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Calming Anxiety, Depression Over Economic Crisis

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Dr. Bell's Perspective

Everyone can do four basic things to minimize the possibility of

depression and anxiety when anything bad happens. First is to prepare

for the possibility for being in a crisis. Second, take a break from the

stress–not a permanent one, as denial is not productive–but a short one

to regroup and to “calm down.” This is essential to mobilizing energy

to deal with the crisis, guiding our decision making, and subsequently

moving into action in order to come out of the crisis not only intact

but stronger.

The final two tasks include changing the situation causing our crisis

by using active mastery and keeping from catastrophizing the situation

and simply accepting it and moving on.

To overcome the feeling of powerlessness that many are experiencing

because of real or perceived economy-related hardships, it's also

important to engage in activities that are recommended for mental health

recovery after mass trauma: engage in self-efficacy, work with others

toward collective efficacy, maintain connections with others, try to

ensure personal safety, and cultivate hope.

A good and seasoned clinician should be able to differentiate between

clinical depression and transient situational distress. For the latter,

the clinician should engage in brief, supportive psychotherapy that

aims to strengthen and encourage active or passive coping.

Situational distress occasionally leads to a more clinical

depression, possibly warranting medication, but it is important to

understand the distinction.

The best way to encourage behavior change in a crisis is to build a

social/emotional infrastructure that not only treats problems of

distress, but also prevents them.

Among the core elements of this infrastructure are a social fabric

encompassing all people, a sense of connectedness with others, the

fostering of a sense of mastery, the development of social and emotional

skills to enable coping with difficult situations, and the provision of

prosocial models of behavior that can be retrieved in times of crisis

as ports in a storm.


 

The investigators also determined that the psychological effects of job loss were not short-lived. At 6-month and 2-year follow-up, when 60% and 71% of the study participants, respectively, had been re-employed, the depression and perceived loss of personal control remained evident, they wrote (J. Occup. Health Psychol. 2002;7:302-12).

Many of these negative effects are preventable through interventions that empower people in the face of adversity, according to Dr. Price, who, along with his colleagues, developed such an intervention in the early 1980s that is still being used. Called the JOBS program, the intervention teaches trainers–often teachers, social workers, or others who themselves have been unemployed–to help participants develop the necessary practical skills and self-confidence they will need in order to get new jobs. In 5-day workshops, participants learn job-search strategies, practice interviewing skills, and engage in role-play and problem-solving activities aimed at helping them cope.

Randomized trials conducted in the United States and Finland have shown that people who complete the program find new jobs faster than those who do not, are reemployed in higher paying positions; and experience fewer job-loss related negative mental health consequences (J. Health Soc. Behav. 1992;33:158-67; Am. J. Community Psychol. 1995;23:39-74; J. Occup. Health Psychol. 2002;7:5-19).

The positive impact of the intervention remained evident 2 years after participation, an analysis of the long-term effects of the program show. By using data from the initial randomized field experiment conducted in 1995, the Michigan investigators determined that, 2 years post intervention, program participants had “significantly higher levels of reemployment and monthly income, lower levels of depressive symptoms, lower likelihood of experiencing a major depressive episode in the last year, and better role and emotional functioning compared with the control group.”

Job-search motivation and sense of mastery at baseline “had both direct and interactive effects on reemployment and mental health outcomes, respectively,” they wrote, noting that participants who initially had lower levels of job-search motivation and mastery benefited the most (J. Occup. Health Psychol. 2000;5:32-47).

Empowering those struggling emotionally during the economic crisis is also the goal of a new Web-based guide developed by SAMHSA called “Getting Through Tough Economic Times” (www.samhsa.gov/economy).

By Diana Mahoney, Share your thoughts and suggestions at cpnews@elsevier.com

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