17 minute read
Never Delay Dealing with Depression
DEALING WITH never delay DEPRESSION
DEALING WITH DEPRESSION
By LEN LANTZ, M.D.
DO YOU WANT TO BE HAPPY?
I know this question sounds ridiculous, but you might be surprised how often I find myself asking it of my patients. Some people have had depression for so long and feel so stuck that they are not sure what they want. So, I make sure to ask.
It’s worthwhile to point out that for many people with depression, it’s not their first time. They may have tried many things to get their depression better, only to see a temporary benefit and slip back into the depression. It’s demoralizing and sometimes people give up trying. If that sounds like you, please consider reading my book, unJoy. It may help you dig deep and find the resolve to try again, because it is my genuine desire that your answer to the question, “Do you want to be happy?” is to stand up and shout, “Yes! Of course, I want to be happy!” and then do something effective for your depression. There are many reasons to set an intention to do something about your depression today.
WHAT POSITIVE OUTCOME DO YOU DESIRE?
The majority of people I know with depression hate it tremendously and want nothing more than to feel normal and start enjoying life again. While many frustrating symptoms occur with depression, rather than focusing on what’s wrong, people often find it far more motivating to focus on the positive outcomes they want for themselves in order to act immediately and with unwavering commitment in getting their depression to remission (full freedom from depression). Examples of positive outcomes to focus on include: + Getting your memory and concentration back to normal + Regaining your confidence + Enjoying yourself when you are with the people you care about + Feeling the dark cloud of depression lift from your mind and body + Laughing again and no longer feeling numb + Experiencing your normal energy level and procrastinating less + Being physically and emotionally present with your kids and partner again + Ending negative or suicidal thoughts
DEPRESSION OFTEN GETS WORSE WHEN LEFT ON ITS OWN
Some people hope they can sleep off depression or simply ignore it until it gets better. The problem when you try to sleep off depression or avoid dealing with it is that those very behaviors can make depression much worse. When you are depressed and in bed all day instead of living life, the depression is right there in bed with you.
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One of the most effective interventions for depression is called behavioral activation. Behavioral activation involves filling your entire day with activities that are in alignment with your values. That might involve regular exercise, getting together with your friends or simply opening up your mail. You can read more about this strategy in my article, “Behavioral Activation for Depression” (https://psychiatryresource. com/articles/behavioral-activationdepression).
One of the problems of depression is that it steals motivation and energy and sends you into a vicious downward spiral. As you give up activities due to low motivation and energy, it fuels the depression to repeat the cycle until the depression becomes severe or even extreme. Just waiting for things to get better without a plan or intervention does not usually work. More often, it allows the depression to sink its claws in deeper.
DEPRESSION TENDS TO FUEL ANXIETY
If you hate feeling anxious, you might consider improving your depression so that you feel less anxious. Anxiety is one of the worst parts of depression. In the deepest part of depression, not only can people feel hopeless about ever getting better, but they can also become overwhelmed by anxiety. For some of the depressed people I help, depression can lead to an unsafe chain reaction due to anxiety and panic. Depression fuels anxiety which, in turn, fuels thoughts of suicide as a means of escape from the anxiety. Deciding to deal with depression can also be a decision to improve your anxiety and safety.
THE SLIPPERY SLOPE LEADS TO A LONG JOURNEY OF RECOVERY
Are you familiar with the term slippery slope? If you have ever tried to inch your way down a very steep and/or slippery slope, then you know what I mean. Once you reach a critical point on the slope, you cannot get back up the same way you came. And in many cases, you will slide all the way to the bottom before you can turn around and find another, longer route back to the top. The farther you slide, the longer the journey.
How long will it take a person trying to get severe depression to remission compared to someone who has mild depression? I treat severe depression for a living. I can tell you that in most cases, it takes much longer to improve severe depression than mild depression.
TRAINING YOUR BRAIN TO BE DEPRESSED
Once established, it’s harder to change long-established brain patterns. The longer you are depressed, the more you set up the depressed brain pattern. If you stay in your depression, you are essentially training your brain to be depressed. Brain research supports this assertion. Both adult and pediatric depression research studies show that the faster depression is improved, the better the outcomes. Dealing with depression as quickly and effectively as possible reduces the odds that a person will end up with chronic, low-grade depression or relapse again into severe depression.
A STORY ABOUT DECIDING TO GET HELP FOR DEPRESSION
Bill was a 37-year-old computer programmer with an eight-year history of depression. He didn’t know why it started and didn’t really think there was a negative life event or problem that had caused the depression to start. He just seemed to slip into it. The depression had been bad for about the last five years and his life was feeling increasingly meaningless to him. His mood usually improved a little bit in the spring and summer, but last winter he developed severe pneumonia. He was in the hospital for a week before the doctors got the infection under control. After pneumonia, his depression became the worst he’d ever experienced, and he decided to talk with his primary care doctor about it.
“Bill,” said his doctor, “the last time I saw you in the clinic was a few years ago. At that time, your depression rating scale showed moderate depression. Wow. Your depression is really severe now. After we met the last time, did you get a chance to do any of the things we talked about?”
“Not really,” Bill admitted. “I called the therapist you recommended, but they were full at the time and not taking on new patients. I kept hoping the depression would get better on its own. I just lost all motivation and things kept sliding downhill. All I can do now is get myself to work and sleep. That’s it. I sleep at least 12 hours a day now and I’m still exhausted.”
“I hear you,” the doctor replied. “I can help you. We’ve got a great depression program right here in our clinic. I can get you in with one of our therapists who is good at short-term therapy. And I want you to start an antidepressant. You shared that you’ve been feeling suicidal and that you’re barely functioning. We need to implement everything we can to get your depression better as quickly as possible. Our depression program is called Collaborative Care, which means that we work as a team – that means you, me and a case manager. The program also allows me to consult with a psychiatrist to make sure you are getting the best care possible. The case manager is going to join us in a minute and she’ll set up times to meet with you once a week to make sure you are getting better and taking care of yourself. If you are not making progress in our program, I also can get you in quickly with an excellent psychiatrist who is affiliated with our program. Are you up for this?”
Bill agreed that he wanted help and liked that he could get the best treatment under the direction of a doctor he already trusted. He agreed that it was time to try an antidepressant, especially if it meant that it could accelerate his improvement. He appreciated his meetings with the case manager and therapist. Through their encouragement and with a gradual improvement in his motivation and energy, he was able to start doing the things – like exercising and engaging in more activities – that would help his depression get better and stay better.
THE BEST TIME TO DO SOMETHING ABOUT YOUR DEPRESSION IS RIGHT NOW
Are you convinced to do something about your depression? There are many things that you can do to help your depression, and the best time to deal with your depression is right now. Start by simply making a commitment to yourself to do something about it. The next thing to do is to meet with a primary care physician or other advanced medical practitioner to talk about your options. In addition to their ability to start an antidepressant, they often have relationships with therapists and psychiatrists in your community, if you desire to work with specialists in your mental healthcare. Your depression can get much better, and it starts with your decision to no longer delay. Feel happier, get your joy back, improve your energy and motivation and start loving life again. Imagine how awesome that will feel! ■
Check out who’s standing out in our community.
IS THERE SOMEONE YOU’D LIKE TO NOMINATE?
Please email shelly@mcsapcoalition.com and tell us why this individual has stood out in your crowd.
Eisley Emmert GRANADA HUNTLEY EAST CHAIN, 11TH GRADE Eisley is in every way what a true leader should be. “Eisley does the right thing in the right way, even when no one is watching,” said Alex Roorda, GHEC math teacher. Eisley serves on student council, is in the National Honor Society, plays volleyball and basketball, and is active in Fellowship of Christian Athletes. She also cheers and participates in the high school band, choir, and theatre programs. She does all this while taking college courses. Although her plate is full, Eisley has earned both an academic letter and a 2022 Gold Presidential Award for academics. She is a role model student and teenager. “She’s a great kid and a quiet leader that her peers look up to,” Roorda added.
Tiffany Lowry FAIRMONT HIGH SCHOOL, 11TH GRADE Tiffany plays on the girls’ basketball and softball teams and is a Fairmont varsity football cheerleader. She is co-president of the Fairmont Empower youth group where her leadership and dedication in prevention work are an asset to her school and community. Last summer, Tiffany attended a prevention conference in Orlando, Fla. She is using that experience and training to speak to local groups like Kiwanis and Rotary. She also volunteers at the Fairmont Elementary School during Cardinal Community days, which allows her to work with younger students in their classrooms and get to know them oneon-one.These experiences are a highlight for Tiffany as one of her goals is to become a special education teacher.
Keegan Hasted TRUMAN HIGH SCHOOL, 11TH GRADE Keegan is one of the nicest kids you will ever meet. He plays basketball and baseball for the varsity teams at Truman. He is club president for his 4-H club and is vice president for State Future Farmers of America. He shows cows and sheep in the county fairs and has done very well showing at the Minnesota State Fair. He dedicates his time to all these activities and still finds time to be an excellent student. “He is also a person of very strong faith, and I believe that guides him in all that he does,” said Jim Utermarck, Truman teacher. “Keegan is a fabulous person who continues to do things that make him even more fabulous!”
Diana Sargent MARTIN LUTHER HIGH SCHOOL, 12TH GRADE Diana has been a member of 4-H for 11 years and is in club and county 4-H leadership. She was awarded the Key Award from Watonwan County 4-H, has earned purple ribbons from the state fair, and won 10 champion ribbons for 2022 fair projects. The Lewisville Women’s Auxiliary chose her to attend Girls State last summer. This experience “helped me grow and gave me an in-depth understanding of the processes of local government,” she said. At Girls State, she was the Chaplain of the House and a member of the Girls State Choir. At MLHS, she is a member of the National Honor Society, serves as Student Council secretary, and participates in Empower, Knights for Life, and Spirit Club.
Jim Utermarck TRUMAN HIGH SCHOOL, TEACHER Jim has been a teacher at Truman for 31 years. He has also coached football, basketball, baseball, trapshooting, golf, and knowledge bowl. He is passionate about working with youth, and they know it, as they suggested he would make a great advisor for the school’s Empower substance abuse prevention group. In Empower and classes, “I always try to give my students opportunities to do different things, to find where their interests lie, and to help them make good choices,” he said. This summer, he also chaperoned several students from Truman and Fairmont to a prevention workshop in Florida. His ultimate goal with all his students? “To see all these students achieve success in high school and beyond!”
40 DEVELOPMENTAL ASSETS
40 Developmental Assets are essential qualities of life that help young people thrive, do well in school, and avoid risky behavior.
Youth Connections utilizes the 40 Developmental Assets Framework to guide the work we do in promoting positive youth development. The 40 Assets model was developed by the Minneapolis-based Search Institute based on extensive research. Just as we are coached to diversify our financial assets so that all our eggs are not in one basket, the strength that the 40 Assets model can build in our youth comes through diversity. In a nutshell, the more of the 40 Assets youth possess, the more likely they are to exhibit positive behaviors and attitudes (such as good health and school success) and the less likely they are to exhibit risky behaviors (such as drug use and promiscuity). It’s that simple: if we want to empower and protect our children, building the 40 Assets in our youth is a great way to start.
Look over the list of Assets on the following page and think about what Assets may be lacking in our community and what Assets you can help build in our young people. Do what you can do with the knowledge that even through helping build one asset in one child, you are increasing the chances that child will grow up safe and successful. Through our combined efforts, we will continue to be a place where Great Kids Make Great Communities.
Turn the page to learn more!
The 40 Developmental Assets® may be reproduced for educational, noncommercial uses only. Copyright © 1997 Search Institute® , 615 First Avenue NE, Suite 125, Minneapolis, MN 55413; 800-888-7828; www.search-institute.org. All rights reserved.
assets in action 40 DEVELOPMENTAL ASSETS
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Valero Renewables invested $25,000 in Martin County youth through the MCSAP Coalition
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Martin Luther students presented the whodunit “Alibis” at the Fairmont Opera House
Dawn Waterbury (right) mentored confirmand Ilana Moeller for three years
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Kinship leaders have fun with mentees during a Pizza Ranch dinner
SUPPORT
1. Family support: Family life provides high levels of love and support. 2. Positive family communication: Young person and her or his parent(s) communicate positively, and young person is willing to seek advice and counsel from parent(s). 3. Other adult relationships: Young person receives support from three or more nonparent adults. 4. Caring neighborhood: Young person experiences caring neighbors. 5. Caring school climate: School provides a caring, encouraging environment. 6. Parent involvement in school: Parent(s) are actively involved in helping young person succeed in school.
EMPOWERMENT
7. Community values youth: Young person perceives that adults in the community value youth. 8. Youth as resources: Young people are given useful roles in the community. 9. Service to others: Young person serves in the community one hour or more per week. 10. Safety: Young person feels safe at home, at school, and in the neighborhood.
BOUNDARIES & EXPECTATIONS
11. Family boundaries: Family has clear rules and consequences and monitors the young person’s whereabouts. 12. School boundaries: School provides clear rules and consequences. 13. Neighborhood boundaries: Neighbors take responsibility for monitoring young people’s behavior. 14. Adult role models: Parent(s) and other adults model positive, responsible behavior. 15. Positive peer influence: Young person’s best friends model responsible behavior. 16. High expectations: Both parent(s) and teachers encourage the young person to do well.
CONSTRUCTIVE USE OF TIME
17. Creative activities: Young person spends three or more hours per week in lessons or practice in music, theater, or other arts. 18. Youth programs: Young person spends three or more hours per week in sports, clubs, or organizations at school and/or in the community. 19. Religious community: Young person spends one or more hours per week in activities in a religious institution. 20. Time at home: Young person is out with friends “with nothing special to do” two or fewer nights per week.
If you or your child would like to submit a picture that represents one of the 40 Developmental Assets, please email shelly@mcsapcoalition.com with a picture and the number of the asset the picture represents.
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Not all pictures are guaranteed publication.
COMMITMENT TO LEARNING
21. Achievement motivation: Young person is motivated to do well in school. 22. School engagement: Young person is actively engaged in learning. 23. Homework: Young person reports doing at least one hour of homework every school day. 24. Bonding to school: Young person cares about her or his school. 25. Reading for pleasure: Young person reads for pleasure three or more hours per week.
POSITIVE VALUES
26. Caring: Young person places high value on helping other people. 27. Equality and social justice: Young person places high value on promoting equality and reducing hunger and poverty. 28. Integrity: Young person acts on convictions and stands up for her or his beliefs. 29. Honesty: Young person “tells the truth even when it is not easy.” 30. Responsibility: Young person accepts and takes personal responsibility. 31. Restraint: Young person believes it is important not to be sexually active or to use alcohol or other drugs.
SOCIAL COMPETENCIES
32. Planning and decision making: Young person knows how to plan ahead and make choices. 33. Interpersonal competence: Young person has empathy, sensitivity, and friendship skills. 34. Cultural competence: Young person has knowledge of and comfort with people of different cultural/racial/ethnic backgrounds. 35. Resistance skills: Young person can resist negative peer pressure and dangerous situations. 36. Peaceful conflict resolution: Young person seeks to resolve conflict nonviolently.
POSITIVE IDENTITY
37. Personal power: Young person feels he or she has control over “things that happen to me.” 38. Self-esteem: Young person reports having a high self-esteem. 39. Sense of purpose: Young person reports that “my life has a purpose.” 40. Positive view of personal future: Young person is optimistic about her or his personal future.
Martin Luther students and families honored grandparents and veterans on November 11
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MCW students taking College Now courses visited SMSU for Aspiring Educators Day
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Granada-Huntley-East Chain Empower students host a Halloween trunk-or-treat table for community youth
Experts share the spiritual, physical, and emotional impacts of substance misuse
