Depression is not an uncommon malady. It is sometimes ironically known as the “common cold” of mental health diagnoses. Depression can be triggered by many environmental events, and it often has genetic origins. The question of when to get help is an important issue to consider. Many people will experience seasonal depression a little later this year, and it is important to have an outlet to discuss these feelings. Seasonal depression is often an exacerbation of underlying depression which, when one is deprived of full spectrum light, will spiral down to a clinical depression. Just having a safe outlet to discuss such feelings is, in itself, the start of healing. Some people find it hard to admit that they are suffering from feelings of depression. I always recommend that people have a “same sex” partner with whom they can discuss such things in a very candid manner. Accountability partners can help us to keep promises we make to ourselves. For example, if I commit to getting up early and exercising, and I consistently do not keep that promise to myself, I end up feeling bad about myself. I begin to feel like I cannot trust myself. This can lead to lowered self esteem, and ultimately to depression. Having another person help us to stay accountable is a way of ensuring that we do what we say we’ll do. That other person also is one to whom we can confide feelings, and get feedback, encouragement, etc. I often see people in counseling who tell me that they sought counsel because someone important in their life, a spouse or a close friend, encouraged them to do so. That other person saw some things that may have been invisible to the other, and they recommended help for their friend. Seeking help for depression can begin with a discussion with a pastor or the family physician to get started on a plan of emotional healing. Family physicians are very often the first people to recognize and treat depression. Upwards of 30% of people seeking help from their family doctor are actually suffering from depression. Family doctors are, by far, the top prescribers of antidepressant medication. At my counseling practice, New Creation Counseling Center, we have excellent relationships with many family practice physicians who refer their patients for counseling in addition to antidepressant medication. Nearly all clinical studies indicate that medication alone, or counseling alone, is often insufficient treatment for depression. A comprehensive approach, which includes counseling, medication, a discussion of spiritual or existential issues, and proper diet and exercise are critical for real success in overcoming depression. One more point must be made in looking at the holistic approach to treating depression. A good physical examination should always precede treatment for depression. Many physical illnesses, such as diabetes, thyroid conditions, metabolic disorders, and a host of other physical problems can cause feelings of depression. We typically encourage people to talk with their family physician before undertaking a course of treatment for depression. The one thing that always makes depression worse is social isolation. Unfortunately, many people, when feeling depressed, avoid other people at the time they need most to have healthy interactions with others. Having a strong support system may be the best indicator of long term success in treating symptoms of depression. In summary, if feelings of depression have persisted for several weeks, and have caused some disruption in any life areas- work, school, family, or other relationships- a discussion with a trusted friend or spouse should take place. A visit to the family doctor could come next, followed by plans to treat the depression in a comprehensive manner. Taking such steps will usually result in a successful conclusion in dealing with depression.

September was Suicide Awareness month, and even though September has come and gone, let us not forget the tragedy of suicide and the hope for prevention. There are 45,000 documented suicides a year in the United States, with 1,707 in Ohio. As shocking as that number is, it is likely very low because there are many reasons why suicides are not documented. To put that in perspective, 123 Americans die each day by suicide. Suicide is the 2nd leading cause of death among our teens, second to car accidents. But, it is not just a teen problem. The largest percentage of suicide per demographic group is among white males over the age of 65. Suicide is a tragedy that hits all ages, all socio-economic groups, and all races. Reading statistics like the above can be overwhelming. It is important to understand the magnitude of the problem of suicide because there are effective interventions and everyone is capable of impacting this problem toward eradication. Everyone includes mental health therapists and others in the helping professionals, family members, friends, teachers, ministers, co-workers….basically all of us who interact with others. Suicide may become an option for people when there seems to be no better options than to end life. Of those who have completed suicide, we know that some have a mental health diagnosis, most frequently, depression. Others are experiencing a high level of interpersonal conflict, typically in the family. Substance abuse plays a factor in many completed suicides. People who have completed suicide may have had a major life change or threatened life change. Isolation is a factor in suicide as well. Although these factors in someone’s life are definitely warning signs, there are numerous other warning signs as well. In general, a person who has thoughts of suicide may be feeling inept to communicate their distress, and feeling that no one is listening or understanding. The person may be trying to control something, and feeling that there is no hope in that area of life. The person may be facing a problem that seems overwhelming and they want to avoid the reality of their situation. There is help for the person with suicidal thoughts. First, we can help by talking openly with someone about their suicidal feelings and thoughts. Talking about suicidal thoughts openly neither puts the thought that wasn’t there in their mind nor encourages someone to follow through. It does just the opposite. It helps a person fully talk about their distress and contemplation of suicide so they can be more understood. We can be with the person and make sure the person is not isolated. We can protect them by surrounding them with people who care and lead them to the medical intervention they may need. We can teach people tools to cope with life’s problems. A listening ear, therapeutic intervention, a physically safe environment, a learning environment, and love and support are the keys to helping the person in distress. The hope for eradicating suicide is to get involved, learn more, and be an advocate! There are many resources available. To get started, check out the SAMSHA Suicide Prevention Center and the work of Dr. Darcy Haag Granello and Dr. Paul Granello at Ohio State University.

The new season is a great reason to make and keep resolutions. Whether it’s eating right or cleaning out the garage, here are some tips for making and keeping resolutions.