Tag Archives: treatment

I Think I’m Depressed – What Now?

Many people have a hard time accepting that they may be depressed. They feel some level of shame or embarrassment, which is unfounded considering that depression is a disease. If you had cancer, wouldn’t you go to a doctor?

Depression hits people of all ages and races. Currently, there are an estimated 15 million people in the US suffering from depression. Realistically, that number is probably higher than what’s reported. Regardless, 2/3 people don’t get any sort of treatment for depression, which is a waste because depression is a treatable illness.

Nobody knows what causes depression. You may be able to identify a trigger, or a stressful event like divorce or death of a loved one as causing your depression, but it may have existed prior.  There is no one reason why depression sets in; however, stress, hormones, and genetics can increase the risk. 

The longer depression lasts, the worse your symptoms may get and the harder it will be to treat.

Without treating depression, people can struggle for months or years feeling absolutely miserable. If you do decide to seek treatment, there are a lot of effective and proven ways to treat depression. Doctors will try psychotherapy or antidepressant medication. Studies have found that combined treatment of therapy and medication works better than medication on its own.

Lifestyle changes can help depression, which is something you and your therapist can talk over. Managing stress, getting enough sleep, eating healthy, and exercising have all been shown to help. The important thing is that there are many options out there.

Some people are appropriately apprehensive when it comes to taking medication. Common worries include if the drugs will change one’s personality, or concerns regarding the side effects. The doctor will inform you about potential side effects. Regarding altering your personality, depression has already put you in a fog and the medication may help you return to your original self.

For those that are interested, antidepressants work by making the nerve cells form stronger and healthier connections to specific parts of the brain. The most common antidepressants are called SSRIs. These types of drugs can take weeks or months to be effective.

Therapy has been shown to have more lasting benefits than medication. Talking to a stranger about the problems bothering you may make you feel uncomfortable. It’s important to remember that therapists are a skilled professional and they will not judge you. Everything is confidential!

Cognitive behavioral therapy helps you see how your own thought patterns can contribute to your depression and it teaches practical ways to change them.

Many people seek a holistic approach to treat depression. There’s the view that if it comes from the Earth, it is natural, and therefore less harmful. However, natural supplements have side effects as well. You should talk to a doctor or do extensive research before taking them. The evidence is unclear if natural herbs actually work or not. Supplements like fish oil and folic acid may have some benefits, but other supplements really don’t do anything.

So how does one start treatment? You can get a referral from your family doctor or call the 1-800 number on the back of your insurance card and they will find you a mental health provider. The American Psychological Association and the American Psychiatric Association also have online locators. Some family doctors prescribe antidepressants but finding a psychiatrist (someone who specializes in mental disorders as opposed to general medicine) will be more beneficial for treatment.

Physical symptoms of depression can include: headaches, back pain, muscle aches, joint pain, chest pain, digestive problems, exhaustion & fatigue, sleeping problems, change in appetite or weight, dizziness or lightheadedness.

Benefits of treating depression include: better sleep, better libido, pain or discomfort relief, improved health, better work performance, better memory, happier home life, healthier lifestyle, increased sense of control, decreased future depression, and stronger ties with family.

Some people avoid getting treatment for the following reasons:

  • “I’ll snap out of it if I give it time.”  You can’t snap out of being depressed. Having the blues may pass, but clinical depression will linger and get worse if it is not treated.
  • “‘I don’t want to take antidepressants.” Psychotherapy is always an option. Cognitive behavioral therapy deals with your thoughts and feelings now; it works to improve your thought pattern and your quality of life.
  • “I don’t feel sad all the time. Why do I need treatment?” Sometimes, people with depression see their clinical physician for ailments like muscle pain or sleeping problems, not knowing that they are symptoms of depression. You don’t need to be crying all the time to be depressed.
  • “I’m embarrassed to talk to my doctor about it.”  Depression is not something to be ashamed of, it is a common medical condition. Your doctor has already treated patients just like you.

You can always voice your concerns to your therapist or doctor and they will work with you to make you feel more comfortable. Apex Behavioral Health is always available to help treat your depression. Make an appointment and help yourself!

Should You Talk to Someone About a Drug, Alcohol, or Mental Health Problem?

Many people struggle with both substance use and a mental disorder. These questions can help you decide whether you need help with substance use, a mental health issue, or both. For people who suffer from both, receiving treatment for both is important for getting better. Recovery starts with understanding that you may have one or both of these problems.

  • Over  the past two weeks, have you felt down, depressed, or hopeless?
  • Over the past two weeks, have you felt little interest or pleasure in doing things?
  • In the past year, have you had significant problems with insomnia, bad dreams, or falling asleep during the day?
  • In the past year, have you thought about ending your life or had thoughts of suicide?

-If you have had thoughts of suicide, please call 1-800-SUICIDE. 

  • In the past year, did you have a hard time paying attention at school, work, or home?
  • Have you ever felt you should cut down on your alcohol or drug use?
  • Have people annoyed you by criticizing your drinking or drug use?
  • Have you ever felt bad or guilty about drinking or drug use?
  • Have you ever taken a drink or drug first thing in the morning to steady your nerves or get rid of a hangover?

-In the past, have you ever:

  • (for men) Had 5 or more drinks in a day?
  • (for women or anyone over age 65) had 4 or more drinks in a day?
  • used recreational or prescription drugs to get high?

Unless you answered “never” to all of the above questions, talk to your doctor, nurse, or counselor about the details. They can help you decide what do to next. They may also help you find more information and resources.

For more information on treatment for co-occurring mental and substance use disorders, call Apex Behavioral Health to set up treatment. You can also go to www.samhsa.gov/treatment.

Dual Diagnosis

A recent survey regarding the homeless people in the Detroit area found that 51% of the people questioned are at risk of dying on the streets, a 9% increase above the national average.

The Neighborhood Service Organization, in coordination with Detroit area homeless service providers, surveyed Detroit, Hamtramck, and Highland Park identifying and counting people to find those that are most at risk of dying on the streets. 211 people were surveyed during three nights during the hours of 4 and 7 a.m.

The survey found that the average number of years homeless is 5.38. 99 people reported a dual diagnosis of mental illness and substance abuse. 29 of the people surveyed were veterans and 32 people reported having a history of foster care. There were a total of 358 inpatient hospitalizations in the past year with a total of 456 emergency room visits in the past three months. 103 people reported having no insurance; 74 people reported having been in prison and 149 people reported having been in jail.

13% of the people were aged over 60, the oldest respondent being 72 years old.

Treating a dual diagnosis of mental illness and chemical dependency is very difficult. Some mental health services are not equipped to deal with patients having both disorders and as a result, only one  issue is identified. However, if both diagnoses are identified, the patient may be bounced between treatments for mental health and substance abuse.

Research studies have concluded that a minimum of 50% of the mentally ill population also have a substance abuse problem. People with mental illnesses may have a chemical dependency problem that their family is not aware of; or the family may underestimate the extent of drug dependency. It may be difficult to determine which behaviors are attributed to mental illness versus what behaviors are caused by chemical dependency.

 In order to have an accurate diagnosis of a mental disorder, the cause of behavior has to be determined. If a person is experiencing delusions or hallucinations, the delusions may be a result of schizophrenia, depressive  disorders, mania, Alzheimer’s related dementia, panic attacks, or drug or alcohol intoxication.  Treatment for schizophrenia is different from treatment for chemical dependency, which is why it is important to pinpoint the cause of behavior to ensure the most effective treatment.

Chemical dependency complicates treatment of mental illness. The individual may be difficult to engage in treatment, they may be in denial; and their diagnosis is further complicated because of the interacting effects of substance abuse and mental illness. Individuals may frequently relapse and require hospitalizations and may not be tolerated in community rehabilitation programs.

Some individuals may begin to drink or use drugs for recreational reasons, but their reasons for continuing use may differ. It is likely that many individuals continue using as a way to treat symptoms or side effects from the medication. Drug use may reduce the level of anxiety or depression, at least short term. It is possible that an underlying vulnerability exists in the individual that precedes mental illness and chemical dependency.

Social factors, such as living environment, may also account for continued drug use. People may find themselves living in neighborhoods where drug use is prominent. An individual may find himself more easily accepted in a social setting when the group’s activity is based on drug use, particularly if he or she has difficulty establishing social relationships.

Typically, there are separate treatment programs for mental health and substance abuse. Clients with a dual diagnosis are referred back and forth between the treatments, but hybrid programs that address both issues prove to be extremely beneficial. Such a program is available at Apex Behavioral Health, in our Westland office.

Drug program treatments are limited in helping mental illness patients because the programs are too confrontational and people with severe mental illness are too fragile to benefit from that particular type of treatment. Confrontation, emotional jolting, and discouraging use of medications has proven to be detrimental to mental health patients. The treatments may lead to stress which can cause relapse.

Desirable treatment programs for a dual diagnosis should be less confrontational and take a more gradual approach. Clients have to proceed at their own pace during treatment and credit should be given for any accomplishments regarding their drug use decreasing.

It is argued that substance abuse treatment programs are more geared toward the young male population. Rehabilitation, substance abuse, and gerontology literature pay little attention to elderly drug abuse and largely ignore it, therefore, little information is known about prevalence or occurrence about drugs in the elderly population.

The types and extent of drug and alcohol use among the elderly is elusive. Individuals aged over 65 make up 12.4% of the total US population; however, by 2030 this group is expected to double in size.  At that time, the elderly population will include baby boomers, many of whom have already been exposed to drugs or alcohol in the 1960s.

Researchers have noted that drug or alcohol symptoms seen in the elderly are often mistaken for various symptoms of aging, such as dementia or depression. It is unknown if elderly patients would require unique substance abuse treatment since little research has occurred on senior illicit drug use.

However, significant data is available for the elderly population on prescription drug use. Elderly adults consume more over-the-counter and prescription drugs than any other age group on a daily basis.  One researcher noted that elderly adults are 2-3 times more likely than younger individuals to be prescribed psychoactive drugs, including benzodiazepines.

The elderly population is not immune from chemical dependency;  there is not an age limit for addiction. Further research needs to be conducted to determine the prevalence of drug abuse among the elderly population. The seniors may require different substance abuse treatment then the youth. There has not been enough research done to prove that the generic substance abuse treatment is effective for all age groups.

It is probable that a 70-year-old male will require different substance abuse rehabilitation treatment than an 18-year-old female. A 70-year-old female suffering from depression and drug use will require different treatment from a 75-year-old male who has PTSD and an alcohol problem.

Treatment is unique for each individual and this is especially true for individuals with a dual diagnosis. Treatment for depression is different than treatment for substance abuse, and a person who has a dual diagnosis will require a different, combined treatment which is available at Apex Behavioral Health.

It is important that the elderly get treated for depression. While the elderly population accounts for 13% of the US population, they account for over 18% of all suicides.

Some people believe that depression is a normal component of aging, but that is not true. Physical ailments and medications can cause depression.

The following diseases or physical problems may result in depression. 

  • thyroid disorders  
  • diabetes  
  • Parkinson’s disease  
  • multiple sclerosis  
  • strokes  
  • tumors  
  • some viral infections 

The following medications may cause symptoms of depression: 

  • blood pressure medication  
  • arthritis medication  
  • hormones  
  • steroids

Many elderly people will hide their depression or substance abuse so it is important to notice subtle hints. Untreated depression is the number one cause of suicide.

Suicide warning signs include:

  • Appearing depressed or sad most of the time.
  • Talking or writing about death or suicide.
  • Withdrawing from family and friends.
  • Feeling hopeless.
  • Feeling helpless.
  • Feeling strong anger or rage.
  • Feeling trapped — like there is no way out of a situation.
  • Experiencing dramatic mood changes.
  • Abusing drugs or alcohol.
  • Exhibiting a change in personality.
  • Acting impulsively.
  • Losing interest in most activities.
  • Experiencing a change in sleeping habits.
  • Experiencing a change in eating habits.
  • Losing interest in most activities.
  • Performing poorly at work or in school.
  • Giving away prized possessions.
  • Writing a will.
  • Feeling excessive guilt or shame.
  • Acting recklessly.
  • A dual diagnosis can be treated effectively with the proper treatment for a person of any age. Please call Apex Behavioral Health if you or someone you know needs treatment.