Depression and Assessing Yourself

This post comes after an interesting evening with a friend who has recently suffered from depression. He has been to see a counsellor and talked through his issues with them.

Essentially, he had worked out what his personal values are and then which areas of his life he uses them in - i.e. a check that the way he is living is in line with his values. He described that for some of his values the situation he was in meant that he was not getting the stimulation/challenge that he wanted, and that this may have been a factor in his depression.

The conversation got me thinking, and reminded me that there is some research showing that people with HSP are sometimes more depressed than the general population (http://hspjourney.blogspot.co.uk/2011/09/depression.html). Joining these two thoughts together it might be that where some people have personal values which are met with physical activity the general deterioration of mobility with HSP, this might mean that they are no longer able to live their lives as much in line with those values.

For example, a person may have immense pride in the quality of what they do for a living - one of their values is around completing tasks to a high quality. If their job is a physical/mobile one - say a teacher/mechanic/tour guide (etc.) then they will be acutely aware of the changes in their mobility and the actual or potential for how this might change the way they undertake their work, and affect their values. Equally, this might be true for any of the other HSP symptoms affecting any other aspect of life.

It occurs to me this approach  might be very useful for others, and so I outline links and things to read/do:

The first thing which you need to do is to understand your own values. There are plenty of ways of doing this, and you can read one here: https://www.mindtools.com/pages/article/newTED_85.htm I also recommend Steven Coveys Seven Habits of Highly Effective People (https://en.wikipedia.org/wiki/The_7_Habits_of_Highly_Effective_People) which has more on this, and there is another method at the beginning of the second thing to do.

My own method for finding my values was to take a list, like the one in the mindtools link. I copied these and added a few more about being a parent and husband (etc.) to the list, so there were over 50 to start with. I then looked at the list and marked each one as "high", "medium" or "low" according to how important/relevant it was to me. I then repeated this process, re-scoring the ones that were "high". After 5 iterations I was down to 13 "high" values, and looking at those I prioritised into 8 themes:

• Being knowledgeable, thorough and accurate
• Being responsible
• Being professional, having integrity and communicating appropriately
• Being honest
• Being ambitious
• Being perceptive
• Being happy and positive
• Being a loving father and husband 

The second step is to place these values into a "bulls eye". The bulls eye splits life into four areas: work/education, relationships, personal growth/health and leisure. For each value you identify you should identify which sector your value sits. This splitting of life into four areas might cause you to think of some more values or some changes to those values, and that is fair enough - you're simply trying to describe yourself. The important thing is to be honest and to have "something" in each sector. (Note - I've not actually done this for myself yet)

You score each value (or each area) by putting an X close to the centre if you are living fully by those/that value and close to the edge if you are acting inconsistently with those values. The bullseye is on page 2 of this link, with other pointers on values on page 1. http://www.thehappinesstrap.com/upimages/Long_Bull%27s_Eye_Worksheet.pdf

The "clever" part is thinking about those values which are close to the edge of the target and what you can do go get them closer to the centre of the target. This is potentially a hard question to answer, but my take on it is that you need to find a different way of living the same value(s). You could do one or more of these things:

• Re-focus so that you change the areas of your life where you live by your values
• Find a new/alternative way of doing the same thing to get the same result
• Move your self from the "do-er" to the "trainer" and transfer your values onto others
• Take up a new hobby/activity/job/career to get new stimulation
• Stop doing some things and move away from the consequent problems

There are probably other approaches you can take, and if that is the case do let me know! You may wish to do this in personal reflection, by discussion with someone you trust, or indeed by writing about it in a blog!

This article, by Kathy Charmaz, Loss of self: a fundamental form of suffering in the chronically ill, actually describes the "problem" that I attempt to describe, but in the general context of  chronic illness. There are some obvious parallels between what she writes and experiences with HSP.
http://qmplus.qmul.ac.uk/pluginfile.php/158532/mod_book/chapter/3334/Charmaz%20K.pdf

The abstract is: "Physical pain, psychological distress and the deleterious effects of medical procedures all cause the chronically ill to suffer as they experience their illnesses. However, a narrow medicalized view of suffering, solely defined as physical discomfort, ignores or minimizes the broader significance of the suffering experienced by debilitated chronically ill adults. A fundamental form of that suffering is the loss of self in chronically ill persons who observe their former self-images crumbling away without the simultaneous development of equally valued new ones. As a result of their illnesses, these individuals suffer from (1) leading restricted lives, (2) experiencing social isolation, (3) being discredited and (4) burdening others. Each of these four scores of suffering is analysed in relation to its effects on the consciousness of the ill person. The data are drawn from a qualitative study of 57 chronically ill persons with varied diagnoses."

Opportunity to influence - changes to PIP benefits, till 29th Jan

Background:

In the UK the Government pays a benefit to those who need help with extra costs as a result of long term ill health or a disability. It is called the Personal Independence Payment, or PIP for short. You can read here: https://www.gov.uk/pip/overview

There are two parts to the payment, which is received every 4 weeks: the "daily living component" and the "mobility component". Both components come in "standard" and "enhanced" levels. You need to fill in an application to determine if you are eligible, which is determined by points" scored by answers to multiple choice assessment questions.

The website says "You must have a long-term health condition or disability and face difficulties with ‘daily living’ or getting around.... You may get the daily living component of PIP if you need help with things like:

• preparing or eating food
• washing, bathing and using the toilet
• dressing and undressing
• reading and communicating
• managing your medicines or treatments
• making decisions about money
• engaging with other people

You may get the mobility component of PIP if you need help going out or moving around.

The Consultation:

The Government are seeking views on changing the way that "aids and appliances" are taken into account in assessing the daily living component. They are keen to hear views from all interested parties, especially disabled people and disability organisations. Events are arranged around the UK in January, or you can respond by post or e-mail until 29th January. The consultation document is here: https://www.gov.uk/government/consultations/personal-independence-payment-aids-and-appliances-descriptors.

The document says that some applicants score all of their points through "aids and appliances".  Overall, about a third of all people who are awarded the daily living component score all their points through "aids and appliances". The definition of "aids and appliances" is becoming broader, and that some are not specialised equipment (for example a chair) or low cost.

The consultation asks your opinion comparing the current system with 5 broad options for reforming how aids and appliances are taken into consideration.  They welcome comments on:

• receiving a regular, fixed monthly sum; 
• budgeting on a monthly basis; 
• having to save to purchase aids and appliances; and 
• having no restrictions on how the benefit can be spent but potentially lower purchasing power. 

I summarise the five options as:

1. Receiving a lump sum instead of a monthly payment
2. Receiving a lower monthly rate than the standard rate
3. Adding a requirement so that some points must come from things not related to aids and appliances
4. Changing the definition of aids and appliances to exclude low cost/non-specialist equipment
5. Reducing the number of points for aids and appliances answers to questions

There are questions on each option, and a final question asking for other ideas and comments. An annex to the consultation document gives the ten questions that comprise the assessment and the number of points for each of the multiple choice answers.