Dr. Lee Ann Gee on depressionHealth Sense

What you need to know about depression – serious or not?

By Dr. Lee Ann Gee D epression affects approximately 10% of the U.S. population. Feeling sad or upset is a normal response to situations of loss, stress, illness, or other emotional occurrences. Major depression, however, is different and will last for long periods of time, interfering with a person’s health and daily life. If you or someone you know has been suffering from symptoms of depression, there are a few things that are important to know.

Recognizing depression The signs and symptoms of depression can be variable. People who have been suffering from the disorder may not even realize that they have it.

Intense feelings of sadness, hopelessness, worthlessness, or emptiness are the most well-known characteristics of depression. You might also experience a loss of enjoyment for activities or things that used to make you happy as well as a lack of motivation for performing daily tasks, increased irritability or anger outbursts, or trouble becoming aroused in an intimate way. It may be difficult to concentrate, remember things, or make decisions. Thoughts of self-harm, death, or suicide are also signs of severe depression.

Your mental and physical health are very closely tied. During a depressive episode, there are physical symptoms you may notice such as low energy, sleeping too much or too little, appetite changes, indigestion and other digestive problems, and weight loss or gain. Odd pains such as headaches, stomachaches, or backaches are also possible. You may find yourself crying nonstop, exhibiting purposeless physical actions such as handwringing or pacing, or slowing your speech and movements.

Depression is a real illness One of the most important things to understand about depression is that it is a real disease with physiological connections. While the most obvious symptoms may be emotional, a major depressive disorder is not a passing emotional state. You can’t expect someone with depression to “snap out of it,” “be happy,” or “get over it.”

Depression is essentially caused by an imbalance in brain chemistry. Neurons (brain cells) use several complex methods for communicating between each other and along nerves. One mechanism involves sending specific chemicals, called neurotransmitters, as messengers. The main neurotransmitters in emotional regulation are serotonin, norepinephrine, and dopamine. Though these have many functions, they are involved in controlling feelings of happiness, reward, pleasure, appetite, and energy. Changes in the balance or composition of these neurotransmitters can lead to conditions such as depression. What often happens in depression is too little serotonin is produced, or it is reabsorbed too fast. Some scientists now think this may be related to chronic low levels of inflammation in the brain or central nervous system.

Depression is treatable There are many different treatment options available for managing depression, and the majority of patients who receive proper treatment will be able to overcome this condition. However, every person and every case is unique. This means that patients need to work closely with health care providers to develop treatment strategies that work. The first course of action is to make an appointment with your doctor. He or she may perform a physical and/or psychiatric evaluation to determine factors contributing to your illness.

The most common and well-known treatments for depression are antidepressant medication and psychotherapy. For mild depression, psychotherapy or “talk therapy” is often adequate. This involves speaking with a licensed therapist, either alone or with family members or in a group. For moderate or severe depression, psychotherapy is best alongside antidepressant medication. Antidepressant medications work to restore a normal balance to the neurotransmitters in your brain, enabling normal emotional control and response.

Pixabay

They are not stimulations and are not addictive.

Research is continually uncovering information about the causes of depression. With it, newer treatments are being developed. One example is transcranial magnetic stimulation, or TMS, a non-invasive technique that sends magnetic pulses to stimulate specific regions of the brain. This therapy has been shown to be effective even for patients who are resistant to antidepressant medication.

Self-care and coping There are a few things you can do on your own to help ease the symptoms of depression. Most have to do with taking care of your body. Good physical health is important for mental wellbeing.

Regular exercise is especially helpful. Not only does exercise improve your physical health, it also boosts the production of endorphins, which elevate your mood. Eating a healthy diet with plenty of nutrients and low amounts of inflammatory foods is also good for your brain. Maintaining connections with friends and family is important, too. Additionally, make sure you get plenty of sleep at night.

Emergency help is available If you are ever thinking about committing suicide or harming yourself or others, it is critical that you stop and seek help immediately. Even if you don’t have time to make an appointment with a doctor, there are several ways to receive help at any time of day, any day of the year. Calling 911 is always an option, and there are several mental health hotlines available. You can also walk in to a hospital emergency room.

• National Suicide Prevention Hotline: 1-800-273-TALK (8255)

• Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline: 1-800-662-HELP (4357).

Dr. Lee Ann Gee is a licensed and board certified general practice psychiatrist based at Achieve Medical/TMS Center of Alaska in Anchorage. She also practices in Fairbanks. For more information please visit info@tmscenterofalaska.com or call 833-872-5867.

Something to smile about

An Alaska dental program reaches far-flung patients

By Sean McDermott J anette Ulak recalls her time working as a dental assistant in private practice and in the Air Force, when she was limited to helping dentists set up, or assisting during procedures. Today, however, she’s the one performing essential dental services, doing so for three Alaska Native communities.

“The table has turned,” she said. Ulak is a 2018 graduate of the Alaska Dental Therapist Education Program and is now a dental health aide therapist with the Yukon-Kuskokwim Health Corp. based in Hooper Bay. “I wanted to be here, helping my people.”

The program that Ulak attended was designed to help tribal health programs and Alaska Native communities cope with a severe shortage of dentists and higher rates than national Janette Ulak

Achieve a more active pain-free lifestyle.

Education is an integral part of dental health aide therapist’s work. Stephanie Woods gives an oral health lesson to students at the local school. Courtesy of Stephanie Woods

averages of dental caries, or tooth decay. Some rural communities only had dentists visit for as few as several weeks a year. Tom Bornstein, who served as dental director for the Southeast Alaska Regional Health Consortium for 30 years, recalled seeing “little kids who by the time they were 3 or 4 had rampant caries.”

To help combat these problems, the Alaska Native Tribal Health Consortium in 2003 sent six students to study dental therapy at Otago University in Dunedin, New Zealand. While dental therapy is still a relatively new concept in the United States, New Zealand started using dental nurses in elementary schools in 1921 after dental problems prevented military recruits from serving during World War I. Now, more than 50 countries have similar dental therapy programs, including Canada and Australia.

5 locations statewide Customized Physical Therapy to fit your personal needs. aptak.com

603263-1-4-1-20PULSE

ANCHORAGE WASILLA FAIRBANKS SOLDOTNA SEWARD 279.4266 376.8590 374.0992 420.0640 224.7848 A new way of thinking The idea of having dental therapists practicing year-round in rural communities also represented a shift in focus toward preventive care. Bornstein, who played a pivotal role in initiating the dental therapy program, saw the idea as something that “could drastically impact the health of the folks that we were trying to serve,” he said.

Nevertheless, the Alaska program met with some initial resistance from traditional dentistry, including a court case, led by The Alaska Society of Dentistry and the American Dental Association in 2006, which attempted to stop its graduates from practicing in the state.

Stephanie Woods, a graduate of the first cohort in New Zealand who was listed in the lawsuit, remembered being “scrutinized quite a bit when we first started practicing.” But, she said, “We just did our jobs that we were trained to do.” The case settled out of court, and in 2007, Alaska Dental Therapy Education Program began to offer classes in

Above, 2019 Alaska Dental Therapy Education Program graduates Asiah Gonzalez and Kari Douglas practiced removing dental plaque in a training simulation. Top right, first year dental health aide therapist students in 2020 in the ADTEP clinic in Anchorage. Photos courtesy of ADTEP. Bottom right, Stephanie Woods gives an oral health lesson to students at the local school. Courtesy of Stephanie Woods

Anchorage and hands-on training in Bethel.

Since then, the program has been widely lauded for its well-documented, positive impacts — a 2017 study of the Yukon-Kuskokwim region from the University of Washington found increased preventive care use and fewer tooth extractions, and a recent initiative near Bethel helped decrease tooth decay and cavities in young schoolchildren by more than 50%. In addition to helping Alaska communities, the dental therapist program has paved the way for therapists to work in a growing number of states in the Lower 48.

Woods is now a dental health aide therapist working in Shungnak, in the Northwest Arctic Borough. She said there is much more of an understanding today that “we are just part of the team.” She has the support of regional supervising dentists and feels empowered to provide important dental care for her community.

The first four students who completed their dental therapy studies in New Zealand are all still serving communities in Alaska.

“Having this educational program here in Alaska has allowed people to pursue their dreams, then go back and help their communities,” said Mary Williard, director of the dental therapist program.

The program continues to grow. In the summer of 2019, the program had its largest graduating class ever, with 10 new dental therapists joining communities in Alaska and in the Lower 48. Program graduates now provide preventative care and education, teeth cleaning, fillings, X-rays, extractions, and more for over 40,000 residents in rural communities across the state.

“We’re educating [students] to do work well. And they’re staying around and providing that care for a long time,” Williard said.

‘Love what I am doing’ Woods, the dental therapist in Shungnak, said there’s still a need for more dental aides therapists to serve rural communities but that the program has “made a huge, huge dent in getting people treatment and raising people’s awareness.”

She and her dental assistant go to the school in Shungnak every day as part of a dental health program. The reward is having kids tell her they’re brushing their teeth and flossing now and, Woods said, to “hopefully make a positive change in their life, in their health.”

Educating parents and children about preventative care is also an important part of the job for Ulak, the dental therapist with the Yukon-Kuskokwim Health Corp. As a testament to her strong ties to her community, she explained, “patients want to come back and see me. People come to me for advice even when I am not at work.” “I absolutely love what I am doing,” she said. “I never ever thought I would be in this position.”

Sean McDermott is a freelance writer in Fairbanks. Comments? Contact editor@AlaskaPulse.com