Dr. Victor Emanuel MD

Dr. Victor Emanuel MD

I remember well that as I was about to begin private practice many moons ago, a veteran even then, (now Director General of the PAHO), told me that I should expect that 25 percent of my practice would consist of patients with emotional/ psychological/ mental problems, because this had been her own experience up to that time. She was not wrong.

One of the major challenges for a non-psychiatrist is to get someone to accept that they are depressed. I diagnosed someone as far back as in the 1990’s, and two years ago, after having been around the world for help, they came back to tell me that they were given the same diagnosis and were still trying to come to grips with it.

Every doctor must have some knowledge and skill in Medicine, Surgery, Pediatrics, Obstetrics and Gynecology and Psychiatry.

I need to make it clear that the knowledge I have of depression, some of which I will present to you, does NOT mean that I have ever been trained in Psychiatry. I have never been one, clearly am not one, and will never ever be one!!

MYTH: Hard Work Beats Depression

Depression affects nearly one in six people at some point in their lives, so folk remedies and half-truths about this common illness abound. One such idea: throw yourself into work and you’ll feel better. For a mild case of the blues, this may indeed help, but depression is a whole different kettle of fish. Over- working can actually be a sign of clinical depression, especially in men.

MYTH: It’s Not a Real Illness

Depression is a serious medical condition – and the top cause of disability in many societies. But it’s still confused with ordinary sadness. Biological evidence of the illness can be seen in brain scans, which show abnormal activity levels. Key brain chemicals that carry signals between nerves also appear to be out of balance in depressed people.

FACT: Men Fly Under the Radar

A depressed man, his loved ones, and even his doctor may not recognize depression. That’s because men are less likely than women to talk about their feelings – and some depressed men don’t appear sad or down. Instead, men may be irritable, angry, or restless. They may even lash out at others. Some men try to cope with depression through reckless behavior, drinking, or drugs.

MYTH: Depression is Just Self-Pity

Our culture admires will power and mental toughness and is quick to label anyone who falls back as a whiner. But people who have clinical depression are not lazy or simply feeling sorry for themselves. Nor can they “will” depression to go away. Depression is a medical illness – a health problem – related to changes in the brain. Like other illnesses, it usually improves with appropriate treatment.

FACT: Anyone Can Get Depressed

Poet or cricketer, shy or outgoing, anyone from any ethnic background can develop depression. The illness is twice as common in women as in men, but it may be that women are more likely to seek help. It’s often first noticed in the late teens or 20’s, but an episode can develop at any age. Tough personal experiences can trigger depression, or it may develop out of the blue.

FACT: It Can Sneak Up Slowly

Depression can creep up gradually, which makes it harder to identify than a sudden illness. A bad day turns into a rut and you start skipping work, school, or social occasions. One type, called dysthymia, can last for years as a chronic low-level illness – a malaise that silently undermines your career and relationships. Or depression can becomes a severe, disabling condition. With treatment many feel substantial relief in 4-6 weeks.

MYTH: Help Means Drugs for Life

Despite the buzz about a “Prozac Nation,” (specific reference to the U.S.) medication is only one of the tools used to lift depression. And asking for help does not mean you’ll be pressured to take prescription drugs. In fact, studies suggest that “talk” therapy works as well as drugs for mild to moderate depression. Even if you do use antidepressants, it probably won’t be for life. Your doctor will help you determine the right time to stop your medication.

Myth: Depressed People Cry a Lot

Not always. Some people don’t cry or even act terribly sad when they’re depressed. Instead, they are emotionally “blank” and may feel worthless or useless. Even without dramatic symptoms, untreated depression prevents people from living life to its fullest – and takes a toll on families.

FACT: Family History is NOT Destiny

If depression appears in your family tree, you may have an increased risk yourself. But that does not mean you are certain to develop the disorder. People with a family history can watch for early symptoms of depression and can take positive action promptly – whether that means reducing stress, getting more exercise, counseling, or other professional treatment.

MYTH: Depression is Part of Aging

Most older people navigate the challenges of aging without becoming depressed. But when it does occur, it may be overlooked. Seniors may hide their sadness or have different, vague symptoms: food just doesn’t taste good anymore, aches and pains worsen, or sleep patterns change. Medical problems can trigger depression in seniors – depression can slow recovery from a heart attack or surgery.

FACT: Depression Imitates Dementia

In older adults, depression can be the root cause of memory problems, confusion, and in some cases, delusions. Caregivers and doctors may mistake these problems for signs of dementia, or an age-related decline in memory. Getting treatment lifts the cloud for the majority of older people with depression. Psychotherapy is particularly useful for people who can’t or don’t want to take medication.

MYTH: Talking Makes Things Worse

People were once advised not to “dwell on” problems by talking about them. Today, there’s evidence that guided discussions with a professional can make things much better. Different types of psychotherapy help treat depression by addressing negative thought patterns, unconscious feelings, or relationship troubles. The first step is to talk to a medical health professional.

FACT: Positive Thinking May Help

The old advice to “accentuate the positive” has advanced into a practice that can ease depression. It’s called cognitive behavioral therapy (CBT). People learn new ways of thinking and behaving. Negative “self-talk” and behavior is identified and replaced with more upbeat thoughts and a more positive mood. Used alone or with medication, CBT works for many people.

MYTH: Teens are Unhappy by Nature

Although many teens are moody, argumentative, and intrigued by “the dark side,’ prolonged sadness or irritability is not normal for teens. When unhappiness lasts more than two weeks , it may be a sign of depression – which develops in as many as close to 10 percent of teens. Other signs a teen may need help include: being constantly sad or irritated even with friends, taking no pleasure in favorite activities, or a sudden drop in grades.

FACT: Exercise is Good Medicine

Very good studies show that regular, moderately intensive exercise can improve symptoms of depression and work as well as some medicines for people with mild to moderate depression. Exercising with a group or a good friend adds social support, another mood booster.

MYTH: Depression is Tough to Treat

The reality is most people who take action to lift their depression do get better. In a large study by the U.S. National Institute of Mental Health, 70% of people became symptom-free through medications – though not always with the first drug. Other studies show combining medication and talk therapy is even more effective.

FACT: It’s Not Always Depression

Some life events cause sadness or disappointment, but do not become clinical depression. Grief is normal after a death, divorce, loss of a job, or diagnosis with a serious health problem. One clue of a need for treatment: the sadness is constant every day, most of the day. When people are weathering difficult times appropriately they can usually be distracted or cheered up for short periods of time.

FACT: Hope for Better Days is Real

In the depths of Depression, people may think there’s no hope for a better life. This hopelessness is part of the illness, not a reality. With treatment, positive thinking gradually replaces negative thoughts. Sleep and appetite often improve as the depressed mood lifts. And people who’ve seen a counselor for talk therapy may be equipped with better coping skills to deal with the stresses in life that can get you down.

See you next week.