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GLBT Health by Bob Donovan, MD

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Dealing With Depression

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In this gloomy time of the year, we may join the weather and FEEL gloomy, too. But for the as many as 9 million people in the US in any 6-month period who suffer from depression, itís more than just a bit of the blues. Depression is a common, serious, potentially deadly and treatable illness.  

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I want to emphasize that depression is a treatable disorder. People who are depressed often fall into hopelessness and feel that nothing can be done to help them, and this is not the case. I was recently at a medical conference and I canít begin to tell you how often depression was brought up. Not only is it a problem in and of itself, but it can also complicate many other medical problems. For instance, people who have heart attacks often can get depressed. If the depression is overlooked, those people have many more heart-related complications than those who have their depression treated. Depression costs more in terms of money lost from work than heart problems and many cancers. 1 out of every 5 Americans will have some form of depression in their lifetimes. 

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This is a list of symptoms people who are depressed often feel. That doesnít mean that this is all of them or even most of them, but if these sound like you, itís a good idea to consider that depression may be affecting you: You feel depressed, sad, empty, discouraged, tearful, hopeless, helpless, worthless; Youíve lost interest or pleasure in once-enjoyable activities; Youíre eating more or less than usual; Youíre having trouble sleeping or over-sleeping; You lack energy; You're having trouble concentrating and getting forgetful; Youíre having persistent thoughts of death or suicide; You lack interest in sex; Youíre having persistent physical ailments not caused by obvious illness, like headaches, stomach aches, pain.

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Now, all of us sometimes feel out of sorts or blue for a short period and may have some of the milder parts of these symptoms. Thatís normal and usually doesnít require intervention. But if these symptoms are lasting beyond two weeks, are getting worse, or especially if thoughts of suicide are present, itís time to act.

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That brings up an important issue - suicide. Depression is an even bigger problem for gays and lesbians, especially teens. A significant percentage of teen suicide may be related to issues of homosexuality. Teen years are difficult enough, but when gay feelings surface, and there appears to be no positive way to go, teens may feel hopeless, become depressed, and consider or commit suicide. And this problem extends beyond the teen years, too, as adults confront issues of sexuality in a culture that doesnít often value homosexuality.

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One of the first things to do if you feel you may be depressed is to make an appointment with your family doctor. There are several reasons for consulting with your family doctor if you have these symptoms. First, you want someone to help you determine if thatís indeed what your problem is. Second, there are other things that can cause depression, like reactions to some medications, thyroid disease or other medical problems and itís critical to treat these.

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If depression is found to be a problem, your doctor may prescribe medication and/or suggest counseling. Iíd like to comment on these treatments. Most of us like the thought of a quick fix for problems. The newer medications for depression can be quite helpful, but itís the unusual person for whom they are an answer by themselves. Most often, something in our psyche is leading us into depression, or at least depression has made changes in our psyches that need talking out. All of these things can create chemical changes in the brain that can be helped with medications, but when used alone, often depression can break through again. The body and mind have a wonderful method of getting their own way if we try the quick fix. So seriously consider counseling as an important part of getting better and staying that way.

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That brings up another important point: many people donít act on getting help with depression because our society tends to look down on people with depression and other mental illnesses because theyíre seen to have a character flaw. We now know much more about depression - how itís a problem with the chemicals in the brain. Itís not a personal failing to be embarrassed about, any more than youíd be embarrassed that you had a heart attack. There may be psychological things that need to be worked on, just like someone who has a heart attack may have to start an exercise program and eat differently. However, thereís a physical problem with depression that also must be addressed.

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What if you have a friend whom you think is depressed. There are some dos and doníts: Offer reassurance. Your friend needs to hear that thereís hope; things can get better with time and treatment. Encourage your friend to get professional help. Listen. Allow your friend to talk. Donít feel you need to fix anything, but lend an ear. Encourage your friend about positive things that happen. Sometimes depressed people fail to be able to see progress being made. Donít criticize or judge. Your friend probably has enough bad feelings about him- or her-self. Be affectionate if your friend will accept that. Be ready for difficult times. Your friend may show anger, even towards you. Try to get past these emotional outbursts. Encourage your friend to get out. Many depressed people end up withdrawn. Take small steps if necessary - a short walk outside, then a movie or dinner.

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What if you think someone may be considering suicide? Donít worry about talking about suicide with someone youíre worried about. Many studies have shown that talking about suicide will not "give them the idea". Most people who commit suicide talk about it beforehand, so if someone is talking about it, take that seriously. Listen for comments that give a clue, like "You wonít have to worry about me much longer." Watch for risky behavior - that may be a death wish. Look at drug or alcohol use. Alcohol is involved in over half of suicides. If someone you know starts "putting their affairs in order", that may be a sign that theyíre considering suicide. An adult may make out a will, suddenly pay bills off, check that thereís insurance available. Or they may get the tools ready for suicide like buying a gun or hoarding prescription medications. A person who is contemplating suicide may give away treasured objects or say good-bye. Strangely enough, if a depressed person suddenly develops a good mood, it may be the relief of planning suicide. This also may occur when someoneís being treated for depression. When someoneís seriously depressed, they may not even have the energy to commit suicide. As treatment begins, they may get enough energy to do it.

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Many people experience depression in their lives. Getting help early can help get rid of depression, and hopefully keep it away. .  

     

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