Here’s What Depression Looks Like

Recognizing Depression: The Seven Signs

Depression is a serious mental disorder that has the ability to deprive one of their emotional stability and increase their chances of partaking in risk behaviors. According to the Center for Disease Control and Prevention (CDC), about 9% of the total U.S. population report having feelings of depression. The 2013 Gallup-Healthways Well-Being Index suggests a relationship between unemployment and escalated depression rates among U.S. citizens. Statistical data from the index reports about a 16% increase in depression among unemployed Americans in comparison to their employed counterparts, which is a clear indication of the prevalence of depression and the impact it has on society. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) characterizes major depressive disorder (MDD) by a sum of symptoms. The symptoms are described below. Recognizing the signs and symptoms of depression are the first steps to getting treatment and overcoming this mental illness.

The Seven Signs:

  • Feelings of hopelessness and worthlessness. You may have a bleak outlook regularly, feel as though there is no tomorrow and as if things will not improve in your life. You may also notice a decrease in your self-esteem and self-worth.
  • Low energy level: You may have feelings of extreme tiredness, loss of energy majority of the day and not feel like doing much of anything.
  • Poor concentration. You may have an inability to focus on things and activities that you normally can direct your focus on, or you may have difficulty making simple, every day decisions.
  • Abnormal sleep patterns. You may notice significant changes in your sleep pattern as evidenced by problems falling or staying asleep. You may wake up odd hours of the night and/or fall asleep for prolonged periods of time throughout the day.
  • Weight Loss. You may experience a significant amount of weight loss or weight gain in addition to changes in your appetite.
  • Loss of interest. You may have minimal to no interest in doing activities you once found pleasurable and have trouble motivating yourself to do them once again.
  • Suicidal thoughts. You may have repeated thoughts of harming yourself, that life isn’t worth living and/or you’re better off not living. You may have also developed a plan for committing suicide and/or have recurrent thoughts of carrying it out.

If you or your loved one experience a number of these on a regular basis, it is vital that you seek help from a health care provider for assessment and determination of the next steps.

Note: Special thanks to Amaris Watson, MSW for her research and work on the initial draft of this post.

 

 


From Upheaval to Heroism: Cool “Disco” Dan

Posted by Guest Blogger: Amaris Watson, MSW, LGSW

Courage. Acceptance. Perseverance. Hope.

I was recently reviewing online content regarding stories of triumph for those suffering from a mental illness and came across this story in the Washington Post. Link: http://www.washingtonpost.com/lifestyle/style/cool-disco-dan-opens-up-about-his-battle-with-mental-illness/2013/10/28/e81bef10-3da2-11e3-b7ba-503fb5822c3e_story.html

Almost one year ago, Danny Hogg (also known as Cool “Disco” Dan) achieved virtue and notoriety after sharing his battle with mental illness to his community and ultimately the world. Cool “Disco” Dan, one of Washington, DC’s most well known, artistic icons admitted to being diagnosed with schizophrenia, bipolar disorder, and personality disorder all of which caused great strife in his life.

To help cope with his mental illness, Hogg admitted to regularly seeking mental health treatment to prevent outbursts of rage. This is remarkable as we know African American males are less likely to utilize services. According to work by Dr. Michael Lindsey (NYU Faculty Profile: http://socialwork.nyu.edu/our-faculty/full-time/michael-lindsey.html), Black males are less likely to admit emotional struggles and experience internalized struggles regarding mental illness and treatment services. They see treatment use as a sign of weakness. According to a 2012 article by Lindsey and Dr. Arik Marcell, published in the American Journal of Men’s Health, Black males fear the stigma that comes with a diagnosis. Lindsey and Marcell also note that cultural mistrust of providers, lack of access to and negative perceptions towards mental health services also serve as barriers to black males participating in mental health treatment. Such was the case with Hogg. But, he overcame those barriers to care. In addition to seeking mental health treatment, Hogg also exercises and watches television to help relieve symptoms.

To the untrained eye, a person with schizophrenia can appear “crazy” because they may engage in “bizarre” behaviors. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition – DSM-5, persons with schizophrenia may experience delusions and hallucinations, experience disorganized thinking and catatonic behavior. Bipolar disorder is a mood disorder characterized by an extreme change of emotions. The individual may experience a continuum of feeling joyous and deep distress over the same period of time. Lastly, a personality disorder represents a continuity of behavior, which deviates from the expectations of one’s culture. They may include but are not limited to patterns of instability, impulsivity, social inhibition and detachment from social relationships. As you can imagine, such behaviors if not properly treated can have a devastating impact on the development and maintenance of relationships.

Each of these mental disorders can elicit major changes in a person’s thoughts, moods and behaviors. Any form of mental illness may make it quite challenging for an individual to interact with others and deal with the constant changes and demands of life. Lack of understanding of these mental illnesses causes many to fear, mistreat, or in Hogg’s case, shy away from those suffering from a mental disorder. This is disheartening. To help combat this, mental health professionals should passionately collaborate to produce impactful mental health education materials, interventions and strategies that will provide knowledge regarding symptoms and the various forms of expression portrayed by mental disorders such as schizophrenia or bipolar disorder. Such education and work with family members can ensure that those who need mental health treatment get to it and stay connected.

Here are five things you can do to help the Hogg (“Cool Disco Dan”) in your life:

  1. Take a non-judgmental approach when conversing about recent problems or behaviors
  2. Offer emotional support by letting your loved one know you care
  3. Become educated about the signs and symptoms of mental illness (Here’s a helpful site: http://www.nimh.nih.gov/index.shtml)
  4. Encourage your loved one to visit a mental health professional
  5. Offer a ride, provide child care or even accompany your loved one to sessions

 Amaris Watson is a 2014 graduate of the University of Maryland’s Master of Social Work program. Amaris’ passion lies with helping underserved adolescents and their families both identify their mental health needs and seek treatment services. She is a research assistant on the Making Connections Project, led by New York University Silver School of Social Work Associate Professor, Dr. Michael A. Lindsey. Amaris plans to pursue a PhD in Social Work to continue her research in the area of mental health service delivery to ethnic minority adolescents. Her contact email is: amariswtsn@yahoo.com


A Tragic Death – One We Need to Understand

Terrie M. Williams (author of Black Pain: It Just Looks Like We’re Not Hurting) continues to raise our consciousness:

http://thegrio.com/2014/04/17/karyn-washington-death-puts-suicide-mental-health-back-in-spotlight/


Face of Darkness

This riveting short documentary (produced by Kenneth Todd Nelson and Squeaky Moore) highlights the need to address mental health help-seeking behaviors among men of color. Understanding of how men of color perceive their mental health needs and engage in help-seeking behaviors might play an essential role in efforts to improve their symptoms and access to care.


The Tragedy of Unaddressed Mental Illness

Twelve victims.  And the thirteenth fatality—the presumed perpetrator, Aaron Alexis.  Unfortunately, the Navy Yard shooting tragedy has become commonplace in our society.  And, once again we learn the perpetrator had underserved or inadequately treated mental illness.  All too often, we connect with these mass shootings on levels other than mental illness.  The proponents for stiffer gun ownership legislation will point to this tragedy as another indication that too many guns on the streets, in the wrong hands led to this unfortunate and very sad outcome.  On the other side of the argument, those who lobby for gun ownership suggest that it is a fundamental right to bear arms—consistent with the protections offered under the Second Amendment.  Gun ownership, they argue, may even be a deterrent to criminal behavior.

However, in the case of mass shooters, we are continually learning of their untreated/undertreated mental illness.  How can we learn from these tragedies?

First, we can become more impassioned about creating better access to treatment, particularly in school- and community-based settings.  Studies show that when mental health services are co-located in communities that tend to have an overrepresentation of mental health need they create better access to treatment, and thus more use of those services.  Second, we need to have more public health campaigns that target messages toward mental illness stigma.   Third, we need to offer stronger support to those who experience mental illness; family members can be vital cogs to ensuring that loved ones connect to treatment.  Offer to accompany a loved one with mental illness to treatment.  Be patient and listen to their concerns or struggles with life.  Finally, there is also an interesting gender perspective to this issue.  That is, what we tend to see in mental health services research and practice is that men have a tougher time both connecting to and staying in treatment.  There is an implicit gender bias in our society in terms of what it means for a man to ask for or seek help when he experiences an emotional, psychological struggle.  There is a pervasive masculinity ethic suggesting that men are supposed to “tough it out,” or “show no sign of weakness.” Such perceptions counter positive, help-seeking behaviors one might engage in to get connected to mental health treatment.

Such tragedies as the September 16th Navy Yard shooting remind me that we have so long to go in terms of how we as a society view and treat mental illness.

Michael Lindsey, PhD, MSW, MPH holds a joint appointment as associate professor in the School of Social Work and a faculty affiliate in the Center for School Mental Health, School of Medicine (Department of Psychiatry) at the University of Maryland, Baltimore. Dr. Lindsey’s research and mental health practice experiences examine the prohibitive factors that lead to unmet mental health need among vulnerable, Black youth with depression and other serious mental health needs. Dr. Lindsey is developer of the Making Connections Intervention (MCI), a program designed to prepare adolescents to be positively involved in mental health services for depression. He can be reached by email at nerve.us.breakdown@gmail.com. He can also be followed on Twitter @DrMikeLindsey.


Dying to Ask for Help

Two weeks ago, the Prince George’s County (Maryland) police shot my friend, Keith. At the tender age of 38, he died from six bullets to the chest. The police took him out in front of his sons’ daycare center. His parents, wife, friends and I – the mental health professional in his network – are still asking, “How did it get to this?”

Did the police really have to shoot to kill Keith? I pondered how many times Black males across this country reached a similar fate as Keith. Police officers are not sufficiently trained to handle mental health-related calls. They are trained to protect the innocent and themselves if the person is exhibiting any threatening behavior. But to those of us who knew him, Keith was also “innocent;” a victim of his own mental anguish.

Check out the work of my colleague, Dr. Michael Compton at George Washington University. Michael has developed a program to train police officers on how to respond to psychiatric crises without resorting to violence. (Link: http://www.gwumc.edu/faculty/comptonmichael)

For two weeks, Keith acted out of character. He said he felt the pain of African slaves. He feared his life was in danger. He believed Lil Wayne was God. His increasingly strange behavior scared everyone around him. Keith was losing his mind and we didn’t even know it.

Keith’s wife, Brittany, tried to make sense of her husband unraveling right in front of her eyes. She confronted his delusions. She prayed with him. She called his friends and asked if they could spend time with him. She hoped some male bonding would make things better. Nothing worked. By the time Brittany called me, she was freaking out. She wanted a referral to a mental health professional. She tried to understand what all this madness meant. I could tell, as I explained that Keith was having a psychotic break, she had no idea what was happening to her husband. She was in shock.

My advice that Keith get immediate professional help did not reach him in time. While I was on the phone with his wife, Keith was at his sons’ daycare center for the second time that afternoon trying to pick up his one- and two-year old boys. This time, he had an ax! Of course, the daycare professionals called the police and what the officers saw by the time they arrived on the scene was a Black man with a weapon.

Did this have to happen to Keith, though? Obviously, no because if mental health problems like a psychotic break are identified early, they are highly treatable. Might the awareness of the signs of a psychotic break, like when Keith thought people were out to get him, and knowledge about how to get help, have saved Keith’s life? Perhaps, yes.

However, many Black males fear asking for help because of the male ego. We are reluctant to go to a mental health professional because we are afraid to be called “crazy.”  We fear being misunderstood by professionals; told we are psychotic or schizophrenic instead of receiving some understanding about the tough time we’re having as we navigate a bad situation. We fear that we are alone; that no one else is feeling the kind of “blues” we feel. And we don’t like to say, “I’m just – you know – depressed.” Why not? Because we expect to be rejected by our “boys,” our family and our community with comments like, “Man, you heard about Junie? They said he ‘trippin.’ I guess he couldn’t handle the pressure.”  Yet, mental health struggles can be as benign as “having a bad day” to more intense conditions, behaviors like having psychosis (i.e., delusions or hallucinations).

Remember the time you saw that dude running down the street in a ski suit, rocking a fur coat in 100 degree weather?  You cast off him off as “crazy,” or “tripping.”  Or, what about the “bag lady”  you saw talking to herself at the bus stop as she guarded her grocery cart stuffed with newspaper? These are illustrations of the “break” I’m talking about. We all shun those people never realizing that what they are experiencing is already beyond their control. They’re in need of serious professional help and you may be the one that helps them get it.

Most often, a psychotic break can be brought on by drug use like PCP. Or, someone can be “pre-wired,” to experience a mental break down because of an inherited gene, you know, it can “run in the family.” Being “pre-wired” is the scariest, though, because psychosis can lie dormant and then surface out of nowhere, often brought on by life’s stresses. But for many reasons, we are not connected to mental health support and treatment. I challenge you, my reader, to identify why that is.

Granted, our mistrust of mental health professionals because of the past may be legitimate. There has been an uneasy relationship between Blacks and the U.S. healthcare system, in general. Remember the Tuskegee Syphilis Experiment? But this shouldn’t hinder us from seeking help for ourselves or our loved ones.

Although there is no rhyme or reason for knowing when a psychotic break might occur, getting help at the first sign of a break (e.g. paranoid thoughts or delusions) is VITALLY important. Pick up the phone, call for an ambulance. Mental health professionals suggest that there are psychotropic drugs and talk therapies that can successfully treat the patient. A combination of both may well have saved my dear friend, Keith’s life.

Now, he is another statistic of the Black community: a Black man gunned down by the police; a father never to be known by his sons; a husband gone too soon; a son whose parents are burying their own child; and the beloved friend who has left us to make sense of the inexplicable. Keith deserved a better outcome.

Many of you out there, like Keith, are “dying to ask for help.” Or, you may know someone dying to ask for help. My hope is that, through this blog, we begin to have serious conversations about the mental health challenges we all face. If you cannot talk about something, it is already out of control!

Michael Lindsey, PhD, MSW, MPH holds a joint appointment as associate professor in the School of Social Work and a faculty affiliate in the Center for School Mental Health, School of Medicine (Department of Psychiatry) at the University of Maryland, Baltimore. Dr. Lindsey’s research and mental health practice experiences examine the prohibitive factors that lead to unmet mental health need among vulnerable, Black youth with depression and other serious mental health needs. Dr. Lindsey is developer of the Making Connections Intervention (MCI), a program designed to prepare adolescents to be positively involved in mental health services for depression. He can be reached by email at nerve.us.breakdown@gmail.com. He can also be followed on Twitter at DrMikeLindsey.


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