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Depression: Not a laughing matter

by Crackerbox Palace ( 54 Comments › )
Filed under Healthcare, Medicine, Science at September 10th, 2014 - 7:20 pm

Co-written By Carolina Girl and Live Free or Die


The tragic suicide of Robin Williams recently seems to have sparked all sorts of response – finger pointing by both sides about the coverage, the potential for copycats, the “state of world” he was living in, and on and on.  Everyone from Russell Brand (who used it to attack Fox News) to Rush Limbaugh (who used it to comment on the state of popular culture and social media), seemed to have a particular take.  The most common response among the “common folk” was surprise that someone so innately funny was so sad to the point of self-destruction.  And the speculation of what made him “sad” .

More sad is the one dialogue it has not sparked – a discussion of the causes and effects of depression.  And it is a dialogue and discussion that is sorely needed in this county.  Considering that it is estimated that depression make strike 10% of the population, it’s time we had one.

While it’s a positive step that we have moved beyond our previous reluctance to talk in the open about mental illness, and we no longer use barbaric methods to neutralize those suffering from schizophrenia and bi-polar affective disorder (“BAD”) (getting away from the phrase “manic/depressive”), depression somehow has moved almost into the mainstream in terms of viewpoint- almost TOO mainstream.  Think about it.  Fifteen years ago , you would never have seen television or magazine advertisements touting the relief from symptoms of mental illness, and how – you can safely bet you’ll see at least one while you enjoy the latest episode of your favorite show.

Which brings me to a bit of a sticking point.  In some respects, we have reduced the treatment of depression to the equivalence of acid reflux disease or getting “Claritin clear.”  The cartoon lady with her bouncing black ball of depression seems almost harmless when viewed in the string of ads for Ikea and Pier One.  Gee, my medicine isn’t working, here’s something that will help.  It runs through the list of side affects and says “thoughts of suicide” in the same breath as “headache and nausea.”  It uses the same catch phrases for obtaining the drug as another commercial – “ask your doctor if Cialis is right for you.”

It is important for those who have never been affected by depression (either themselves or a loved one or friend)  that true depression isn’t for the most part a minor psychological disorder.  It is considered in general psychological parlance a “mood” disorder that to the layman’s ear makes is sound almost harmless, but it is not.  Someone faced with true depressive disorder cannot, as some would wish “snap out of it” or “get over it.”  Also, the use of chemotherapies and prescriptions seems to have pushed aside the need for psychotherapy in conjunction with dealing with the effects of depression — in most cases, these are necessary in that behaviors associated with depression often leave consequences that must be dealt with and the need to express one’s feelings and need for desirable outcomes in a non-judgmental environment is more important than modern medicine would give it.

 

I am now going to turn this over “Live Free or Die”, a practicing professional who will not only give some sound advice on what to look out for in friends and loved ones that can be symptomatic of depression but also how to give real support to someone who may be suffering from depression.

Professionals look for some key symptoms when addressing depression, which include a sad, “down” mood or increased irritability. People may share that they’re feeling low or it may be noticed by others. Feelings of hopelessness, worthlessness, and guilt are very common.  In addition, people with depression often experience disruptions to their sleep and eating patterns. Some people sleep more when they’re depressed, some sleep less. Some eat more, some eat less. Concentration and the ability to focus on work (I’m including school under this for children and adolescents) often decline. I have had children sent to me for evaluation of ADHD who were actually severely depressed; unfortunately, their other symptoms went unnoticed  because difficulties with attention tend to immediately get lumped under attention disorders in schools. Low energy and loss of pleasure in areas they used to enjoy can also be present.

People with depression often have thoughts of death. These may include suicidal ideation, but it is not unusual for such thoughts to involve dwelling on themes of death they see in the world around them or worrying about people they know dying.

If you are concerned someone you know may be depressed and/or suicidal, the best thing is to bring it up with them directly. Find a private opportunity and let them know you are concerned about them (“I’ve noticed you’ve seemed really sad lately. I was worried and wanted to know if there is anything I could do to help.”) If they acknowledge they have been feeling depressed, let them know about some specific people or places that could provide help. People with depression may feel guilty, hopeless, or overwhelmed about seeking help; the more specific the information you can provide the better. Contrary to popular myths about suicide, talking about it does not put the idea in someone’s head.

 

Certain behaviors should raise “red flags” when you are worried that someone is suicidal. A person planning to kill themselves may start giving their possessions away or provide instructions on how to run their funeral. They may start to talk about “When I’m gone” or tell you directly that they have thought about killing themselves. At this point they need to be seen by a professional to determine their risk level and if they need to be hospitalized. With children/adolescents, let their pediatrician and/or guidance counselor know that you are worried the child is suicidal and tell them the specific reasons for your concerns. They should see the child immediately. If they won’t/can’t, call your insurance company, state you want the child evaluated ASAP, and explain why. Another option is to take the child to the nearest emergency room for an evaluation.

With adults you can express your concerns to their primary care doctor or other professionals involved with them (if you know who these people are). Another good option is to call your nearest crisis intervention center or police station and get advice from them on how to proceed immediately. If the adult is willing to go the nearest emergency room, take them there. If someone in your home has a history of suicidal behavior in the past and seems to be depressed again, lock up any and all items they could use to kill themselves (i.e., weapons, sharp knives, all prescription and nonprescription medications.) Whenever suicide is a possibility, it’s better to go into crisis mode than be afraid of being wrong.

Update: This article was republished to be given more time to be read.

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