Month: April 2018

Provider Training

At the time of this writing, I am just a few days away from a NAMI (National Alliance on Mental Illness) Provider Program training.  It will be two days of learning how to teach health care providers about working with those who suffer from mental illness.  What specifically is involved in the training?  I don’t know much about that yet.  However, I have no doubt that it will be very educational and uplifting experience.

I could not be more excited about working on one of my biggest areas of concern when it comes to depression.  As a pharmacist and a family member, I have seen depression on both sides.  One of the experiences that still haunts me is how my dad was treated by health care professionals, especially when they were concerned about a physical issue that he had.  Now, I have no doubt that most practitioners are well meaning, and I understand they are very busy with paperwork and many other demands.  However, there were so many times that I felt that we were literally begging for help regarding my dad’s depression, yet it seemed that there was a deaf ear to it most of the time.  It was heartbreaking.  All humans are more than just a physical body.  We are also mental, social, and spiritual beings.  And, depending on how you define it, there may be more than that.  We need our providers to take care of the whole person and to understand why that is important.

I can’t go back and change my dad’s experiences, but I can do my part to help make sure others don’t have the same issues.  No doubt there will be lessons there for me as a pharmacist too.  I think we are always looking at ways to do better, and my hope is that this training will allow me to help other providers understand some ways to do just that.

Energy

As I have mentioned before, I am a pharmacist.  However, over the years I have come to realize that medications do not take care of everything.  They may help, but when it comes to depression they are probably not the end all be all of treatment.  One of my hopes with this blog is that I introduce people to other possible treatment modalities, and that is the topic for today.

A possible treatment (or complimentary treatment) for depression that I would like to mention today is related to energy healing.  Have you ever heard of auras?  Chakras?  Energy fields?  Using crystals?  Reiki?  These are probably some of the more widely used terms out there related to energy healing, but no doubt there are other ones used.  What is energy healing?  Well, it can be difficult to describe, but it is related to some ideas about the energy in you and around you.  In this arena, depression can be thought of as an imbalance of energy, and I suspect that this description makes a lot of sense for people.  Energy healers work to restore that balance.

Is energy healing right for you or worth a try?  I have tried a reiki session many years ago, and I did feel better afterwards, but it is hard to fully explain why.  I can’t guarantee it will help you, but if you are interested you can learn more about it and look for practitioners in your area.  A lot of these healers are not regulated by anyone, so it can be hard to determine who is legitimate, but there are energy healing groups you can find online to help in your search.  As with most things in life, do your research to make sure you are seeking help from a professional in the field.  Overall, energy healing may just be the added treatment that can help alleviate your depression.

Hesitation

No matter what your relationship to depression is, living with it or around it can present difficulties.  One of those challenges is about what activities you can and can’t do because of the depression.  You may find yourself saying, “I will take that class when so and so is feeling better”, or “I will go on the trip once my depression has lifted”.  In some cases, those statements may make a lot of sense, but today I want to challenge anyone affected by depression in some way to really look at what they want to do and decide if the depression has to stop them from doing so.

Here’s the thing – life is short, and there is not much value to pretend to make plans for something that is not going to happen.  Worried about leaving a depressed family member so you can travel?  Could that family member go with you?  Are there other friends or family that could look after the person while you are gone?  Are there respite services available that you could use?

If you are depressed yourself, can you imagine things you have always wanted to do?  If not, that is ok.  If you can, however, what does that look like?  Although you may not be feeling the best right now, can you begin taking some steps to make it happen once you are feeling better?  Could part of what you want to do involve different treatments for your depression that may work better than what you are doing now?

I understand that my view might be seen as overly optimistic, but when my dad was depressed I know we hesitated to do anything – travel, celebrate anything, or even enjoy ourselves around him.  I know now that this hesitation was not fair to anyone.  Life has so much to offer, and we need to continue to make those experiences happen.  Hesitate less and live more.

How to Talk to a Depressed Person

As you can imagine, anytime I see an article or video about depression I am curious.  Lately, it seems I have been hearing a lot about the stories of people who have experienced depression.  In what I have heard, one of the big themes that has come up is how depressed people want to be treated, and that is what I would like to touch on today.

While I will make some generalizations here, it should be noted that not everyone will agree.  However, I also think these are some good rules of thumb to use at first, and then you can modify your behavior from there if needed.

The answer to how to talk to a depressed person is pretty simple.  How would you talk to someone who has a broken leg?  How would you talk to someone who has cancer?  How would you want someone to talk to you?  The answer to those questions is the same as how you would talk to someone with depression.  From what I have heard, depressed people want to be included, just like anyone else.  They also want to feel like they can contribute, so asking them for favors is not out of the question.  They may not feel up to those actions, but asking alone can be helpful for depressed individuals.  A couple of other tips: first, don’t tell them to cheer up, and second, don’t stay away from them.  Your connection is important, and depression is not contagious.

As you have noticed, talking to a depressed person does not have to be any different from talking to anyone else.  In fact, there are probably many times that you have talked to someone who is depressed and you didn’t even know that fact about them.  In the end, treat a depressed person like anyone else – they are no different than someone who has a physical condition.

Can Suicide Be a Side Effect?

As a pharmacist, I spend a lot of time thinking about the side effects of medications.  Unfortunately, they come with the territory of taking medications, but as you know not all side effects are equal.  Someone may be able to live with some constipation or nausea, but the medications that list death as a possible side effect are a very different story.  Even more disheartening is that medications affect individuals differently, so what may be safe for one person could be a disaster for someone else.  There are a lot of gray areas, and it is messy at best.

So, you may wonder – is suicide a side effect?  Some medications, especially antidepressants, will come with a warning of increased suicide risk.  Recently there has been media coverage that Tamiflu (used for the flu) has led to suicide as well.  Not all medications come with a warning for increased suicide risk, but for those that do I think it is important to take it seriously.  For example, the idea with suicide and antidepressants is pretty straightforward.  Before someone starts an antidepressant they are too depressed to act on any suicidal feelings.  However, if the medicine starts to work but has not been on board long enough for the patient to feel better, that may just give the person enough ability to act on any suicidal thoughts.  Again, I think it is important to take any medication warnings about suicide seriously.

In general, medications are very powerful things.  They can do some great things, but they can also be harmful.  No matter what medication you take, if it is new to you try to be extra aware and see if you are noticing any changes in behavior, mood, physical changes, etc.  Side effects can and do happen, and while I don’t want people to overreact, I want everyone to have a healthy respect for the medications they are putting into their bodies.

Research

I would like to think that my blog is a journey that I take with you as readers of the blog.  With that in mind, my hope is that together we learn more and more about depression and how to better understand, live with, and treat it.  Sometimes it can be difficult to find credible information on the internet, and ultimately it is up to you to decide how you will use the information you have seen.  Today I want to list some resources that I’ve come across that might be worth some additional research.  They are in no particular order, and this is by no means an exhaustive list of what is out there.  I wanted to give you some ideas of what is available in terms education, information, advocacy, research, and support.

NAMI – I talked about this organization in the last post – www.nami.org

AFSP (American Foundation for Suicide Prevention) — www.afsp.org

Bring Change 2 Mind — bringchange2mind.org

One Mind — onemind.org

Crisis Text Line — www.crisistextline.org

OK2Talk — ok2talk.org

Kelly Brogan — kellybroganmd.com

Daniel Amen –- danielamenmd.com

Another point here is that as far as I know these are on a national (United States of America) level.  I know for sure that NAMI has state and local organizations, and I am sure there are also many local organizations out there.  Typically a Google search will help you find what might be available to you in these areas.

While today I have focused on some overall ideas for resources, I am also hoping to bring some scientific research and evidence to my blog.  As a pharmacist, one of my considerations is whether there is evidence out there to support certain treatments and certain findings.  One thing I have discovered in my research so far is that medications are not the end all be all for treating depression.  That may be surprising to hear from a pharmacist, but there is so much research going on, and I’m excited to share new ideas that could help treat depression in different ways.

NAMI

When dealing with depression, resources are important.  Today I would like to highlight a resource that I know fairly well – NAMI (also known as the National Alliance for Mental Illness).  NAMI is an organization in the United States that works at 3 levels – the national, state, and local level.  NAMI is found in almost every state, and there are many local chapters.  The main work of NAMI revolves around education, advocacy, and support.

Education includes classes that are free for students.  There are classes for those affected by mental illness.  There are also classes for family members, veterans, young people, and health care providers.  Essentially, there is usually something available no matter what your role in mental illness may be.

For advocacy, work is done at all levels to pass legislation to help improve mental health.  Other advocacy work, which can involve speaking at press conferences or public events, can help to reduce stigma and increase conversations about mental health.

Next, support can include things such as providing resources and helping people know where they can get help.  As you may guess, these three activities don’t always work alone – education, advocacy, and support can be found together in a lot of what NAMI does.

Overall, I feel that NAMI is a great organization when it comes to mental health.  I have benefitted from its help over the years, and I continue to be a member and supporter of it.  If you are interested in learning more about NAMI I encourage you to go to their website at www.nami.org  Many state and local chapters have websites that can be found by a simple Google search.  For a fee you can become a member, and there are reduced fees for those with limited means.  Even if you don’t become a member, I hope you at least take a look at the group to see how they might be helpful for you.

Causes of Depression

What causes depression?  That is a big question.  No doubt many of you have heard about there being a “chemical imbalance” in the brain, and maybe genetics was thrown in there as well.  Today, I want to give a general overview of some other theories that may explain what can lead to depression.

While there may be some truth to the genetics cause, the “chemical imbalance” doesn’t seem to be as likely, however, it cannot be completely eliminated.  Here is a listing of some other ideas:

1.Depression can result from an inflammatory/infection/immune reaction process

2.Depression can result from a hormone imbalance

3.Depression can result from a “leaky gut”, which is related to the food that we eat

4.Depression can result from losing our connection to important things in our life such as our values, face to face interactions with others, etc.

5.Depression can result from toxicity and/or environmental exposures

6.Depression can result from trauma that is experienced

7.Depression can result from taking medications

8.Depression can result from the food that we eat

As you can see, this is a fairly good sized list, and I probably have not captured all of the possible theories out there.  And, it seems likely that there are several components that go into causing depression, not just one thing.  That makes it harder to understand who will or will not have depression, but it is helpful to understand that depression is a lot more complicated than what we might have thought in the past.  While we may not understand the exact combination leading to depression (and it probably is different for every individual), these theories give us so many more options to pursue when treating depression, and I think that is important.  It may take a lot more trial and error, but hopefully there are some answers here that work better when medications don’t work and/or don’t seem like a good option.