According to the National Institute of Mental Health (NIMH), 21 million adults in the United States had at least one major depressive episode in 2020. This is the latest data available, but it would be no surprise to see that number even higher in 2023.
With such a sweeping occurrence, it’s important to recognize signs of depression in yourself or a loved one. Dr. Kenneth Robbins, clinical professor of psychiatry at the University of Wisconsin School of Medicine and Public Health and medical director of Stoughton Hospital’s Geriatric Psychiatry Department, shares helpful information on this crucial topic.
What Does It Really Mean to Be Depressed?
Everyone gets sad from time to time. That is not categorized as the clinical definition of depression. Individuals who are living with depression lose the capacity for joy for an extended period of time.
Additional symptoms include eating too much or too little, problems with focus and concentration, a change in sleeping patterns, alcohol or drug abuse, and feelings of hopelessness. In the most severe cases, people may experience suicidal thoughts, make a suicide plan, or attempt to commit suicide. What’s problematic is that depression can look and feel different to each person.
“For some people, the primary symptom is sadness or very little energy. They withdraw. They just want to cover themselves with a blanket,” explains Dr. Robbins. “For others, anxiety is the primary symptom and they’re more agitated. Those are the people with less sleep and who tend to eat nervously.”
What Can Be Done?
Dr. Robbins urges individuals to first acknowledge there’s a problem, one that’s more than a state of unhappiness. Depression is actually a biological issue. It’s related to changes in brain chemistry.
“We now know that when somebody has serious depression, there are changes in the way the body’s immune system works. There’s a whole cascade of physiologic changes, and so one needs to acknowledge it’s there and it’s a problem, and they should get help. There are very effective treatments for depression.”
Experts propose the most effective treatment is a combination of antidepressant medication and talk therapy. Different types of medications address different needs. Some are more stimulating, which can be helpful for a person who has no energy. Others help people sleep. That can be beneficial for an individual who is struggling with insomnia.
“Different antidepressants have different ways in which they work neurochemically. In turn, they may have different side effects. It’s almost always possible to find an antidepressant that’s going to be helpful to the person with depression. When it’s combined with talk therapy, where somebody who has the skills to know how to help a person with depression, it can make a gigantic difference.”
What to Do if a Person Is Suicidal
Because depression manifests in various ways, it can be challenging to identify it in another person. However, a clear indication is when someone mentions suicide—even in passing. Should that happen, it’s time to act immediately.
Dr. Robbins urges the concerned person to encourage the suicidal person to talk about what they’re feeling. “People are often afraid that if they talk about suicide, it’s going to put ideas into someone’s head. We know very well from a number of studies that’s not the case. In fact, if you can get someone to talk about it, it dramatically lowers their risk of actually making such an attempt.”
Example questions to ask:
- Are you feeling hopeless?
- Have you thought about causing your own death?
- Do you have a plan? What is it?
- Is this something you plan on doing right away?
- Is there something that’s stopping you?
For most people who are thinking about suicide, it’s a relief to have someone who’s interested and willing to listen. The process itself can decrease the risk of them making a suicide attempt.
The next strategy is to expand the field. People who are closest to the person who’s thinking about suicide need to get involved. “If they have a significant other, adult kids, parents, or close friends who they have been too embarrassed to tell, this is the time to encourage them to do it,” says Dr. Robbins. “Of course, if it’s a situation where you can remove the method, then by all means, do it. If somebody is thinking about shooting themselves and there’s a gun in the house, get it out of the house until the person has been properly treated and the suicide risk is dramatically less.”
Addressing Unique Needs of the Geriatric Population
One population Dr. Robbins wants to raise awareness about is the geriatric sector. Often, older people are more vulnerable to depression and suicidal ideations. They also tend to be susceptible to risk of medication interactions.
“If someone needs inpatient care to treat their mental health problem, the multidisciplinary team at Stoughton Hospital and other professional facilities have the skills to work with people who not only have psychiatric difficulties but medical difficulties. With older people, there’s often an interaction between medications. Experts assess their medical problems and the psychiatric difficulties they’re experiencing, and they do it in an environment where they are around other older people. That’s somewhat comforting.”