With the recent suicides of two prominent members of our society, many people are opening up about their personal struggles with depression and anxiety. Telling stories of struggles with mental health is a way to help normalize these issues, end stigmatizing thoughts and behaviors, and encourages people to seek help from professionals. This is a step in the right direction as our society tries to solve an epidemic of mental illness and rise in suicide rates. The culmination of these stories indicates that people are suffering, but seeking medication treatment is not always providing an easy solution (Powers, 2018, Amen & Amen, 2018 & Nocera, 2018). Reading these stories reminded me of the first time I sought help for anxiety during college. I went to a psychiatrist in the area of my college. I talked to him for 15 minutes and he told me I seemed anxious and prescribed me an anti-anxiety medication. I went back to him a couple of weeks later, talked to him for 15 minutes again, and told him I had felt depressed, and he took me off the anti-anxiety medication and prescribed me an anti-depressant. I continued to struggle with my anxiety and depression, despite being on medication. I saw a therapist, but talking about my childhood every week didn’t seem to help me. It was only after I spent years learning about mental health diagnosis and treatment in a clinical psychology graduate program, that I understood my diagnosis and strategies for treating it that my mental health improved. By understanding and applying cognitive behavioral techniques that I learned in classes to my own struggles with depression and anxiety, I began to manage my mental health successfully. Through my studies and understanding research, I became an expert at knowing which therapies are best suited for different diagnoses such as depression, anxiety, bipolar disorder and adjustment disorders. A wise professor once noted that mental illness is much like a chronic illness such as diabetes. Monitoring personal mental health and corresponding moods is the same as a diabetic has to monitor their blood sugar. Your clients will have good days and bad she said, and much would depend on factors such as exercise, diet, weather and sleep. While we could teach others how to minimize stress in their lives by conscious choices, other things would be beyond their control. A pill could help, but it wouldn’t be the solution to their problems. Hearing that and applying it to my life helped me to approach my depression and anxiety in a practical and thoughtful way.
Why did it take an advanced degree in psychology for me to finally learn how to understand and manage my mental health? With the push towards being open about our mental health struggles in an effort to reduce stigma, let’s take it a step further and talk about treatment. 1 in 4 people will be diagnosed with a mental illness in this country, but how does the medical profession come to these conclusions? Once a diagnosis is made, what is the education and the treatment? A definite change is needed in how we diagnose and treat mental illness in this country, a systemic change will take time, effort and advocacy. I am committed to advocating for this change, the change that can make an immediate impact is how we as consumers, clients and parents approach the professionals that are providing the care. What are some of the steps we can take on our own to ensure that the correct diagnosis is reached and the proper treatment is prescribed?
Take an Assessment:
If you are struggling with depressive symptoms, it is important to seek help as well as a thorough assessment of your symptoms. The U.S. Preventive Services Task Force (2016), a 17-member task force comprised of scholars and practitioners in the mental health field, suggest that Primary Care Physicians screen all adults for symptoms of depression using specified assessments. These include: The Patient Health Questionnaire (PHQ) the Hospital Anxiety and Depression Scales in adults, the Geriatric Depression Scale in older adults, and the Edinburgh Postnatal Depression Scale (EPDS) in postpartum and pregnant women. According to their website, all positive screening results should lead to additional assessment, consideration of severity of depression and comorbid psychological problems, alternate diagnoses, and medical conditions. (see U.S. Preventive Services Final Recommendation). A good tool for ruling out manic and hypomanic episodes is the Mood Disorders Questionnaire that can be found at Stanford Medicine Bipolar Disorder Clinic. We are living in a time where people are more self-aware than ever; most of my clients can tell me their personality type, love language and enneagram number. These mental health assessments are readily available and take a short time to complete, and doing so will help one understand their own symptoms.
See a therapist that specializes in treating your diagnosis
Different therapists provide expertise in treating different diagnoses. If you have a diagnosis of major depressive disorder, CBT has been shown to be effective in treatment (Greenberger & Padesky, 1995). If you are exhibiting depressive symptoms due to substances, working on your sobriety first is a critical element (Pinsky, 2017). If bipolar disorder is the diagnosis, learning how to be aware of your symptoms and managing them with medication, adaptive coping skills and family support is critical (Miklowitz, 2008).
Understand the importance of biological health
Factors such as lack of sleep, poor diet, and lack of exercise can precipitate or exacerbate mental health issues. Finding natural ways to improve physical health can go a long way in contributing to better mental health.
Accept that mental health is a lifelong commitment
Many treatment plans can take six months to several years to be effective, so stay the course. Ensure that your therapist is communicating regularly with your psychiatrist or physician and is customizing a treatment plan to your diagnosis. It is also important to note that if you have experienced one episode of depression, you are more likely to experience one again in the future, so be aware of yourself and your symptoms and seek help immediately if they should surface again.
In a society where we can have anything we want with a click of a few buttons on our smart phones, treating mental illness is not easily solved by taking one pill and expecting to be cured. As complex as the diagnosis is, the treatment should address medical, psychological and emotional needs. If you would like to learn more about therapy, consider finding a therapist in your area.
Amen, D. & Amen, T. (2018, April 9). “How to effectively treat depression.” The Brain Warrior’s Way Podcast. Retrieved from: http://brainwarriorswaypodcast.com/how-to-effectively-treat-depression/
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5 (5th Ed). Arlington, VA: American Psychiatric Association.
The Enneagram Institute. The nine enneagram type descriptions. Retrieved from: https://www.enneagraminstitute.com/type-descriptions/
Greenberger, D., & Padesky, C. (1995). Mind over mood: Change how you feel by changing the way you think. New York, NY: The Guilford Press.
Miklowitz, D. (2008, Nov 1). Adjunctive psychotherapy for bipolar disorder: State of the evidence. American Journal of Psychiatry. Retrieved from: https://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2008.08040488
Nocera, J. (2018, June 11). “Hiding my depression almost destroyed my job.” USA Today. Retrieved from: https://www.bloomberg.com/view/articles/2018-06-11/let-s-talk-about-kate-spade-anthony-bourdain-me-and-depression
Pinsky, D. (2017, May 1). The Dr. Drew podcast: Maria Bamford. The Dr. Drew Podcast. Podcast retrieved from: https://itunes.apple.com/us/podcast/the-dr-drew-podcast/id592284993?mt=2&i=384986639
Powers, K. (2018, June 13) “Americans are depressed and suicidal because something is wrong with our culture.” USA Today. Retrieved from https://www.usatoday.com/story/opinion/2018/06/09/kate-spade-suicide-anthony-bourdain-depression-culture-success-column/687388002/
Smith, M., Robinson, L. & Segal, J. (2018, February). Bipolar Medication Guide. Helpguide.org. Retrieved from: https://www.helpguide.org/articles/bipolar-disorder/bipolar-medication-guide.htm
Stahl, A. (2017, May 30). What your Myers-Briggs Personality type means for your career. Forbes.com. Retrieved from: https://www.forbes.com/sites/ashleystahl/2017/05/30/what-your-myers-briggs-personality-type-means-for-your-career/#19bc0e4b4513
US Preventative Services Task Force (2016, January). Final Recommendation statement: Depression in adults screening. Retrieved from: https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/depression-in-adults-screening1#Pod2%20).
Weber, M.R. & Dennison, D. (2014). An exploratory study in the relationship between personality and student leadership. Journal of hospitality and tourism education 26 (2).