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[Mental Mealth Awareness Month is May.  That’s way too far off.  So I’m calling this Early Mental Health Month. We’ll come back to it again in May.  My friend Michele Sandberg, a psychiatrist and military veteran, agreed to write a guest post on identifying and treating depression. Please, share this if you know anyone who might benefit from it.]

Depression. It’s a word with a Latin origin (deprimere which translates to press down) that has meaning across many fields in our world: astronomy, geography, meteorology, economics and human psychiatry. It’s most ubiquitous use in our culture today, however, is the latter in describing the human condition and one’s brain processes. Depression can be related to or caused by a host of factors to include genetics, physical health changes, seasonal changes, holidays, and other environmental triggering events. Depression can mean something slightly different for anyone I talk to.

My background is in mental health, so the stories I hear can be extremely varied due to many factors, including the individual’s experiences in life, hereditary factors and emotional supports available to the storyteller. The threads that run through most stories includes a sense of hopelessness, helplessness, sadness, or emptiness. Accompanying symptoms can include decreased or total lack of energy, poor appetite, poor sleep, lack of interest in previously pleasurable activities, and sometimes thoughts of self harm. Anxiety can also be a huge accompanying presence or completely absent. (One might think of depression as a spectrum to include major problems with anxiety on one end and no anxiety at all on the other.)

Why talk about depression? Well, it’s truly everywhere in our culture. Depression (what mental health people call depressive disorders as a diagnostic category) is common among many age groups (with the highest prevalence currently in 18-25 year olds) and occurs more often in females. Many people find it difficult to discuss the topic of mental health with others. Perhaps someone was told “it’s a sign of weakness” to be depressed (or whatever mental health concern is expressed) or “you’re not trying hard enough.” Mental health disorders have nothing to do with strength/weakness or mental effort on the part of the individual.

The social stigma surrounding mental health issues still persists despite attempts to educate the public and proactive attempts with patients in routine medical checkups. As a military trained psychiatrist, I can tell you that, years ago, many military members would rather be sent off to war than be sent to a mental health clinic appointment. (I hope that the military has less stigma against mental health concerns, but I wouldn’t hold my breath that it has changed significantly in the last 25 years.)

If we as community members can discuss mental health issues candidly, we might find that we are not so alone in our struggles. Imagine if a medical disorder, such as diabetes, had such a strong stigma. Would patients check their blood sugar regularly during the day as needed? Would a patient stop using their medication because they didn’t want to “rely” on something to make them feel better and live a healthier life? Would a patient call a friend or health professional if they needed help with some aspect of their medical care related to their diabetes? Perhaps you’ve heard similar comparisons before between physical and mental health diagnoses. Truly, there is little medical difference. There are many medications and other treatments for depression, anxiety and other psychiatric disorders.

So, what if you think you or someone you care about is suffering from depression? Well, again, depression is common and there are degrees of severity. If you just experienced a huge loss (of a loved one, a job, a home, or other major stressor) keep in mind that an emotional response of sadness/grief/anxiety to a loss or a large stressor can be normal. However, if mood and other symptoms (energy/sleep/appetite, etc) become affected and persist for at least two weeks, it is reasonable to talk to a primary care provider for assessment or referral to a mental health clinician. A provider can assess whether your response is a normal emotional response versus one that suggests clinical intervention.

How do you know if you need help now? Possible symptoms include: if your sleep is poor, your energy level is low to nonexistent, your appetite has taken a nosedive, and/or you don’t want to hang out with your favorite people in your life like you might have in the more recent past. Of course, another clear indication that you need help is when you don’t care about your own life or want to end it altogether. Please know that feeling suicidal is treatable (like diabetes) and that people want to help and can help you or your loved one. There are people who train and spend their careers treating others whose thoughts of self harm keep them from living normal healthy lives.

Again, the term “depression” has varied meanings in our culture. What I might call depression as a clinician might look very different than a high school student talking about the depressing day ahead, or a retired widow’s depressed state, or a single parent’s depressing week in trying to solve a rent crisis in the family’s home. BUT, all might have a true clinical depression and could benefit from treatment.

 If you’re still reading this, I want to give you some final (and truly sobering) thoughts and statistics on suicide.

 -Asking someone if they are thinking of hurting themself does not “plant the idea” of suicide in a person. Also, It is far more important to ask the person if you are worried about someone’s safety (and get the person help if they are suicidal) than not to ask at all.

 -40 percent of all people who complete suicide have made at least one previous attempt.
-Individuals with serious drug or alcohol problems are six times more likely to complete suicide than those who don’t have those use issues.
 -8 out of 10 people considering suicide give some signs of their intentions.
-Females attempt suicide twice as often as males.
-Males are four times as likely to die by suicide.
-Firearms account for 51 percent of all suicide deaths.
-Suicide is the tenth leading cause of death in the United States, but the second leading cause of death in people 15-24 years of age.
-From 1999 through 2017, the age-adjusted suicide rate in the U.S. increased 33%.
-Save this number in your phone contacts. It might someday save the life of you or someone else you know. National Suicide Prevention Lifeline: 1-800-273-8255