Transcription:
Depression Hurts: Don’t Be Afraid to Ask For Help

Melanie Cole (Host): When you think of depression symptoms, you probably think of someone looking sad and withdrawing from friends. While these are, in fact, some of the symptoms of depression, depression can also manifest itself in physical symptoms that appear to be unrelated to a mental health issue. It’s a common but very serious illness. My guest today is Dr. Dave Miers. He’s the counseling and program development manager for mental health services at Bryan Medical Center. In addition, he co-chairs the Nebraska State Suicide Prevention Coalition. Welcome to the show, Dr. Miers. Tell us about how to identify somebody - in yourself or in someone that you love - that’s going through real serious clinical depression versus just feeling the blues sometimes.

Dr. Dave Miers (Guest):  Well, it’s important to note that depression is one of the most common mental illnesses. About 10 percent of the population at a given time is known to be suffering from some type of depression. So, it is important to know the signs and symptoms. There’s hope; there’s healing. If you know these signs and symptoms and can get folks connected to resources, that’s very important. Everybody has a down day, feels the blues once in a while but, typically, starts feeling better within a couple of days. When we are talking about depression, and the symptoms interfere with your daily life and routine for a period of two weeks or more, we’re generally talking about some type of depression. The symptoms to look for in yourself or in others would be a change in your mood. A lot of times individuals with depression feel irritable; have trouble sleeping… either you’re sleeping too much or you’re having trouble falling asleep; change in appetite. That can go both ways as well; either you’re eating too much, eating all the time or you just have no interest in eating. So then, you see either weight gain or weight loss. Also, you could have lack of energy; feelings of worthlessness, self-hate and guilt; sometimes having trouble concentrating. Another sign and symptom to look for is if you lose interest in activities. If you like to play basketball or you like to play a musical instrument and all of a sudden, you find yourself not wanting to do those things and being more isolative. That’s generally a sign of depression. If you are feeling hopeless or helpless or having repeated thoughts of death or suicide. If you’re having thoughts of suicide, then that’s a symptom that we need to take action with right away and then, just lack of pleasure in any other activities that you really like to do. Again, if it’s a period of two weeks or more, then we really need to get somebody connected to help.

Melanie:  Dr. Miers, recently in the news there’s information about screening even our teenagers for signs of depression and do you think we should be screening teenagers and looking at people more closely or wait until they come to you?

Dr. Miers:  It is important that we do screen individuals. There are depression screenings available and on the Bryan Medical Center website. There’s actually a screening there if you’re a parent concerned about your teenager. You can go on and answer questions based on your concern about your teen and it tells you whether or not the signs and symptoms are there. It’s not a diagnostic tool but it is a good, confidential way to go in and determine “is depression possibly present” and then it gives you what steps to take. I think that’s a good practice universally. I think if sites or physician clinics and different places have the protocol in place, that if we screen somebody and it does screen positive, then to have those resources to connect them to; then yes, it’s important to have that screening in place. We have counselors and programs in place to help individuals with depression, so having that screening in place and then getting an individual connected if needed is very, very important.

Melanie:  So, let’s speak about treatments a little, Dr. Miers. We hear about, even on the news and advertisements all over the place, for Prozac and things to help you and mood elevants and so, speak about the treatments and what’s going on in the world of treatments for depression.

Dr. Miers:  Well, with treatment with depression, it’s really individualized as with treatments of other mental illnesses. Research shows that depression is one of the most treatable of the mental illnesses and what research also shows is that if you take a look at a couple different treatment approaches, that can be very effective. Sometimes individuals can see a therapist and go for counseling and that is the only treatment that is needed and they find relief from their symptoms relatively quickly from talk therapy. Some individuals work with their medical providers, their physician or psychiatrist and receive medication treatment for depression and that alone can sometimes be very effective for individuals. Research shows that combining those things together, medication and talk therapy together, sometimes leads to quicker results or quicker symptom relief. So, those are some things that individuals can do. There are different support groups. There are some different things the individuals can do on their own as well in terms of, in addition to getting treatment such as counseling and medication, if individuals are monitoring their sleep and getting adequate sleep and exercise and nutrition, combining all those things together can be very effective.

Melanie:  What are the medications intended to do?

Dr. Miers:  There are different theories in terms of treatments for depression. One of the theories is that there’s a chemical imbalance in an individual’s brain — that chemical imbalance in the neurotransmitters — and the medication helps re-balance that or put that into the correct balance and helps an individual feel better from their symptoms.

Melanie:  Okay. So, if somebody has depression and you’ve diagnosed them, and maybe put them on medications, is this a life-long thing? Is this something that does not go away or is it something that can be helped and possibly even cured?

Dr. Miers:  Again, it’s a very individualized thing but a lot of individuals who experience depression and received treatment have a very positive outcome and that is, as I mentioned earlier, very treatable. They see symptom relief and, oftentimes, individuals do not see a reoccurrence of that depression. There are some cases where individuals may receive treatments and receive symptom relief but then see a reoccurrence of that depression later on in life. Really, it is an individualized approach to looking at depression and how that affects individuals but, in a lot of cases, you’re treated, you see symptom relief and sometimes individuals may be diagnosed and then receive medication and therapy and sometimes they might need medication for a longer term than someone else. So, again, it’s very individualized. There are some types of depression, in terms of some cases of depression, where medication and talk therapy are not effective; then, there is what we call “electroconvulsive therapy” or “ETC treatment” that a psychiatrist administers that is oftentimes then prescribed as a treatment approach for treatment resistant to depression.

Melanie:  Dr. Miers, do you feel there’s still a stigma? There’s been a stigma around mental illness for years and depression being one of them. Do you feel that that’s still there or are we talking about this more and it seems to be a more accepted thing that people are now more willing to get help for?

Dr. Miers:  There’s still some stigma surrounding mental health but it has improved greatly over the years. There are a lot of positive steps in terms of that movement to lessen the stigma. Depression is something that can happen to anybody. We see more depression. It’s actually higher with individuals who are seeking treatment or have a medical diagnosis such as cancer, diabetes or heart disease. We’re seeing that treating depression can help individuals with greater health outcomes when they’re dealing with other health issues as well. So, we are seeing more and more people realizing that and identifying that depression is real, it is treatable, there is help and there is hope for depression and making sure that the individual is aware of those resources. We are definitely seeing improvement in that area.

Melanie:  In just the last minute, tell listeners why they should come to the counseling program at Bryan Medical Center.

Dr. Miers:  We have a very passionate group of staff who are very dedicated to working with individuals with mental health issues and care greatly about our community and helping individuals find strength and find the path to feeling better. By going to our online screening, oftentimes that’s the first step in identifying if the signs and symptoms are there and, if so, they can contact the Bryan Counseling Center and be connected to a therapist for an outpatient appointment. If it’s an emergency — if it’s considered a mental health emergency — we also have a mental health emergency department available 24 hours a day, seven days a week here at the Bryan West Campus Emergency Room. It’s one of the few of its kind in the United States and we have a staff available 24 hours a day to help individuals in a mental health crisis.

Melanie:  Thank you so much, doctor, for being with us. I applaud all the great work that you’re doing. You’re listening to Bryan Health Radio. For more information you can go to bryanhealth.org. That’s bryanhealth.org. This is Melanie Cole. Thanks so much for listening.