Mood Archives - Jeffrey Sterling, MD

Straight, No Chaser: Depression Quick Tips – How to Avoid It, When to Get Help

As a physician, I’m not willing to advise you on how to ‘care’ for yourself at home if you’re clinically depressed. I can discuss how to avoid depression (to the extent possible) and what warning signs should prompt emergent access to care. If you’re good at accomplishing the items listed below, you have less of a chance of being unhappy and clinically depressed.

Avoid alcohol and other mood-altering drugs.
Eat healthily.
Exercise regularly.
Get enough sleep.
Remove yourself from negativity, including your choices in friends, mates and work environments.
Surround yourself with positivity, including your choices in friends, mates and work environments (Please note this is a different consideration than the previous bullet point.).
Learn how to relax and where to go to relax (These considerations include such things as yoga, meditation and your religion/spirituality, not the business end of a bottle or drug use.).

Look out for these potential warning signs for suicide: Remember that approximately 30% of suicides are preceded by the individual declaring intent. Be alert for the following additional considerations:

Increasing levels of depression, withdrawal, reckless behavior, alcohol and other drug use, and/or desperation.
Notice activity that could be a prelude to a suicide attempt, such as obtaining knives, firearms or large quantities of medication.
Changing one’s will and settling one’s life affairs in the midst of depression
Ongoing comments about lack of worth and desire to end it all.

The following considerations should prompt an immediate visit to an emergency room or other treatment facility.

You have a compelling, overwhelming feeling that you want to hurt yourself, with or without an actual plan.
You have a compelling, overwhelming feeling that you want to hurt someone else, with or without an actual plan.
You hear voices or see things or people who are not there.
You find yourself crying often and uncontrollably for no apparent cause.
Your depression has affected your activities of daily living (work, school, consistent forms of recreation or family life) for longer than 2 weeks.
You think your current medications are affecting you abnormally and are possibly contributing to making you feel depressed.
You have been told or believe that you should cut back on drinking or other drug use.

I wish you and your loved ones all the best in avoiding and/or dealing with this disastrous condition. I welcome any comments, thoughts or questions.

Straight, No Chaser: Are You Depressed and/or Suicidal?

I have a strong distaste for do-it-yourself websites that want to ‘screen’ you for depression. Folks, if you’re wondering whether you’re clinically depressed, you don’t need validation from some makeshift online questionnaire. That said, if you’d like to learn something, go ahead and find one. More importantly, seek assistance immediately from a qualified counselor or therapist. They do wonderful work and can get through to you before you get to yourself. Instead of a quiz, I will simply give you common signs and symptoms consistent with the diagnosis. Note the progression in the symptoms. The bottom line is: odds are, you already know if you need help. Yes, there are different depression syndromes; I’m not getting into that. You and a psychiatrist or therapist can sort that out. Don’t be reassured by a quiz when you already know better.
You may be depressed if…

You feel sad, hopeless, empty, or numb to the point where you wallow in these emotions, and they dominate your existence.
You have a loss of interest in your normal activities of daily living. It’s not just that you don’t enjoy things. You don’t even want to be bothered with them. You don’t want sex. You don’t enjoy your friends. You don’t want recreation. You can’t eat. You can’t sleep, or you can’t stop sleeping. You can’t breathe (because of your crippling anxiety). You might actually be depressed if you have these symptoms and didn’t get the ideas from listening to the lyrics of a Toni Braxton song.
You find yourself exceedingly irritable and/or anxious. These feelings are explosive and over the top. You’re waiting, ready and looking for a reason to embrace gloom, doom or anger.
You have difficulty moving forward and making decisions. This occurs for many reasons. Your attention may be shot. Your interests aren’t there. You’re overwhelmed. Stuck in a rut is not only where you are, it’s where you want to be.
You feel worthless and blame yourself for any and everything. Again, these feelings are explosive, dramatic and over the top.
You have thoughts of death and suicide. This is where things get beyond scary. You may simply have a passive wishing that things would end and a belief that your friends, family and the rest of the world would be ‘better off’ without you. You may have fleeting voices that aren’t your own suggesting or commanding suicide as an option. You may see visions of people telling you to harm yourself. You may have an active plan. When depression gets to this point, nothing good is going to happen without intervention. Never allow someone to make such comments and then pretend as if they were insincere.

Now consider these most common precipitants for suicide:

Problems with one’s intimate partner
Problems with one’s physical health
Problems with one’s job
Problems with one’s finances

You will have a lot better chance getting someone help at a warning stage than preventing someone from doing something once they have a weapon in their hands. Approximately 30% of suicides result after the individual has expressed an intent to do so. Listen up… Take the signs of depression and any expressed thoughts of suicide seriously.
I welcome your comments, thoughts or questions.