From the Desk of Dr. Earp "Little Depressed?"- For your Health Series #2

Are you feeling depressed? Feeling down, tired and fatigued? Well, pardon the pun but don’t feel bad (that is, don’t despair!). Depression is one of the most common maladies affecting persons throughout the world. It is also one of the most highly undiagnosed (i.e., unrecognized) and untreated problems facing all of us.

Depression ranges from very minimal or mild situational depression, such as that stemming from a severe argument with a loved one, the loss of a distant relative or ongoing relationship problems with fellow coworkers to severe, chronic depression with or without suicidal intentions. All of us feel “blue” from time to time but that is not true depression. Also, most folks with depression are helped with 6-8 months of antidepressant therapy plus or minus psychotherapy or counseling. Situational depression and SAD (Seasonal Affective Disorder) are the more common types of depression which are either self-limited or resolve with therapy.
A diagnosis of depression requires that your signs and symptoms be present continuously for at least 2 or more weeks. Review these and see if any hold true for you or someone you know fairly well. Don’t delay diagnosis or treatment as there is always the possibility of worsening making resolution and recovery more difficult.

Your Primary Care Physician may be a good place to start for an evaluation but if this is relegated to a 10 minute visit and a prescription with instructions to return in a month you need to seek better advice and help. Particularly treatment with antidepressants, you need to be monitored closely early on with frequent visits and titration of the medication to a dosage therapeutic for you. Unfortunately, the majority of Family Physicians and Internists are neither trained nor experienced in this; also, precious few have the time to devote to you that you need. Don’t hesitate to see a psychiatrist or a therapist who can refer you to a psychiatrist. Also, read about it as much as you can; insight is sometimes half the battle.

Many theories abound concerning the cause or etiology of depression. While it is borne out in studies and through the use of medications which alter brain chemistry (neurotransmitters), a “chemical imbalance” likely plays a major role in causing depression. Depression is a very real and at times disabling illness. Few persons, including the majority of physicians, who have no personal experience with it have any or little empathy for those affected. However, the phrase has become a politically correct catch-all term to explain depression and de-stigmatize it. Of course, it should never have carried a stigma to begin with.

Unresolved emotions issues, particularly anger and “letting go” of past experiences with significant emotional overlay are frequently at the heart of depression. Just how and when mild depression crosses over to clinically significant and/or chronic depression is not truly known. Sometimes it is helpful to inventory your emotions; don’t label them “bad or good.” Emotions are what they are; they can be helpful or disruptive to your thinking or lifestyle but don’t place a value system on them. They are real and only you are the one to validate them.

Examine in whatever objective manner you can the many emotional and relational aspects of your life and your responses to it. Oftentimes this will reveal one or more anger issues with which you have not effectuated a resolution. Listing these in order of not only importance but magnitude of reaction is helpful to sort through them. Then, one by one, you can start the very slow and sometimes mentally painful process of dealing with them. Give yourself plenty of time, empathy and sympathy. Keep a private journal of your feelings, what you are going through and your reactions to the help and treatment you are receiving. Writing about yourself is very therapeutic in and of itself, particularly when the only reader is you.

While it is very helpful to have loved ones or friends to help you through this oftentimes a therapist and/or psychiatrist is the only means of objectifying the disorder for you and giving you a guiding hand. Do not expect on any level much sympathy or empathy from anyone; it is profoundly difficult for most people, especially those rooted in Western Society, to understand depression as an illness. A broken bone is so much more easily recognized as a form of illness than an aberration of the mind!

Above all else, treat yourself with kindness, empathy and patience. Your physical AND mental health are the most important things about your being.



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