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Depression
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Now . . . spending an evening with a group of depressed people may not sound like a barrel of laughs at first . . . but you'd be surprised! Support groups provide a forum for mutual acceptance, understanding, and selfdiscovery. Your involvement with a group gives you something proactive to do while you may be waiting for a new medication to take effect or while you're ticking off the days until your next therapy session. Buoyed by the bond of depressive or manicdepressive illness, you may find yourself rediscovering strength and humor which you'd thought you'd lost. As with any chronic illness or serious injury, we can sometimes fall into the mistaken belief that we are inherently defective people. In a support group, where you have the opportunity to reach out to others and benefit from the experience of those who have "been there," it becomes a little easier to remember that depression or manic depression does not define who you are.

With over 275 local chapters dotting the U.S., Canada and countries overseas, the National Depressive and ManicDepressive Association offers one or more support groups associated with each chapter. The groups have medical advisors and appointed facilitators, most of them patients or family members. Each chapter operates at a different level of sophistication. Resources are often modest, and leadership is typically volunteer. Some chapters have lending libraries, fundraisers, newsletters, and organized activities ranging from seminars to softball games. Their chief purpose is to carry out the National DMDA goals of education, advocacy, support and destigmatization at the local level. Through National DMDA's Department of Constituency Services, dedicated individuals find the technical support they need to start and operate these local affiliates.

While chapter activities and support groups are no substitute for professional care, the benefits are enormous. Whether you are a patient or a family member, you have a lot to offer to others who may be thinking that no one could possibly understand what depressive illness feels like . . .

Coming Out: Telling Others About Your Illness

While a support groups is an ideal environment to share your experiences with depressive illness, you may be concerned about "coming out" in public. It is your personal choice whether or not to disclose your diagnosis with anyone other than your doctor or therapist. Discuss with him or her how and what to tell people. Most people will appreciate your honesty, and you will help them understand how to respond to your fluctuations in mood and behavior. Because your illness or medication side effects may impair your functioning, teachers may need to be alerted and in some cases, your employer--especially if your job involves the safety of others. Print this booklet and share it with them or contact National DMDA for other resources.

The Americans with Disabilities Act (ADA) prohibits employment discrimination on the basis of a physical or psychiatric disability. Through the ADA, an employee may request that reasonable accommodations be made through modifications to the employee's schedule or job environment. Reasonable accommodations may be required to minimize functional limitations for workers with psychiatric disabilities. These limitations may include difficulty in maintaining concentration, managing time pressure and deadlines, initiating interpersonal contact, or maintaining stamina throughout the workday.

Disclosure may be especially difficult for people with psychiatric disabilities. An employee is not required to disclose all the details of his or her illness--only those necessary to demonstrate eligibility for an accommodation under the ADA, and only if an accommodation is needed. Moreover, the employee may request confidentiality, a right protect by the ADA. It is in your company's best interest to safeguard your mental health and to offer reasonable accommodations necessary to help you on the job. Untreated depression leads to absenteeism, work-related injuries and lost productivity. Your illness is a medical problem, not a personal shortcoming.

Economic Cost Of Depression

Fact: Depressive illness costs almost $44 billion each year.

Breakdown of expenses attributable to all affective disorders:

National DMDA

Description of Overall Services

The National Depressive and ManicDepressive Association offers a variety of services including:

• A Chapter Network which brings National DMDA's mission and services to local communities.
• Support Groups run by local chapters provide a forum for patients and family members to share coping skills and build selfesteem. Many physicians recommend these groups for people who otherwise may feel alone or victimized by their illness.
• A Bookstore with over 80 titles of printed and audiovisual materials created for a variety of knowledge levels.
• The National DMDA Newsletter, available quarterly to members, covers research and treatment, consumer awareness and advocacy, and exchanges ideas and information by reporting on local chapter activities.
• Free Information is mailed to anyone who calls our toll free numberoften the first step a person takes towards finding help for themselves or for a family member.
• Professional Staff, some who have themselves experienced depressive illness, is available to offer support and guidance. Although National DMDA does not operate as a crisis hotline or offer medical advice, callers will always find someone to send them in the right direction for the kind of help they need.
• Conventions and Conferences are held periodically where experts in the field join patients, family members and members of the advocacy community.
• A National Speakers Bureau allows National DMDA to reach audiences everywhere with the goals of education, support, advocacy and destigmatization. We recruit and supply professional and lay spokespersons who are willing to share their personal experiences with community groups and the media.
• Education Programs like the Physician Awareness Campaign, ManicDepressive Illness Awareness Day, and Everyone Needs A Hand To Hold On To video campaign serve as vehicles to emphasize the importance of recognition of symptoms, early diagnosis, and access to treatment.

Sources: National Institute of Mental Health, Office of Scientific Inquiry and Information; American Psychiatric Glossary, American Psychiatric Press; ManicDepressive Illness, A Guidefor Patients and Families, Clarke Institute of Psychiatry, Toronto; Electroconvulsive Therapy: A Guide, Center for Affective Disorders and Lithium Information Center, University of Wisconsin, Madison.

Reviewed by Martin B. Keller, MD, Chair, Department of Psychiatry and Human Behavior, Brown University, Butler Hospital, Providence, RI; Peter C. Whybrow, MD, Professor and Chairman, Department of Psychiatry, University of Pennsylvania, Philadelphia; and Philip Janicak, MD, Professor, Department of Psychiatry, and Medical Director, Psychiatric Institute, University of Illinois at Chicago. Written by Ellen Szalinski.

First Printing March 1996

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