I have have known people in my life that suffer form serious depression, and some that have come to a very distressing and upsetting end, not because no one cared, not because people didn’t say the right things, but just because everyone has a breaking point, and you never know what it is. May is mental health awareness and suicide prevention month, so this is coming a little bit early, but the world has been filled with a lot of sadness and a lot of great stuff too, but people have been focusing on the sad and negative.  Life can be tough, and dealing every day with depression can be so unbearable, on top of every day stress, and you never know who is battling to live every. single. day.

Depression is a very serious problem, that can cause an array of health issues, but be easily overlooked by sufferers and by people close to them.  Sometimes it is just a feeling of not being “right” or feeling “off” or being really sad or listless, and it can effect different age groups in different ways. And there are numerous different types of depression: postpartum (after giving birth), chronic, Seasonal Affective Disorder SAD (related to less light in the winter), major depression, transient depression (related to one major traumatic issue), etc. And it may be hard to diagnose or notice an issue.  I think depression should be better screened for by HCP’s in general, but I look towards patients and their family members to mention if you see any of these signs or symptoms because if you don’t tell us what is really going on, it is very difficult for HCPs to pick up these symptoms during an appointment or quick visit:

Adults:

-Feelings of sadness or unhappiness
-Irritability or frustration, even over small matters
-Loss of interest or pleasure in normal activities
-Reduced sex drive
-Insomnia or excessive sleeping
-Changes in appetite — depression can cause decreased appetite and weight loss, but in some people it causes increased cravings for food and weight gain
-Agitation or restlessness — for example, pacing, hand-wringing, or new aggression
-Slowed thinking, speaking or body movements
-Indecisiveness, distractibility and decreased concentration
-Fatigue, tiredness and loss of energy — even small tasks may seem to require a lot of effort
-Feelings of worthlessness or guilt, fixating on past failures or blaming yourself when things aren’t going right
-Trouble thinking, concentrating, making decisions and remembering things
-Frequent thoughts of death, dying or suicide
-Crying spells for no apparent reason
-Unexplained physical problems, such as back pain or headaches that aren’t related to allergies, etc. that don’t respond to OTC medications (i.e. ibuprofen, acetaminophen)

Young Children: can show signs of hopelessness, sadness, worry.

Teens: Can be irritable, anxious, angry, and avoid social interactions. Also, changes in sleep patterns….are they up all night for no reason?  Sleeping excessively?   We also need to be aware that during the teenage years is when other mental disorders can start to become prominent.

Elderly: fatigue, loss of appetite, loss of interest in sex, feel bored and helpless or worthless, and avoiding social interactions.  With the elderly, there are usually other health issues involved, so people can tend to link in the symptoms of depression with their other disease processes, so it is important to be aware of the signs.  For example, cardiac disease can also cause depression, so is the issue new onset?  Did something major just happen like the loss of a loved one?

For some people the signs are really severe and very obvious, but for other people, they are very subtle and occur over a period of time making them much harder to notice, especially with those close enough to the person suffering.  People are really good at hiding things, and the longer you live with (or around someone) it’s easier to make excuses for behavior, exhaustion, and you might not even notice the behavior because you are so used to it.  I also think that it is the first instinct to get very defensive when other people make comments to you or your loved ones about various behaviors, but once you get over the initial defensiveness, soak it in, and try to see things from a different perspective.  Obviously if someone is just being mean, then let it slide, but if a close friend/family member tries to give you some insight, take it….when you are ready. 


Awareness of the signs is the first step to getting help, so please take notice in your own life and of your loved ones and do a mini checklist to see if  you or they have any of these symptoms.  If you or your loved ones do, try to talk to them, open up the discussion, and if they are not willing to, then please call your HCP and make an appointment to talk about it, OR if you want to talk to someone immediately, please call the National Suicide Prevention Lifeline at 800-273-8255.  I also encourage you to talk to anyone…a friend, family member, clergy member about your feelings, about what you think may be going on. Talk to anyone you feel comfortable with because the first step to getting help is to realize that there is a problem.  Also, sometimes you keep things inside and you realize that other people are going through what you are going through, and talking to someone with similar problems and issues may help you, or help you to get professional assistance that you need.


Please remember that the person you may see crying while walking down the street might be on the edge, or the “crazy” person you see that is pissed off in line at the Post Office, or the person that you know really well acting totally different than you remember them to be, may be suffering from depression or another mental illness. I used to not think about that, and think people are totally off their rockers, until things have happened to me and my family; there are some days you do what you can to get through the day, but you have to remember that there is a light at the end of the tunnel.
If you/your friends/loved ones have thoughts of suicide or homicide please seek help immediatelyand call 911 or go to the nearest Emergency Department for help.



Yours in Good Health
B