Brighten Your Mood Program

「活出晴天」

The Brighten Your Mood Program is a new research project at the VirtualClinic. The aim of the Brighten Your Mood Program is to develop an educational program for Chinese people in Australia to help them learn skills to manage low or depressed mood. You can apply by clicking the 'Apply' button at the bottom of this page, but please carefully read the information on this page first.

VirtualClinic is a not-for-profit initiative of the Clinical Research Unit for Anxiety and Depression (CRUfAD) at St Vincent's Hospital, Sydney, Australia and the School of Psychiatry, University of New South Wales, Australia. VirtualClinic is an Internet-based clinic that aims to develop and provide free education and treatment programs for people with anxiety and depressive disorders who cannot readily access face to face treatment. The Brighten Your Mood Program is kindly sponsored by beyondblue: The national depression initiative.

「活出晴天」是一個由「網上診所」發展的新研究項目。「活出晴天」的目的是為澳洲華人建立一個中文的情緒低落網上教育計劃，幫助他們學習一些有效的方法來使情緒轉好。

「網上診所」是遞屬雪梨聖雲仙醫院 (ST Vincent’s Hospital, Sydney) 以及新南威爾斯大學 (UNSW) 的「焦慮及抑鬱臨床研究中心」 (Clinical Research Unit for Anxiety and Depression) 的非牟利項目。「網上診所」的宗旨是透過互聯網服務，為患有焦慮或抑鬱而未能得到面對面治療的人提供和發展免費的教育和治療。「活出晴天」」是由beyondblue: the national depression initiative慷慨贊助的。

What is the difference between sadness and depression?

When something bad happens, feeling down and sad is a normal human reaction. However, if these feelings of low mood last longer than 2 weeks, and the person feels hopeless and helpless, empty and unmotivated, this might mean that they have depression.

The main difference between depression and normal sadness is:

1. Feeling down all the time, as if the sadness will never end
2. This lasts 2 weeks or more
3. This affects personal relationships, school or work performance

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情緒低落及抑鬱須知

當一個人遇上失意的事情的時候，感到情緒低落和不快樂是一種很正常的自然反應。 但如果情緒低落持續多於兩星期，而且感到生活沒有出路和曙光﹐以及對四周的人和事感到麻木及失去動力，這就可能代表患上抑鬱。

抑鬱跟一般不快樂的最主要分別是:

1. 終日被沮喪的感覺纏繞，覺得以後也不會快樂
2. 持續至少兩星期或以上
3. 人際關係、學業成績或工作表現受影響。

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What are the symptoms of depression?

People who are depressed may have lots of different symptoms, but often they feel sad (feel unhappy, feel down, or feel blue), suffer low energy levels (tiredness or fatigue), and have low self-esteem. These symptoms must have been present for at least two weeks for a formal diagnosis. Other symptoms that people often report include changes to sleep patterns, changes to eating patterns, and irritability.

When people are depressed they may avoid social contact, and other activities that they usually enjoy. When people are severely depressed they may have thoughts of hurting themselves or of ending their life. If you are having such thoughts please urgently contact Lifeline (ph 13 11 14), your GP, another health professional, or your local mental health team. Or, in a crisis, dial 000. Remember, depression can be treated!

Depression has three main types of symptoms:

1. Physical symptoms. These include a lack of energy, and changes in appetite (some people eat more, while others eat less), and changes in sleep patterns (some people sleep more, while other sleep less).
2. Worrying and negative thoughts such as “I'm a failure", “I’m never going to succeed", “the world is a bad place”, and so on. These types of symptoms often lead to low self esteem and feelings of hopelessness and helplessness. Depression can also affect our ability to concentrate, which then affects our memory, so people who are depressed often feel forgetful (which makes them feel worse!).
3. Changes in behaviour. People with depression often avoid doing activities they used to do. So, they may avoid going out to see friends, going shopping, going to the supermarket or bank, or even going to work.

抑鬱的徵狀是什麼?

抑鬱會令人出現不同的徵狀，但最主要的徵狀包括情緒低落 (感到不開心或麻木)，失去動力 (經常疲勞﹐容易累)，和失去自信心。 這些徵狀需要持續至少兩星期或以上才算患上抑鬱症。 其他常見的徵狀包括飲睡眠和飲食習慣出現改變和易怒。

當人們患上抑鬱的時候，他們會變得孤僻，不想見人，和不想再做從前喜歡做的事。 患上嚴重抑鬱的人也很可能會有輕生或傷害自己的念頭。 如果你有這些念頭，請立刻致電生命熱線 (Lifeline 13 11 14)，你的家庭醫生﹐醫療專業人士，或你的地區性精神健康服務隊伍。 在緊急情況請致電 000。 請謹記抑鬱是可以醫治的!

抑鬱徵狀可以分為三類:

1. 生理徵狀: 這包括缺乏動力﹐食慾改變 (有些人會吃多了，有些人會吃少了)，和睡眠習慣改變 (有些人會失眠，有些人會睡多了)。
2. 負面的想法和憂慮: 例如經常覺得自己是失敗者﹐做什麼都沒有用，世界黑暗，沒有希望，等等。 這些想法會令人感到沮喪，自信心下降，和令人感到無奈和無助。 抑鬱也會影響我們集中精神的能力，使我們的記憶力下降，從而使患上抑鬱的人變的沒有記性，然後令他們的心情更差!
3. 日常生活行為習慣改變: 患上抑鬱的人會逃避做一些他們從前做的事。 這可能是逃避見朋友，社交，買東西，去超市或銀行，甚至是上班。

How common is depression?

Depression is a very common mood disorder. About 25% of people will be affected by depression in their lifetime. Depression affects people from all ages and both genders. However, depression may be undetected in some people because they may present as irritable, …. And so they themselves and their friends and family may not have noticed that they might be depressed. Chinese people may also misinterpret the physical symptoms of depression as a physical illness, and seek help from other sources instead, like seeing their Chinese medicine doctor or GP. In older adults, the physical symptoms of depression may be misdiagnosed as dementia or other physical illnesses. In children, depression may present as behavioural difficulties such as skipping school.

抑鬱常見嗎?

抑鬱其實是一種常見的情緒病。 大概每一百人當中就有二十五人會在有生之年患上抑鬱。 不同年齡、性別的人都有機會患上抑鬱。 只是﹐因為抑鬱除了以上的主要徵狀外，有一些人可能會表現為經常易怒﹐氣餒，提不起神，甚至無緣無故的感到疲勞，所以自己和身邊的親友都可能未必察覺其實可能患上抑鬱。 抑鬱的徵狀，例如經常疲勞和失眠﹐也容易被人誤以為身體出了問題，所以人們可能會求診中醫師或家庭醫生。 抑鬱在在長者中也容易受忽略，因為抑鬱的生理徵狀，例如不能集中精神和失眠，容易被誤以為是身體機能的退化和其他的問題。 而患上抑鬱的兒童則可能會表現為一些行為問題如逃學等。

Does having depression mean that I’ve gone crazy?

Depression does not mean that you have gone crazy. Depression is a mood disorder, other common mood disorders include social phobia, panic disorder, generalised anxiety disorder and so on. (somehow mood and anxiety disorders are grouped together in Chinese)

抑鬱是精神出現問題嗎?

抑鬱不是精神出現問題，也不是「癡線」，更加不是神經病。 抑鬱是一種情緒病。 其他常見的情緒病包括社交焦慮症 (Social Phobia)，恐慌症 (Panic Disorder)，和廣泛性焦慮症 (Generalised Anxiety Disorder) 等等。

Why do I have depression? Is it because I’m not strong enough?

Having depression does not mean you are not strong enough, or that you have a weak personality, or that you have impairments in managing your mood. Brave, strong, determined people may also have depression. No matter age or gender, people from all different backgrounds can have depression.

The causes for depression are very complex. Generally speaking, genetic, biological, psychological, and environmental factors may all contribute to depression. Hardship and difficult life events such as losing a loved one, ending a relationship, losing a job or financial loss, disability, having a lifelong disease, mid-life crisis… may be triggers for depression. However, sometimes depression can happen for no apparent reason.

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為什麼會患上抑鬱? 是因為不夠堅強嗎?

患有抑鬱的人絕對不是性格軟弱或在控制自己情緒方面出現缺陷。 意志堅定、個性剛毅、不論男女老幼，來自不同的背景的人也有可能患上抑鬱。

抑鬱的成因很複雜，一般涉及先天遺傳、生理、心理和環境因素，並不是單一因素形成。 沉重的人生打擊或失意，例如失去至親、分手或離婚、失業或破產、投資失敗、永久的身體創傷、患上不治之症、青春期心理轉變、中年或老年危機等，都可能成為抑鬱症的源頭。 然而，也有些情況，抑鬱症的出現並無明顯原因。

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Can depression be treated?

Depression can be treated. Like physical illnesses such as flu, people can recover from depression. Research shows us that antidepressant medication and cognitive behaviour therapy is effective for mild to moderate depression, and even works for severe depression. In addition, CBT can effectively reduce relapse.

抑鬱可以醫治嗎?

抑鬱是可以醫治的。 抑鬱跟其他生理病，如傷風感冒一樣，都是能夠痊癒的。 研究指出抗抑鬱藥物及認知行為治療對輕度及中度的抑鬱有效，甚至對嚴重的抑鬱都有幫助。 而認知行為治療對預防復發是很有效的。

Is acupuncture and Chinese medicine useful for depression?

To date, there are mixed results for the effectiveness of acupuncture and Chinese medicine for depression.

針灸和中醫藥對治療抑鬱有效嗎?

研究暫時對於利用針灸和中醫藥治療抑鬱的效用並沒有一致結論。

Depression vs. grief

Depression is different to grief. Grief is often triggered when we experience a loss (death of a friend or family member or pet, change in job or occupational status, or some other significant loss). Grief usually involves feeling sad, and experiencing some of the symptoms of depression described above. And, for some people grief can take a long time to recover from. But, the main difference between grief and depression is that people who are depressed often also suffer low self-esteem. That is, they feel "bad about themselves" or "unworthy", while people who are grieving usually have normal self-esteem.

抑鬱跟哀傷的分別

抑鬱跟哀傷不一樣。 哀傷是當我們失去重要的東西時的自然反應 (例如家人、朋友、或寵物去世，工作或職業出現變動，又或其他重要的損失)。 通常哀傷會令人感到不開心，也會令人出現一些以上提及的抑鬱徵狀。 有一些人需要多些時間才能走出哀傷。 但抑鬱跟哀傷的主要分別是患有抑鬱的人的自信心也會明顯地減低。 他們會覺得自己「不好」或 「沒用」，但哀傷的人的自信心會跟平時沒兩樣。

Treatment for depression

Depression is treatable! The best treatments involve learning about your symptoms, learning how to control those symptoms (using Cognitive and Behavioural techniques or CBT), and gradually resuming your usual activities. These techniques are usually very effective for people with mild levels of depression. Antidepressants plus these techniques are recommended when people have moderate to severe symptoms of depression, and it's important that anyone learning CBT also see their GP regularly.

You can talk to your GP about getting a referral to a Clinical Psychologist, Psychiatrist, or another mental health professional to learn to manage your depression. Or, you can try our Brighten Your Mood Program.

抑鬱的治療

抑鬱是可以醫治的! 最有效的治療方法是認識你的徵狀，學習認知行為治療 (簡稱CBT)控制這些徵狀，和逐漸回復正常的日常活動。 這些方法都對患有輕度抑鬱的人非常有效。 對於患有中度和嚴重抑鬱的人來說﹐最有效的治療是抗抑鬱藥物加上認知行為治療雙管齊下。 不過，任何學習認知行為治療的人也應該定期見他們的家庭醫生。

你可以請你的家庭醫生把你轉介給臨床心理學家、精神科醫生、或其他精神科專家，幫助你處理你的抑鬱。 你也可以試試參加「活出晴天」計劃。

What is the Brighten Your Mood Program?

Brighten Your Mood is an Internet-based educational  program designed to teach people with depression how to manage their symptoms. We developed this program because many Chinese-Australian people with depression never seek treatment, but many have access to the Internet. By providing good education and guidance on simple but effective treatment techniques we hope that you will get better control over your symptoms, improve your confidence, and get back to living a full and happy life!

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什麼是「活出晴天」計劃?

「活出晴天」是一個網上的抑鬱教育計劃。 計劃的目的是幫助情緒低落的人控制他們的徵狀。 我們發展這個計劃的原因很簡單，那就是因為很多人，尤其中國人，都因為各種原因不會因為他們的情緒問題就診。 但是他們可能有互聯網服務，所以我們可以透過互聯網提供有效的教育和指引，幫助你控制你的徵狀和建立自信，重新對生活有掌握和希望!

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To participate in the Brighten Your Mood Program

To participate in the Brighten Your Mood program you must:

• Have a diagnosis of depression. We will determine this on the basis of your answers to online questionnaires and a telephone interview
• Be at least 18 years of age and reside in Australia
• Never have been diagnosed with bi-polar disorder or schizophrenia
• Not drink more than 3 alcoholic drinks per day
• Not use illicit substances such as marijuana, amphetamines or cocaine
• Not have extremely severe depression. Severe depression requires immediate face-to-face treatment and support. We will determine the severity of your depression on the basis of your answers to questionnaires and a telephone interview. If we think your level of depression is too severe for the Brighten Your Mood program, we will tell you so and make suggestions of where you can seek appropriate help.
• Not be planning to kill yourself. People with depression can have thoughts about suicide or think they may be better off dead. Such thoughts are common, and will not exclude you from participating in the Brighten Your Mood program. However, if you are actually planning to kill yourself it is absolutely vital that you contact Lifeline (ph 13 11 14), your GP, another health professional, or your local mental health team. You require urgent assistance, which we can't provide over the internet.
• Be a Chinese Australian and speak fluent Cantonese or Mandarin

參加「活出晴天」計劃需知

如果你想參加「活出晴天」計劃，你必須:

• 患有抑鬱的徵狀。我們會透過一些網上問卷和評估電話確定你是否出現抑鬱徵狀
• 是十八歲或以上的澳洲居民
• 能夠聽講流利粵語或普通話
• 從沒有被診斷患上精神分裂症或躁鬱症
• 每天不喝多於三杯標準酒精飲品
• 不使用違禁藥物，例如大麻、安非他命、可卡因等
• 不是患上嚴重抑鬱。 嚴重抑鬱是需要立刻接受面對面治療的。 我們會透過你的問卷答案和電話評估斷定你的抑鬱的嚴重程度。 如果我們認為你的抑鬱太嚴重或不適合「活出晴天」計劃，我們會告訴你和建議你在哪裡可以得到適當的服務。
• 沒有計劃結束生命。 很多有抑鬱的人都會有自殺的念頭或認為自己「死了比較好」。 這些想法都是在抑鬱中很普遍的，所以不會使你不適合參加「活出晴天」計劃。 但是﹐如果你有自殺的計劃，你必須聯絡生命熱線 (lifeline 13 11 14)、你的家庭醫生、其他醫療人員、或你的地區精神健康服務。 你是需要緊急的幫助，而我們不能在互聯網提供這種服務。

What is involved in the Brighten your Mood Program?

If you are accepted into a program﹐ you will be randomly allocated to 1) internet education with telephone reminders, or 2) waitlist. You will start the program soon if you are allocated to the internet education with telephone reminders group, or 9 weeks later if you are in the waitlist group. During the program, our researchers will monitor your progress. One of our research team who can speak Cantonese or Mandarin will also contact you to inform you about the specific details of that program, including the starting and finishing dates. The program basically involves:

• Online educational lessons. Each lesson tells a story about a person with that condition, who learns to manage their symptoms.
• Homework assignments. These summarise the information in each lesson, and provide practical assignments to help you learn new skills for managing your symptoms.
• Regular email contact to encourage you and support you in the program
• Weekly telephone calls to check on your progress.

The program takes 8 weeks. You will complete your program along with about 30-40 other people. Each person will choose their own login name, so that people will not be able to identify you. Please do not choose a username you use for other websites.

「活出晴天」計劃包括了些什麼?

如果你適合參加這個計劃﹐你將會被隨機分配到 : (1) 參加短期內開始的「活出晴天」計劃，或 (2) 等候名單 ; 若被分配到等候名單，你將會在遲些才開始課程 。

在參加計劃的過程中﹐我們的研究人員會跟進你的進度。 我們會聯絡你告訴你計劃的實質內容和計劃的開始及結束日期。 計劃主要包括:

• 網上教育課程。每節課程中，你會看到一名患有抑鬱的人的康復過程，從而學習有關抑鬱的治療方法。
• 課程練習。 這些練習會總結每一節課和提供一些練習，幫助你學習控制你的情緒的方法。
• 定期的電郵聯絡，鼓勵和支持你參加這個計劃。
• 我們其中會說粵語或普通話的研究人員會每星期透過電話聯絡你。

這個計劃需時大概八個星期。 你將會與三十至四十人同時參加這個計劃。 每一個人會有自己的用戶名，所以其他人不會知道你的身份。

What benefits are likely?

We expect that your program will help reduce your symptoms. However, we cannot guarantee that you will receive any benefits from this program.

If you continue to experience symptoms at the end of your program we will explain how you can arrange a referral to a Clinical Psychologist or Psychiatrist for face to face individual or group treatment. We expect that by having already participated in this program that you will make good progress if you subsequently choose to work with a mental health professional. Or, you may choose to continue to practice the techniques you learnt during your program.

我參加這個計劃會有甚麼得益?

雖然我們預期這個計劃會幫你減少你的徵狀，但是我們並不能確保你會從這個計劃裡得益。

如果你在計劃完成後依然有抑鬱的徵狀，我們會跟你介紹如何安排轉介見臨床心理學家或精神科醫生﹐接受面對面的個人或小組治療。 你參加了這個計劃後如果選擇見其他精神健康專業人士，我們相信你將會取得良好的進展。 又或，你可以選擇繼續練習你在這個計劃裡學到的技巧。

How much time/effort is involved?

Each program requires perseverance, determination, and courage. If you apply we expect that you want to learn about your condition and are prepared to follow structured advice to overcome it. We also expect that you will spend at least 4 hours per week working on the Lessons and homework assignments. The homework assignments are compulsory, because just reading about helpful techniques for managing symptoms won’t fix the problem, particularly because most people have had their symptoms for many years.

Our programs will not cure you overnight, but they can really help. If you follow the guidelines we expect that you will learn the foundations for success and, with consistent practice, you should gain mastery over your symptoms. 

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參加這個計劃需要多少時間和努力?

參加這個計劃是需要毅力、決心和勇氣。 如果你申請參加這個計劃﹐我們預期你想了解你的抑鬱狀況，並願意按照計劃裡的建議打敗它。 我們預期你將每週花至少4小時閱讀和實踐計劃的內容和練習。 練習是非常重要的，因為單靠閱讀有關抑鬱的控制技巧是不會解決問題的，尤其是當大多數人已患上抑鬱多年。

「活出晴天」不能把你的抑鬱一夜之間改變過來，但它將會對你很有效的。 只有你按照我們的指引，我們相信你將會學到成功打敗抑鬱的基本技巧。 如果你加以練習﹐你將會對控制你的徵狀更有把握。

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Your rights

We hope that by participating in Brighten Your Mood program you will learn more about how to control your symptoms. But, you can withdraw from a program at any time, without any penalty. You are also welcome to contact us to ask questions. But, if you have medical questions, you should first see your General Practitioner. If you are unhappy with any aspect of this study you are welcome to contact us (either via our Contact Us button, or by contacting one of the clinicians or the Human Research Ethics Committee (HREC) of St Vincent's Hospital, Sydney, or the HREC of the University of New South Wales (contact details are supplied in the consent forms we send to you after you have applied).

你的權利

我們希望你會從「活出晴天」計劃學習到一些控制你抑鬱徵狀的方法。 如果你想退出參加計劃，你有權隨時退出，而且不會有任何後果。 我們也歡迎你聯絡我們問有關計劃的問題 (電話: 02 8382 1420)。 如果你有有關醫療的問題，我們建議你先跟家庭醫生商量。 任何人如對研究項目的推行有擔憂或投訴，可以聯絡我們或Deputy Manager, Human Ethics Administration, University of Sydney。 (聯絡資料會在你申請參加後的參加者需知簡介裡有所提供)

Your responsibilities

We undertake to provide you with the best service that we can and we are dedicated to supporting people to recover from anxiety and depression. But, we are a very small team, and we need your help. So, before applying please ensure you are prepared to accept the following responsibilities (if not, please DO NOT apply):

• You will read our emails very carefully and save these in a secure location.
• When requested, you will complete all questionnaires within 48 hours of receipt.
• When requested, you will complete and return all Consent Forms within 48 hours.
• You have checked to ensure you have a healthy computer and reliable Internet connection, and have checked that you have the necessary software.
• You will only apply if you are really determined to challenge yourself, to change some of your habits, and are prepared to worked consistently at this, every day, for up to 8 weeks.

你的責任

我們承諾為你提供我們最好的服務。 我們的宗旨是支持人們從焦慮和抑鬱中康復過來。 但是，因為我們是一隊非常小的團隊，所以我們需要你的幫助。 因此，我們請你在提出申請參加計劃前請確保你準備接受下面的責任（如非，請不要申請）：

• 你會仔細地閱讀我們的電郵和安全地保管這些電郵。
• 請案我們的要求，在48 小時內填妥及寄回參加者同意書。
• 請案我們的要求，在48 小時內填妥我們的問卷。
• 你有檢查確保你有一個健康的電腦和可靠的互聯網連接，並檢查你已安裝有必要的軟件。
• 你確定你有決心改變自己和一些習慣，並且準備好在未來八個星期努力練習計劃裡的技巧，才申請參加計劃。

How do I apply to join the Brighten Your Mood Program?

First, read all the information on this website. Applications for the Brighten Your Mood Program open on the 30th of June. You may apply by clicking on the link, below. You will then be asked to complete questionnaires about your symptoms of anxiety and depression, and to answer some questions about yourself. If your online application is accepted, we will then telephone you to complete your application and answer your questions. We will then email you an Informed Consent Form, which you must complete and return. And, then, you will be able to begin your program!

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如何申請參加「活出晴天」計劃?

首先，請閱讀這個網頁裡的所有資料。 「活出晴天」計劃將在 6月30日接受申請。 你可以點擊以下的“申請”按 鈕申請參加計劃。 您將會被要求填寫一些有關你抑鬱徵狀問卷，及回答一些有關自己的問題。 如果你的網上申請被接受，我們將會至電 你作一個電話評估﹐並且回答你的問題。 我們將會用電郵寄給你一份同意書，你必須把它填妥及寄回才能參加計劃。 然後你就可以參加「活出晴天」計劃了！

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