Using the Internet to tame the "black dog" of depression

Lapland experiment makes use of videoconferencing

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By Vesa-Pekka Hiltunen in Rovaniemi
     
      Wartime British Prime Minister Winston Churchill used to refer to his bouts of clinical depression as his "black dog".
      Helena Hanni from Rovaniemi also has a black dog, in the shape of a labrador puppy.
      Hanni sits at her PC with Lumi the puppy on her lap and laughs aloud at the parallel.
      She has managed to get her other dog, that of depression, under control.
     
Hanni and eight other depression sufferers have just been through a two.month "depression school".
      The idea of the counselling project is to offer means of warding off bouts of depression in advance and to offer peer group self-treatment under the guidance of mental health professionals.
      The scheme, arranged in the Lapland Hospital District area, was the first experiment in schooling depression patients via a video link.
      The group members and their mentors discussed the subject of depression once a week for the first couple of months of the year, using computers and webcams to stay in touch.
     
From time to time the online links were a bit iffy, but for the most part the counselling discussions over the Net went smoothly, says social worker Paula Perttunen.
      "It's really much the same whether we talk like this or face to face", says Pia Länsman from Utsjoki, Finland's most northerly municipality, nestled on the border with Norway.
      The very remoteness of Utsjoki is a factor arguing in favour of an online connection: distances up here are colossal.
      Länsman joins the depression school discussion from the Utsjoki Health Centre, since she does not have a Net connection at home.
     
It is fortunate that there is a broadband connection at the health centre, as otherwise Pia Länsman would hardly have taken part in the depression school scheme.
      Getting together around a table in some other community would have entailed an insurmountable amount of driving for someone at work.
      The depression patients found the school through their own therapists.
      Before they were taken into the scheme, each applicant was interviewed thoroughly and the depths of his or her depression were charted.
     
"We had more willing applicants than we could take. The group was put together on the strength of the interviews, and mainly consists of people with mild or moderate levels of clinical depression", reports specialist nurse Sirkku Valve.
      The groups of three and six persons met a total of eight times, with the first and last of these sessions taking place "in real life" and face to face.
      In the course of the programme, group members learned such things as techniques for relaxation.
      "The discussion progressed on the personal level, and we gave examples from our own lives", explains Länsman.
     
For a majority of the participants, the experience led to a reduction in symptoms of depression, but for three of the sufferers, things seemed to be made worse. This was conceivably because at the outset of the course their depression was only in a nascent phase, says Valve.
      "Another possibility is that the person was suffering from a difficult and deep depression that activated itself during the two months", adds mental health nurse Seija Vauramo.
     
Even if the results were not unequivocally positive in this sense, the experiment has provided some hope and some useful experience.
      The group members and their advisors see the potential offered by videoconferencing.
      "For young people in particular this is an excellent idea", believes Helena Hanni.
      Mental health nurse Pentti Vuorma points out that as such a "depression school" is not a form of treatment, but merely a means of prevention in advance.
      "This must not be seen as a means of reducing other health care options", concurs Sirkku Valve.
     
Helsingin Sanomat / First published in print 7.4.2009

More on this subject:
 FACTFILE: First experiment in online depression counselling

Links:
  Lapland Hospital District

Helsingin Sanomat