Managing stress and depression

Stress and depression

There were 2844 deaths in Australia due to suicide in 2014.

The hydroponic and greenhouse environment can be a stressful workplace; the pressure to produce a quality product consistently, providing good customer service, dealing with complaints, working to tight timelines, financial worries, climate and rural isolation, can all impact on grower and worker wellbeing. This article looks at stress, depression and suicide in the Australian farming community.

By STEVEN CARRUTHERS

Although farmers are renowned for being tough, it is well recognised that primary production is a physically and psychologically demanding occupation (Deary et al., 1997). In Australia, farming is characterised by high rates of stress (Gray & Lawrence, 1996), injury and suicide (Page & Fragar, 2002). According to the latest Australian Bureau of Statistics (ABS) data, there were 2844 deaths due to suicide in 2014, a rate of 12 per 100,000 people. That’s about 7.8 suicides each day. The data  shows that all people who live in rural and regional Australia – not just farmers – are at an increased risk of suicide.

On a global scale, about 800,000 people commit suicide worldwide every year. Of these, 135,000 (17%) are residents of India, a nation with 17.5% of world population. Between 1987 and 2007, the suicide rate increased from 7.9 to 10.3 per 100,000, with higher suicide rates in southern and eastern states of India. Most suicides result from stress and depression, two insidious mental health issues in society.

An insight into stress and depression in the Australian farming community can be found in a BeyondBlue research project – Depression in farmers and farming families – which was completed in 2005. The study involved farmers across northwestern Victoria and western New South Wales and examined rates of psychological distress among farmers. Farmers were also interviewed about their perceptions of the impact of their lifestyle and work on mental health, and help-seeking behaviours for mental health problems. There have been no other definitive studies on depression in the farming community of note.

The Beyondblue research project  identified Four key issues:

  • Rates of psychological distress
  • Resilience in the face of adversity
  • Limited acceptance of depression and other psychological problems among individuals and the farming community
  • Barriers to care in farming communities.

Rates of psychological distress

While farming is recognised as a high-stress industry, the study did not find higher rates of psychological distress among farmers, compared with non-farmers (Judd et al., 2006). In fact, this study identified that common personality traits found among farmers may protect against psychological distress.

Resilience in the Face of adversity

All the farmers interviewed were strongly attached to farming as both an occupation and a way of life. They also described an array of stressors. Despite these demands, people displayed a high level of resilience in the face of adversity. It was clear from the data that there was considerable evidence to support the stereotype of farmers as tough and resourceful.

The survey data also identified that farmers were less likely to be depressed and anxious compared with nonfarmers. Participants spoke about overcoming a range of challenges through their determination and hard work, as the quote from Sally, a female farmer, highlights:

“Life was pretty damn tough, it was tough for me and it was extremely tough for the kids, we had no money … we had nothing, we didn’t even have a television or a refrigerator… we had an esky from the tip! How did I cope mentally? I focused on the future and …on the job at hand…and on my own ability and I just worked my guts out.”

Limited acceptance of depression and other psychological problems among individuals and the farming community

Participants identified that when faced with problems, it was important to stay positive and develop practical solutions. There was limited acceptance and acknowledgement of distressing feelings and issues such as depression. People who dwelled upon problems were described as ‘whingers’. This attitude was most common among male farmers, who often rejected the notion that farming difficulties affected them psychologically, as the following exchange between Paul and Alice demonstrates:

Alice: Paul, at one stage, was not sleeping. It was just dreadful. All he could talk about was water; it was not easy to live with him for quite some time. He used to lie there and toss and turn… but they don’t admit to having a problem.

Paul: There is no point going out and whinging about it; you just sort of wear it, don’t you? They don’t admit to it, but then they don’t have a problem.

Alice: It is not something you admit.

Paul: I don’t get stressed.

Alice: See, there you go!

Not all male farmers in the study reported these types of responses to stressful situations, with a number emphasising the importance of talking to others and seeking help.

They did note however, that their attitudes were not common among the farming community. While open discussion of problems was often seen as inappropriate, alcohol use was seen as a much more acceptable response to dealing with challenging times and experiences and alcohol consumption was deeply entrenched in the farming culture.

Barriers to care in farming communities

A range of barriers to mental health care were identified including:

  • A preference to seek help from friends and family rather than from health professionals
  • Stigma associated with mental illness leading to limited acceptance of mental health care
  • Reduced sense of confidentiality: the population size of small farming communities typically means there is a high level of local knowledge and visibility among residents. Thus, there was a sense that maintaining anonymity and confidentiality when accessing services could be compromised. Participants reported that this increased likelihood of community awareness of service utilisation, limited their access to mental health care.
  • limited accessibility of formal health providers and services due to geographic distance and limited availability of providers.

Study conclusions

Farmers do not appear to experience higher rates of psychological distress, compared with the non-farming community. However, a range of personal and structural barriers does exist for farmers in terms of accessing mental health care when mental health problems emerge.

Personal strength, independence and ‘toughing it out’ are central values in farming culture, and seeking help for mental health problems is seen as the antithesis of these values.

The project concluded that further efforts needed to be made to address the personal implications of acknowledging that one has mental health problems.

In addition, the study concluded that there needed to be greater availability and accessibility of mental health care providers.

Workers and employees

Workers and employees can also be stressed for reasons ranging from a hot and humid working environment, poor teamwork and morale, to difficulties in the family home.

Here are a few suggestions on how to reduce stress in the workplace, recommended by EPIC Access, a leading not-for-profit organisation that provides a personalised service to assist people with disability or disadvantage to achieve their goals:

  • Be clear – make sure everyone knows their job role and their tasks for the day.
  • Be supportive – help someone who looks like they’re struggling, sometimes just asking if they need help will make them feel better • Don’t apply undue pressure – no good comes from making emands or setting deadlines, which can’t be met.
  • Notice – has there been any change in someone’s behaviour, or are they complaining more often than usual?
  • Be honest – stop and think. What was the contributing factor? What happened before the changes began?
  • Talk – ask your colleague R U OK? Have a long discussion about the issues affecting their behaviour.
  • Change – form a plan of action to rectify the situation and reduce the workplace stress for everyone.

Alcohol and depression

There is a strong link between excessive alcohol consumption and depression. Self-medication with alcohol is a common, but unsafe and an ineffective coping strategy for farmers and other people living in rural and remote areas. The National Centre for Farmer Health highlights that alcohol only masks the symptoms of depression and stress, and can make you feel worse.

Support services can assist country people to find other ways to tackle depression. Find out more about this topic on the Better Health Channel.

 

sunflower-wellness_webSymptoms of depression

Studies suggest that farmers who are depressed don’t tend to use the word ‘depression’ to describe their state of mind, but may describe it as ‘stress’ instead. However, stress and depression are not the same and require different approaches to treatment.

Some of the symptoms of depression include:

  • feeling sad or flat
  • losing interest and pleasure in normal activities
  • appetite or weight loss (also binge/comfort eating and weight gain)
  • sleep problems, such as an inability to fall sleep or early waking
  • feeling tired all the time
  • concentration problems
  • feelings of restlessness, agitation, worthlessness or guilt
  • not motivated to socialise or exercise
  • feeling that life isn’t worth living.

24-Hour telephone counselling

If you or someone you know is thinking about suicide, call:

  • Lifeline Australia on 13 11 14
  • Kids Helpline on 1800 55 1800
  • Samaritans on 13 52 47
  • Suicide call back service on 1300 659 467
  • Beyondblue on 1300 22 4636 (24/7)

Final remarks

Investigators and health care workers continue to explore stress and depression and issues around stigma, attitudes toward help-seeking, alcohol and depression, and suicide in the farming community.

References:

Australian Bureau of Statistics (http://www.abs.gov.au/). Accessed 18 Sept 2016

BeyondBlue (https://www.beyondblue.org.au). Accessed 18 Sept 2016

Deary, I., Willock, J., & McGregory, M (1997), Stress in Farming, Stress Medicine 13 (131), 136.

EPIC Assist (http://epicassist.org/au/). Accessed 18 Sept 2016.

Gray, I., & Lawrence, G., (1996), Predictors of Stress Among Australian Farmers, Australian Journal Of Social Issues 31 (2), 173-189.

Judd, F., Jackson, H., Fraser, C., Murray, G., Robbins, G., & Komiti, A., (2006), Understanding suicide in Australian farmers, Social Psychiatry & Psychiatric Epidemiology 41 (1), 1-10.

National Centre for Farmer Health (http://www.farmerhealth.org.au/). Accessed 18 Sept 2016.

Page, A & Fragar, L (2002), Suicide in Australian farming, 1988-1997, Australian & New Zealand Journal of Psychiatry. 36 (1), 81-5.  Ω

PH&G Oct 2016 / Issue 172


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