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Approved by Dr Adil Jawad MBBS, DPM, FRCPsych — Clinical Lead for MindClinix

A diagnosis of depression can send you into a tailspin. What is the next step?  How do you move forwards when you are in distress, despondent and dejected?

Depression affects everyone differently. In men, it may be disguised as: risky behaviour, headaches, digestive issues, difficulty sleeping or sleeping excessively,  irritability and impulsive anger.  

Accepting a diagnosis of depression can be challenging for men:  

“Admitting that I had depression”, said Tony (45), “was the biggest hurdle for me. I was the man of the house, the breadwinner, the strong and stable husband and father. It was devastating to think I may not be any of those things”.

Initially, Tony found it difficult to seek help and support. He grew up in a house where depression was not discussed, even though he suspects his father may have struggled with ill mental health.

“My dad was old school. He didn’t talk about feelings and emotions. He was always the dominant and, seemingly, strong father figure. When I was about ten years old he became very distant and didn’t have much to do with myself or my siblings for a long time. Mum would say he was tired from work so we all just accepted it. Depression wasn’t something I would have even thought about.”

 

What happens when diagnosed with depression?

The NHS proposes a three-tier approach to depression.

1. Watchful waiting for mild depression to see if it improves without too much intervention. This can include suggestions of attending self-help groups and exercise.

2. If the above recommendations do not provide significant improvement, a course of cognitive behavioural therapy (CBT) may be offered and the possibility of a prescription of antidepressants.

3. A multi-modal approach of talking therapies and antidepressants are offered for moderate to severe depression, with added support from a specialist mental health team.

What to take for stress and depression.

As challenging as it was, Tony was able to seek support through his GP, who offered him the option of medication and CBT:

“It was hard to accept that I was depressed as well as approaching my GP for help but once I got over that hurdle it seemed manageable.” He adds that: “It took a couple of attempts to get the right medication but my GP was brilliant – really helpful and understanding.”

Tony wanted to find something in his local area that he could do to encourage his recovery but felt that he would have to build up his confidence before taking part in a group activity. He used to be an avid gardener, but lost interest when he moved to a smaller property with reduced outdoor space. A friend mentioned Ecotherapy, which he was able to research in more depth.

Ecotherapy.

Mind, one of the leading mental health charities in England and Wales suggests Ecotherapy as a way of improving well-being and self-esteem. Ecotherapy, in essence, is a therapeutic treatment that focuses on the outdoors and taking part in activities close to nature:

Studies have shown that a simple walk in nature can reduce anxiety, keep your spirits high, and even improve memory… Spending time in nature reduces stress and helps people feel energetic and more alive.” (1)

There are organisations who specialise in this area such as The Centre for Ecotherapy, which is a community space in Brighton. It was established in 2014 to, amongst other things, enable people to connect with the local, natural environment and support personal wellbeing in a natural healing environment. They offer a variety of workshops such as: Therapeutic Horticulture, an Introduction to Ecotherapy and, for the existentially inclined, a more advanced course on Exploring Ecopsychology.  

Throughout his recuperation, and the Pandemic, Tony has been able to grow his own herbs and vegetables through a time that could have hampered his recovery. He comments:

“It’s not so much about ‘what’ I’ve grown but the fact that I did it as part of my healing process. It’s bought me a lot of joy and contentment and has introduced me to a hobby that supports my mental health.” 

Become a pirate!

An alternative outdoor pursuit that will encourage you to channel your inner pirate is Geocaching. It is free to join and is a healthy, addictive outdoor activity. It involves searching for small, waterproof containers which have a logbook and pen and small items of little or no value. When the geocache is discovered you have the option of taking an item then replacing it with a trinket of similar value. Record in the logbook your success with the aforementioned plunder and put it back for other geocache enthusiasts to locate. With over three million geocache locations worldwide, there is plenty of swag to be found!

Geocaching is good for you, according to Sarah, aka The Geocaching Junkie. Sarah has been an avid enthusiast since 2013 who, in her own words, states:

“I was never very active and definitely not the ‘outdoorsy’ type. That all changed when I started geocaching. Now I find myself going on long hikes for just one or two caches. I can’t get enough!”

Sarah lists eight ways in which geocaching helps participants benefit from this particular hobby:

  1. Helps to boost immunity.
  2. Relieves stress.
  3. Taps into your creativity.
  4. Improves memory.
  5. Boosts mental health.
  6. Gets you moving.
  7. Promotes Eustress (positive stress).
  8. Reduces symptoms of depression.

In 2017, Gwalia Care and Support in Powys, Wales, linked up with the Brecon Beacons National Park Authority to take its residents on monthly geocaching sessions. One of the participants, Joel Leaman, a resident who had first-hand experience of depression and anxiety and says:

“Getting fresh air is beneficial…It helps you get outside because exercise has been proven in a lot of cases as effective in helping to treat depression.” (3) 

From Ecotherapy to bird-watching or mindful walking to volunteering, there is sure to be something to help you on your journey to recovery. Mind has produced a Nature and Mental Health Booklet, which outlines the benefits of the outdoors with a veritable list of tips and ideas to try. However, if you are unable to find something in there of interest, remember, Geocaching allows you to become a pirate for a few hours. Always be yourself – unless you can be a pirate. ‘Ooh arr, me hearties!’

Sources:

(1) The benefits of being present: mindfulness and its role in psychological well-being.
Brown KW, Ryan RMJ Pers Soc Psychol. 2003 Apr; 84(4):822-48.

(2) https://thegeocachingjunkie.com/about/

(3) https://www.insidehousing.co.uk/insight/insight/on-the-hunt1-50359

Written by Beverley Nolker, Education Development Officer for Psychiatry-UK and the HLP-U Clinics.

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