Occasionally everyone feels down or sad, but these feelings are usually short term and pass within a couple of days. When you or a loved one has depression, it interferes with daily life and causes pain for the person suffering and for the people who care about them. Depression is a common but serious illness. People who suffer from depression don’t all experience the same symptoms, severity, frequency, or length of the illness. Many people never seek treatment; however, the majority of people who do seek treatment get better. According to the National Institute of Mental Health (NIMH), these are common signs of depression:

• Persistent sad, anxious, or “empty” feelings
• Feelings of hopelessness or pessimism
• Feelings of guilt, worthlessness, or helplessness
• Irritability, restlessness
• Loss of interest in activities or hobbies once pleasurable, including sex
• Fatigue and decreased energy
• Difficulty concentrating, remembering details, and making decisions
• Insomnia, early-morning wakefulness, or excessive sleeping
• Overeating, or appetite loss
• Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment.
• Thoughts of suicide, suicide attempts. If you or your loved one is feeling suicidal call the United States National Suicide Prevention Lifeline immediately. They are open 7 days a week, 24 hours a day and can be reached at 1 (800) 273-8255. Help is provided in English and Spanish. Their website is: www.suicidepreventionlifeline.org

If your child is feeling sad, this does not mean he or she has a depressive illness. Depression is more than the blues. However, if you she an overall change in your child’s mood and behavior, and when sadness becomes persistent, affecting daily behavior, interests, schoolwork, family life and activities, your child may be suffering from a depressive illness. A child with depression may pretend to be sick, refuse to go to school, cling to a parent, or worry that a parent may die. Older children may sulk, get into trouble at school, be negative and irritable, and feel misunderstood. Because these signs may be viewed as normal mood swings typical of children as they move through developmental stages, it may be difficult to accurately diagnose a young person with depression without the support of a professional.

Before puberty, boys and girls are equally likely to develop depression. By age 15, however, girls are twice as likely as boys to have had a major depressive episode. Depression during the teen years comes at a time of great personal change—when boys and girls are forming an identity apart from their parents, grappling with gender issues and emerging sexuality, and making independent decisions for the first time in their lives. Depression in adolescence frequently co-occurs with other disorders such as anxiety, eating disorders, or substance abuse. It can also lead to increased risk for suicide. Adolescent girls who are compliant and over achieving in school and activities may mask their depression well, due to their level of maturity and responsibility; however if you see a notable change in your child, your daughter may be suffering unnecessarily.

Often other disorders accompany depression, such as anxiety disorders, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder, panic attacks, and social phobia. PTSD can occur after a person experiences a terrifying event or ordeal, such as a violent assault, a natural disaster, an accident, terrorism or military combat. People experiencing PTSD are especially prone to having co-existing depression. Alcohol and other substance abuse or dependence may also co-exist with depression. Research shows that mood disorders and substance abuse commonly occur together. Depression also may occur with other serious medical illnesses such as heart disease, stroke, cancer, HIV/AIDS, diabetes, and Parkinson’s disease. People who have depression along with another medical illness tend to have more severe symptoms of both depression and the medical illness, more difficulty adapting to their medical condition, and more medical costs than those who do not have co-existing depression. Treating the depression can also help improve the outcome of treating the co-occurring illness.

Every therapy session is unique and caters to each individual and their specific need.  It is standard to discuss the primary issues and concerns in your life during therapy sessions.  It is common to schedule a series of weekly sessions, where each session lasts around fifty minutes.  If you are experiencing severe depression, multiple sessions each week may be recommended. Therapy can be short-term, focusing on a specific issue, or longer-term, addressing more complex issues. In some cases a combination of medication and therapy is the right course of action.  Working with your medical doctor, you can determine what’s best for you.  It is well established that the long-term solution to mental and emotional difficulties and the pain they cause cannot be solved solely by medication.  Instead of focusing treating the symptoms, you can best achieve sustainable growth and a greater sense of well-being with an integrative approach to wellness of core concerns.

If you know someone who is depressed, it affects you too. The most important thing you can do is help your loved to seek help, get a diagnosis, and treatment. You may need to make an appointment and go with him or her. With depression, everything feels more difficult, including seeking help.
To help your friend or relative

• Offer emotional support, understanding, patience, and encouragement.
• Talk to him or her, and listen carefully.
• Never dismiss feelings, but point out realities and offer hope.
• Never ignore comments about suicide, and report them to your loved one’s therapist or doctor.
• Invite your loved one out for walks, outings and other activities. Keep trying if he or she declines, but don’t push him or her to take on too much too soon.
• Provide assistance in getting to the doctor’s appointments.
• Remind your loved one that with time and treatment, the depression will lift.

If you have depression, you may feel exhausted, helpless, and hopeless. It may be extremely difficult to take any action to help yourself. But as you begin to recognize your depression and begin treatment, you will start to feel better.
To Help Yourself

• Do not wait too long to get evaluated or treated. There is research showing the longer one waits, the greater the impairment can be down the road. Try to see a professional as soon as possible.
• Try to be active and exercise. Go to a movie, a ballgame, or another event or activity that you once enjoyed.
• Set realistic goals for yourself.
• Break up large tasks into small ones, set some priorities and do what you can as you can.
• Try to spend time with other people and confide in a trusted friend or relative. Try not to isolate yourself, and let others help you.
• Expect your mood to improve gradually, not immediately. Do not expect to suddenly “snap out of” your depression. Often during treatment for depression, sleep and appetite will begin to improve before your depressed mood lifts.
• Postpone important decisions, such as getting married or divorced or changing jobs, until you feel better. Discuss decisions with others who know you well and have a more objective view of your situation.
• Remember that positive thinking will replace negative thoughts as your depression responds to treatment.
• Continue to educate yourself about depression.

• My loved one doesn’t want to go to therapy; won’t it make things worse if I force them to go?
  I trust that you know your loved one well and know whether or not what they are going through is a phase that will pass on its own or is a more concerning issue that the support of a therapist is important. Therapy is a supportive healing environment and does not promote making things worse. Once initial resistance and fears about therapy are worked through, therapy is an ideal place to work through depression. If therapy isn’t the answer for your loved one, I would be happy to discuss other possible options for each individualized situation.

 

• Our schedule is very impacted, how will we add one more thing?
  I do try my best to work out a schedule that will work. With a little flexibility on both our parts, the schedule tends to work out. With that said, once an agreed upon time is arranged, consistency and commitment to therapy is important for a good outcome. I work Tuesday – Friday and afternoon appointments tend to fill up quickly. If my schedule cannot accommodate you, I will do my best to place you with a trusted therapist.

 

• Can I afford therapy?
  This answer is different for each person; however with your consent I am happy to bill your mental health insurance as an out-of-network provider for you as long as it is a PPO plan. This typically works well, only being responsible for the coinsurance or copay amount. There are some insurance plans that have high deductibles, low reimbursement rates, or does not cover certain diagnostic codes that could make the cost of therapy difficult to manage. I’m happy to check into your insurance benefits for you, and with that information you can make an informed decision about seeing me, or possible going with an in-network-provider on your plan.

 

• This is informative, but I’d like to speak to a real person about my concerns.
  It’s best to call me to discuss your specific concerns. I typically return non-urgent calls within the same day you leave a message, unless it is on a weekend or holiday. I recommend leaving a message with some good times to call you back. I’m often unable to pick up calls immediately when in session.