Reflective Essay on depression and mental illness

Reflective Essay on depression and mental illness Depression is the commonest mental illness in the world yet only a few can tell you what exactly it is. Most people can well enough to recognise signs and symptoms of heart attack, diabetes, breast cancer and many more medical conditions. This statement is not only true for the general population, medical practitioner are no exclusion. Many different impression, perception and thought about depression from one person to another person, from one culture to another culture and from one place to another place. For me what is common throughout the world about this mental illness is ignorant. No wonder why John Kirwan, former New Zealand All Black rugby player, now rugby coach, recently said about his depression: Beating that was the hardest thing I had to do in my life. I didnt have a clue what was wrong with me, nor did lots of the doctors I saw. I finally found a doctor who really got it, understood. Thats what you need. There are so many preconceptions out there about mental illness. Before I learn this psychiatry module about a year ago, I like many of my friends thought that depression is not so common and it is actually not an illness of any kind. However after knowing that approximately about 20% of women and 12% of men worldwide suffer from depression1, which is higher than prevalence of other common disease such as diabetes where worldwide prevalence is about 2.8% in year 20002, it changes my perspectives on depression. Interestingly even though depression is very common I rarely encounter any patient who was diagnosed with depression during my medical and surgical attachment. I only saw one patient with depression for the whole attachment. This totally contradicts with what I learn where prevalence for depression among patient in hospital is about 10%1. This makes me think why such a gap occurs between what I learn and what I encounter in a real world. I began to question myself in lots of different ways in order to answer this question. I start looking back to myself first how my perception toward depression before I learn about this mental illness. I was clueless about depression. I used to have perception that depression has the same meaning to sadness. Depression is a normal thing to happen to someone that encounter unfortunate event in their life. I never knew depression is a mental illness that needs to be diagnosed and treated accordingly. I never heard people went to a doctor because they feel their life miserable and I also never heard a doctor prescribing a medication to patient because of depression. That was me before I learn this psychiatry module. Majority people in my country, Malaysia, have the same perception like me. There never knew that depression is a mental illness where it has specific criteria to diagnose and need to be treated accordingly like other disease. Why it is like this? In my opinion this is very much related to how culture in my country which is eastern culture where a lot of people believe in mysticism. Even though majority of them will seek medical practitioner when they get other physical illness but when it come to the illness related to mood, feeling or behaviour where there is no obvious physical pain, they prefer to go to shaman or spiritual healer. They believe some other spirit are harming and controlling their inner self. Although many of them are Muslim where they shouldnt believe in such away but a very long history of mysticism in that part of the world has made it hard to be washed away from people perception. This is the perception about depression in this part of the world. Here in Ireland or in the western culture, I find peoples perception toward depression is quite different. Many of people here know the depression is part of mental illness. However a lot of them as other place in the world dont know what exactly we called depression as a mental illness. If they do get depression they dont know to whom they should consult, how to deal with it and what the treatment option are available. Not many advertisements about the illness can be found out there in the public. Apart from that depression as other mental illness carry some stigma in the community here. Stigma that there is no cure for the depression, the depressed person will never come back to normal and they are dangerous to public. It seems clear to me that many factors why people are less likely to seek medical attention when they have depression. As many as two thirds of the people with depression do not realize that they have a treatable illness and do not seek treatment3. Lack of knowledge together with misconception what exactly the depression is unable people to distinguish and determine whether they are having depression or something else. As bad as ignorant about the disease itself, people dont know what to do when they know they have depression. Stigma that surrounding the depression also contribute to this phenomenon. The evidence for this is clearly stated in the conclusion of the research done by Lisa J. Barney et al where they wrote self- and perceived-stigmatizing responses to help-seeking for depression are prevalent in the community and are associated with reluctance to seek professional help4. Then I start to question myself it is only because of the public that do not seek medical treatment that contribute to the under diagnose of depression or there are others factor determine it. When I read an article title Depression over and under diagnosed in primary care4, it make me realise that most GPs have difficulty in diagnosing depression. According to the article a meta-analysis of more than 50,000 patients has shown that general practitioners (GPs) have great difficulty separating those with and without depression, with substantial numbers of missed and misidentified cases of depression5. Doctors in the primary care is the first medical person that patient will come and complaint about their depression symptoms. However if most of these doctors fail to recognise and diagnose it, this will bring the number of undiagnosed depression further up. Why is this happen? Why depression is so common to be unrecognised even by a doctor? I dont know the exact reason but for me may be because of the symptom of depression is a lot and varies from one person to another person make it harder to diagnose. According to the DSM-IV-TR diagnostic criteria for a major depressive episode includes at least 5 of the symptoms which are low mood, anhedonia, significant weight loss, insomnia, loss of energy, psychomotor agitation, feeling worthlessness, low concentration and recurrent thoughts of death for the same 2-week period, representing a change from previous functioning, must include either low mood or anhedonia1. Apart from this criteria patient also present with atypical presentation where major depressive disorder may not initially present. In primary setting patient with depression often come with symptoms such as fatigue, headache, abdominal discomfort or change in weight1. Patients can become more irritable rather than low mood or sad. Initial symptoms of depression in children is harder to recognise and can be misleading as the children may present with irritability, decline in school performance or social withdrawal1. Misdiagnose depression in patients in primary care will lead to inappropriate treatment and poorer outcomes6. In term of treatment of depression, I learnt about biopsychosocial approach which is for me is very unique module of treatment. This type of treatment helps to tackle each aspect of the depression including brain pathophysiology, psychological state and social circumstances of the patient. For most patients with mild to moderate depression psychotherapy (cognitive behavioural therapy, interpersonal therapy) is the treatment of choice. However, the combined approach with medication generally provides the patient with the quickest and most sustained response1. Usually, antidepressant medication such as SSRIs is used for severe depression. In conclusion, learning psychiatry module has change a lot of my perspective toward depression and mental illness generally. It has exposed me to a different and new perception in this topic. Before this I see depression as something that not important to diagnose and treat but now I see depression as a very serious illness that can lead to fatality if left untreated. I will make sure that in the future, I always put depression as part of my differential diagnosis for most medical or surgical cases that I encounter as a doctor.

Short Story Analysis

Short Story Analysis In this essay, your purpose is to fully explain an element (theme, characterization or symbolism) in a short story of your choice. I will provide you with examples of each element from stories by Hemingway, Updike and Vonnegut ; you may write about any of these authors except the ones that we have discussed in class. However, you may choose to investigate an author of your own choice. Below I have listed some contemporary authors and story collections you may want to check out: Jhumpa LahiriFlannery O'Connor Raymond Carver William Faulkner David Sedaris Tobias Wolff Ernest Hemingway John Updike Kurt Vonnegut Carolyn Ferrell E. Annie Proulx T. Coraghessan Boyle Melissa Bank John Edgar Wideman Jim Ray Daniels Kevin Canty Nathan Englander Amy Tan Z. Z. Packer Thom Jones Sarah Vowell â€Å"The Best of Non Required Reading† Series All-Story Magazine *If you choose an author not listed above, please clear your choice with me before you begin drafting. __________ _________________________________________________________ Below re definitions of the three elements that you can focus on for your analysis. Characterization – the creation of the image of imaginary persons in drama, narrative poetry, the novel, and the short story. Characterization generates plot and is revealed by actions, speech, thoughts, physical appearance, and the other characters’ thoughts or words about him. Theme-The idea or point of a story formulated as a generalization. In American literature, several themes are evident which reflect and define our society.The dominant ones might be innocence/experience, life/death, appearance/reality, free will/fate, madness/sanity, love/hate, society/individual, known/unknown. Themes may have a single, instead of a dual nature as well. The theme of a story may be a mid-life crisis, or imagination, or the duality of humankind (contradictions). Symbolism- A person, place or object which has a meaning in itself but suggest s other meanings as well. Things, characters and actions can be symbols. Anything that suggests a meaning beyond the obvious.Some symbols are conventional, generally meaning the same thing to all readers. i. e: white= purity, fire=passion/intensity, Spring=rebirth Short Story Analysis Requirements You will complete 2 short story analyses for this unit; you will choose 2 of the 3 elements (theme, characterization or symbolism) to focus on. You may do the 3rd element for extra credit. In this essay, write as if your audience is not familiar with the story; therefore, you may have to do some summary of the story and provide some background so that you discussion would be understandable to your audience.Here is what you will need for this essay: 1. A great title that alerts your reader to the content of the discussion. 2. A full introduction in which you present the title of your story, the author’s full name, and your thesis about the story. 3. A multi-paragraph body in which yo u explain the major element you are focusing on (theme, characterization or symbolism). 4. Strong transitions that move the reader smoothly through the discussion. 5. A wealth of evidence from the story in the form of plot summary and quotation that SHOWS what you are saying is true. . Parenthetical references to show where your quotations come from. 7. A Works Cited page showing where you found your story. 8. A suggested total length of not less than 500 words (excluding Works Cited, title, etc. ) 9. An authoritative tone that displays a thorough understanding of the story in question and the particular element being analyzed. 10. A conclusion that provides a sense of closure and leaves us with a strong thought or observation about the story or its themeWithout Politics: An Analysis of Symbolism in Ernest Hemingway’s â€Å"The Old Man at the Bridge† Masterpiece. We tend to overuse that epithet today, but Ernest Hemingway’s short story â€Å"The Old Man at the Bridge† is certainly deserving. Set during the Spanish Civil War, Hemingway’s tale is a masterpiece of conciseness and verbal economy, and the plight of the defenseless old man who is â€Å"without politics† clearly demonstrates the author’s condemnation of the senseless brutality and destructiveness of modern war (Hemingway 79).In this brief glimpse of war, Hemingway weaves several important symbols into the story to enhance his theme and point out the tragically ironic features of war’s ability to destroy even the most innocent creatures in its wake. The story’s most obvious symbol is the bridge itself. The nameless old man of the title has walked over six miles from his home in San Carlos and now finds himself exhausted at the foot of the bridge over the Ebro River. There he is met by the narrator, a scout for the anti-fascist forces, and warned to move along. Unfortunately, the old man is too tired to journey any further.On the far side o f the bridge lies Barcelona, which symbolically represents the possibility of safety and refuge. On the near side, only certain destruction awaits as the old man was warned to evacuate his hometown because of the impending shelling by fascist artillery. In short, the bridge symbolizes the point of no return for the old man: if he crosses over, he may be safe but he must give up all that he knows and loves in San Carlos; if he stays, however, he will most likely share the fate of his beloved animals he cared for in San Carlos.The unseen animals are also important symbols in Hemingway’s story. The old man tells the narrator that he cared for â€Å"two goats and a cat and then there were four pairs of pigeons† (Hemingway 79). Caring for the animals is the old man’s sole purpose and joy in life, and because he does not have the strength to bring them with him to safety, he has had to leave them behind. Their fate troubles him. He tells the scout, â€Å"The cat, of course, will be all right. A cat can look out for itself, but I cannot think what will become of the others† (Hemingway 79).When the narrator tries to assure him that the birds will also be fine, the old man says, â€Å"Yes, certainly they’ll fly. But the others. It’s better not to think about the others† (Hemingway 80). Of course, the animals are all that the old man is thinking of and concerned about, and their safety is more important to him than his own. Unlike the warring factions, the old man feels compassion for those who are not equipped to survive the massive destruction about to be unleashed.Also, the different animals were able to live together peacefully with the old man’s care and love, but the two human armies, ironically, cannot. The significance of the old man’s birds is heightened when the narrator asks the old man if he left â€Å"the dove cage unlocked† (Hemingway 80, my emphasis). By referring to the pigeons as dove s, the narrator is alluding to the traditional symbolism of the dove as a bird of peace and innocence. In such an environment of hatred and carnage, these symbols of peace have no place and must â€Å"fly† or face death.Their beauty and gentle nature are not fit for survival under such conditions, just as anyone who stands for peace will have no effect on the bloodshed to come. The narrator also points out that the story is set on Easter Sunday, a Christian holiday meant to celebrate Christ rising from the dead. The irony is apparent; no one will rise from the dead, only join the dead, when the shells begin to rain down and the skies clear to allow the fascist bombers to make their runs. Easter is symbolically viewed as a highly anticipated, welcome time of rebirth, renewal, and possible change.For the old man at the foot of the bridge, this Easter brings only inevitable death and the destruction of all that is meaningful to him. Finally, he most important symbol in the story is the old man himself. His symbolic innocence is seen when he tells the narrator, â€Å"I am without politics† (Hemingway 79). The unarmed old man does not belong to either side and he has no interest in participating in the conflict. He is 76 years old and has barely enough strength to make it to the bridge; he clearly poses no threat to anyone.Even so, his fate is made clear when the narrator ominously tells us that the momentary delay of the imminent bombing â€Å"and the fact that cats know how to look out for themselves was all the good luck that old man would ever have† (Hemingway 80). Since the Spanish Civil War was a precursor to World War II and alerted the world to what horrors would lie ahead for innocent men, women, children, and animals all over the planet when the conflict spread, Hemingway shows us what happens to the innocent and the powerless in this new brand of total war.There is no place for sympathy—beyond alerting the old man to keep movi ng and possibly hitch a ride to Barcelona, the narrator does not go out of his way to help the defenseless old man. Since the old man cannot help in the war, he is a hindrance, as is feeling any excessive emotion for him that might detract from performing one’s military duty. The scout tries to reassure the old man that his animals will be fine, but he is not going to go retrieve them for the old man.He advises the old man to cross the bridge, but he is not going to move the old man himself. After all, he has the â€Å"business† of war to tend to (Hemingway 78). This is as much kindness and compassion as the innocent can expect, and it is nowhere near enough to ensure survival. In the end, Hemingway captures the inhumanity and barbaric nature of war. Ironically, he does so without a single shot being fired or one drop of blood being spilled in his tale of a nameless old man at a forgotten bridge.His symbols are carefully placed and subtly developed, allowing readers to focus on the tragic fate of the old man without being sidetracked by heavy-handed literary devices. We feel sympathy and sorrow for the old man and ultimately realize that he is a symbol of all those caught in the crossfire, those who have died and will continue to die in the wake of and the inhuman â€Å"business† of modern war. Works Cited Hemingway, Ernest. â€Å"The Old Man at the Bridge. † The Short Stories of Ernest Hemingway. New York: Macmillan, 1986. 78-80.

Commonwealth Games Gold Medallists for Jamaica Asafa Powell Free Essay Example, 1750 words

It is evidently clear from the discussion that Asaf Powel is the first International Ambassador for the Diana Awards. On February 4th, 2012, Maggie Turner, the Chief Executive for Diana Award announced Asafa as the award s International Ambassador in Jamaica s Terra Nova Hotel. Asafa was the first Jamaican to break the world record. In addition to this, the athlete has historically run more sub ten seconds one hundred meters races than any other person. Similar to the young people who are represented by the Diana Award, Asafa is an inspiration. In a span of one year, Asafa lost two of his brothers. Most people would let this tragedy affect their lives and performance due to the emotional trauma associated with losing a sibling. However, Asafa found strength and never stopped running. Maggie Turner commented that Powel had channeled pain and suffering positively and obtained strength from pain, which made him a better athlete. By doing this, Powel acted as an example to youths and th e entire community. People learn that tragedy and death need not be reasons for one to destroy their lives or lose hope. We will write a custom essay sample on Commonwealth Games Gold Medallists for Jamaica: Asafa Powell or any topic specifically for you Only $17.96 $11.86/page This recognition also helped to change this negativity towards Jamaicans. The Diana charity award inspires young people to work and excel, which are the motivations youths in Jamaicans need. Asafa Powell also has a positive influence on his community through his Asafa Powell Foundation. The foundation s central aim is to contribute to the welfare of young Jamaican field and track athletes.

Record-Low Unemployment - Free Essay Example

Sample details Pages: 2 Words: 584 Downloads: 3 Date added: 2019/05/31 Category Society Essay Level High school Topics: Unemployment Essay Did you like this example? Unemployment in America is reaching new lows which makes the business owners to go out and find candidates with work ethic to work for them. Nationally, according to Smialek and Newkirk, the unemployment rate is expected to drop below 4 percent in the US. This effect will have a big impact on small towns and cities throughout the country as the unemployment rate continue like this at all time. For example, in Portland, Maine, the unemployment rate has reached 1.8 percent which has given perspective employees the ability to be pickier about the jobs that they pursue and has forced companies to get creative with hiring employees. Since the employee industry is getting limited, employers are talking on employees that they generally wouldnt employ. However, some companies are hiring employees on a temporary basis to see if they have the moral ability to handle the job. While other companies are hiring people with paid benefits as well as vacation time included by increasing their wages so that they can keep hold to them and to prevent them from other companies as well as to attract other employees. Don’t waste time! Our writers will create an original "Record-Low Unemployment" essay for you Create order For example, Smialek states that With more money comes less stress. It helps us recruit and keep quality people.(Paragraph 16). As a result, it has affected the businesses sectors in many ways due to the fact that the businesses bottom line havent been affected too much, but the business operate has. For example in Maine, a business called shipwreck and cargo has been slightly affected due to the low employment rates in which companies have not been able to attract a third employees because they believe in having the right people standing and smiling in front. Due to the lower unemployment, families have more income coming into the household in which families spend most of their money in the stores and to keeping the cost relatively low or the same. This relates to the circular model where we see more money income for the families, which in turn translate to more consumer spending turning into revenue for the businesses. Another results of increased income is more taxes being made by the government. Add in an influx of taxes and interest rates can stay level or be increased slightly to continue growth in the economy. Statistically, as we all know that the United States economic is one of the best in the world and its unemployment rate at low rate carries many positives to the worker. As someone who went through a bad US economy and struggled to find employment in the late 2000rs thereve being surplus of jobs which creates great opportunity for the people. Jobs now have to find ways to stay creative to keep employees by offering higher wages, benefits or even vacation time. I feel that it is importance to keep the employees happy in order keep them productive and working at maximum effort. Being that there are so many option on the market, many workers may feel that if a job isnt offering enough, there is always another opportunity out there which keeps employers on their toes which will benefit to the worker being happy and productive is that the business is also more productive which generate more income. Ultimately, it help the economic boom is great and I hope to see more growth over the years.Work cited Smialek, Jeanna, and Margaret Newkirk. This Is What Record-Low Unemployment Looks Like in America. Bloomberg.com, Bloomberg, 15 Mar. 2018, www.bloomberg.com/news/features/2018-03-15/this-is-what-record-low-unemployment-looks-like-in-america.