Seeking Help for Depression

With October being Depression Awareness and Mental Health Screening Month, our last article was devoted to understanding the extent and seriousness of depression and depressive disorders, that police officers are not immune and in may be even more susceptible to falling victim, and the importance of awareness and screening to proper intervention. We then touched on some basic screening questions used by mental health professionals to initially screen for depression that also work well as a self-administered check-in anyone can use if they feel they may be suffering from a clinical depression.  Here we’ll dive a little deeper to look at the realities of treatment for those who know or suspect they are.

It is first important to know that depression is both very common and very treatable.  As many as one in four persons will experience a clinical depression at least once in their lifetime, and police officers are not immune.  The earlier someone takes steps to intervene the quicker and better the response to treatment. Any time a depressed, sad, or angry mood has been present for more than even a few weeks, you should seek the assistance of a medical professional, whether it be your primary care physician, a licensed counselor, or a psychiatrist.  Feeling sad or “blue” is certainly not uncommon but when those feelings persist an uncommonly long time, seem unrelated or out of proportion to a known antecedent or ongoing stressor, are seriously impairing your daily living and relationships, or lead to a sense of hopelessness or worthlessness, they have gone from the normal “blues” to something far more sinister and concerning. 

Medical research is showing that treatment of depression has a 90% success rate when a licensed counselor and a psychiatrist, who can prescribe medication if needed, are working together.  Once under their integrative care, people will generally report feeling more like their old selves in about 3 to 6 weeks.  While the psychiatrist or a highly trained and experienced nurse practitioner manages medication therapies, the counselor will identify and challenge patterns of behavior and cognition that lead to greater vulnerability to depression, thought distortions, and impaired functioning.  It is learning how to put better, more functional behaviors and thoughts into practice, over time, which bolsters medication therapies and helps good feelings to eventually follow.  It is the repetitiveness of good behaviors that finally begins to heal the depression and prevent its return.

One of the reasons we stress early screening and intervention is because too many people wait to seek help, hoping their depression simply goes away or is something they can manage alone.  The problem with this is that a mild depression can worsen, and its mere existence can effect decision making and the ability to cope with additional stressors.  Too often, it is not until someone is in crisis that they seek help, and crisis management is never the preferred method or time to initiate treatment. By the time depression has become a crisis, personal functioning is often notably diminished, the sufferer is less likely to make good decisions, and the number of viable treatment options are reduced. Very personal issues may go uncomfortably public, with the likelihood of long-term consequences increasing. At this stage the depression and resulting crisis is often a true medical emergency and should be treated as such.

Early intervention by a mental health professional is far better and more effective as the patient can be more involved with and better informed about treatment decisions, minimize disruptions to life and work, and choose who to involve from their interpersonal circles and how control how much information is shared and with whom. Early intervention better ensures privacy will be protected, while waiting for a crisis may well put someone's personal problems on wide display, with privacy concerns and how others might interpret the need to seek help often foremost on a cop’s mind.

Finding help for depression is generally easy for police officers.  Most departments offer fairly generous health benefits, including mental health options, so looking on your health insurance provider list for a psychiatrist, nurse practitioner, or licensed counselor is an easy first step.  Asking your primary care physician for a referral may help you target professionals your doctor is comfortable with and worthy of recommendation. You can also talk to your pastor or department chaplain, the department social worker(s) or psychologist for a referral, or simply call your EAP.  Going straight to a professional in the field is the most direct path to help, and – this is very important - all are bound by strict legal and ethical rules of confidentiality as determined by HIPPA laws or, in some cases, even more protective state laws!  Unless you are actively a danger to yourself or someone else they and their staff will not and cannot tell anyone you have come to them for help, advice, guidance, or treatment.

But what if they try to make me go on pills?

Don’t rule it out!  While depression is a mental illness it is still very much a medical problem first, since it is typically caused by impaired biochemical functioning within the brain.  If a mental health professional such as a psychologist or social worker suggests a referral to a licensed prescriber for a medication evaluation, it is because they think it might help.  If that prescriber suggests medication, consider it.  Medication will not alter who you are or change your fundamental personality, it will just help you to not experience extreme lows or extreme highs that put you at risk or hinder getting better.  And psychotropic medications are not mood “altering” drugs so much as mood “stabilizers”; the disease is what altered your mood and brought you to dark places, so shouldn’t something be done about that?  When medications begins start taking effect most people report a return to their “old selves.”

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Depression and depressive disorders affect a huge number of people every year, cost the economy billions in lost productivity and costs, diminish the quality of life for those suffering from them directly as well as those who love them, and even kill far more than you might suspect.  But no one needs to suffer without hope.  Treatment options and effectiveness for depression have never been better.  If you or someone you know suffers, please get the help you deserve.