Dan Hunt - Former NRL Player, mental health ambassador & founder of the Mental Health Movement
Former Australian NRL player, Dan Hunt, 30, Sydney, played 150 games for the St George Illawarra Dragons during his prestigious nine-year-long career that concluded in July, 2015.
Dan has continued to partner with the NRL in retirement, as its State of Mind community and mental health ambassador.
In April 2016 Dan founded the Mental Health Movement, which encourages “people to take the first step in being the change this world needs” by joining his movement and starting a conversation. Dan targets community groups, industry, schools and corporates with his movement and tells his personal story to keep himself honest and to acknowledge his past.
By sharing his personal, lived experience with mental illness, Dan strives to educate the public and ultimately, reduce the stigma associated with mental illness that prevents many from people seeking the help and advice they so urgently require.
This is Dan’s story.
Growing up in Dapto, on the south coast of NSW, Dan dreamed of playing rugby league.
During this period, Dan, his mother, two brothers and sister alike were all subject to domestic violence. At the time, Dan was unaware of the significant impact this would have on his life.
Following his graduation from high school, Dan was drafted into the St George Illawarra Dragons, a first grade NRL team, and in 2007 made his debut as a professional rugby league player.
Soon, Dan found himself playing every game with the Dragons, until he ruptured his Achilles tendon in 2010, requiring surgery. That year the Dragons went on to win the premiership, but Dan had to watch from the sidelines – a devastating experience which hit Dan “like a tonne of bricks”.
Following his surgery, Dan was treated with a string of pain killing medications, which, for the ensuing six-to-eight months, he abused, to mask not just the physical pain, but also the emotional pain he had been battling since childhood.
Observing his out of character behaviour at the time, his coach, Wayne Bennett, approached Dan and asked whether he was okay. This marked a turning point for Dan, who was finally able to explain that he was not okay, and required help. The following day, mental health organisation, The Black Dog Institute met with his team. Two weeks later Dan met with several psychologists and physiologists at The Black Dog Institute in Randwick, Sydney, and was diagnosed with Bipolar 2 disorder – a mental illness characterised by extreme, uncontrollable changes in mood (ranging from elevated to depressed moods), thought, energy and behaviour.
“When I was diagnosed in 2010, by the Black Dog Institute, I started to access a lot of different treatment methods, from meeting with psychologists and psychiatrists, to using different antipsychotic and mood- stabilising medications, which I took for a period of nearly five years from 2010,” said Dan.
“Today, I am nearly three years’ medication free, but I am thankful that the medicines were there when I needed them.”
Further to accessing medication, Dan was treated with various different techniques, including Cognitive Behavioural Therapy (CBT) and Schema Therapy, to aid his recovery.
For Dan, the medication was very beneficial, but deep down he knew that weaning himself off the medication to self-manage his illness would aid his recovery. So he set this as his goal, working closely with his psychologist and psychiatrist to come off of medication when ready.
“I got to the point where I had gone to TAFE and studied mental illness, and I work well when I challenge myself. So I spoke to my psychologist and psychiatrist about how to best manage my condition without medication, as I wanted to challenge myself to see whether I could do that,” Dan said.
“Today, I am managing my illness without medication, but I’m always very open to the fact that should I ever get back to a point where I need medication to manage my bipolar disorder, I will take it.”
At the height of his illness, Dan felt alone and isolated, given his access to information back then was not readily available. This left him feeling vulnerable and fearful, and growing increasingly concerned about displaying weakness by requesting help.
“When I was struggling with my mental health, I often felt alone. I didn't know where or how to get help.
“I had no understanding of mental illness, and was scared to ask for help, because I thought it was a sign of weakness,” said Dan.
“In retrospect, I wish I had asked for help sooner.
“I don’t want others to experience what I went through. I want to empower people with knowledge and acceptance of how to ask for help,” Dan said.
Today, Dan is supporting the Australian Genetics of Depression Study, a ground-breaking international collaboration exploring the genetic risk factors associated with clinical depression, and how genes influence one’s response to treatment. QIMR Berghofer Medical Research Institute is leading the Australian arm of the research, and Dan genuinely hopes his contribution will allow experts to unravel more answers to help combat clinical depression.
“Knowing what I know now, I suspect I lived with bipolar 2 disorder for as long as I can remember. Years before I was diagnosed in 2010, I was very volatile,” said Dan.
“I have a family history of mental illness – close members of my family have lived with clinical depression, bipolar disorder and other mental illnesses.
“Having come through it, I am now working to be the best version of myself. I have a six-month-old son, and recently, when I was speaking with a psychologist, I enquired as to what would happen if he too, develops a mental illness, and she said, ‘he’s got the best teacher to guide him, and support him through the process,’ which was great for me to hear,” Dan said.
“The Australian Genetics of Depression Study is really important, because it will help to provide a scientific base and credibility to the illness. This research will help determine the causes of clinical depression, in order to improve our understanding of the illness, which is excellent,” Dan said.
Link between genetics & clinical depression
- The link between genetics and clinical depression is very clear. Approximately 20,000 genes make up the human genome.3 Alterations in some genes cause clinical depression. But right now, we don’t know what they are. What we do know, however is how to find them. We just need a large enough study, performed the right way, to identify them.
- This groundbreaking research should allow us to identify between 50-100 genes that influences a person’s risk of developing clinical depression.
- By cracking the genetic code, we will be able to develop new, and more effective, personalised treatments that target the problem directly.
Interim data
- Our interim data reveals better targeting of existing treatments through individual genetic profiling before commencing medication, would drive a major advance in clinical therapy.1
- Given our lack of diagnostic methods to predict different responses to antidepressants, or forecast the potential for intolerable side-effects, we are exposing those battling clinical depression, to trial and error, which is often slow to deliver significant benefits.1
- To date, we have failed to move from effectively from the general principles of treating clinical depression, to much more personalised and targeted approaches that minimise risk to maximise benefit.1
- Our interim data also reveals the overwhelming majority of study survey respondents taking antidepressants discussed their mental health problems with friends (90%) and family (86%) – an important finding, for many of the risks associated with clinical depression, and the sense of isolation that ensues, can be reduced by sharing this information with trusted others.
- Open discussion however, did not always fix the problem. Respondents reported discussion with family (20%) members and friends (10%) was unhelpful.
The Australian Genetics of Depression Study
- The Australian Genetics of Depression Study is the Australian arm of an international scientific collaboration created to understand the genetics of depression.2
- Scientists are aiming to identify the genes that predispose people to clinical depression, with the eventual aim of developing new treatments.2
- 200,000 international participant DNA (saliva) samples are required and Australia is planning to contribute 10% of the total study population.2
- Participation in the study is free and simple – volunteers complete a 15-minute online survey and are asked to donate a saliva sample.2
- QIMR Berghofer Medical Research Institute (QIMR Berghofer), is the base for the Australian arm of the international collaboration, with collaborating centres in all States.2
- Head of the Genetic Epidemiology group at QIMR Berghofer, Professor Nick Martin, is Lead investigator for the Australian Genetics of Depression Study.2
- Professor Ian Hickie, AM, Head of the University of Sydney’s Brain, and Mind Centre, and Co-Director for Health and Policy, is the Co-lead investigator for the study.2
About clinical depression
- One in seven Australians will experience clinical depression during their lifetime.4
- Clinical depression has the third highest burden of disease in Australia (13.3%).4
- Clinical depression is a complex disorder that occurs commonly within families; it typically results from a combination of both genetic and environmental influences.4
- Australia has one of the highest antidepressant prescribing rates per head of all OECD countries – behaviour that delivers considerable benefits, but also forces many people to contend with ongoing, disabling and potentially life-threatening medication-related side-effects.5
INTERIM DATA – IN DETAIL
- Our interim results reveal the importance of genetic profiling for personalised treatment with antidepressant medications to minimise the frequency with which people living with clinical depression need to trial various medications, and experience their potential, and often harrowing, side-effects. 1
- Our data represents a collation of responses from 12,985 Australian study survey respondents aged between 18 to 89, as of July 4, 2017. 1
- 33 per cent of study survey respondents reported having used one antidepressant medication to treat their illness 1
- 24 per cent had used two antidepressant medications; 1
- 16 per cent had used three different antidepressant medications 1; and
- 10 per cent reported using four or more. 1
- 14 per cent reported having used five or more different antidepressant medications throughout the life cycle of their clinical depression. 1
- 76 per cent of survey respondents who had experienced medicinal intervention for their clinical depression, have experienced some medication-related side-effects. 1
- 38 per cent of those survey respondents who have used antidepressants (51 per cent of those who have experienced side-effects) reported having to either cease, or change at least one of their medications due to their side-effects. 1
- 75 per cent of survey respondents described relief of their depressive symptoms (including sadness and loss of pleasure in life) to be the best aspect of taking antidepressants. 1
STUDY PARTICIPATION – IN DETAIL
- Participating in this study could make a genuine contribution to solving clinical depression.2
- Study participation is strictly confidential. All patient information provided will be maintained in accordance with the Commonwealth Privacy Act (1988) and National Health and Medical Research Council (NHMRC) Guidelines.2
- Participating in the study involves completing a simple online survey.2
- Permission will be sought from participants for access to some of their Medicare and Pharmaceutical Benefits Scheme (PBS) history.2
- After completing the study, participants may be asked to donate a saliva sample, so that researchers can extract their DNA.2
- Researchers will send a collection kit together with a pre-paid return envelope to select participants.2
- QIMR Berghofer will biobank DNA from saliva samples for immediate and future genetic analysis.2
- Study researchers will analyse all saliva samples collected to investigate any specific genes that may be associated with depression. 2
THE AUSTRALIAN GENETICS OF DEPRESSION STUDY
- Many international studies to date have explored an individual’s genetic predisposition to depression. However, no study has yet identified the specific genes that cause depression.2
- Identification of the genes that predispose individuals to clinical depression could revolutionise future research into causes, treatment and prevention of the illness.2
- Study researchers will analyse biological (saliva) samples to investigate and identify specific genes that may be associated with clinical depression.2
- Before analysis can begin, DNA is extracted from the biological sample and genotyped to provide a read out of each participant’s genetic code. The analysis process, known as a ‘genome-wide association scan’ (GWAS), involves comparing the genotype of people who have experienced clinical depression to the genotype of those who have never experienced clinical depression.2
- The study will allow researchers to look for genetic factors that determine why some people experience clinical depression, while others do not, why some people living with clinical depression respond to certain treatments, while others do not, and why some people experience side-effects, while others do not.2This knowledge will be used to improve existing treatments and to develop new treatments.
ABOUT CLINICAL DEPRESSION
- Clinical depression is a serious illness that affects physical and mental health.6
- It is characterised by regular and intense feelings of sadness, moodiness or feeling low and may last for long periods of time (weeks, months or even years), often with little or no identifiable reason.6
- Clinical depression severely affects the way people feel, think, and react to general daily activities, such as eating, sleeping, or working.7
- Globally, one-in-five people will experience clinical depression during their lifetime, and, one-in-10 will have clinical depression.8
- By 2020, clinical depression is predicted to impose the second leading cause of world disability, and by 2030, is expected to be the largest contributor to disease burden.8
- Globally, clinical depression has a lifetime prevalence of around 16 per cent.9
- Causes and risk factors for clinical depression7,10
Clinical depression is caused by a combination of genetic, biological, environmental and psychological factors including:
- Personal or family history of clinical depression;
- Major life changes, trauma or stress;
- Certain physical illnesses and medications;
- Personality, particularly personality types who tend to worry, have low self-esteem, are perfectionists, sensitive to personal criticism, or are self-critical and negative; and
- Drug and alcohol abuse, which can both lead to, and result from clinical depression.
There are many different types of depression, ranging from minor to very severe, including:11
- Clinical depression
- Bipolar disorder
- Cyclothymic disorder
- Dysthymic disorder; and
- Seasonal affective disorder (SAD).10
Warning signs of clinical depression include:
Psychological signs:7
- Persistent sadness, anxiety or emptiness
- Feelings of hopelessness, or pessimism
- Irritability
- Feelings of guilt, worthlessness, or helplessness
- Loss of interest or pleasure in hobbies and activities
- Thoughts of death or suicide, or suicide attempts.
Physical signs:7,12
- Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that fail to ease, even with treatment
- Decreased energy or fatigue. Getting out of bed in the morning may seem very hard, even impossible
- Moving or talking more slowly
- Feeling restless or having trouble sitting still
- Difficulty concentrating, remembering, or making decisions
- Dizziness or lightheadedness
- Difficulty sleeping, early-morning awakening, or over-sleeping
- Appetite and/or weight changes
- Chest pain
- Digestive problems – feeling queasy or nauseous, developing diarrhoea or becoming chronically constipated.
- Clinical depression can be treated; however, different forms of treatment are more suitable for different people.13 Treatment includes medication, psychotherapy and brain stimulation therapies, including electroconvulsive therapy (ECT).7
- Medications used to treat clinical depression in Australia, include antidepressant therapies, tranquilisers, and mood stabilising medication.14
- Cognitive Behavioural Therapy (CBT), a type of psychotherapy, involves working with a therapist or psychologist to identify and change the thought and behaviour patterns associated with clinical depression.14,15 Other psychotherapies include Interpersonal Therapy – treatment focuses on recognising life patterns that can lead to depressive episodes,14,15 and, Mindfulness-Based Cognitive Therapy – treatment focuses on the present moment, rather than the past or possible future.15
- ECT involves passing an electric current through the brain.16 It is typically used where medications or psychotherapies fail to provide adequate relief of symptoms.7
- Health professionals who offer treatment services to people living with clinical depression, include GPs, psychiatrists, psychologists, mental health nurses, mental health social workers, and counsellors.
References
1. Hickie, I. Targeting treatment: the Australian Genetics of Depression Study. MJA InSight. August 21, 2017.
2. The Australian Genetics of Depression Study. Available at https://www.geneticsofdepression.org.au/ [last accessed March, 2017].
3. Ezkurdia, I., Juan, D., et al. (2014). Multiple evidence strands suggest that there may be as few as 19,000 human protein-coding genes. Human Molecular Genetics, 23(22), pp.5866-5878.
4. Black Dog Institute. Facts and Figures about Mental Health, 2012. Available at:
https://www.blackdoginstitute.org.au/docs/default-source/factsheets/facts_figures.pdf?sfvrsn=8 [last accessed August, 2017]
5. OECD. How does Australia compare?. Health at a Glance 2015, 2015. Available at:
https://www.oecd.org/australia/Health-at-a-Glance-2015-Key-Findings-AUSTRALIA.pdf [last accessed August, 2017]
6. Beyond Blue. What is depression. Available at: https://www.beyondblue.org.au/the-facts/depression [last accessed January, 2017]
7. National Institute of Mental Health (NIMH). Depression. Available at https://www.nimh.nih.gov/health/topics/depression/index.shtml [last accessed January, 2017].
8. World Health Organization (WHO). Depression: A Global Crisis, World Mental Health Day, October 10, 2012, pg. 14. Available at: http://www.who.int/mental_health/management/depression/wfmh_paper_depression_wmhd_2012.pdf [last accessed January, 2017].
9. Sullivan, P.F., Neale, M.C. & Kendler, K.S. Genetic epidemiology of major depression: Review and meta-analysis. American Journal of Psychiatry 157, 1552-1562 (2000).
10. Beyond Blue. What causes depression. Available at https://www.beyondblue.org.au/the-facts/depression/what-causes-depression [last accessed January, 2017].
11. Beyond Blue. Types of depression: Major depression. Available at: https://www.beyondblue.org.au/the-facts/depression/types-of-depression [last accessed January, 2017].
12. Boots: WebMD. Depression Guide. Available at http://www.webmd.boots.com/depression/guide/depression-symptoms [last accessed January, 2017].
13. Beyond Blue. Treatments for depression: Available at https://www.beyondblue.org.au/the-facts/depression/treatments-for-depression [last accessed January, 2017].
14. Black Dog Institute. Treatments for depression 2012. Available at http://www.blackdoginstitute.org.au/docs/Treatmentsfordepression.pdf [last accessed January, 2017].
15. Beyond Blue. Psychological Treatments for Depression. 2017. Available at https://www.beyondblue.org.au/the-facts/depression/treatments-for-depression/psychological-treatments-for-depression [last accessed January, 2017].
16. Beyond Blue. Electroconvulsive therapy. Available at https://www.beyondblue.org.au/the-facts/depression/treatments-for-depression/medical-treatments-for-depression/electroconvulsive-therapy-(ect) [last accessed, January, 2017]
17. QIMR Berghofer Medical Research Institute. Available at http://www.qimrberghofer.edu.au [last accessed, March, 2017].
18. QIMR Berghofer Medical Research Institute. Mental Health Program. Available at http://www.qimrberghofer.edu.au/our-research/diseases-and-conditions/mental-health/ [last accessed March, 2017].
To coordinate an interview with Dan Hunt, please contact Kirsten Bruce or Mark Henderson from VIVA! Communications on 0401 717 566 / 0431 465 004.
