Would You Know if You Were Depressed?
It’s 3:30am. You need to get your children on the bus in three and a half hours, and you have a big meeting at work in five. But there you sit on the couch – eating potato chips, drinking a coke and watching the fifth episode of House of Cards in a Row, seemingly glued to the television. You feel almost paralyzed. You can do nothing else but click play and ride the wave of your insomnia.
Your oldest has been having difficulties at school, you recently put your dog to sleep, and you are having difficulties with your boss. And you managed to take out your frustrations on your spouse, which led to a blow up and your appearance on the couch. But now you can’t seem to leave. You know you are sad, exhausted, mentally taxed, anxious and emotionally overwhelmed.
But are you depressed?
“I think we are all exposed to situations that can trigger a depressive episode,” says Dr. Kasey Shienvold, Clinical Psychologist and Partner at Riegler, Shienvold & Associates. “Loss of a relationship, loss of a loved one, death of someone they care about very much. Anything like that can trigger a depressive episode. There’s a normal adjustment for anybody to a major life transition, but if it’s persistent and lasting for weeks on end, and if it comes with major changes in their personality, that’s a sign. So if they start dropping out of activities that they used to do – if this is somebody that used to volunteer every week and suddenly they stop, or they played sports regularly and suddenly they’re not active anymore – those are some signs that would indicate that there may be something greater going on that needs to be addressed.”
The National Institutes of Health list the symptoms and signs of depression as:
- Persistent sad, anxious, or “empty” feelings
- Feelings of hopelessness or pessimism
- Feelings of guilt, worthlessness, or helplessness
- Irritability, restlessness
- Loss of interest in activities or hobbies once pleasurable, including sex
- Fatigue and decreased energy
- Difficulty concentrating, remembering details, and making decisions
- Insomnia, early-morning wakefulness, or excessive sleeping
- Overeating, or appetite loss
- Thoughts of suicide, suicide attempts
- Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment.
With our fast-paced society, and our need to do everything bigger, better and faster, most people reading this list will identify with at least a few of these symptoms. So how common is it for people to not recognize their own depression?
Dr. Melissa Brown, Clinical Psychologist for PinnacleHealth, says, “It is not uncommon for people to not recognize that they’re in a depressive slump. Or even to say ‘I’m depressed, but I don’t know what to do about it or I don’t know how to get out of this.’ We do live in a society where we’re always “on”, and that is hard for a lot of people because there is a stigma about mental health illness and that people aren’t allowed to be upset or depressed. And it’s really hard for some people to say they need help.”
But both experts said that one of the best things you can do to keep from sinking into a depression is to lean on your family and friends – and talk to them about how you are feeling, especially during times of transition, hardship or loss.
“You need a good support system,” says Dr. Brown. “Most times, friends are able to recognize when we’re not at our healthiest or when we’re having struggles and don’t know what to do about them. I always say, it’s not the quantity of friends. It’s about the quality of friendships. And we should all really try to have at least one person in life that we can say whatever we need to say to.”
And if you feel like you can’t share your feelings even with your closest friends or family members, Dr. Brown has this advice – “it may be a professional person that you need to go talk to. If they feel like they’re sharing too much with their friends, then they absolutely need to go talk to someone professionally. Anything you take to a psychologist or social worker is confidential.”
Although there is conflicting research about depression, one thing is clear across all research – cases of diagnosed depression and use of anti-depressants has been on a steady increase throughout the world. And women are at a greater risk than men to suffer from a depressive episode during their lifetime.
The Centers for Disease Control report that from 1994 until 2008, the use of anti-depressants in the US increased nearly 400%. They also report that less than one-third of persons taking a single antidepressant have seen a mental health professional in the past year. And some insurance providers cite anti-depressants as their number one reimbursed prescription – ahead of blood pressure medications and antibiotics.
Anti-depressants can be taken for more than just depression. People diagnosed with anxiety, fibromyalgia, premenstrual dysphoric disorder (PMDD) and other illnesses all may find relief from anti-depressants as well. But does everyone who is diagnosed with a depressive disorder need to be on anti-depressants?
Dr. Shienvold says not necessarily. He explains, “one of the ways that I approach it when I talk to clients is to tell them – talk therapy doesn’t work very quickly. Whether its cognitive behavioral therapy or insight oriented therapy, it can take months. That’s a long time to struggle with those symptoms until we can make a lot of progress just through talk therapy. So if the symptoms are so severe and limiting and debilitating, it’s not a bad idea to get evaluated to see if you could benefit from anti-depressants. The medication can alleviate or lessen the symptoms while we deal with the issues in a therapeutic setting.”
Talk therapy, leaning on friends and family, exercise, eating well, anti-depressants -all these things can help with bouts of depression. But if you are feeling overwhelming sadness, and find it difficult to go to work, to talk to friends or get your normal routine done, you may need to seek out professional help. “A depressed person has struggles that are real,” says Dr. Brown. “Depression is a neurobiological disorder of the chemicals of the brain. The brain is an organ just like the lungs or the heart and it should be treated like that. It should be treated as a medical disorder. It’s not a choice.”
If you think that you are depressed, Dr. Shienvold has this advice, “Call your primary care doctor and go see them. They are a great first step.” Primary care doctors have a history with you and should be able to schedule you for an appointment quickly, and refer you to a clinical psychologist or licensed social worker to begin talk therapy. But if your need is urgent, call 911 or go to the emergency room. Dr. Shienvold says, “If it’s so severe that you are having thoughts about hurting yourself, my recommendation is to go to an emergency room to get the attention you need to get you better.”
Kasey Shienvold, Psy.D., M.B.A., works extensively with families in high conflict. He provides child custody evaluations for the courts, and works with adolescents and adults along a multitude of emotional, behavioral and relationship issues.
Melissa Brown, Psy.D., works with toddlers, children, adolescents and adults with co-morbid diagnoses of autism and anxiety, obsessive-compulsive symptoms, depression, ADHD and trauma.
