Culture of Responsible Choices: 341st MDOS explains depression symptoms, treatment Published Aug. 27, 2009 By Capt. Anthony C. Wilson 341 Medical Operations Squadron, Mental Health Flight MALMSTROM AIR FORCE BASE, Mont. -- Airman X just received a "Dear John" letter from his girlfriend of two years. He reported to work stating that he has lost his motivation to work, can't eat, can't sleep and can't concentrate. Airman Y recently received news from home that her twin brother was killed in a car accident. She reports being unable to sleep, eat, and she admits losing motivation to get out of bed. These are just two examples of how life can change and cause a person to fall into a state of depression. It's natural to feel down occasionally but if that low mood lingers day after day, it could be a sign of depression. Depression is an episode of sadness or apathy that lasts at least two consecutive weeks and is severe enough to interrupt daily activities. Depression is not a sign of weakness, a negative personality or a bad outlook on life. It is a major problem in our society but it is a treatable medical condition. The key concern for someone suffering with depression is the awareness of the condition and seeking medical attention. The first step in solving any problem is the recognition of having a problem. The critical step in addressing depression is making the responsible choice to get help. Depression is a medical problem that needs to be treated. The Malmstrom Mental Health Flight has qualified and trained providers with experience in treating depression. As with other illnesses, the providers can't treat if the patient doesn't report to the clinic for medical assistance. There are specific medical symptoms that accompany depression. Individuals, supervisors, first sergeants and commanders should be familiar with these symptoms to help identify the condition. The medical community isn't sure what causes depression, but many doctors and scientists believe an altered brain structure and chemical function could be the cause i.e. chemicals in the brain called "neurotransmitters" become out of balance. Many researchers believe the stress of a traumatic event, such as the death of a loved one or the loss of a job, could trigger depression. Other triggers include certain medications, alcohol or other substance abuse, hormonal changes or even the weather. Who's at risk? Anyone can become depressed, but many experts believe genetics play a role. If a parent or sibling has been diagnosed with depression it triples an individual's risk for being depressed. Women are twice as likely as men to become depressed. Women very commonly experience "baby blues" typically called post-partum depression. As many as three out of four new mothers experience post-partum depression. Researchers state that nearly 12 percent develop a more intense dark mood after the birth of their baby. These symptoms are very similar to those of major depression however an important difference in post partum depression is that the baby's well-being is also at stake. A depressed mother may have trouble enjoying and bonding with her newborn infant. Children are also at risk and researchers state that one in every 40 American kids is diagnosed with depression. Depression interferes with their ability to play, make friends and complete school work. Symptoms are very similar to depression in adults, but some children may appear angry or engage in risky behavior, sometimes called "acting out." Without treatment, depressed children can become at risk for suicide. If someone's mood matches the weather - sunny in the summer, gloomy in the winter- many people develop a form of depression called seasonal affective disorder, or SAD. The onset of SAD usually occurs in the late fall and early winter, as the daylight hours grow shorter. Experts believe up to 9 million Americans suffer from this disorder. Signs and Symptoms of Depression: Emotional symptoms: The primary symptoms of depression are a sad mood and/or loss of interest in life. Activities that were once enjoyable lose their appeal. Patients may also be haunted by a sense of guilt or worthlessness, lack of hope, and recurring thoughts of death or suicide. Physical symptoms: While depression is known to cause havoc on the emotions, it also takes a toll on the body. Numerous patients report their depression is accompanied by pain. Many depressed patients experience persistent nausea, diarrhea or constipation. Changes in appetite or weight are another hallmark of depression. Some patients develop unusual cravings, while other lose their appetite altogether. Impact on daily living: Without treatment of any kind, the physical and emotional turmoil brought on by depression can derail careers, hobbies, and relationships. Depressed people often find it difficult to concentrate and make decisions. They turn away from previously enjoyable activities, including sex. In severe cases, depression can become life threatening with the risk for suicide. People who are depressed are more likely to attempt suicide. Warning signs include talking about death or suicide, threatening to hurt people, or engaging in aggressive or risky behavior. Anyone who appears suicidal should be taken seriously. There are a number of factors that may increase the chance of depression, including but not limited to the following: Physical and Emotional Abuse- Past or present physical, sexual or emotional abuse can cause depression. Certain medications- Some drugs used to treat high blood pressure, such as beta-blockers can increase the risk for depression. Conflict- Personal conflicts or disputes with family members, supervisors, co-workers and subordinates may result in depression. Death, separation, or loss- Sadness or grief from the death or loss of a loved one or relationship, though natural, can increase the risk of depression. Genetics- A family history of depression may increase the risk. It's believed that depression is passed genetically from one generation to the next. Major events- Joyous occasions such as starting a new job, graduating, or getting married can lead to depression. So can moving, a demotion, losing a job or income, getting divorced, being deployed or retiring. Serious illnesses- Sometimes depression co-exists with a major illness or is a reaction to the illness. Substance abuse- Researchers believe nearly 30 percent of people with substance abuse problems also have major or critical depression. Other personal problems- Problems such as social isolation due to other mental illnesses or being cast out of a family social group can lead to depression. The role of social support: Because loneliness goes hand-in-hand with depression, developing a social support network can be an important part of therapy. This may include joining a support group, finding an online support community, or making a genuine effort to visit with friends and family more often. Even becoming involved in intramural sports, local social clubs, taking classes and social organizations can help people make connections with other people on a regular basis. The wingman concept truly can make a difference in someone suffering with depression. Knowing your co-workers and subordinates and being able to respond to them when they are experiencing difficult times is a very important quality that all Airmen should have. Supervisors and co-workers need to be very aware of the signs and symptoms of depression. Early detection and support could be the difference in reducing the severity of depression. Online depression support groups, such as WebMD's "Depression Support Group," can provide individuals with encouragement from others. Online depression support groups can help individuals realize that they are not alone in dealing with their feelings of depression. This added support can give members confidence as they learn how to manage the illness and handle the daily challenges in a reasonable fashion. This online support group also provides support for areas that may not have an established support group in the city or town for which the individual currently resides. How to combat depression: Therapy- Talking to a mental health professional, chaplain or downtown counselor can provide ways to combat depression. Numerous therapies are used to help change the thoughts and behaviors that contribute to depression and help identify how relationships and specific problems contribute to bringing you down and your mood. Some patients make great progress in just a few months of therapy while others continue long-term care. Medications- Anti-depressants change the levels of "feel-good" brain chemicals such as serotonin. While there are many anti-depressants on the market now, dozens of medications are used as options for overcoming depression. If the first medication doesn't help then try another, there's a good chance one of the others will work. The combination of talk therapy and medication by many physicians appears to be the best mode of treatment for depression. Exercise- Researchers suggest exercise is a potent weapon against mild to moderate depression. Physical exercise releases endorphins that boost mood while reducing the perception of pain. Regular exercise at least three times a week is also linked to higher self-esteem, better sleep, less stress and more energy. Any type of moderate activity, from swimming, to housework, to rollerblading, can help. Choose something you enjoy and aim at performing it for 20-30 minutes at least three times a week. Pets-Having a playful pet is no substitute for medication or therapy, but researches say pets can ease the symptoms of mild to moderate depression in many people. Pets provide unconditional love, relieve loneliness and give patients a sense of purpose. Researchers have found that pet owners have less trouble sleeping and better overall health. Resources- Often many people suffer from depression due to experiencing a traumatic event. Every military installation is subject to traumatic incidents occurring. Aircraft disasters, natural disasters and suicides can result in many becoming clinically depressed. Symptoms of traumatic impact may occur during and after the event. Even though the event may be over, the person may experience some strong physical, psychological and behavioral reactions to the traumatic event. No one is immune from these reactions. It simply indicates that a normal person is naturally responding to an abnormal situation. Symptoms can vary from individual to individual. i.e. insomnia, nightmares, loss of appetite, restlessness, anger, vomiting and diarrhea. Some people will experience many symptoms while others will be fine without assistance. For many, the effect occurs quickly and for others symptoms may not occur until weeks, months or even years later. Fortunately, the Air Force recognizes these symptoms and has in place a team of professionals to assist members who are affected by these events by having the base Traumatic Stress Response Team. The wing commander and each squadron commander has access to the TSR team. The TSR team is a group of devoted professionals who are on stand-by 24 hours a day to respond to any tragedy, disaster or death that occurs to our Air Force and Civilian personnel assigned to Malmstrom. Our team of professionals support Malmstrom personnel to help them recover and continue to meet mission goals. The death of an Airmen has a ripple effect across a squadron and that rippling effect can be felt and spread throughout the entire wing. The aim of the TSR team is to help members resolve and overcome the effects of a traumatic experience. Accepting the reality of the traumatic impact, as well as providing help and support, is of utmost importance. Fostering resilience is the goal of every TSR team. Base resources: Mental Health Clinic: The mental health clinic is available during normal duty hours along with an on-call provider 24 hours a day via the command post after duty hours. The mental health clinic has a staff of Psychologists, Clinical Social Workers and a Psychiatrist who are trained to provide quality mental health care to Malmstrom personnel. The mental health clinic can be reached at 731-4451. Chaplains: The base chaplains provide a full range of religious activities and services as well as pastoral counseling and community services. The chaplains and chaplain assistants also provide extensive visitation for all work areas throughout the base and missile fields. The chaplains also offer unlimited confidentiality regarding counseling services for which individuals can share information with chaplains that stays between the individual and the chaplains. (unless life threatening, for which the chaplains are mandated to report). Chaplains are available during duty hours at 731-3721 and also can be reached via the command post after duty hours. Military & Family Life Consultants (MFLCs): MFLCs are available through the Airman and Family Readiness Center and are available to help service members, spouses, family members and children address numerous issues including but not limited to depression. Their consultants are trained licensed counselors who provide consultation and training; free and anonymously. No records are kept. They are available after duty hours and weekends. For an appointment, they can be reached at 750-3605. Resources and websites. Military One Source is a DOD sponsored Web site for active duty, guard, reserves and family members of military service members. This Web site provides articles, audio, video, booklets, CD's and DVD's, resource guides and Web links pertaining to the subject of depression. The Web site also has video presentations on depression that the observer can download, listen or read a transcript of the presentation. Topics such as: "Understanding depression," "The symptoms of depression," "Getting help for depression," and "Coping with depression." These resources are free and available 24/7 for anyone to view. Military One Source can also refer individuals to local providers in the area for up to 12 sessions. A toll free number for Military One Source is 1-800-342-9647. The Web site link for military one source is: www.militaryonesource.com./MOS/about/Counselingservices.aspx Other resources available on depression are: American Academy of Child and Adolescent Psychiatry www.aacap.org American Psychiatric Association www.psych.org American Psychological Association www.apa.org American Society of Adolescent Psychiatry www.adolpsycho.org Depression and Bipolar Support Alliance www.dbsalliance.org Mental Health America www.nmha.org National Alliance for Research on Schizophrenia and Depression www.narsad.org National Alliance on Mental illness www.nami.org Downtown providers: TriWest.com provides a provider directory of all of our Tricare accepting Behavioral Health/Mental Health providers in the Great Falls area. You can request their most updated listing by calling them at 731-4633 or visiting their office in the Medical Group. Benefis Hospital is a resource that can be used for emergency cases. The emergency room is a valuable resource during or after duty hours when someone is suffering from depression and progresses to having suicidal thoughts. Benefis can also offer assistance when patients are referred for psychological treatment in their Behavioral Health department. 911 should always be remembered as a resource for assistance when someone is in serious need for medical attention. As you can see, depression affects many people but it can be treated with medications and psychotherapy. Providing support is very critical in helping someone who is depressed. As wingmen, we are responsible for being watchful of each other, intervening when appropriate, and helping individuals suffering from depression get the assistance they need to recover from its potentially fatal consequences.