The signs and stigma of depression
Jay-Sheree P. Allen, MD
Family Medicine
CentraCare Health – Long Prairie Clinic
Editor’s Note: Dr. Jay-Sheree Allen recently was a guest to discuss depression on “Your Health” — a weekly radio program on KNSI discussing issues important to your health featuring providers across CentraCare. In the St. Cloud area, you can listen to “Your Health” weekly on AM 1450 and FM 99.3, Saturdays at 2:30 p.m. and Sundays at 9:30 a.m. Or you can listen live at knsiradio.com.
To listen to a previously recorded episode or view the full list of topics that have been discussed, visit Your Health on KNSI Radio
Here are some questions from Dr. Allen’s interview. You can listen to the full program here. Some of the text below has been edited for length and clarity.
Q: What is depression?
Dr. Allen: Depression is when you feel sad and blue and it persists for more than two weeks. It is totally normal to have a bad day or couple of days, but if this feeling is overwhelming and impairs your ability to function otherwise, then you should talk with your health care provider to discuss if — in fact — you have depression.
Q: What are the causes of depression?
Dr. Allen: There are so many. Medical illnesses or a major change in your health is one we see a lot. After you’ve had a stroke or heart attack, your quality of life drastically changes and makes you dwell on the things you used to be able to do.
After you’ve had a birth, post-partum depression also is very common. All over social media we see beautiful pictures of new babies. But we lose sight of the reality of having a new child and how difficult that transition can be for new mothers.
Medications, alcohol, drug use, stressors that you can’t control in your life — such as changes in your job or relationships — can also be causes.
Q: What signs will someone show if they have depression? Crying, general malaise, lack of energy, etc.?
Dr. Allen: This can vary from person to person. In addition to the ones you mentioned, other symptoms include losing interest in things that have been important, feeling hopeless, constantly worrying or having thoughts of hurting themselves or suicide.
This is why it’s important that if you think you are struggling — then it’s OK to come into the clinic and discuss how you are feeling with a health care provider.
Q: How can depression affect a partner?
Dr. Allen: If you are nervous, restless, not sleeping, or experiencing any of the symptoms we’ve mentioned — the people who are closest to you feel that burden too. This can impact your life both at work and at home. This can even impact your sex life. Depression can impact your partner in so many different ways, which is another reason why it’s important to seek treatment.
Q: Can exercise help in the treatment of depression?
Dr. Allen: It absolutely can help. I am a family medicine physician. And one of the ways we like to approach medical conditions are lifestyle interventions — or things that we can do naturally to help. These include getting outside, exercise, yoga, walking, getting out with others.
Other things you can do too include journaling or reflective writing — so you can get those thoughts out of your head and down on paper. That can be a big help.
I will say; however, that lifestyle interventions are great — but they often aren't enough. In those cases, we recommend therapy with a trained social worker or psychologist who is able to help you deconstruct some of those issues that are contributing to one’s depression.
Q: Is it possible to come off medication for depression?
Dr. Allen: Depression can go into remission and you can get off medication. Here's one way I like to talk about depression with my patients. Suppose you are driving on the interstate in wintry conditions and you end up in the ditch. No matter how much you press on the gas pedal — you’re not getting out. When this happens, you need help (in the form of a tow truck or emergency responders) to help get you out. But it doesn’t mean that you won’t be able to drive again. It just means that at this moment you are in the ditch and need some help. That’s what therapy is. That’s what medications are. But that’s OK, the goal is get you to the point where you can drive on your own again.
Q: Why is there such a stigma attached to depression?
Dr. Allen: For one, we tend to experience our negative feelings in isolation and we keep them to ourselves. We think that we’re weak, not strong enough, not living up to expectations. And it's very hard to leave that place of vulnerability.
In some cultures, talking about your feelings and having conversations about not feeling well and not being happy is discouraged. But as a society, I think we are getting better at this.
You would never believe the people — those who are successful and who are admired from the outside — who come into our practices and start breaking down. It’s one of the privileges as health care providers. It’s not something we take lightly — that we get to have this insider view of humankind. So I’m here to tell people who have negative thoughts and other feelings of depression that they are not alone.
