Maybe I am Depressed…

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“The only thing more exhausting than being depressed is pretending that you’re not.”

– Unknown

One of the first mental health issues we will tackle together will be depression. During the COVID19 pandemic, many people have either relapsed into depression or questioned whether they have it. In this post, I will highlight the key points you should know about depression.

You’re not alone

You may hear a lot of people say they are depressed given the current social climate and recent events. Nevertheless, at baseline, NAMI estimates that more than 17 million adult Americans ( 7%) had a major depressive episode in the last year. The World Health Organization estimates that number to be more than 264 million worldwide. The means that if you were in a room of 14 people, at least one of you may have had a major depressive episode in the last year.

Sad or Depressed

There is a difference between being sad and depressed. Ironically, you don’t have to be sad to be depressed. Depression is also not necessarily on the spectrum of sadness. Sadness is a feeling. Although you can feel depressed, I will refer to depression as a group of symptoms. In medical school, I crammed a lot of information into my brain with mnemonics. One of my favorites mnemonics was SIGECAPS, the mnemonic for depression. If you have 5 of more of the symptoms from the mnemonic for more than 2 weeks, it was likely you had depression. SIGECAPS stands for Sleep ( decreased or increased), Interest ( decreased), Guilt, Energy (decreased), Concentration (decreased), Appetite ( increased or decreased), Psychomotor ( slowed down, or more keyed up), and Suicide ( thoughts, plans, intentions, attempts). I’d like to point out that sadness is not in that SIGECAPS. You either have to have low mood or decreased interest. Just think about all the combinations of SIGECAPS and decreased interest that could make the criteria for depression, but don’t fit the mold of what people would readily identify as depression.

Why me?

Many of us have heard of nature vs. nurture. The “nature” component of mental health are the things we were born with. For depression, a factor that can increase your chances for depression is if you have people in your family with depression. Another component would be disease. Whenever I get a new patient I send them straight to their primary care providers to make sure there aren’t any general medical reasons for depression. This can include and are not limited to vitamin deficiencies, hormone imbalances /shifts ( don’t forget during and after pregnancy!), electrolyte imbalances, sleep apnea, and thyroid disease. The ” nurture ” part happens to be a combination of everything else. Many people have had traumatic things happens to them throughout or at some point in their life that increased their chances of depression. Now, more awareness is coming out about micro-aggressions which are the small assaults to one’s humanity that add up to one huge trauma. Moreover, we cannot negate the effect substances ( legal and illegal) have on our minds. I think it is more accepted that recreational and illegal substance may cause shifts in mood, but we should never for get that the drugs you buy over the counter and get prescribed from your doctor may affect your mood as well.

Is there help?

Yes. There is. I wouldn’t be a psychiatrist or take the time to write this post if I didn’t believe that. However, fighting depression takes work. For some, it is literally a battle for their life. The main classes of treatment are medications, therapy, and alternative treatments. I will not get into medications at length, because I believe that this is something you should discuss with your doctor. This should be a full discussion in which you talk about the risks, benefits, uses, and alternatives to whatever medication in presented. Alternative methods include things like yoga, meditation, supplements, exercise, procedures and diet changes to name a few. I would approach supplements like they are mediations. Please tell your provider about anything you are ingesting or using to help with your symptoms. Last, but not least, there are so many therapies for depression. The cool thing about depression is that therapy alone can treat some cases of depression. Therapy with medications are ideal. Again, I won’t go into all the types of therapy. However, I will say that many of the skills we will go through in the first series will be rooted in Cognitive Behavioral Therapy. Although we will be going through skills and ways to cope with depression, I encourage you to find treatment if you feel you are depressed.

So what’s next?

If you are suicidal and don’t feel safe from yourself, the next step if to call 911 and or go to your nearest emergency room. For less severe symptoms, the first step would be to talk to your primary care provider about the possibility of you being depressed. If you don’t have a primary care provider, you can visit a mental health clinic or your local hospital to ask if they have providers available or resources. Many states and cites now have mental health initiatives to help people find mental health care. The links below are my favorite resource websites. No matter how you get help, you’re worth it and should take that first step in your journey to wellness.

Links to Resources

NAMI (National Alliance on Mental Illness)

CDC ( Centers for Disease Control and Prevention)

WHO (World Health Organization)

Suicide Prevention Lifeline

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