Am I Depressed?

Mental health struggles are common for so many people living in the United States, and yet they can be very alienating. What depression might look and feel like in one person may not be the same in another person.

Constance J. Rose, M.A., M.S., a Pre-doctoral Clinical Psychology Intern with Rochester Regional Health, gives insight into what this might look like for different people.

Symptoms of depression

Professionals and patients will agree that mental health is just as important as physical health. Defining what a person is experiencing mentally can be the first step toward making progress toward healing.

Depression is a serious mood disorder that affects how a person thinks, feels, and experiences themselves, others, and the world around them. Depression may impact how someone functions socially, occupationally, and during daily tasks such as eating and sleeping.

Some of the symptoms include:

• Feelings of sadness
• Not engaging in activities you usually enjoy
• Increased or decreased eating and/or sleeping patterns
• Fatigue
• Feelings of worthlessness or hopelessness
• Difficulty concentrating
• Restlessness or moving more slowly
• Thoughts of suicide

“It’s not just a day or two,” Rose said. “It has to be at least two weeks persistently – especially for it to be diagnosed as clinical depression.”

Who usually knows first: others or myself?

Just as depression does not look the same for everyone, it is not always recognized in the same way for everyone.

Some people may notice changes in themselves and wonder if they are depressed. Others may have a close friend or relative come to them and suggest recent changes may be related to their mental health.

A person may know what their baseline is for their emotional and mental state and recognize some changes such as consistently isolating themselves or not reaching out to others.

These can go both ways; there is no “right” way to recognize potential signs of depression.

Pre-screening process

Once a person decides to see someone about their depression, they will usually sit down with a mental health professional and go through a pre-screening evaluation.

The evaluation or clinical interviewing process can take up to 3 sessions and focuses on gathering information about demographics, symptom onset and duration, mental health history, and other behavioral health data. This helps the provider provide the patient with the most individualized care and treatment needed. Cultural differences – such as social norms, environmental, and genetic predispositions – are very important to consider during this evaluation process.

“We really try to get a full picture of what you’ve been experiencing as every situation looks different for each person. In addition to the clinical interview we also provide assessments or screeners,” Rose said.

An assessment or screener allows a provider to numerically identify symptoms on a spectrum of mild to severe. For depression, some of these might include a Patient Health Questionnaire (PHQ-9), Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HAM-D), or other assessment.

Following this process, a mental health professional and the patient will collaboratively identify personal goals for treatment, map out a potential treatment plan, submit referrals to community-based resources and possibly to a psychiatrist for medication management.

Possible treatments

There is a wide range of treatments for depression. These depend on the severity of symptoms and what the patient is comfortable with pursuing.

Talk therapy is one method that focuses on helping a person to identify possible negative feelings, thoughts and behaviors they may find troubling and work on changing them. Evidence-based therapeutic techniques, such as Cognitive Behavioral Therapy (CBT), help to address and shift these negative cognitions, emotions, and behaviors. This is often done between a mental health professional and a patient, although some providers may opt to collaborate with other professionals - such as a religious leader - in order to make treatment more culturally inclusive.

Medication Management is another approach to treatment involving a patient collaborating with a physician for prescribed psychotropic medications. If a patient feels as though medications are beneficial towards improving their mood and overall well-being, this is a suitable option. However, it is recommended to participate in both talk therapy and medication management as it produces better improved and longstanding outcomes.

“The patient is the expert on what works for them and their consent to a suggested style of treatment is important,” Rose said.

Seeking help

It is important to remember that millions of people experience depression through different points in their lives. This experience is very common and normal.

If you are experiencing depression, you are not alone in this process.

“Normalizing and providing a space that is very empathetic and culturally affirming is important for people to seek treatment,” Rose said.

Find someone who will work with evidence-based practices and help you to develop coping mechanisms that are specifically beneficial for you.

In conjunction, a patient may also be referred to community-based resources that may provide a more well-rounded approach to care.