

PLEASE FEEL FREE TO CONTACT ME IN CONFIDENCE OR TAKE YOUR TIME AND GO THROUGHT THE RELATED ARTICLES AND LINKS ON THE LEFT OF THIS PAGE.

HELP

Employers and Workplace Stress

Why should employers be concerned about workplace stress?

A Report by

The National Institute of Occupational Safety and Health

Stress is a normal occurrence. However, with increasing demands of work and home life, stress on the job is a problem causing physical, mental, and financial consequences for employers as well as employees. Studies show that stressful working conditions are associated with increased absenteeism, tardiness, and intentions by workers to quit their jobs—all of which have a negative effect on a company’s success. Employers, managers, supervisors, and business owners have many reasons to consider the stress level of their workers:

Financial
Stressed employees take more sick days and file more disability claims than do contented employees
Disgruntled employees often quit after extensive investment has been made in their training, and another person has to be trained in their place
Job stress can result in decreased productivity
Errors made by stressed workers can result in faulty products that cannot be sold, or worse, that fail after sale and lead to lawsuits

Emotional
Stressed workers may become depressed or angry
Alcohol or drug use increases as self-medication for distress, which in turn creates more problems

Safety
People who are overly stressed are less attentive and can accidentally damage equipment or injure themselves or others
At the extreme, stress can lead to violence, and management or co-workers can be hurt or killed – the term “going postal” has become part of the language expressing a murderous rampage as a result of job dissatisfaction

What is job stress?

A survey by St. Paul Fire and Marine Insurance Co. found that problems at work are more strongly associated with health complaints than are any other life stressor—more so than even financial or family problems. While challenges are a normal and satisfying part of work life, stress is not a necessary evil in the workplace. However, for many people stress has become synonymous with work.
According to The National Institute for Occupational Safety and Health (NIOSH), early warning signs of job stress include:

A. headache
B. sleep disturbances
C. difficulty in concentrating
D. short temper
E. upset stomach
F. job dissatisfaction
G. low morale

What causes stress in the workplace?

The National Institute for Occupational Safety and Health (NIOSH) is the federal agency responsible for conducting research and making recommendations for the prevention of work-related illness and injury. As part of its mandate, NIOSH is directed by Congress to study the psychological aspects of occupational safety and health, including stress at work. NIOSH works in collaboration with industry, labor, and universities to better understand the stress of modern work, the effects of stress on worker safety and health, and ways to reduce stress in the workplace. Through its research program in job stress and through educational materials, NIOSH is committed to providing organizations with knowledge to reduce this threat.

A report by the National Institute for Occupational Safety and Health.
The NIOSH report states that job stress results from both the characteristics of a worker and the working conditions, but that there are differing views as to which set of circumstances is the primary cause of job stress:

1. Individual characteristics – According to one school of thought, differences in personality and coping style of the worker are most important in predicting job stress. Thus, what is stressful for one person may not be a problem for someone else. This viewpoint leads to prevention strategies that focus on workers and ways to help them cope with demanding job conditions.

2. Working conditions – Scientific evidence suggests that certain working conditions are stressful to most people. Evidence from recent studies argues for a greater emphasis on working conditions as the key source of job stress and for job redesign as a primary prevention strategy.

Both viewpoints suggest ways to prevent stress at work, but NIOSH “favors the view that working conditions play a primary role in causing job stress.” The report cites the following job conditions that may lead to stress:

1. The design of tasks – heavy workload; infrequent rest breaks; long hours; and routine tasks that do not utilize workers' skills
2. Management style – poor communication in the organization and a lack of family-friendly policies
3. Interpersonal relationships – an unsupported social environment
4. Work roles – conflicting or uncertain job expectations; too much responsibility
5. Career concerns – job insecurity; lack of opportunity for advancement or promotion
6. Environmental conditions – unpleasant or dangerous physical conditions such as crowding, noise, air pollution, or ergonomic problem.

What are the health effects of job stress?

The nature of work is changing at whirlwind speed. When the requirements of the job do not match the capabilities, resources, or needs of the worker, harmful physical and emotional responses occur. Perhaps now more than ever before, workplace stress poses a threat to the health and safety of employees and to the health organizations responsible for their care.

According to NIOSH, many recent studies have looked at the relationship between job stress and physical and emotional problems. The report states: “Mood and sleep disturbances, upset stomach and headache, and disturbed relationships with family and friends are examples of stress-related problems that are quick to develop and are commonly seen in these studies. These early signs of job stress are usually easy to recognize. But the effects of job stress on chronic diseases are more difficult to see because chronic diseases take a long time to develop and can be influenced by many factors other than stress.”

NIOSH reports that evidence suggests workplace stress plays an important role in several types of chronic health problems, especially:

1. cardiovascular disease
2. musculoskeletal conditions
3. psychological disorders

The economic impact of these issues impacts not only the individual, but also the businesses that employ them: Health care expenditures are nearly 50% greater for workers who report high levels of stress.

What can managers or employers do to reduce stress at work?
To reduce stress at work, an individual should try to maintain a balance between work and family or personal life, a supportive network of friends and coworkers, and a relaxed and positive outlook. But it is also important that the workplace is a “healthy” organization. There are several ways to reduce stress in the workplace. While the employee may not have control over whether the workplace entirely supports a more stress-free lifestyle, possible changes can be made, or individuals can make an educated decision as to whether the workplace is right for him or her.

An understanding of the relationship between individual and organizational health
Recent research suggests that policies benefiting worker health actually benefit the bottom line. A healthy organization—one that has low rates of illness, injury, and disability in its workforce—is competitive in the marketplace. NIOSH research has found the following organizational characteristics to be associated with both healthy, low-stress work and high levels of productivity:

1. recognition of employees for good work performance
2. opportunities for career development
3. an organizational culture that values the individual worker
4. management actions consistent with organizational values

Stress prevention
According to the Journal of Applied Psychology, St. Paul Fire and Marine Insurance Company conducted several studies on the effects of stress-prevention programs in hospital settings. Program activities included:
employee and management education on job stress
changes in hospital policies and procedures to reduce organizational sources of stress

establishment of employee assistance programs
In one study, the frequency of medication errors declined by 50% after prevention activities were implemented. In a second study, there was a 70% reduction in malpractice claims in 22 hospitals that implemented a stress-prevention program but no reduction in claims in a matched group of 22 hospitals that did not implement stress prevention policies.

Stress management
Nearly one-half of large companies in the United States provide some type of stress-management training and Employee Assistance Plans (EAPs) for their workforces. Workers can learn about stress, time management, and relaxation. EAPs also provide counseling for employees with work or personal problems. Stress-management training can help to rapidly reduce stress symptoms such as anxiety and sleep disturbances. Such trainings are often easy to implement and provide, but NIOSH reports that:

1. The beneficial effects on stress symptoms are often short-lived
2. They often ignore important root causes of stress because they focus on the worker and not the environment

Organizational change

Companies that bring in a consultant to recommend ways to improve working conditions take the most direct approach in reducing stress at work. According to NIOSH, programs that identify the stressful aspects of a working environment deal with the root causes of stress at work. Such programs result in the design of strategies that target the identified stressors. However, such programs can involve changes in work routines, production schedules, or organizational structure. Often managers are uncomfortable with this approach.

Yet as the NIOSH report states, this strategy is key: “As a general rule, actions to reduce job stress should give top priority to organizational change to improve working conditions.” The report continues: “But even the most conscientious efforts to improve working conditions are unlikely to eliminate stress completely for all workers. For this reason, a combination of organizational change and stress management is often the most useful approach for preventing stress at work.”

http://www.peersupport.org/

Extracts taken from a Help Guide to Mental Health Issues.

Workplace Stress Resulting From Brain/Spinal Injury

Memory Help One
Amy Price PhD

In MVA involving injury memory deficits can become an issue. Pain and lack of sleep contribute to this as do many of the medications prescribed to make it go away. There is anxiety and grief over financial loss or changed status. This compounds the issue. Each year more money is spent on pet food than for treatment to restore survivors of mild traumatic brain injury. Eighty percent of individuals diagnosed with mild brain injury have needs pertaining to the injury that are not presently met by current legislation. Treatment is described as too little, too late. It was once thought that if there was no improvement in cognitive status in the first six months following an injury further progress would be minimal. Advances in science show this is no longer an absolute. Progress is possible.Every year Traumatic Brain Injury causes 20 times more disabilities than AIDS, Breast Cancer, Spinal Cord Injuries, and Multiple Sclerosis combined. Traumatic Brain Injuries have claimed more lives than all U.S. wars combined since 1977. Approximately 1.5 million Americans sustain a Traumatic Brain Injury each year. Traumatic Brain Injury is the number one cause of both death and disability in children and young adults.

WHAT IT DOES & HOW IT WORKS

Do you need help fixing your broken brain? Even if you don’t this article contains great strategies for improving memory skills and coping with life.

Want help with your memory? Let us look together at where the problem might be so we can suggest solutions. Information is first filtered through the senses (seeing, hearing, touching, smelling) or sensory memory. The sensory input combines with what we already know as the brain attempts to classify the information before it is encoded into our memories. Before it can be encoded accurately we have to pay attention or attend to it. The brain has only a few seconds of what is called working memory to encode material. When the information is needed we call on it to come out. This process is called retrieval.

POSITIVE STRATEGIES FOR A VARIETY OF SITUATIONS

Retrieval can be enhanced by rehearsal. The most common kind of rehearsal is saying something like a phone number over and over until it sticks in the brain. This is a problem for a person with memory deficits as by the time they get to the last number they forget what it is! In this case there is an unorthodox but useful strategy called chunking, instead of remembering numbers digit by digit such as 301 5700 think of three hundred one, fifty seven hundred. There are other solutions, write information down while repeating it to your self or ask someone else to write it for you. This is most useful when someone is giving you directions. The next step is to read the information back to who ever you got it from and ask them if your version is correct. This is also good for reinforcing understanding in conversation as sometimes what someone says to us is different to what we heard them say or is not what they meant.

To deal with problems of losing things here is some help. Pick places where you are comfortable storing things like keys, licenses etc. Make it a habit to always put them back in those places only. Write down where these places are and put it somewhere you will see it everyday in case you forget. When you go to a store only take something that can be attached to your body, forget about the purse that could be left in the shopping cart or car keys you carry in your hands.

When the memory is less than stellar even a parking lot can seem like a hopeless maze. Most cell phones have voice recorders on them as do many other devices. Record where you parked the car, for example the car is at exit c parking lot level three, third car down. Pay attention to which store you enter and what is close to the door, for example Macy’s, men’s shoes. This way if you get lost you can ask someone where these landmarks are and find your way. Here is another strategy A piece of paper/card with a grid (kids math jotter paper with the little blocks) with place for a couple of stores names around the periphery or a land marks/monument, a McDonalds or a gas station and make an X in the block of the area where you best estimate your car is. A good place to put ID, credit card, money, parking lot stubs is in a 'fanny pack'. If you can not remember how to get somewhere or get home buy a turn by turn GPS or phone a non judgmental friend.

There are many kinds of memory, visual auditory episodic, semantic, conceptual and more. This is good news because it means that you can use another kind of memory to enhance which ever kind is not working for you right now.

Here are some useful strategies. To remember an event think about what else you did, where it happened, the conditions around the event, ask your self how you felt that day, who was with you even what you did afterwards. Anyone of these can release a cue to help you remember.

To remember Peoples' names, think about where you first met the person or go through the alphabet mentally, sometimes it helps to recall their significant others’ names or occupation. Just one piece of information can trigger the missing link. If all else fails ask them for a business card and read it or ask how they spell their names.

Learning something?-To remember something you need to learn, teach it to someone else, read your notes on tape and play them as you walk or at the gym, create a mind map or make the information into a story. Trouble finding words, look up a word that means the same in a good dictionary usually the synonyms will be displayed and your missing word will show up. A good dictionary can also show you how to pronounce words you have forgotten how to say. Forget how to spell it and spell check is not bright enough to figure it out? Break the word into syllables and spell the part you can figure out, from here spell check may pick it up or you may remember the whole word.

In the kitchen-For kitchen memories….don’t leave the room or be otherwise distracted when you have a pot on the stove. The same people that distracted you will remind you over and over about how you forgot something again! Do one thing at a time until your memory is healed, your ability to multitask will usually return. Buy appliances that turn off automatically, this may be expensive initially however it is cheaper than a house fire! Discipline yourself to use timers.

Often individuals forget steps of a process/task. In this case it is useful to lay everything out ahead of time. Think through what steps you need to take to complete a process/task. If this is difficult get someone to help you and write it down or record it for yourself.

For schedules…got an appointment write it down, put it on the computer, in the day timer or on a PDA. Another method is to call your telephone answering service and leave your self messages as they come up. Alternately make a list and number it for priorities then cross them off when you are finished. Too busy to prioritize…you are too busy! Make changes or you will get buried.
I Hope this helps some, nobody remembers everything so don’t beat yourself up. Keep working at it slowly and surely the more you use your brain the better it will get.

Amy Price, Ph.D. Is the Executive Director of The Spinal Injury Foundation. Their Mission "is dedicated to research, education, and advocacy for those with chronic spinal injuries".