Healthy Beginnings

Ask the Experts: Combating Depression

Addressing depression and seeking help during the holiday season. A raw Q&A interview with local mental health professionals.

Rudy von Ravensberg, LMFT, and Chris Edwards, LCSW, psychotherapists and owners of Great Basin Behavioral Health and Wellness, provide insight on the signs, symptoms and triggers of depression. von Ravensberg and Edwards help individuals focus on lifestyle changes to achieve behavioral health and holistic wellness goals.

What is depression?

Edwards: Depression is a very common mental health issue that is characterized by a set of symptoms. [These symptoms] include feeling down more often than
not, difficulty sleeping or oversleeping, low energy, and this can be accompanied by thoughts of suicide. So, that experience can be fairly individualistic depending
on the individual and their activity levels before their onset of depression. It’s important to recognize what those general symptoms are, but also try to understand how those look within that individual.

von Ravensberg: And then, I think you’re referring to clinical depression as opposed to what many people will describe as, ‘I’m feeling depressed,’ which is a common misnomer in our society. We have a tendency to say, ‘Oh, I’m feeling really depressed today,’ just to indicate that maybe you’re having a down day or you’re feeling sad – that’s not clinical depression, it’s very different.

One of the most clear-cut criteria that we look for from a professional standpoint is: are the depressive symptoms interfering with the person’s work or school, with their social life or their family
life? Is it causing conflicts?
If [the symptoms are] not causing problems in any of those areas, it isn’t clinical depression. Not to say that they’re not struggling. If somebody’s depressed to the point that they’re skipping school or they’re missing work regularly and can’t get out of bed in the morning – that’s clinical depression.

Is it common for society to misunderstand depression? Is depression truly recognized as an illness?

Edwards: Lack of general education into what mental health problems actually look like is really unfortunate for the people that do struggle with these mental health issues. Not only do they have that issue, but then from their role within society they kind of become shunned or stigmatized and that only perpetuates the mental health issue.

von Ravensberg: For example, if an individual is actually experiencing clinical depression, they share with a family member that ‘I’m feeling very depressed.’

Oftentimes, that family member might marginalize their emotional state and say ‘Oh, you know, you’ll just get over it – you’ve got to tough through it,’ which feels very invalidating for that individual. It creates more isolation which perpetuates depression.

How are both stress and expectations connected to depression, and what causes depression to heighten during the holidays?

von Ravensberg: Stress is more clumped together with anxiety than depression, but simultaneously anxiety is clumped with depression – it’s very common to experience both. The stressors [are] involved with numerous factors including having extended family together (oftentimes, there is a strong history between those family members, sometimes there’s a history of conflict and ill feelings … exacerbating stress).

There’s a physiological stress from an increased consumption of poor foods, unhealthy foods [and] snacks, but also the increased stress from substance use and the expectation in our culture that substance use is the norm at a family function or other holiday party. So, we tend to drink more, eat worse food, sleep less [and] we have less opportunity to get outside (there’s less light outside, there’s reduction in physical activity due to cold weather, and it increases isolation outside of the actual family experience).

Edwards: This is the time
of year where expectations somewhat go through the roof. How many other times throughout the year are we expected to cook a multi- course meal with a turkey and all the trimmings? That’s a lot of pressure. And then, 4 weeks later, we do it again and in that interim we also have to buy everybody presents, so I think a lot
of these expectations lead people to feel like they’re not doing enough – which leads to [thoughts of] ‘I need to do better, I need to try harder,’ which in a lot of cases is not necessarily the truth.

von Ravensberg: It’s really a form of self criticism that perpetuates again the depressed mood. Also, there
is a cultural
expectation
that has been
increasing for
quite a long time
involving materialism
and status. Especially
with kids who demand increasingly more expensive
gifts so that they can maintain social status and, if they don’t, if their parents are not able to provide those items, that could lead to and perpetuate a depressed mood.

How can an individual feel isolated during the holidays?

von Ravensberg: There’s a strikingly large difference between being lonely and being alone. Being lonely is the lack of connectedness that one might experience in a social setting.
So, I can be at a party surrounded by friends and family but, if I don’t have that connection with them, I’m going to feel lonely
and isolated. The tendency to isolate is one of the primary characteristics of clinical depression. So, circling back toward
the question of how somebody can tell if they’re more clinically depressed, there’s going to be a tendency to isolate and withdraw.

How does an individual struggling with depression share their battle and seek help?

von Ravensberg: You have to identify the individual that is going to lend you their attention, and not be invalidating or possibly reject your request for help. Finding an individual in the family or a close friend that can give an objective opinion about whether or not this is something that’s different than the normal blues… Beyond that though, if in doubt, it really makes quite a bit of sense to see somebody. It starts with simply making an appointment and having a one hour meeting to determine if you really have a need for services.

What are the benefits of addressing depression and seeking help early?

Edwards: Depression is more likely to continue and possibly get worse.

von Ravensberg: Which
will then require numerous interventions as opposed to possibly just one. It’s much more difficult to manage severe depression or even moderate depression, so an ounce of prevention leads to strikingly improved outcomes.

In this community, there is
a shortage of mental health professionals. We will always expect that, in the first couple of weeks after New Year’s, us and everyone else are inundated with people trying to get in because they wait until after the holidays – until things are really bad. Try to nip it in the bud in November or December – you have a better chance of getting in and having access to care.

For more information, call Great Basin Behavioral Health and Wellness at 775-453-4143 or visit www.greatbasinwellness.com