October is Depression Awareness and Mental Health Screening Month. As awareness of depression and mental illness grows, stigmas are confronted, and many traditional prejudices fall away, people are increasingly able to speak about mental health issues with greater ease and openness than in the past. Being able to say, “I have depression” or “I suffer from mental health issues” is now – and thankfully - considered more an acknowledgement than an “admission.” In many ways law enforcement has been a leader by coming to see police officers as first responders not only to crime but also as part of the critical front line in the provision of mental health services to people in crisis. Accordingly, officers are better trained and educated than ever before, with younger officers much more open to their place on this front line. This has been remarkably beneficial for the communities they serve.
Increasingly, even the need for officers to be alert to the signs and symptoms of depression and mental illness in themselves and their peers has been embraced. The psychological risks of a law enforcement career are being taken more seriously, options for officers in need of help are being developed and implemented, and sincere efforts to reduce stigma are being made. We salute this!
Still, a lot of myths surrounding depression remain, as well as negative biases towards people who have depression (and other mental illnesses). Some continue to believe it is something that classifies someone as emotionally weak or somehow lesser of a person. Others believe that a diagnosis of a depressive disorder will disqualify them from a law enforcement career, is more than it is or somehow on par with more serious and often permanently debilitating psychoses, or cannot be “fixed” through therapy or medical intervention. Myths are dangerous when facts can easily counter them, and it is our hope to further reduce stigma.
According to the National Alliance on Mental Health:
“Major depression is a serious medical illness affecting 15 million American adults, or approximately 5-8 percent of the adult population in a given year. Unlike normal emotional experiences of sadness, loss or passing mood states, major depression is persistent and can significantly interfere with an individual's thoughts, behavior, mood, activity and physical health. Among all medical illnesses, major depression is the leading cause of disability in the United States.”
Research into depression is extensive and ongoing and has illuminated both the scope of the problem and its roots in genetic and biological etiology. In addition to what has long been understood about the biochemical aspects of depression – that depressed people have a lack of, or overproduction of, certain chemicals needed in the brain to be released into the bloodstream to stabilize a person’s mood, and that without the proper chemical balance a person’s mood will fluctuate and go to lows from which a person cannot rebound back without the proper medical help and interventions – we now know individuals coping with depression have a higher level of stress hormones present in their bodies, and that brain scans of depressed patients show decreased activity in some areas of the brain. There are other types of serious depressive disorders, as well, such as bipolar disorder, dysthymia (a chronic low-grade depression often lasting for months or years), and adjustment disorders with depressed mood. Considering the number of people suffering from these disorders the number of people touched by depression grows by millions more.
Not all depression looks or feels the same. It can come and go, fluctuate in severity, and affects people in many different ways. At its worst, depression is deadly, leading to suicide or self-destructive habits. In less severe forms it impairs functioning, makes happiness a distant memory, stymies success, or leads to a self-inhibiting feedback loop.
Depression is not only common and widespread, but those who suffer from it are in good and esteemed company. Some famous people known or suspected to have suffered from depressive disorders, with a number of them being very open about it,, include Mike Wallace of 60 Minutes, Larry King, former Israel Prime Minister Menachem Begin, Marlon Brando, Truman Capote, Earnest Hemingway, Abraham and Mary Todd Lincoln, Winston Churchill, Dick Clark, Calvin Coolidge, Harrison Ford, Anthony Hopkins, Elton John, John Lennon, Richard Nixon, Deborah Norville, Boris Yelstin, and even General George S. Patton. The suicides of Soundgarden’s Chris Cornell and Linkin Park’s Chester Bennington have just this year shaken the music world, and the overwhelming popularity of Lin-Manuel Miranda’s hit musical Hamilton has opened a window into the complicated psyche and drives of our most workaholic Founding Father (as well as closer examination into the psychological makeup of the largely hypomanic group of peers with whom he worked, bickered, fought, led, played, and – famously and finally – dueled).
Depression is not selective in who it affects. As this very limited list demonstrates, even productive, strong people who have made significant contributions to the world are susceptible. If world leaders, artists, and the principle architect of American Federalism can suffer from depression and mental illness maybe the rest of us should be more compassionate and less certain of our own invulnerability.
So, maybe you wonder if (or are pretty sure) you might have a little (or more than a little) depression and are wondering if screening is appropriate. Maybe it’s not you, but a friend, spouse, child, or coworker you’d like to encourage to get screened. Recognizing some of the common symptoms of depression is easy and will help decide whether further screening is necessary. If you are experiencing any of the following and they are affecting your quality of life and functioning, it is time to look for help:
- Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feeling sad or empty) or observation made by others (e.g., appears tearful). (In children and adolescents, this may be characterized as an irritable mood.);
- Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day;
- Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day;
- Insomnia or hypersomnia nearly every day;
- Psychomotor agitation or retardation nearly every day;
- Fatigue or loss of energy nearly every day;
- Feelings of worthlessness or excessive or inappropriate guilt nearly every day;
- Diminished ability to think or concentrate, or indecisiveness, nearly every day;
- Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide;
- Marked irritability and easily frustrated;
- Feeling overwhelmed and increased anxiety;
- Crying more often.
If any of these symptoms persistently fit, or even if you generally are “having more bad days than good”, it is time to seek help. Contact your EAP, flip through your health insurance company’s provider manual, talk to your pastor, department chaplain, or social worker, or simply check online or in the yellow pages. Help awaits and, best of all, seeking it out is entirely confidential!
Depression is far too common to be embarrassed by, and far, far too serious not to take seriously. October is Depression Awareness and Mental Health Screening Month. The time is right to get help if you need it.
