By Mike DuBose with Blake DuBose
May 24, 2013
No one wants to talk about depression, yet at some point in life, most of us either experience it ourselves or know someone who has. Fourteen percent of Americans will experience serious depression in their lifetimes (according to Consumer Reports), and this number is unlikely to decrease. I, too, have lived with depression. Now, I want to share the story of how I passed through that dark tunnel and into the light to give hope to others who are fighting the same demons.
Temporary sadness is a normal part of life. Clinical depression, however, is a serious illness where mind and body descend into a dark state of despair. It has many symptoms, including anxiety, anger, feelings of hopelessness, inability to concentrate or hold down a job, withdrawal, negative thoughts, frequent crying, incessant worrying, irritability, insomnia, or excessive sleeping. Depression can also lead to physical problems like weight changes, pain, and psychosomatic conditions (which feel real but cannot be verified by physicians). According to Science Daily, depression sufferers are twice as likely as those without mental health problems to have a heart attack.
If left untreated, depression can also zap the sufferer’s energy and will to live. In fact, according to the Centers for Disease Control and Prevention, suicide rates have increased substantially during the past ten years. For men aged 50 to 60, the number grew by nearly fifty percent; for women in their 60s, sixty percent. With Americans feeling the pain of losing their homes, savings, and jobs during the Great Recession, more people now die from suicide than from car crashes.
I first learned about depression while studying psychology in college and graduate school. After taking most of the courses offered on the subject, I understood it in the academic sense. However, I had no clue at that time I would experience it personally. Depression often develops gradually. Peoples’ perspectives get bleaker and until they find themselves mired in a state of unhappiness…which is what happened to me.
No one chooses to have depression. It has many causes, some of which are environmental. People who experience life-changing events, such as the loss of a loved one, the end of a relationship, financial disaster, the birth of a child, a major surgery, job dissatisfaction, divorce, retirement, business failure, or the loss of a job/purpose (like a stay-at-home parent whose children leave) can find themselves spiraling into depression. The list is long! Although some people are more resilient than others, a series of negative events can wear almost anyone down. Even Bible characters like King David and Job showed signs of serious depression.
Certain people are also genetically predisposed toward depression, although having the gene does not mean you will absolutely become depressed. One of the first men to walk on the moon, Buzz Aldrin, told the Wall Street Journal that depression runs in his family. His mother actually killed herself one year before he made his history-making trip. Looking back on my own family lineage, I recognize the signs—my great grandfather, grandfather, father, and uncle all suffered from depression and/or bipolar syndrome. I carried this predisposition in my blood, waiting to be unlocked by outside factors.
In the case of my depression, genetics and environmental factors collided in 1983, when my businesses failed, to form a perfect storm of misery. Over six months of being beaten up by creditors and beaten down by bad experiences, my positive, can-do mindset morphed into serious clinical depression. The feelings of hopelessness and despair, coupled with my genetics, threw me into a black hole of negativity. I could feel the stress hormones coursing through my body. Cortisol and norepinephrine increase heart rate, blood pressure, and breathing and shut down processes like digestion, growth, and immunity, which is why many depressed people experience aches, pains, and sickness. I had studied the symptoms extensively and knew what was happening, yet I didn’t seek help. For two years, I suffered without medicine or therapy—a huge mistake. I could temporarily drink my problems away with alcohol until bedtime, but I would wake up at 3 AM and lie in bed for hours in a cold sweat. The sun was my greatest enemy: when it rose, I knew I would have to suffer through another painful day. I was in serious trouble, going so far as to think about how I would commit suicide.
No words can adequately describe the horrors of serious depression. My mind fought me every step of the way when I tried to exercise, and my desperate prayers to God seemed unanswered. Fortunately, my wife and partner, Debra, refused to let me give up on life. Then, a miracle came along in the form of my son Blake. With renewed purpose and some spiritual interventions, I pulled myself together and journeyed back into government. I worked for South Carolina Governor Dick Riley (who later became Secretary of Education) until 1986, when I left to begin my current businesses. As time progressed, my businesses became successful, and we obtained steady money and insurance benefits. I eventually paid off all of my debts. Finally, I stepped out from under depression’s cloud. Although my demons occasionally resurface during times of major adversity, I have never been truly depressed since! I have learned how to face fate and cope through the storms that I know will eventually pass.
Often, depressed people push their loved ones away, and the stress put on the family of a depressed person can be enormous. Depression can also be contagious! Because of the societal stigma attached to mental illness, many people feel ashamed or defective. As a result, they often hide their feelings, neglect to learn more about their disease, or refuse treatment. Many people, especially men, try to just tough it out. It’s not surprising that, while about 20% of American adults believe they have some type of mental illness, more than 60% of those people didn’t seek treatment, according to a major government study.
Some individuals erroneously think that people can just get over depression without professional help, pray their way out of it, or simply take a few pills and be instantly cured. However, it takes time to become depressed, so it takes time to overcome it as well.
Since my struggle, I have dedicated significant time to learning more about psychiatric issues, even working with professionals and professors from Harvard University’s School of Medicine and Psychiatry. Although I am not a psychiatrist or a physician, I can offer the following suggestions based on my experiences, knowledge, and the literature. If you suffer from depression or any other illness, please keep in mind that these are only suggestions and it’s important to work with medical and psychiatric professionals to design a treatment plan that fits your needs. Some of the following suggestions can be implemented immediately, while others should occur gradually.
1. Document the causes of your unhappiness: First, find somewhere quiet and concentrate on listing anything that is causing you unhappiness or any events from your past that could be consciously or subconsciously hurting you (unresolved conflicts). Then, make a detailed list of your symptoms and how often they occur. You may need to make several attempts over a week or so to complete this personal assessment, but it will be valuable in helping clinicians understand, diagnose, and treat your depression. Keep it in a folder along with any other notes and relevant medical test results.
2. Review the drugs you take: Carefully research all medicines you are taking. Some prescriptions (like painkillers, sleeping pills, and others) can cause or worsen depression. If you are seeing several doctors, make sure that they are all aware of your mental and physical conditions and the different prescriptions you are taking to avoid negative side effects or drug interactions. Don’t be afraid to ask your doctor or pharmacist questions. Most pharmacists can plug different drug names into a computer program to determine potential interactions. Go to Google and type in side effects and the name of each of your medications to learn more about them. Beware: don’t be alarmed at the scary side effects you will find. All medicines have side effects, even the most innocent ones, and they react differently with each person. Some medicines will not affect you at all or will yield negligible results—only experience will tell.
3. Obtain a thorough medical examination: Next, focus on your body. Medical problems, such as an imbalanced thyroid, kidney disease, or diabetes, can be biochemical contributors to depression. You should see an experienced internist, who will have advanced training beyond that of a general family doctor. Your relationship with your physician should be a partnership, so do your research and come prepared. Before the appointment, make a detailed list of your medications and symptoms to share with your doctor. Be prepared to undergo as many tests as he or she recommends to rule out any physical sources of the depression. Some literature suggests that about half of depression cases are misdiagnosed and that these patients are often prescribed too little medication for too short of a time. Also, because new research has shown that low levels of vitamin D can cause depression (and other diseases), ask your doctor to run a vitamin D test and a thyroid panel. My internist, Dr. Surb Guram, MD (803-749-1111), is one of the best medical diagnosticians I have ever seen. However, if physical reasons are not the sole source of your depression, you will need to see professionals who are trained in psychiatric illnesses.
4. Seek the right diagnosis: Evaluating and treating psychiatric disabilities like depression can be frustrating, mind-boggling, expensive, and time-consuming, especially for those with overlapping problems such as bipolar disorder, attention deficit disorder, and addiction. Doctors can’t just run a lab test and write a prescription as they can with other illnesses. They must know as much as possible about the patient’s behavior, background, symptoms, relationships, medications, and assessments to date to make an accurate diagnosis; even then, it could be an educated guess. The quality of the diagnosis and treatment are therefore directly correlated to the quality and experience of the professionals who work with you. To give your doctor the best chance of correctly diagnosing your illness, take an active role in your assessment and treatment. Bring your self-analysis, notes on your concerns and issues, and a list of your symptoms. Once you have a diagnosis, the trial and error of treatment can begin. If you feel like seeking a second opinion, do it!
5. Get treatment from the best professionals available: Psychiatric problems require specialized treatment, just like diabetes or any other medical issue. You need to find an experienced therapist who is personable, knowledgeable about your condition, and gently pushes you to make progress and achieve specific mental health goals. This is not always easy; especially since it comes at a time when would-be patients are feeling most vulnerable, according to the Wall Street Journal. Ideally, you want to find a practice where a psychiatrist, physician, and counselor work together as a team to help you.
Psychiatrists today often focus more on medications, whereas therapists guide and counsel you. You should always try therapy first before getting on any medication. Research has suggested that a successful form of counseling is cognitive behavioral therapy (CBT), which teaches you to recognize and change problematic thoughts. Another effective technique that is gaining popularity is mindfulness, which encourages patients to pay attention to the present without judgment. Mindfulness acknowledges that stress does not go away and focuses on helping patients spend less time worrying about the future and the past. Both of these options can help individuals with depression step back, listen, recognize their choices, and make wise decisions. However, each technique requires that you find a counselor with specialized training in that area. To find counselors, review your insurance provider’s list of approved clinicians; ask friends or relatives, spiritual leaders, and doctors; and search online reviews in your area for recommendations. If you hear the same names pop up, you know you are on the right path, although you may have to try out several therapists to find your ideal match.
Hospitals also offer short-term, six-week day psychiatric programs and intensive, 24-hour inpatient services, but I have not been impressed with local programs. If you have serious, long-term depression, seek expert diagnosis and treatment from the top psychiatric hospitals in the nation, like Johns Hopkins, McLean, Massachusetts General, or Menninger. Harvard University’s McLean Hospital has an excellent program called Pavilion where patients live in a home with a wide variety of clinicians who leave no rock unturned; however, it’s very expensive and insurance is not accepted (although you may be able to write off some of the expense on your taxes).
6. If counseling appears ineffective after seven sessions, consider adding medications: You can’t just swallow a pill and expect depression to disappear. However, antidepressants and therapy can work together to create better results than either one alone. Consumer Reports determined that talk therapy (especially with the same therapist for 7 or more sessions) combined with the appropriate medications is the most effective way to treat serious depression. This is due to the way chemicals work in the brain to cause emotions. Nerve cells, or neurons, talk to one another via chemical signals called neurotransmitters, which include serotonin, dopamine, and norepinephrine. Research suggests that depressed brains have lower levels of serotonin, which can be boosted through SSRI (selective serotonin reuptake inhibitor) drugs, aka antidepressants.
Popular as they may be (they are the third most commonly prescribed type of drug, according to Consumer Reports), antidepressants’ effectiveness varies by person. Consumer Reports states that 60% of the patients who are prescribed anti-depressants respond to the treatment, but 40% don’t. According to a 2012 New York Time articles, Patients with severe depression tend to respond most meaningfully to antidepressants, while patients with moderate and mild depression do not. If your clinician prescribes medications, keep a daily journal of how you feel so he or she can see how you are progressing. Some of my friends say that they were very depressed, even with medication, but once they switched to another antidepressant, they noticed a positive difference. Antidepressants can have significant side effects, and if one doesn’t work within six weeks (current medicines typically take 4-6 weeks to really kick in), you and your doctor will need to discuss changing the dosage or medication. In fact, Consumer Reports found that it usually takes about three tries to find the right drug combination. In addition, many people who suffer from depression and experience insomnia may need a sleeping agent. Restoril (or the generic, temazepam) is my choice.
Always monitor your feelings closely, as some psychiatric drugs can make people suicidal, anxious, or even more depressed! However, don’t fear medication, especially if you have been seriously depressed for more than a few months. According to Consumer Reports, the following generic drugs are less expensive than brand-name antidepressants and equally effective: bupropion (Wellbutrin), citalopram (Celexa), fluoxetine (Prozac), parxetine (Paxil), and sertraline (Zoloft). New medications are being released each day, so consult with your professionals to make the best choice for you. Recent medical findings documented in the Wall Street Journal and by Harvard psychiatrists confirm that a new prescription supplement, Deplin, can increase antidepressants’ effectiveness. Deplin contains folic acid (plus other ingredients) and provides the most benefits when combined with four capsules of fish oil (I like Nature’s Made) per day. Over-the-counter supplements such as St. John’s Wort and vitamin D3 (1,000 iu) and natural sunlight also appear to help ease depression.
NOTE: Many folks start to feel better after taking an antidepressant, so they quit cold turkey! It is very important to slowly taper off of antidepressant medications; otherwise, you may experience major withdrawal problems, such as a total shutdown of your digestive system or other medical issues. If you are doing fairly well on medications, think twice before stopping them.
If you ever think about suicide, especially how you would perform it, your condition is very serious. Alert your clinicians immediately and go to the nearest emergency room if you feel you have lost control. Don’t give up! If a loved one is suicidal and refuses treatment, involuntary commitment may be needed, which requires a physician, psychiatrist, or hospital professional to authorize forced commitment to a psychiatric facility.
7. Keep an open mind: If you are unhappy with traditional options like therapy and medicines or want to try a new angle in combination with them, experiment with alternative treatments. For example, hypnosis can do amazing things! Dr. Joel Sussman, MD recommends Dr. Fredric Mau (803-750-2000). I know for a fact that he has done wonders with patients who experience anxiety, depression, weight gain, stress, and smoking. Hypnosis is not usually covered by insurance, but it may still be worth it to try. Another new (but non-invasive) alternative treatment is transcranial magnetic stimulation (TMS), which employs painless magnetic fields to treat depressed patients. According to The Wall Street Journal, one-third of patients who didn’t respond to antidepressants reported positive results from TMS. (Unfortunately, it is also rarely covered by insurance plans.) Electroshock convulsive therapy (ECT) has come a long way from its dubious past and can help those with particularly hard-to-treat depression, but still, make it a last resort. Yoga is also an excellent exercise for reducing stress and anxiety.
8. Eat right: Psychology Today magazine noted that keeping your blood sugar stable reduces mood swings, so eat three balanced meals per day. Try to incorporate foods rich in omega-3 fatty acids (such as salmon, walnuts, and sardines), which can boost the mood-improving hormone serotonin. Likewise, limit your intake of caffeine, which can reduce serotonin levels and cause anxiety. Those who love coffee can switch to a mixture of at least 2/3 decaf and 1/3 regular coffee to cut out some caffeine.
9. Exercise: Brisk, regular cardiovascular exercise for 30-45 minutes a day, five to seven days per week releases endorphins (happy chemicals) into the bloodstream. Go to the mall, gym, or your neighborhood street and walk fast for half an hour or a mile or two, preferably with your spouse or a friend. Individuals with some physical disabilities can lift weights until they are huffing and puffing, swim, and/or use gym machines. Exercise counters negativity and keeps your weight balanced!
10. Socialize: Because of your depression, you may find yourself drawn to negative people and complainers. Instead, seek out positive people and find something that gives you purpose. This can be volunteering or a fun hobby, as long as you look forward to it each day. Find ways to laugh, which causes serotonin to be released into the brain. It’s a natural antidepressant! My favorite laugh generator is the Home Alone movie series.
11. Stay busy: Most individuals with depression tend to hide their feelings—and themselves—away from society. Don’t sit at home aimlessly surfing the web or watching depressing TV, especially negative news and talk shows. In my opinion, this can contribute to depression by fueling anger and anxiety! Volunteering with charities like animal rescues or Meals on Wheels will help you feel good and help others at the same time. Although at first you’ll want to make excuses not to, get out and do something productive every day. Keeping the mind and body active is one of the best depression-fighters! Above all, don’t feel sorry for yourself. When you think you have it rough, remember: there are millions worse off than you are!
12. Make life changes: If you are stuck in a terrible relationship, soul-killing job, or hostile environment, don’t be afraid to leave. It’s better for your mental health to find another job (even if it pays less), make the switch, and be happy than to suffer in a negative office for higher pay.
13. Pray: If you are a spiritual person, pray! If God can create the universe, surely He can help you overcome your pain, right? However, don’t expect an angel come knocking at your front door with a solution. You have to help yourself first!
The bottom line: In this case, there is no bottom line. It takes time and many built-up issues to reach the depths of depression, and it takes more time and differing strategies to escape from the darkness. I firmly believe that in conflict, there is always opportunity, although it may not be easy to see when you’re in the eye of the storm. In time, I have seen that my journey through depression was a gift from God. In terms of the knowledge gained, taking my businesses out of business was better than earning an MBA! I also developed a desire to help others, which inspired my family and companies’ purpose of creating opportunities to improve lives.
Clinical depression is a very complex and serious condition that is still a mystery in many ways. However, as the proverb says, a journey of 1,000 miles begins with the first step. You can get better, and I am speaking from personal experience! You just have to take that first step and keep going (even if it’s just in baby steps, as a Harvard University psychiatrist told me) until you’re out of the darkness and can see the light! Remember, as musician Gary Allan sang, Every storm runs out of rain! It’s worth the hard work to wake up most mornings as I do now—with excitement about what the day will bring!
About the Authors
Our corporate and personal purpose is to create opportunities to improve lives by sharing our knowledge, experience, success, research, and mistakes.
Blake DuBose graduated from Newberry College School of Business and is president of DuBose Web Group. View our published articles at www.duboseweb.com.
Mike DuBose has been in business since 1981, authored The Art of Building a Great Business, and is a field instructor with USC’s graduate school. He is the servant owner of three debt-free corporations, including Columbia Conference Center, Research Associates, and The Evaluation Group. Visit his nonprofit website www.mikedubose.com.
Katie Beck serves as Director of Communications for the DuBose family of companies. She graduated from the USC School of Journalism and Honors College.
© Copyright May 21, 2013 by Mike DuBose and Blake DuBose–All Rights Reserved. You have permission and we encourage you to forward the full article to friends or colleagues and/or distribute it as part of personal or professional use during the year 2013, providing that the authors are credited. However, no part of this article may be altered or published in any other manner without the written consent of the authors. If you would like written approval to post this information on an appropriate website or to publish this information, please contact Katie Beck at [email protected] and briefly explain how the article will be used and we will respond promptly. Shorter versions of some articles may be available upon request.
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