Depressed? Get treatment!Let's start with a question. Which of the following conditions do you think results in the most days spent in bed: ulcers, diabetes, hypertension, or depression?Why, depression, of course. You are right. Depression has hit the news spotlight again, with the results of a Roper poll, sponsored by the National Mental Health Association. The results are pretty well known to mental health clinicians — that only 18 percent of the people surveyed who were depressed actually went and got treatment for their depression. Now, if you consider that other surveys have already shown that over 19 million Americans suffer from clinical depression, then these are staggering numbers of untreated people. What is the cost and the human significance of these numbers? According to a Rand study, as a national public health threat, depression is estimated to cost over 44 billion dollars annually, and these are 1990 numbers. In lost workdays alone, the cost is over 11 billion dollars a year. The personal significance is in the unnecessary suffering that accompanies untreated depression. Research findings show that up to 80 percent of people who go to treatment are actually helped. Some depressions are very resistant to treatment and may result in prolonged suffering or loss of the capacity to thrive and even suicide — but this is the minority of cases. What are the symptoms of depression? Depression is a condition that is usually made up from a number of symptoms that occur in different patterns with different people. You or a loved on should consider seeking treatment if you experience a change in your ability to function well in your daily life and some (more than three, one if very severe) of the following symptoms: • Persistent sadness • Lack of interest or pleasure • Marked appetite or weight change • Troubled sleep • Low energy or fatigue • Guilt or worthlessness feelings • Trouble concentrating • Indecisiveness • Hopelessness • Thoughts of death or suicide There are a lot of conditions that may look like depression, but may be caused by something else. Your physician or a mental health professional can help direct you to get the right care for your well being. How should we respond to the depression problem? We need to treat it like the public health problem that it is. Everybody needs to take psychology 101, so to speak. We need to know more about the warning signs of psychological illness and to make it ok to talk to each other as well as to somebody else about our mental states, good and bad. I know this sounds like a joke, but there ought to be a pit stop, like a service station, where people could go to get soothed and remove the pain of unnecessary negative mental states, to re-build self-esteem and to promote positive feelings and thoughts about themselves and the world. Isn't that what people do when the see a therapist? In the best of cases, yes. The sad truth so far is that people don't seem to be able to identify the warning signs of mental illnesses very well. Many people are afraid of the stigma, so they don't share their distressing inner thoughts and feelings with family or friends. These people need support and encouragement to get treatment, which is the right thing to do. Lastly, a lot of people are not aware that there are effective treatments for depression. Antidepressant medications can help a lot of people, fairly quickly — in about 3 weeks. Medications tend to improve sleep and energy and help uplift mood. Psychotherapy teaches us how to recognize problems in thinking that generate persistent negative states and then how to re-regulate and shift thoughts and behavior to support true positive experiences of self, others, the world and the future. What about self-help? Can people talk themselves out of their own depressions? There are several forms of self-help and some of them can help. Some people find help by joining groups like 12-Step or Recovery, Inc. Some people may benefit from reading books about depression or other wellness topics. This practice is sometimes called "bibliotherapy." One of the biggest limitations to self-help is that many people who think they can get over their problems on their own end up mostly trying to ignore their problems in hopes that they will go away. Clinical depression is an enduring state that stays around by becoming a cycle of negative thought and perception, misguided actions, and repeated failures and dissatisfactions. For self-help to be effective, it has to embody some of the same qualities of effective therapy: changing negative thinking, challenging fears of failure, encouraging social support through participation, and staying focused on the task of healing, supported by regularly scheduled visits. Today's lesson #1 is that people need to know more about depression and other human conditions and provide support and trust so that those who need help can get it. Remember, depression is a not a sign of weakness but a treatable condition that causes unnecessary suffering because too few of us know enough about it to help. Feel free to pass this column on to a friend or write to me at the address below for an easy to reproduce copy. |
