...towards A RECOVERIST MANIFESTO

Last Thursday saw partners from across Europe coming together to celebrate the work of the I AM: Art as an Agent for Change project. The symposium was a rip-roaring success with lots of passion and vision from speakers including Zoe Welch from Lifeline who set the UK recovery movement in context for us. This was followed by Dr Zoe Zontou from Liverpool Hope University who shared her vision for addiction to be re-framed in terms of social activism. Following presentations from partner organisations in Italy and Turkey, it was superb to hear the voices of Joe from Pescara and Carl from good old Blighty, whose poem, I Annihilated God for U was profound and moving - and just brilliantly performed. I can’t thank you both enough. The artists Cristina Nunez and Ali Zaidi passionately shared their experiences and background to their participatory work with the delegates. This was all wrapped up in an illuminating and honest debate, and it was heartening to see people had come from as far as Brighton in the UK and superb to meet so many people in recovery - new faces and old friends.

I gave a presentation (of sorts) of the first iteration of the Recoverist Manifesto which you can see a more tempered version of, by clicking on the image above. But it is the sort of thing that needs performing. A gentle warning - it contains the f-word! But you’re an adult - you can cope! A written version of the Recoverist Manifesto with all sorts of augmentations and enhancements from new voices, will be published online in September alongside an oh-so-limited-edition, trilingual hard-copy!

The opening of the exhibition of work by Cristina Nunez, Selda Asal and Ali Zaidi - I AM: Memoirs of Addiction - followed the symposium and is open to the public until the 31st July. Because the university is more ‘secure’ over the summer months, I recommend going to the new School of Art Benzie Building on Ormond Street and the reception staff will direct you to the Link Gallery. Alternatively, access to the Link Gallery can be made via the Holden Gallery in the Grosvenor Building on Cavendish Street, but only after 12:00 each week day.

The video Per te Mamma by Ali Zaidi, is available to watch online above. All this work would have been impossible to achieve without the project management and vision of Mark Prest, Director of Portraits of Recovery, to whom I give my big thanks.

All of the work will be available online shortly, on a dedicated website that will include the art works, Recoverist Manifesto and other elements of Italian and Turkish perspectives.

WILL SELF and Urban Psychosis

The Will Self event this Friday is completely SOLD OUT, but we will record the event and post online.

Arts & Health: An International Evidence Base update

The the new online International Evidence Base that interrogates the Long-Term Health Benefits of Participating in the Arts is available free of charge and I note from a couple of emails, that those of you using Explorer as a browser, can’t see the icon at the top right of the screen that links to the work! I recommend using Firefox of Chrome, but we are looking to resolve this and will post online next week. Great responses from so many people to this work. Again, my big thanks to Dr Rebecca Gordon-Nesbitt for her great work.

Wallace & Gromit’s Children’s Foundation 

The Wallace & Gromit's Children's Foundation has announced that its grants making programme will re-open for applications on the 1st October 2014. The Foundation supports projects in children's hospitals and hospices throughout the UK to enrich and enhance the lives of patients. Projects that could be considered by the Foundation include amongst others:

Arts, music, play and leisure programmes

Facilities to support families of children treated in hospitals or hospices

Care and facilities in hospices

Supporting children with physical and emotional difficulties

Medical equipment; etc.

The closing date for applications will be the 5th December 2014. Read more at:

http://www.wallaceandgromitfoundation.org/about/apply-for-grant/

Register and submit abstracts by clicking the above banner.

Austin and Hope Pilkington Trust 

The Austin and Hope Pilkington Trust which awards grants to registered charities in the United Kingdom has announced that the next closing date for applications is the 1st November 2014. During 2014, the Trust is seeking to fund projects that promote Music and the Arts and help the elderly. Grants are usually between £1,000 and £3,000 and are awarded for one year. Previous grants awarded include: http://www.austin-hope-pilkington.org.uk/what-we-fund/

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...in a week when a critical debate is to take place in the House of Lords on Assisted Dying, it's heartening to hear Desmond Tutu speak out in favour of serious debate on this, the most important of subjects. The debate takes place on Friday and you can find out more, by clicking here.  

For those of you who missed last weeks blog, Rebecca and I have been thrilled with the positive responses to the new International Evidence Base that interrogates the Long-Term Health Benefits of Participating in the Arts. Thank you.

APPG update...
I know some people are curious about the All Party Parliamentary Group for Arts, Health and Wellbeing (APPG), so I thought I’d just give you a flavour of the session that took place on Wednesday 2nd July. A full set of formal notes from the meeting will be HERE very soon, but these are my informal notes.

The APPG was really quite something, chaired beautifully as ever by Lord Howarth of Newport and with guest speakers Sir Robert Francis QC, (author of the Francis Report) Dr Elen Storm (paediatric trainee and award-winning poet), Head of Arts Strategy at Guys and St Thomas’ charity, Nikki Crane and her collaborator Dr Suzy Wilson, Artistic Director of Clod Ensemble. The framework for the session was The Care Act and the question: How the arts and culture can contribute to the quality of care following the Francis Inquiry? 

It was refreshing and inspiring to hear Robert Francis wistfully and with a smile, reflect that he wished that he had included an arts recommendation in his report. In truth, amongst other things, he used the group to share a personal account of his own mothers admission to hospital via a 7 hour wait in casualty and his provocative question - was EastEnders on a pay-for TV set, really the best cultural offer we can give people staying in our hospitals?

Describing hospitals as ‘bleak places’ he reminded us that it is poetry that communicates the reality of disease, citing poet Clare Best’s lyrical description of a breast cancer mastectomy, which had moved him in ways beyond any functional description of the procedure. He emphasised ‘the healing properties of the arts’ and described the arts as having ‘an important part to play in health and care.’ Perhaps some of his more potent reflections were on health care staff who start their careers with good intention and vision but who ‘have it crushed out of them.’ He suggested very persuasively that he believed that ‘the arts can address this.’

Questions and comments from the floor that particularly resonated with me, included Professor Chris Fowler from Health Education England. who questioned the that the evidence could ever be completely definitive, but describing the work needing to be a social movement. Former chief inspector of prisons, Lord Ramsbotham astutely pointed out that this work is about the ‘social process rather than a scientific process and the evidence can lead to a culture change in the NHS.’ 

It would be very easy to ask, is this just another talking shop? Well, I'm one of the most cynical, but what I see and hear, are passionate and committed people, who aren't chasing votes, but actively pursuing a vision for greater health and wellbeing - and critically - who see creativity, the arts and culture - as a powerful force for change. The full minutes will shortly be available from a dedicated webpage alongside the other material already available here. My personal thanks to Alex Coulter for her brilliant organisation.

I've had the pleasure of speaking at two public health conferences over the last couple of weeks and have been blown-away by the response of people in the field. It genuinely feels like we are at an important moment in this Arts and Public Health Movement. I have been particularly impressed by Valerie A. Little the Director of Public Health for Dudley's annual report, which in fact, is an Arts and Health report par exellence. Brilliant work Creative Health too! Click on the image above to see just what I mean.

URBAN PSYCHOSIS
Opened in the Holden Gallery on Friday evening. My thanks to Dr Steven Gartside and Zoe Watson for their excellent vision, curation, and planning. Whilst the Will Self event is sold out, I am keeping a waiting list, so click on his name to join it. If you have booked tickets, but can’t make it, I’d appreciate it if you would also click on his name and cancel your place.

Whilst at last years collaborative MORTALITY exhibition, I contributed an essay to the catalogue, to this year exhibition, I offer a tidbit below as my small contribution to this Urban Psychosis agenda. No offence is intended - well maybe just a little...

IN PRAISE OF THE UGLY BASTARD  

I’ve been obsessing over a few images recently, both of which somehow remind me of my childhood. One is a photograph by John Davies of the cooling towers of the long-gone Agecroft Power Station in Salford; the others are the aggregated urban fantasies of my hometown’s latter-day Fauvist, Chas Jacobs. It’s a cloying nostalgia from which I’m suffering, in which these works provoke a little melancholia and just a touch of impotent rage. It doesn’t matter if you don’t know these works; I'll explain my thinking.

In the late 1970s, I came into my own, initiating a retreat from the shadows of some familial dysfunction by starting to paint. I’d observed my mother doing something similar as part of her own escape into increasingly complex painting-by-numbers kits. This was considered high art by the family, and my own experiments in copying portraits of pop stars from the NME were considered a bit pretentious by comparison. Only my early emulation of the erotic fantasy world of Frank Frazzetta generated some interest from the men of the house. In truth, this kind of copying was lazy and uninspired. Eventually, art school beat it out of me, and I settled down into a flat and bland ‘style’, something akin to Patrick Caulfield’s colour-blind, half-witted acolyte. Although I didn’t quite realise at the time, I was really quite talentless. 

Over this same period of long hot summers and first kisses, I was increasingly aware of the slow decline of my home town, Morecambe. Its once grand promenade was witnessing the up-market Littlewoods transformation into a down-beat Hitchens, which, in turn, congealed into an anonymous discount furniture warehouse. Busy high streets have slowly emptied, their cinemas and swimming-pools closed. Tourists dwindled and, with the building of two nuclear power stations, a different kind of economy emerged, based on transient labour. Many were the hours that my brother spent with the navvies who set up camps on the building sites around our school, his appetite for drink nurtured at an early age.

Much of my distorted memory from this period is moderated by television, with its three-channel output burnt into my memory – the bleached out technology-obsessed utopia pitched at us through the lens of free-marketeers. How beautiful Spaghetti Junction looked alongside well-oiled industry when mediated by a smooth-tasting Cadbury’s aesthetic, Jimmy Saville promises, Diddy Men, Dirty Old Men and Bernie the Bolt. 

Like others who grew up in this era, I was peddled fast-moving and high-rise glamour – plumes of smoke from chimneys and curling around seductive mouths. I’ve found that aesthetic hard to shift, and have incrementally become drawn to the beauty of the discreet urban invasion of giant pylons, carrying the necessary electricity to televisions, computers and mobile phones alike. Like a latter-day Marinetti, I am continually enticed by our beautiful ‘scars’ on the landscape.

Is it unthinkable to love the belching plumes of sulphurous smoke that somehow enhance swaying cornfields? Does this mean I’m divorced from any neo-romantic aesthetic? The most thrilling part of a journey across England this week was the emergence of the eight water-cooling towers of Ratcliffe-on-Soar power station. In the early morning sun, these sentinels thrilled me to the core. Give me the Kalgoorlie Super Pit over any divinely created Arizonan land gash. Intelligent design? No. Imagined and created by human minds and hands. Quite thrilling.

Actually, there must be poets lying in brown-belt factory discharge, waxing lyrical about our augmented, liminal no-mans land. Weren’t Bernd and Hilla Becher doing something of that through their meticulous documentation of our industrial landscapes? It’s natural then, that I’m drawn to this sumptuous photograph of Agecroft Power Station taken by John Davies in 1982. 

As public art seems to balloon in size, we appear to be hell-bent on destroying these functional industrial giants. Yet, at the same time, the NIMBYs assert/defend their rights to a manicured or rustic Arcadia – those smug, self-centered guardians of our green and pleasant land, who rally the troops to protect their myopic individualism and who bleat the loudest when the tides rise and they can’t get the power on, hysterical when the phone signal goes and desperate for high-speed access to stocks and shares. So artists are drafted in to redesign electricity pylons to ‘blend in’ with the countryside or look ‘beautiful’, and those nasty radio-transmitting masts can be dressed up as trees, to disguise their function. Hoorah. You’re deceiving yourselves. Not in My Back Yard? YES, in MY Back Yard. 

I dream of the largest wind turbine being erected in my meagre back yard, its fat base bolted into Victorian tiles and its constantly moving shadow blocking out the light, like some great sundial, counting my days, soothing me to sleep. I can but dream.

  >>>>>>>>>>>>>>>>>><<<<<<<<<<<<<<<<<<

A Chas Jacobs design on a chip shop plastic bag, found in the gutter outside my home and which was the spur to write this doggerel

I recently had the pleasure of sitting with my fellow, pallid patients in the waiting rooms of my GPs surgery and local hospital, and it was with great horror that, in both these settings, I was subjected to the psychological battery of some dim-witted middle managers’ idea of an ill-conceived son et lumière  – on repeat! The local radio station, 96.9 The Bay, droned on through my extended wait in the doctors, whilst daytime TV was the dish of the day in the hospital. Force fed sound – local adverts, inane chatter and the music I’ve studiously avoided all my life. But it was the walls of the rooms that drove me to despair, peppered with nastily framed monstrosities that are the feverish delusion of local ‘artist’, Chas Jacobs. (no link intended...do your own google search) Imagine, if you will, some bilious flattened-out, artless rendition of purgatory, dressed up with figments of your own home town – a fifth-hand rendition of an opiate addict’s directions from one tourist hell-hole to the next. If I was the talentless mimicker of Caulfield, this is surely L.S. Lowry’s simpering, punch-drunk offspring. If an arts and health researcher had taken bloods, saliva, heart rate etc, they would have found my mind and body grievously assaulted by this deficit of imagination, in its bargain-bucket approach to aesthetics. Unnecessary harm was inflicted on me by our dear NHS. 

Those who create delusional romantic pot-boilers from the rubbish-strewn streets of faded seaside ghettos are oblivious of a deeper aesthetic. Let the dwarf mountains of Morecambe Bay, still bathed in Chernobyl's wind-swept phosphorescence, hold onto that temporary setting sun. Let’s imagine that Friday night booze-spewed tsunami engulfing it all. Chrome Yellow, Soylent Green, Purple Haze, Blue Velvet, Lady in Red, Lady Di dead (and dancing with some trumped-up hanger-on). Street loads of dying flowers to someone you never knew and despite all the caressing of HIV hands, she probably never really gave a damn about you and your 9 to-5 life. Pigs are eating pigs, cows are eating cows and we’re crying as we eat the horses, knee-deep in our own shit. Please Chas, this is the vision of dear Albion that needs your rendition.

My High Street is less the idiosyncratic idyl of Eric Ravilious, and anyhow, it has been replaced by the cloying stench of ‘hand made’ cosmetics, spewing out insidious pseudo-organic toxins from the open doorways of air-conditioned soap and candle shops. How I miss the sickly-sweet stench of my own childhood and the weekly rendering of animal parts at the poetically named Nightingale Hall Farm. 

The countryside can, indeed, be enhanced by a carefully positioned smelting unit. Derek Jarman’s little shack is only what it is because it hitches a ride on the shadow of Dungeness’s advanced gas-cooled nuclear reactor. No potted plants can detract from the beauty of this, the ultimate provider of all our consumer needs.

Diversity Mental Health Month: Why It is Needed and How It Came to Be

By Steve Koh, MD, MPH, MBA

July of 2014 is the very first APA Diversity Mental Health Month. This
emphasis on mental health needs of diverse populations is much needed. While we
have diversity oriented month observances for specific population groups like
the Black History Month (February), National Women’s History Month (March),
Asian Pacific American Heritage Month (May), Gay and Lesbian Pride Month
(June), American Indian Heritage Month (August), and Hispanic Heritage Month
(September), we have not had a dedicated month more broadly addressing diverse
populations and mental health issues.

I cannot overemphasize the importance of this month. For the first
time, together, we will bring attention to the unique and challenging needs of
the diverse populations with mental illness and substance use disorders, work
to decrease mental health disparities, and engage with diverse populations to
help promote and grow future mental health champions in the communities.

The concept for Diversity Mental Health Month came from a group of
participants in APA’s Minority Fellowship program.  The program’s goal is to eliminate racial and
ethnic disparities in mental health and substance abuse care by providing
specialized training and mentorship. The fellowship fosters those with diverse
backgrounds who have chosen to become physicians specializing in mental health
and to do this work with the diverse populations.  



But what happens when we go home? What then? We felt that it was easy to get
lost when we left our APA meetings in Washington DC. How do we galvanize our
colleagues at home to look at the importance of minority mental health issues?
To recognize the stigma of being an ethnic and cultural minority and also
suffering mental illness? To understand that many minority students do not
consider going into field of medicine let alone mental health profession? To
appreciate the importance of cultural competency and humility in working with
diverse patient population?

Without
involvement a coordinated effort by the APA, it was our belief that while we
personally benefited from the fellowship experience, our impact would be
limited. There needed to be a designated time for all of APA to bring attention
to this important patient population.  So
the idea was born to create a Diversity Mental Health Month. The APA Assembly asked
APA staff to help create a month designated to minority mental health issues
and for the APA to actively promote the month.

I hope that others are excited about this new endeavor of the APA as I
am. The challenges are great but together we can bring the needed attention to
this area of our profession.

Many resources, including an infographic with basic data on mental
health disparities, and brochures and fact sheets on specific populations,
suggested activities, video messages, and more, are available at www.psychiatry.org/diversity-month.

☁ + ☼ = ♒

The Long-Term Health Benefits of Participating in the Arts: An International Evidence Base

Readers of this blog will remember that the Arts and Humanities Research Council funded Arts for Health to conduct research into the evidence that exists around the longitudinal relationship between arts participation and health. We are pleased to announce that the first output from this project was launched at the annual conference of the UK Faculty of Public Health on Thursday, where Dr Rebecca Gordon-Nesbitt and I spoke.

Available by clicking on the image above, or by visiting http://longitudinalhealthbenefits.wordpress.com/ this online repository includes short summaries of each of the studies to have included arts participation in long-term considerations of health, together with links to the majority of the original research articles. While these results are tentatively presented, the combined evidence shows a positive association between attending arts events or engaging in creative practice and physical/psychological health. As ever, we present these studies while remaining mindful of questions around who has access to the arts and health.

URBAN PSYCHOSIS will run from 14.07.14 - 22.08.14 with work by John Baldessari – Matthew Buckingham – Sophie Calle – Marc Camille Chaimowicz – Moyra Davey – Luke Fowler – Gillian Wearing – Catherine Yass 
Only a few tickets left for the Will Self talk...

Preview, Friday 11 July, 6-8pm

I AM - WE ARE - a free s y m p o s i u m

I AM: Memoirs of Addiction Recovery: an exhibition

17th July at MMU. Details and booking by clicking on logo above

GSK IMPACT Awards 

It’s that time of year when I receive my publicity for the GSK Impact Awards in the hope that I’ll publicise them and encourage you, the hard-pressed arts and health community to get your entries in and have the chance of winning up to £40k plus bucket-loads of GSK publicity and national recognition. Hey - I am doing! In fact, I know some great organisations who have applied and won. It certainly does get you publicity. But hang on for a second, before you apply for the GOLD, let’s remember GSK is GlaxoSmithKline, one of the UK’s biggest industries and the provider of all your pharmacological needs, so let’s think about the publicity machine that you’ll be part of.

In terms of clinical trials, GSK have been found guilty of promoting two drugs for unapproved uses and failing to report safety data about a diabetes drug to the Food and Drug Administration (FDA) and fined $3bn - the largest healthcare fraud settlement in US history. Thanks to the forensic work of the GP Ben Goldacre and others, I’ll share some of the reasons why I continue to feel a little unrest, at GSK’s oblique affiliation with the arts/health movement.

The case I’ve referred to concerns 10 drugs and GSK’s admission of their promoting antidepressants Paxil and Wellbutrin for unapproved uses, including treatment of children and adolescents until a ban in 2003 over concerns it triggered suicides. Seroxat or Paxil is a common anti-depressant prescribed to millions of UK patients every year. 

Additionally GSK were found guilty of paying bribes to doctors. The US attorney Carmin Ortiz comments, "The sales force bribed physicians to prescribe GSK products using every imaginable form of high-priced entertainment, from Hawaiian vacations [and] paying doctors millions of dollars to go on speaking tours, to tickets to Madonna concerts." This catalogue of dodgy dealings, is again under the spotlight in China, where a bribery investigation is underway alleging that GSK as a company has orchestrated payments - said to total £321million - offering prostitutes to doctors to persuade them to prescribe its medicines, and funnelling the money through travel agents. One of the arrested GSK executives, Hong Liang, told Chinese state TV, that bribes paid to doctors and officials pushed up the prices Chinese patients pay for GSK drugs by as much as 30%. (click on the 'sex-tape' image above for recent updates on this)

Whilst the company is valued at £113billion, the fines GSK is accruing amount to small fry, but this kind of fraud and deception isn’t limited to GSK - far from it - it has been endemic across the pharmaceutical industry, with “66% of fraud cases in the US involving the pharmaceutical industry…”

Ben Goldacre asserts that the industry in general, spends around twice as much on marketing and promotion as it does on research and development - of which it feels like the Impact Awards are your oh-so-discreet and saccharine-laced opportunity to add to the marketing strategy. (or is that strychnine-laced?)

And if that all isn’t sweet enough for you, in our market-driven world where The American Academy of Nutrition and Dietetics is sponsored by Coca-Cola and the Chair of the UK government’s Scientific Advisory Commission on Nutrition has served on the European advisory boards of both Mars and Coca Cola, and is said to be sceptical that sugar is the cause of obesity! The same man sits on the UK government’s Calorie Reduction Expert Group ultimately influencing public health in England. And by-the-by, the British Nutrition Foundation takes funding from Tate and Lyle, who argue the money has no influence on their scientific independence! Well that’s reassuring then.

Yes, all your pills and potions are legitimised by the state and pedalled to you exclusively by often misinformed clinicians, whilst our alcopops, vodka-shots, cheap supermarket booze and pop - well - they’re all paying their taxes, so what the hell? Not like those nasty dealers on street-corners eh?

And the media have a big part to play in all this too. In terms of mainstream media the more sensational the story, the more column inches are given over. Newspapers, in print and online, are the gatekeepers for what we receive and science and medicine journalists are not immune to prioritising sensation over the more mundane and helpful facts. 

Alasdair Forsyth’s quantitative exploration of drug fatalities in the popular press, reveals that in 1992 you needed to have 265 deaths from paracetamol poisoning for one story to appear, but every death from MDMA received, on average, one story. Similarly a study of the BBC’s coverage in 2003 revealed 8,571 people dying from smoking would result in one story, whilst there were three stories for every death from the more sensational variant CJD (Mad Cow Disease).

Perhaps whilst the popular press more blatantly sensationalises and controls the news that we consume, those illustrious academic journals too have their fair share of gatekeepers. In a 2010 federal court case in Australia against pharmaceutical giant Merke Sharpe & Dohme the court heard that the manufacturing company had engaged in misleading practices to promote the prescription and usage of Vioxx, including "fake" journals and guidelines to "drug reps" that minimised the adverse cardiovascular risks. These much hallowed journals were published by none other than Elsevier, who once rumbled, issued their profound apology! 

Goldacre discusses fake journals, ghost writers and the all out abuse that Big Pharma wage on us; the gullible public as well as the clinical world. His ourage at withheld negative data is something quite palpable.

So, as you prepare your bids to dear old GSK, remember that you’ll also be providing some feel-good marketing for them: actually, can you imagine how cheap you are as a marketing tool?

Winston Churchill Memorial Trust

Do you work across the wide field of Design, Heritage Crafts or Carpentry? Would you benefit from travelling overseas to meet others with the same specialism as you? The Winston Churchill Memorial Trust are seeking people working in carpentry, traditional heritage crafts, the applied arts in architecture, interiors, product and graphic design.  The Designers category is the first year of a joint partnership with the British Council, as part of their new development programme for architects and designers. Successful applicants in this category will be eligible to apply to the British Council's Architecture, Design and Fashion department for a grant to follow up their Churchill Fellowship. These grants will help with events, exhibitions and further international collaboration. Read more here: http://www.wcmt.org.uk/report-categories/designers.html 

Winston Churchill Travelling Fellowship

The Trust awards travel grants to men and women who will be able to undertake research overseas and on their return disseminate their new knowledge and examples of best practice. Applicants must demonstrate that their project will have a wider benefit within their community or field, in addition to their own personal development. You must be over 18, and a British Citizen under the 1981 Nationality Act, who must also be resident in the UK. No qualifications are required.http://www.wcmt.org.uk/ 

Depression & Cancer

By Brad Zehring, DO @DrZehringDO

“Cancer can take away all of my physical abilities. It
cannot touch my mind, it cannot touch my heart, and it cannot touch my
soul”  - Jim Valvano

But, what
happens when it does?

Depression
is a multifactorial disorder that requires acknowledgement of the biological,
psychological, and social aspects of a person’s life. Professionals in the
mental health community describe this as the biopsychosocial model. It provides
an understanding of the factors influencing a person’s mental and physical
state of being.

When mental health professionals talk about depression they
often do so in regards to Major Depressive Disorder (MDD). According to DSM 5
(Diagnostic and Statistical Manual of Mental Disorders), 5 out of 9 criteria
are needed to diagnose MDD. It requires a depressed mood or anhedonia (lack of
enjoying what was previously enjoyed) for greater than 2 weeks including:
disturbances in sleep, guilty/hopeless/worthless feelings, poor concentration,
low energy, changes in appetite (weight loss or weight gain), psychomotor
agitation or retardation, and suicidal ideation.

Depression affects your entire body. But, the physical
aspects of depression are often overlooked. It is common for people with
depression to experience weight changes, digestive problems, headaches, back
pain, muscle and joint pain, and disruptions in sleep cycle. Many symptoms that
are present in cancer.

Depression has been linked with many health problems,
including cancer. Cancer is a heavy word. The enormity of the word brings many
images to the forefront of our imagination: radiation, chemotherapy, losing
hair, sickness, weakness, and death - among others. There is so much symptom
overlap between cancer and depression it can be hard to recognize the etiology
of the symptoms.

It is important that health care professionals, family
members, and other caretakers
are vigilant with a person’s mental well being after they are diagnosed with
cancer. Even if a person has never experienced depression previously, their
risk of depression is increased when they find out they have cancer. Research
shows that the incidence of depression increases proportionately with the
cancer’s progression. It is believed those with depression have increased
likelihood of depression because of increased immune response (cytokines)
within the body.

It is important not to assume that someone with cancer has
an appropriate depressed mood due to his or her circumstances.  This is why it is important to screen for
depression in those diagnosed with cancer. Screening for depression can help
“tease out” symptoms related to depression and symptoms related to the cancer. Treating
depression in patients with cancer can help them focus on their treatment and
have the motivation to do everything needed to possibly achieve remission.
Proper treatment gives them the ability to focus on their future. Cancer alone
is enough, but when combined with untreated depression the results can be
deadly.

After recognizing depression in someone with cancer, there
are ways to treat depression in parallel with cancer treatment. There are two
forms of treatment. One involves medication and the other involves
psychotherapy, or talk therapy. The typical medications for depression are
antidepressants like Selective Serotonin Reuptake Inhibitors (SSRI) and
Serotonin and Norepinephrine Reuptake Inhibitors (SNRI). These medications have
been around for a long time and are generally well tolerated. They take
anywhere from 2-6 weeks for clinical efficacy. These medications should be
monitored with cancer treatment, as there can be drug interactions and side
effects that may not be present in someone taking these medications without
cancer. In addition to medications, psychotherapy can be effective. More
specifically, Cognitive Behavioral Therapy (CBT) can help people change their
negative thoughts about cancer and their future. For the most efficacious
treatment a combination of both should be implemented.

Cancer is a serious illness and a well-developed
multi-disciplinary approach is necessary to best treat the patient. Cancer can
cause a lot of different disturbances in physical and mental health. It is
important to have health professionals, like psychiatrists
and psychologists, part of the treatment team to ensure proper treatment of the
whole patient.

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