Is It Bad News Overload, or Depression?
Most of us can’t visit friends or extended family these days for fear of catching or spreading the COVID-19 coronavirus. With the government-ordered shutdown of many businesses, people have also lost jobs, with no way to know when their income will return.
The isolation and loss of control can leave us feeling down. For some, a low mood can even lead to clinical depression.
How can you know when it’s time to talk to a professional about troubling feelings you’re experiencing now?
We asked for advice from David Greenspan, MD, Chair of the Department of Psychiatry at Einstein Medical Center Philadelphia, and Brian Gallagher, PsyD, Program Director of the Einstein Healthcare Network’s Department of Outpatient Behavioral Health and Psychiatry.
In general, they said symptoms that are frequent, last more than two weeks or cause disruptions in our lives should prompt a call to a mental health professional.
What is depression?
Dr. Greenspan: Depression is a mood or emotion that may occur normally to certain circumstances, such as when frustration, disappointment or a loss occurs.
During the COVID-19 experience, feeling sad for the loss of job security, time with friends or the death of a loved one is very natural. And for most of these experiences, time heals. Even the consuming grief for the loss of a loved one, so natural early on, is rarely a permanent state, despite the fact that the loss itself is permanent.
What can people do to cope with these feelings?
Dr. Greenspan: There are many strategies that can be very helpful to take the misery out of these often unwelcome feelings. They include exercise, mindfulness, virtual time with friends and family, or working at puzzles or online games.
What are the signs that you may be developing clinical depression?
Dr. Gallagher: You need to watch out for changes in biological functions such as sleep, energy levels, appetite and sex drive. Here are some other things to look out for:
- A significant decrease in motivation or ability to complete tasks
- Concentration problems, such as being unable to read books the way you used to
- Frequent tearfulness, or bouts of feeling angry and irritable that are unusual for you.
- Overwhelming feelings of guilt and low self-regard
- Feelings of hopelessness
- Thoughts of suicide
When should people call a professional?
Dr. Gallagher: One needs to think about the time and frequency. If you have experienced some of these symptoms on a few days over the past month but they did not persist in any meaningful way, that is probably not a problem.
But if you have been experiencing some or most of these symptoms most days for two weeks or more, you likely need to consider that you are experiencing a depressive episode that may need attention.
People again should call professionals when they or others notice that these symptoms are having an impact in their day to day functioning, in daily tasks, work and relationships.
Dr. Greenspan: With depression, the future will tend to look bleak, and the desire to wake up to another day falters. If symptoms get so severe that health and functioning become seriously impaired, or if you are considering suicide, there is no reason to wait two full weeks to reach out for professional help.
You also can first assess your symptoms using an online questionnaire. One of those used by professionals is the PHQ-9 (Patient Health Questionnaire – 9), which asks about nine symptoms of a serious depressive episode. The C-SSRS (Columbia Suicide Status Rating Scale) also delves into the risk of someone taking their life.
The City of Philadelphia also provides online self-assessment tools for depression and other mental health conditions.
How can people access mental health care at Einstein now?
Dr. Gallagher: We are offering telehealth visits. Call 215-456-9850 for an appointment.