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Teenage Depression – How to Deal With It and Treatment Options

Written by W. Nate Upshaw M.D. on . Posted in Depression, Step-By-Step Guides.

Being a teenager is already challenging enough, but being a teenager having to deal with a psychological disorder can be pretty exhausting. Many young people have to deal with depression. It’s a common and serious condition that affects how a person thinks, feels and behaves. Over 2 million adolescents from ages 12 to 17 (about 13 percent of the teenage population in the US) have had at least one episode of clinical depression. Fortunately, depression is a condition that can be treated. 

https://www.youtube.com/watch?v=QSmSvTu6DGQ

What Causes Depression?

A person’s ability to think, feel and move is dependent on neurotransmitters, highly specialized chemicals that allow individual nerves, called neurons, to work together. Neurons form large networks of living circuits that control how we think, as well as our emotions. Researchers believe depression and other psychological disorders may be caused when the brain produces too little of essential neurotransmitters.

How to Identify Teenage Depression and Its Symptoms

It can be challenging to identify teenage depression unless you know what to look for. After all, adolescence overflows with moodiness, irritability and sometimes outrageous, rebellious behavior. Depression in any age group usually has no visible cause. Depression in adolescence often comes on slowly.

Kids with depression typically show a notable departure from their average behavior. Withdrawing from family and friends is often the first notice parents get that things are going awry with their teen. Parents may notice them staying alone in their room and rarely coming out. Depressed teens will typically isolate themselves and withdraw from their friends. On the other hand, depressed teens may rely on their phones and social media to an even greater degree than before.

None of these symptoms by itself is enough for a diagnosis of depression, which is why a formal diagnosis from a psychiatrist or mental health professional is necessary. If you’re trying to discern whether or not your child’s condition is teenage sadness or depression, note that for a diagnosis of depression to be made, a teen must have the first two symptoms daily, every day for at least two weeks, along with at least five of the other symptoms.

  • Feelings of deep, relentless sadness or hopelessness
  • Loss of interest in previously enjoyed activities (anhedonia)
  • Isolating behaviors and withdrawing from friends and family
  • Feelings of guilt, shame
  • Drop in energy levels, increased lethargy
  • Panic attacks, increased anxiety in the absence of any stressor
  • Unusual levels of irritability, lashing out verbally
  • Aggression. Teen boys are particularly prone to physical aggression when depressed.
  • A significant decline in grades
  • Loss of self-esteem
  • Drastic changes in appetite or weight (at least 5 percent of the teen’s body weight)
  • Sluggishness. A depressed teen may move more slowly than usual.
  • Fidgeting, restlessness, inability to stay still
  • Self-mutilation, such as cutting on their skin
  • Suicidal thoughts or gestures

How to Treat Teenage Depression

Dealing with your teenager’s depression is hard to do on your own. Working with a psychotherapist makes recovery much more certain. Step one is getting a diagnosis. Your family doctor may be able to recommend a psychiatrist or give you a referral.

A psychiatrist will often order the following tests and treatments:

  • Physical exams, including labs. There are some physical conditions that mimic psychological disorders, like hyper- and hypothyroidism. Many physical conditions aggravate depression and need treatment along with the mood disorder itself.
  • Psychological evaluation. A mental healthcare professional will meet with your young person and get a sense of what’s going on. A psychosocial evaluation takes less than two hours and gives a valuable look at what’s troubling your teen. The evaluation will point to what type of care is necessary.  Every person experiences depression differently from one another. The psychological evaluation allows a proper diagnosis to be made. It also assesses your teen’s risk of suicide.
  • Medication. A psychiatrist can determine if your teen requires medication and what antidepressant medication is the best for them and their unique needs.
  • Psychotherapy. Psychotherapy can be conducted by a psychologist, psychiatrist or psychotherapist.

What are the Best Treatments for Teenage Depression?

There is no way to prevent teenage depression, just as there’s no way to prevent depression in any age group. However, there are some very effective treatments. The best treatments for teenage depression include a combination of medication and psychotherapy. 

Psychotherapy for adolescent depression involves your teen meeting with a mental healthcare professional once a week. Teens learn about what contributes to their depression and ways to manage it. Depression usually requires therapy with antidepressant medications. Although parents can be resistant to the idea of medicating their child, it’s crucial to understand that depression is a medical condition that responds best to a combination of psychotherapy and medication. 

This blog post is meant to be educational in nature and does not replace the advice of a medical professional. See full disclaimer. 

https://www.youtube.com/watch?v=DNgW6p9JFlA

Works Cited

Depression. (n.d.). Retrieved April 1, 2020, from https://www.nimh.nih.gov/health/topics/depression/index.shtml

Tompson, M. C., McNeil, F. M., Rea, M. M., & Asarnow, J. R. (2000, March). Identifying and treating adolescent depression. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1070798/

Stopping Panic Attacks: Here’s How

Written by W. Nate Upshaw M.D. on . Posted in Anxiety, Step-By-Step Guides.

Panic attacks can strike anyone like a bolt from the blue. They are the overwhelming sense of danger, or a feeling of impending death that overrides rationality. Panic attacks are common to those living with anxiety disorders and depression, but there are ways to prevent them from happening. Here you will find out how to stop a panic attack. 

https://youtu.be/wZZZAV-EXzU

What is a panic attack and how do I stop it?

A panic attack is a sudden and overwhelming episode of fear accompanied by intense physical reactions. A panic attack is not typically triggered by any consistent threat. They begin without warning and are debilitating. A panic attack can happen anywhere and do not require a particular context to wreck your day.

Panic attacks typically begin suddenly, without warning. They can strike at any time — when you’re driving a car, at the mall, at home, or in the middle of a business meeting. You may have occasional panic attacks, or they may occur frequently. If you’re having frequent panic attacks, you should seek treatment because the condition is quite treatable. 

Signs and symptoms include the following:

  • Fear of loss of control or death
  • Sense of impending doom or danger
  • Rapid, pounding heart rate
  • Sweats
  • Shakes, all over body shakes or trembling
  • Feeling a thickness or tightness in the throat
  • Chills or hot flashes
  • Chest pain (panic attacks are often mistaken for heart attacks)
  • Numbness or tingling sensation
  • Nausea
  • Cramping
  • Headache
  • Dizziness, lightheadedness or faintness
  • Feeling of unreality or detachment from one’s self.

Stopping a Panic Attack

Controlling your breathing is the first, most crucial step to stopping a panic attack. Panic attacks engage the fight-or-flight response, ramping it from 0 to 100 in seconds. As there’s no real threat in your environment, your body won’t de-escalate the survival response on its own, because there are no cues to tell you the threat has passed. You have to take direct control by slowing your breathing and quickly acting to stop a panic attack. To that end:

  1. Take slow, deep breaths. Use your stomach muscles to contract your diaphragm. To make sure you’re using your diaphragm, place your hand on your upper abdomen. Let your hand lie there with no pressure and allow it to rise up and fall down as you breathe. Inhale for 5 seconds, pause for 1 or 2 seconds, then exhale for 5 seconds. Do not hold your breath for more than a few seconds. 
  2. Ground yourself in your surroundings by using your senses. Look around. What do you see? Where are you? What can you hear? Do you smell anything? What can you touch? A panic attack usually leads to racing thoughts. By switching your focus from your internal state of fear to that of an observer, you can de-escalate a panic attack.
  3. Reassure yourself that you are safe. Use self-talk to comfort yourself. Remind yourself that this is a panic attack. It’s ok to be scared but you are safe, you are in no danger, and you’re going to be just fine. 
  4. Keep up that deep breathing until your heart rate returns to a normal beat.

 

What are Anxiety Attacks?

Anxiety attacks are somewhat similar to panic attacks, except anxiety attacks lack the fear of imminent death and the fear of a loss of control. They also don’t involve a sense of unreality or depersonalization. Unlike a panic attack, anxiety attacks can last off and on for days. 

Treating Depression-Linked Anxiety With No Side Effects

If you have depression and have also been having anxiety because of it, consider treatment via Transcranial Magnetic Stimulation (TMS). This is an FDA cleared non-invasive treatment that uses targeted magnetic pulses to stimulate areas of the brain that affect mood, which helps you get back to your best life quickly and with no side effects. Among the many treatment options out there, TMS therapy is an excellent, pain-free solution that is covered by most major insurance companies. The best part is there are no side effects from TMS therapy, making it an excellent solution for those who fear the side effects of certain medication. 

This blog post is meant to be educational in nature and does not replace the advice of a medical professional. See full disclaimer. 

https://www.youtube.com/watch?v=j6uuRyH4uc4

Works Cited

How to stop a panic attack. (n.d.) Retrieved from https://www.healthline.com/health/how-to-stop-a-panic-attack

Panic disorder: When fear overwhelms. (n.d) Retrieved from http://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms/index.shtml

Panic attacks and panic disorder. (2018, May 4). Retrieved from https://www.mayoclinic.org/diseases-conditions/panic-attacks/symptoms-causes/syc-20376021

5 Steps to Take When You’ve Been Diagnosed With Depression or Anxiety

Written by W. Nate Upshaw M.D. on . Posted in Anxiety, Depression, Mental Health Maintenance, Step-By-Step Guides.

Sometimes a diagnosis of depression or anxiety brings more questions than answers. However, there is no need to panic! These disorders are highly treatable. Depression and anxiety disorders are not character failings and they are not over-exaggerations. They are psychological disorders that have a basis in the brain’s unique biology. Although depression and anxiety cannot be cured, these disorders can be successfully treated. Here, we give you the steps you should take when you have been diagnosed with depression or anxiety. 

https://youtu.be/GOcrDcXO31s

I’ve just been diagnosed with depression and anxiety. What should I do?

Recognizing you have depression and anxiety is the first big step. Then you can focus on creating a plan to deal with the diagnosis. Of course the best you can do is get help from a specialist that can guide you and help you determine what the right treatment is for you. You can always get a second opinion after getting diagnosed, especially when it comes to deciding what next step you should take for treatment. 

  1. Get a referral if you need one. If you have been diagnosed by a general practitioner, ask for a referral to see a psychiatrist or mental healthcare professional, such as a psychologist or counselor. Some general practitioners feel comfortable prescribing psychiatric medication, but most will advise you to see a specialist, which in most cases is a psychiatrist. Psychiatrists may or may not provide therapy, but they will be able to prescribe psychiatric medication for you.
  2. Start psychotherapy. Psychotherapy is essential when learning to live with depression or anxiety. Psychotherapy is a talking therapy; a mental healthcare professional will work with you to help you learn new ways to cope, manage depression and reduce your anxiety. A common kind of psychotherapy, cognitive-behavioral therapy, helps you challenge negative thought processes while learning better ways to approach problems and challenges in life.
  3. Get the facts about anxiety and depression. Although your doctor can diagnose you, there’s still a lot of information to be learned. Your therapist can help you get the facts about anxiety and depression. When reading up on your own, make sure that the sources you’re investigating are based in fact. 
  4. Take a lifestyle inventory.  Depression and anxiety can be worsened by many aspects of the environment we live in. Good mental health is an all-inclusive proposition, in that everything that’s in our lives affects it.  What we eat, what we drink and how active we are affects our mind, our mood and our outlook. Although our diet and activity levels do not cause depression, it’s a recognized fact that a healthy diet and at least some daily exercise can improve a person’s mental state. With that said, consider your diet. What do you eat and drink daily? Think about how often you’re in sustained movement. Do you walk 10 minutes a day without stopping?  Less? More? 
  5. Make changes. Changing your lifestyle can be hard, but it is possible. Your doctor or mental health professional can help you make those changes. Eating better and exercising will not cure depression and it will not eliminate your symptoms. However, your health affects your mood in ways that aren’t always easy to see. Research in mood disorders consistently shows that regular exercise and good eating habits are associated with lowered levels of depression.
  6. Be compassionate with yourself. If you have been asking yourself “Is it depression or am I over-reacting?”—stop. You’ve been diagnosed with depression. It’s time to treat yourself with the kindness and compassion you would show your best friend if that special friend had received this diagnosis. 
  7. Observe and follow your doctor’s and therapist’s instructions. The most important step in any mental healthcare plan is to follow your doctor or mental healthcare professional’s instructions. There’s no room to improvise with your medications on your own when you are living with depression or anxiety. Follow your doctor’s instructions for medication and how to take it precisely. Never get creative with your medication dosages or schedule. Psychiatric medication has to reach a particular concentration in your bloodstream to be effective, which can take several weeks. This therapeutic level will be thrown off if you skip your medications even for a few days. 

 

Treating Depression Related Anxiety With No Side Effects

If you’ve just been diagnosed with depression and anxiety and are concerned about the many side effects of medications, consider treatment via Transcranial Magnetic Stimulation (TMS). This is an FDA cleared non-invasive treatment that uses targeted magnetic pulses to stimulate areas of the brain that affect mood, which helps you get back to your best life quickly and with no side effects. Among the many treatment options out there, TMS therapy is an excellent, pain-free solution that is covered by most major insurance companies. The best part is there are no side effects from TMS therapy, making it an excellent solution for those who fear the side effects of medications. 

This blog post is meant to be educational in nature and does not replace the advice of a medical professional. See full disclaimer.

https://www.youtube.com/watch?v=V6zVPOc5C38

Works Cited

Anxiety Disorders. (n.d.). Retrieved from https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml#part_145338

Robinson, K. M. (2016, April 8). What to Do When Depression and Anxiety Mix. Retrieved from https://www.webmd.com/depression/features/anxiety-depression-mix#1

Ströhle, A. (2008). Physical activity, exercise, depression and anxiety disorders. Journal of Neural Transmission, 116(6), 777–784. doi: 10.1007/s00702-008-0092-x

Tartakovsky, M. (2018, July 8). Newly Diagnosed? What You Need to Know About Depression. Retrieved from https://psychcentral.com/blog/newly-diagnosed-what-you-need-to-know-about-depression/

How to Deal with an Anxiety Episode

Written by W. Nate Upshaw M.D. on . Posted in Anxiety, Step-By-Step Guides.

One of the many unpleasant aspects of living with chronic anxiety is experiencing an anxiety episode. An anxiety episode can derail your whole day, make you feel out of control, and can digress all the way to a full-blown panic attack. That’s why it’s important to learn how to identify the symptoms of an anxiety episode and how to handle the situation in the most calm and collected way. Here’s how you can deal with an anxiety episode.   

What is an Anxiety Episode?

First off, let’s define what an anxiety episode is. Anxiety episodes or anxiety attacks are characterized by feelings of overwhelming fear and worry that often come out of nowhere. They’re not as intense as a panic attack, but that’s no consolation when you’re having an episode. Anxiety episodes are extremely intense and accompanied by physical symptoms like shortness of breath, nausea, dizziness, and a racing heartbeat.

Anxiety episodes and panic attacks are slightly different phenomena. Panic attacks are known for being pretty scary. People feel as if they are in imminent danger of dying or losing control of themselves. Anxiety episodes can last hours or days. They have the following characteristics:

  • Tense, tight muscles
  • A sense of worry, dread or apprehension
  • Feelings of distress
  • Trouble concentrating, going blank easily
  • Irritability 
  • Restlessness or feeling fidgety, on edge
  • Fear (fear may not be attached to a particular situation)
  • Rapid heartbeat or palpitations
  • Shortness of breath, chest pain
  • Choking sensation or constricting throat
  • Tingling or numbness
  • Sweats
  • Stomach cramps or nausea
  • Dry mouth
  • Trembling
  • Headache
  • Feeling dizzy or lightheaded

It’s important to note that you don’t need to have all or even most of these symptoms to be experiencing an anxiety episode. 

Stopping Anxiety Attacks

With practice, you can learn how to stop an anxiety attack before it intensifies further. Here are some key techniques and practices that can help get you back on track.

  1. Take deep belly breaths. When we’re stressed and anxious, we tend to use the top quarter of our chest to breathe. This allows rapid but shallow breathing that doesn’t get enough oxygen into our bloodstream, thus causing us to breathe faster and faster. You can start to get control over an anxiety episode by slowing and deepening your breathing. Breathe from the middle of your body by constricting your diaphragm. Lay your hand on your stomach and think of making your hand rise up and down on your inhalations and exhalations. Inhale for 5 seconds, hold for 1 or 2 seconds, then exhale for 5 seconds.
  2. Reassure yourself. Tell yourself that you are safe. Remind yourself that you’re having anxiety and that anxiety often tends to make us believe our situation is worse than what it actually is. 
  3. Challenge your thinking. Anxiety often comes from looping, repetitive, distressing thoughts. Interrupt them with a stop word, which can be “stop!” or any other word that will get your attention. You can use any short word that’ll break through the tide of fear and worry and let you circle back to reassuring yourself that you’re safe and that you’re experiencing an episode of anxiety.
  4. Ground yourself in the here-and-now. Use your senses and observe your surroundings. What do you see? What can you touch? What do you hear? Can you smell anything? Doing these things will ground you back into your senses and will help control that anxiety attack. 
  5. Get moving. If you can, get in motion. A short walk, even 10 or 15 minutes, can help you calm your thoughts. Feelings of restlessness can be reduced when you move around.

Anxiety attacks can co-occur on top of chronic, lower-level anxiety. They can become a brief worsening of an ongoing anxiety disorder, too. Figuring out what situations and stresses contribute to your anxiety episodes is an essential first step to getting long-lasting relief. 

Consider the following two-step process for reducing daily anxiety:

  1. Figure out your triggers. Meeting with a therapist is a great way to figure out what situations and contexts really set your anxiety levels through the roof. Some triggers might be easy to find but others may require some work to identify. Anxiety isn’t always about imminent threats. Anxiety can easily arise from long-term situations that have never been resolved. These are some common anxiety triggers:
    • Stressful work environment
    • Health issues (yours or a loved one’s)
    • Money
    • Intimate relationships
    • Family conflict
    • Past trauma
    • Existing mental health issues
  2. Learn new coping skills to manage your triggers. This is another task made much easier by visiting a mental healthcare professional. There are many excellent approaches to reducing and eliminating anxiety episodes.  Cognitive-Behavioral Therapy (CBT) looks at how what we believe affects our behaviors. It’s often our beliefs about events that affect us more profoundly than the events themselves. Much of chronic anxiety consists of deeply established negative thoughts. Learning to challenge those thoughts can help reduce unbearable levels of anxiety.

Treating Depression-Linked Anxiety With No Side Effects

If you suffer from depression and are experiencing anxiety because of it, consider Transcranial Magnetic Stimulation (TMS) therapy. This is an FDA cleared non-invasive treatment for depression that uses targeted magnetic pulses to stimulate areas of the brain that affect mood, which helps you get back to your best life quickly and with no side effects. Among the many treatment options out there, TMS therapy is an excellent, pain-free solution that is covered by most major insurance companies. The best part is there are no side effects associated with TMS therapy, making it an excellent solution.

This blog post is meant to be educational in nature and does not replace the advice of a medical professional. See full disclaimer. 

Works Cited

CBT for Panic Attacks Panic Attack Treatment Without Medication. (n.d.). Retrieved from http://cogbtherapy.com/cbt-for-panic-attacks

Symptoms. (n.d.). Retrieved from https://adaa.org/understanding-anxiety/panic-disorder-agoraphobia/symptoms

Tips. (n.d.). Retrieved from https://adaa.org/tips

Wells, A. (1990). Panic disorder in association with relaxation induced anxiety: An attentional training approach to treatment. Behavior Therapy, 21(3), 273–280. https://doi.org/10.1016/s0005-7894(05)80330-2

COVID-19: Increase Physical Resilience by Improving Your Mental Health

Written by W. Nate Upshaw M.D. on . Posted in Mental Health Maintenance, Step-By-Step Guides.

We are experiencing a time of uncertainty in our world as concerns about COVID-19 are communicated from government health agencies and news sources. People who have never experienced mental health symptoms before are feeling depressed and anxious, and people who have dealt with these issues in the past are experiencing exacerbations. People already suffering with mental health issues may experience a worsening of symptoms. If you are feeling depressed or anxious, it is important to remember you are not alone and there are healthy steps you can take to improve mental health during this challenging time. As an added benefit, improving your mental health can improve your physical health. Reducing the amount of stress you feel can improve your immunity.


A national survey conducted between March 13 and 16, 2020, as the public became more aware of the COVID-19 issue, found that 80 percent of people reported concern about the coronavirus. While only 8% of people reported their physical health had gotten worse, 22% reported their mental health declining and 29% said their emotional well-being was worse.

When facing the unknown, it’s easy to fall prey to what neuroscientists call “negativity bias,” a tendency to focus on threats and contemplate worst-case scenarios. This results in depressed, anxious feelings that begin to manifest themselves physically. Symptoms may include trouble sleeping, inability to focus, increased use of alcohol, tobacco or other substances, and flares of chronic health problems. When we feel depressed or anxious, exercising, interacting with others and making healthy food choices can quickly fall by the wayside. The added recommendations for social distancing or isolating may cause people to feel alone too. There’s nothing strange or unusual about experiencing these feelings, and fortunately, there are things we can do to feel better.

In addition to the physical health tips you’re applying to keep yourself healthy, incorporate these mental health tips to feel better and give your immune system a positive boost. 

Healthy Thinking




 

  • Remind yourself this won’t last forever. While experts say COVID-19 may have an impact in the US longer than we would like, this will not be unending. Think of times past when challenges have successfully been overcome as a country, community, company or family and realize that this too will pass. Think about the future and make plans for something you want to do and take action toward it. Research for a future trip. Work toward steps that could lead to a promotion. If you’d like to run a half marathon, begin training now.
  • Differentiate between what’s in your control and what’s not. Then, focus on the things that are in your control and steer your thoughts away from things outside of your control.
  • Be matter of fact. Avoid the tendency to imagine a situation in your mind that is worse than reality. Consider your situation today and the steps you need to take to be safe such as social distancing and proper hand-washing.
  • Look for opportunities. Rather than focus on the bad, or the things you can’t do, focus on the good and the opportunities you may not see until you take a hard look. What are you grateful for? What can you do with the time you’re saving on your commute.
  • Focus on the positive. Remind yourself that experts around the world are hard at work containing the virus and developing a vaccine.
  • Do your part. Staying at home can feel like you’re doing nothing, but experts tell us helping to “flatten the curve” is the most important way we can help at this time. Remind yourself that social distancing or social isolation is a temporary situation and by adhering to the request, you are making a true difference in the trajectory of this virus.
  • Focus on what is true. Many people who test positive for COVID-19 experience no symptoms or only minor symptoms and most recover well. You can lessen your chances of getting COVID-19 significantly by practicing proper hand washing, avoiding touching your face and practicing social distancing.

Healthy Actions

  • Commit to a daily routine. Regular schedules add a sense of normalcy and feel comforting, so keep your daily routine to the extent that you can, or create a new routine if needed. Sleep, eat and take your medicines at the same time each day and maintain a healthy balance of work and relaxation. When planning your activities, toss in a little variety each day to prevent boredom. Plan something you enjoy for the evening—a favorite food, game or show—something to look forward to throughout the day.
  • Exercise. Exercise is always important, but especially so during times of stress. Exercise gives you a boost of serotonin, which helps with healthy mood regulation. If you’re already routinely exercising, keep it up. If not, consider adding an outside walk each day. For added benefit, walk outside in the early morning. It is a scientific fact that early morning sunshine improves mood. Seeing other people as you walk in your neighborhood or park will help negate feelings of isolation as well. On rainy days, Google a yoga class. Yoga is known for reducing stress, doesn’t require much space, can be practiced by any age, and you can find beginner videos online free of charge.
  • Enjoy nature. Whether it’s walking in the park or working from your balcony, try to incorporate sunshine and nature into every day.
  • Live in the moment. If your mind starts to race ahead with worry, focus on your senses to bring you back to the present moment. What are you seeing? What are you hearing? What were you doing before the worry distracted you?
  • Stay informed, but don’t stay tuned in. Seek on the information needed to make good decisions for you and your loved ones and limit the amount of time you spend reading, listening to or watching media that stresses you. Consuming too much media can create anxiety. You may find that reading, is less stress invoking that watching TV because you do not have visuals that linger in your mind.
  • Mute alarming alerts. You can change the settings on your phone, mute keywords that trigger anxiety on Twitter, and hide Facebook posts or feeds that make you feel overwhelmed. If you leave your TV on for company, tune in to a non-news show.
  • Connect with others. Don’t equate social distancing or isolation requirements emotional distancing or emotional isolation. Ironically, social isolation may result in improved connection with family members who live in your home, or time home alone may give you the extra time to catch up or reconnect with old friends via phone, email or social media. If you live alone, proactively pursue emotional connection with others and remind yourself that you’re not alone—we’re all in this together. Talk with people you trust about your concerns.
  • Get creative. Avoiding isolation is important for mental health and with social distancing recommendations, it’s important to think creatively. Here are some tips to help you and your loved ones stay connected in meaningful ways:
    • Make a phone call. While text messaging can be convenient, hearing the voice of a friend or family member and having a real conversation is a little closer to being there. This is possible even with elderly relatives who may not be savvy about using FaceTime.
    • Plan virtual gatherings. That dinner with friends that was scheduled for next Saturday night? Keep it using a virtual tool like Skype.
    • Enjoy dinner together. Make it feel like a real date by enjoying the same entree together virtually over Skype.
    • Start a book club. Start a virtual book club with friends. You may want to choose a light subject matter to add levity to your reading time and conversations.
    • Take a walk in your neighborhood or a nearby park. Enjoy spending time with others in a public space where it’s easy to practice social distancing. As an added benefit, sunshine, fresh air and exercise are good for your mental health too.
    • Get to know your neighbors. Spend time on your balcony, deck or in your yard and chat with neighbors from a safe distance.
  • Adhere to recommended guidelines. If you struggle with OCD, recommendations to wash your hands or stay indoors and avoid contact may be especially difficult for you and boredom may make your symptoms worse. Remind yourself of recommended guidelines and hold yourself accountable to align your actions with them.
  • Schedule worry time. If you feel overwhelmed with worry, schedule no more than an hour each day to contemplate your concerns. Do not allow yourself to think about things that concern you outside of that hour.
  • Accomplish something. Accomplishment feels good, so use the additional time you have to check a task off your list, whether it be reading a book, cleaning your closet or doing a spring deep clean.
  • Continue treatment to the best of your ability. If you are receiving treatment for a mental health issue, continue your treatment. If you take medications, pick up your refills as soon as they are available. If your prescriptions are for 30 days, ask your doctor if he can provide a prescription for a 90-day supply instead. As about online appointments when in-person meetings are not recommended.
  • Do a good turn daily. Ask yourself if there is an act of kindness you can do for someone. Picking up supplies for an elderly relative. Calling to check on someone who lives alone. Helping others helps you feel better too.

Healthy Conversations

  • Get face-to-face thanks to technology. Research tells us that seven percent of communication comes through our words, 38 percent through our voice and 55 percent through our body language. Use Facetime, Skype, Zoom and similar technologies to make communication more human when being there in person is not possible.
  • Reassure kids. It is important to communicate with children factually in ways that are appropriate for their age and temperament. Center your conversation around the need for them to be away from their friends for now because of the risk germs spreading pose to our elderly population. Reassure them that children typically do not get very sick from this germ. Explain the steps you are taking to keep your family healthy and allow them to ask questions.
  • Assist the elderly. We know that COVID -19 has affected the elderly more, and especially those with compromised health.  The elderly should follow all recommendations even though things do not look bad yet in this country. Recognize that limited sight or hearing or lack of skills with technology may cause them to miss important information. They may also fall prey to fake news circulating by email. Make sure they are aware of accurate recommendations, listen to their question and concerns and offer to help with errands.
  • Be helpful, allow for differing opinions and set boundaries. Friends or family members who are not taking recommendations seriously may cause you anxiety. The COVID-19 situation is hard for people to wrap their minds around. In Florida, we have to contend with hurricanes and it’s common for people to become quite anxious in the days leading up to a hurricane. Preparing for a hurricane is a good analogy for preparing for COVID-19.  You have to prepare for something that is days in the future, but when you go outside everything looks normal.  In the case of a hurricane, the damage we’ve seen from past storms informs us of what to do.  If you don’t follow guidelines you put yourself in danger.  In the case of COVID-19, the impacts of previous epidemics and the news we’ve seen unfold with COVID-19 in China and Italy help us understand how to prepare. Likening it to a situation they already have familiarity with can make it easier to understand. There are many reliable articles you can share with people who are not taking recommendations seriously, but some people will hold different opinions. If this causes you anxiety, you can set healthy boundaries to keep you and your loved ones safe, like interacting with the person through technology instead of being in close proximity.

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Signs You Are Experiencing Depression vs. A Midlife Crisis

Written by W. Nate Upshaw M.D. on . Posted in Depression, Step-By-Step Guides.

Aging is a process that can sometimes feel uncomfortable while we go through profound, abrupt changes throughout our lives. A midlife crisis isn’t a psychological disorder per se, but it’s still an uncomfortable period of transition between 40 and 55, although there’s some variability in the timing of midlife crises. Men and women experience midlife crises somewhat differently.

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It is common for people to mix up the symptoms of a midlife crisis with the symptoms of depression. However, the most differentiating factor is the frequency in which these feelings arise. The difference between depression and a midlife crisis comes down to whether the symptoms are present on a daily basis. A person who is experiencing a midlife crisis may have periods of time in which they are feeling fine, whereas a depressed person feels down and experiences the symptoms on a daily basis. Depression is a chronic, biologically-based mood disorder, while a midlife crisis is not.

A midlife crisis is a conflict between a person’s perception of themselves and their lives as they think they are and what they want them to be. It’s generated by the desire to change one’s identity. A middle-aged person who is content with their life standing can experience depression but will not experience a midlife crisis. A midlife crisis is a purely psychological disorder, although it can co-occur with depression.

What are the Symptoms of a Midlife Crisis?

Midlife crisis symptoms vary widely from person to person. The most common midlife crisis age range is 35 to 55, with some variability between genders. There’s overlap between many symptoms of a midlife crisis and depression too. Figuring out what’s going on can be a challenge, as different disorders may be occurring at once.

Consider the following symptoms of a midlife crisis common to both men and women:

  • Feeling unfulfilled in life
  • Intense feelings of nostalgia, chronic reminiscence about the past
  • Feelings of boredom, emptiness and meaninglessness
  • Impulsive, often rash actions
  • Dramatic changes in behavior and appearance
  • Marital infidelity or constant thoughts about infidelity
  • Constantly comparing oneself to others, who seem happier or more fulfilled
  • Intense feelings of regret

The Symptoms of a Midlife Crisis in Men

Men may also experience the loss of their sex drive, erectile dysfunction, decreased levels of testosterone and feelings of sadness. Sadness in a midlife crisis tends to be much less intense in comparison to full-blown depressive disorders.

Note that people show great individual differences in their symptoms. Some may show only one or two characteristics, while others may experience all of them.

In contrast with a midlife crisis, symptoms of midlife depression include:

  • Changes in sleep habits, either insomnia or sleeping too much
  • Changes in appetite
  • Intense, often debilitating feelings of sadness
  • Feelings of guilt and worthlessness
  • Lack of interest or enjoyment in previously fun activities (anhedonia)
  • Changes in body weight (unplanned loss or gain)
  • Loss of interest in sex
  • Withdrawal from social interactions
  • Elevated levels of anxiety, fear and worry
  • Irritability and anger (typically in men)
  • Tearfulness, uncontrollable emotions (most often in women)
  • Thoughts of death or self-harm
  • Aches and pains without an identifiable cause, including muscle pain, digestive problems, and headaches


Midlife Crisis and Depression in Women

Depression is a significant concern in midlife. When looking at gender and age, women from age 40 to 60 have some of the highest rates of depression.

Depression in middle-aged women is made more complex due to menopause. Menopause during midlife crises naturally makes the situation worse. Female depression at age 50 or above can be perimenopausal depression. Perimenopausal depression is a type of depression unique to women and is in part aggravated by fluctuating levels of estrogen. Painful or abnormal menstrual cycles, hot flashes, and intense, abrupt mood swings are often symptoms of depression that middle-aged women endure.

Women in midlife crises suffer many of the same symptoms as men; however, women tend to experience less anger and irritability and more tearfulness. At the same time women usually have midlife crises, they are also in the approximate age range for menopause, which has a big impact on their midlife experiences.

Depression versus a Midlife Crisis

Major depression isn’t linked to a particular age or period in a person’s life. It is a disease that can strike anyone, regardless of their feelings of satisfaction or contentment with their lives. Although midlife depression can be aggravated by external situations, it’s a disorder of the nervous system, particularly the way in which the nerves and tissues of the brain communicate with each other, coupled with the challenges brought about by a person’s unique environment.

Depression also has nothing to do with goal-directed behavior; that is, a person cannot become depressed by trying to or wanting to. Likewise, they cannot move past a depressive episode by force of will. A midlife crisis without co-occurring depression involves impetuous, rash and impulsive behavior that originates from a person’s desire to recapture lost youth or to make radical life changes without careful consideration.

A midlife crisis involves a person’s questioning of their identity as they leave young adulthood behind. Successfully resolving a midlife crisis means making peace with one’s life as it has been and either continuing on or making changes to get more satisfaction out of life.

Midlife Crisis and Depression in Middle-Aged Men

Not only are men at elevated risk for depression in midlife, they’re at an increased risk of suicide. According to the Centers for Disease Control, white men between 45 and 54 have the highest rates of suicide in the nation. The symptoms of depression in middle-aged men are similar to those in women except men tend to become irritable, angry and may act out with some aggression.

How To Deal With Midlife Crisis Symptoms

Coping with a midlife crisis is challenging because a person’s feelings are screaming at them that something is wrong and must be corrected immediately. It’s the sense of urgency, the feeling that time is running out that drives people to make poor, even disastrous decisions. It’s important to slow down.

  • Make no hasty decisions. Making a change for the sake of having done something isn’t a good plan. The bigger the decision, the more thought needs to be given to it.
  • Talk to someone. Men and women in a midlife crisis often feel lonely and isolated. Find someone to open up to, and if you don’t have anyone you trust, see a professional mental health expert.
  • Touch base with reality. Remember that your emotions are not necessarily grounded in reality. Emotions themselves are real, but they may be based on an incorrect interpretation of things. Get some objective input into your situation.
  • Be kind. Be kind to yourself and others. If you’ve given thought to dissolving or changing a big relationship and decided after reflection you want to do that, proceed with kindness. If you’re quitting your job to go back to school, consider the proper way to break the news to family and loved ones. No matter what you decide, remember that you’re always part of a tapestry of connections.


TMS Therapy: Treating Depression With No Side Effects
If you’re seeking treatment for depression and you’re concerned about the many side effects of antidepressants, consider Transcranial Magnetic Stimulation (TMS) therapy. This is an FDA cleared non-invasive treatment for multiple mental health disorders. TMS therapy uses targeted magnetic pulses to stimulate areas of the brain that affect mood, which helps you get back to your best life quickly and with no side effects. Among the many depression treatment options out there, TMS therapy is an excellent, pain-free solution that is covered by most major insurance companies. The best part is there are no side effects from TMS therapy, making it an excellent solution for those who fear the side effects of medications.

This blog post is meant to be educational in nature and does not replace the advice of a medical professional. See full disclaimer.


See If You Qualify

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Works Cited

Capetta, A. (2019, August 26). 17 Signs You’re Having a Midlife Crisis. Retrieved from https://www.womansday.com/health-fitness/wellness/g2966/signs-of-midlife-crisis-in-a-woman/

Department, M. E. L. P. (n.d.). Development in Midlife. Retrieved from https://www.annualreviews.org/doi/10.1146/annurev.psych.55.090902.141521

Doheny, K. (2009, November 11). Midlife Crisis: Depression or Normal Transition? Retrieved from https://www.webmd.com/depression/features/midlife-crisis-opportunity#1

McFadden, J. R., & Swan, K. T. R. (2012, February 14). Women During Midlife: Is It Transition or Crisis? Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1552-3934.2011.02113.x

Morin, A. (2020, February 24). What Really Happens During a Midlife Crisis? Retrieved from https://www.verywellmind.com/what-are-the-signs-of-a-midlife-crisis-4175827

How To Treat Depression Without Medication

Written by W. Nate Upshaw M.D. on . Posted in Depression, Mental Health Maintenance, Step-By-Step Guides.

When it comes to depression treatment, individuals have a variety of options to choose from depending on what will best suit their personal needs. Oftentimes, medication is the first treatment type that comes to mind. But can depression be treated without medication? While traditional medications are a common and beneficial form of treatment for depression for many people, there are multiple ways to treat depression without drugs.

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What are the symptoms of depression?

Depression manifests itself as low moods, feelings of sadness, hopelessness, sometimes thoughts of suicide, and social isolation among other symptoms. Depression can also be present in physical symptoms. You or someone you love who experiences depression may feel exhaustion, sleep for excessive amounts of time, or struggle to sleep at all. While serotonin does play a large role in our mood, sex drive, and social connections to name a few, there are other aspects of one’s life that can lead to the development of depression such as trauma, environmental circumstances, and genetic predisposition. Medications such as SSRIs (Selective Serotonin Reuptake Inhibitors) can help with treating depression, but there are other methods of treatment for depression. For some individuals suffering from depression, medication can be ineffective, with many drugs for depression also causing harsh side effects. Non-drug treatment for depression exists, and is possible.

Treating depression with traditional psychotherapy

Psychotherapy is one effective form of treatment for depression. Research shows that the learning and practicing of Cognitive Behavioral Therapy techniques can help challenge the negative thoughts that depression is notorious for, improve motivation, and improve social skills. The creation and consistency of a relationship with an effective therapist or counselor, the coping skills learned, and the safe space to feel uncomfortable feelings are all great benefits in treating depression without drugs.

TMS therapy: remission is only a step away!

Another highly effective treatment option is Transcranial Magnetic Stimulation (TMS). TMS is a non-invasive procedure that stimulates nerve cells in the brain to improve depressive symptoms. The 20-minute therapy sessions are pain free, and provide patients with the opportunity to treat even severe depression without medication. This non drug therapy for depression is an option that should be considered. early on in your treatment journey. Always know that there are options for treating depression without drugs. 

 

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Everyday habits to improve your mental health

Physical movement, social interaction, and taking care of our basic needs are other ways in which we can treat depression without drugs. Physical movement doesn’t only impact our bodies, but has a great impact on our mental health as well. Physical movement doesn’t have to be a rigorous, sweaty workout, necessarily. Taking a walk outside, a short hike, or taking your dog out for a walk can often be sufficient. Social interaction, despite the desire to isolate that usually comes along with depression, can remind us and challenge the various negative personal beliefs often associated with depression. Ensuring that we are taking care of our basic needs such as eating regularly, staying hydrated, and keeping tabs on our hygiene are important, particularly if experiencing a depressive episode. Keeping a routine can help you to stay present and be a good reminder that you are worthy of having your basic needs met.

This blog post is meant to be educational in nature and does not replace the advice of a medical professional. See full disclaimer.

Works Cited

Depression (major depressive disorder). (2018, February 03). Retrieved from https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007

Treatment of Depression. (n.d.). Retrieved from https://www.psychologytoday.com/us/basics/depression/treatment-depression#what-does-psychotherapy-do