HEALTH AND WELLNESS -Depression - Part 1

What is depression? If you were to ask your friends or family, or be brave enough to conduct a survey of passing strangers on a street corner, I guarantee you would get a variety of different responses. That is because depression has become an umbrella term used by many individuals to describe a number of different moods ranging from "the blues" to a severe, debilitating state where nothing but suicide could end their pain. There is quite a gap between these two ends of the spectrum. So, let's begin by defining depression more clearly.

First of all, I am very grateful to have a person who is feeling "depressed" actually sitting in my office. Most of my patients who are depressed may be referred by their primary care provider (and may not follow through). Some are brought by a family member or friend, not necessarily willing to provide details to a complete stranger. Very few individuals come on their on volition. So, when I am given this opportunity, I better be able to diagnose my client correctly.

As a psychiatrist, I rely on specific criteria to diagnosis an individual with a major depressive episode. The interview is critical in gathering the objective data. I rely on an acronym to obtain the necessary information - SIGECAPSS. This represents the following symptoms: (S) Sadness or depression; (I) lack of interest or anhedonia; (G) guilt, poor self-esteem, worthlessness; (E) loss of energy; (C) poor concentration; (A) changes in appetite, either increased or decreased; (P) psychomotor retardation or agitation - most likely observed by others ("All you do is sit around" or "You seem more edgy than usual"); (S) changes in sleep pattern, either increased or decreased; and, most importantly, (S) suicidal thoughts, plans, or intent. The DSM-IV manual (the psychiatrist's bible for establishing diagnoses) requires that at least five (or more) of the above symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) (S) depressed mood or (2) (I) loss of interest or pleasure. If the symptoms cause significant distress or impairment in social, occupational, or other important areas of functioning such as family relationships then it becomes a major depressive disorder. I have also been required to rule out any medical condition that could contribute to depression (e.g. hypothyroidism), any concurrent use of alcohol or drugs that can influence or mimic some of the above symptoms, or bereavement symptoms that have not become more debilitating after a two month interval. I am not at all dismissing the depression that can be attributed to other general medical conditions, substance abuse, or pathological bereavement. These individuals are just diagnosed under a different terminologies. In addition, individuals with other mental illness, including bipolar disorder, schizoaffective disorder, or adjustment disorder with depressed mood can also experience the same symptoms. It is beyond the intention of this posting to address these other conditions but will be discussed at another time.

When I wrote above that I am "grateful" to be able to assess a person face to face, I truly meant this. Depression is treatable. Statistics claim that women are twice as likely to develop depression than are men. Based on the gender of my clients, I suspect that this statistic is true. However, men are also less likely to admit that they might be suffering from depression. Considering the other statistic that woman are more likely to attempt suicide but that men are more successful, I am concerned that this younger segment of my generation (the 46 to 54 year olds) are experiencing more stressors.

PLEASE!!!!! Even if you are feeling "a little blue", or if a friend, a colleague, a family member gives you some feedback about a change in your behavior, promise me that you will at least talk to your primary care physician. If you do not have one, turn your insurance card over and call the number for behavior health services for a referral. If you do not have insurance, there are community mental health services in your county that can offer you services. MOST IMPORTANT - if you have thoughts of suicide, please go to the nearest Emergency Room for an evaluation. Please promise me that. I may not know you or the extent of your grief or your stressors. But I do know that everyone on this earth is precious. Life is precious. Please have faith and know that you are loved.

With Blessing and Peace to all, Dr. Elaine

FASHION - Four Boobies

I don't know about you, but I always have to do a reality check when watching the latest ads on TV promoting skin creams that promise to reduce "fine lines". If you really pay close attention, the models complaining about their so-called wrinkles can't be any older than 30. What happened, you poor little thing? Did your pillow case have a crease in it? I guarantee that streak will disappear by mid-morning. Oops - sorry. I did not mean for my disgust at these marketing madmen to show through. As we age our body does respond to various environmental factors that cannot be easily erased. Doctors may find some plant extract that promises a fountain of youth, but I cannot believe that the answer is that simple. If I want my face to look years younger, and I'm talking so dramatic that people do a double take, I would have to visit a very reputable plastic surgeon. But most of us cannot afford that. So - this article is devoted to an area of our body, often neglected, but if properly cared for can take years off of our appearance in seconds! Yes you read that correctly. And I am not a marketing madwoman.

Let's talk boobies. If I knew then what I know now, I would have been doing handstands, starting in my teens, to counteract the effects of gravity. But Mother Nature had it's way with me. My dear manicurist reminded me of the pencil test. If you can hold a pencil under your breast, you need to wear a bra. Are you kidding me? I can hold the whole darn pencil cup and anything else on my desk under these babies. And as I began to look like those granny caricatures with the breasts, one always longer that the other (my right one), I was more embarrassed to "bare" myself to a lingerie consultant in a department store. Anyhow, if you glance at the racks, your were lucky to find an E cup size. Where are the Z's?

So, I decided to go into the very popular and sexy lingerie store in the mall. I found a bra to snap in the back. At my age, that's all I need. Give me a big enough cup - the store's largest size is a 40EE - and I can fold these babies in anywhere. Here's the problem. I am a curler. You know that silly game on ice with brooms? Well, when I lean down to sweep the stone, I stand up with 4 boobies - yes, count them, 4! As eager as I was to slide my babies into this beautiful, lacy adornment, my babies were just as eager to release themselves from their misery. So what was the price of bringing home a lovely item in a pink bag that had my husband jumping for joy? "That's for you and not for daughter Molly - Wow Elaine"! A woman - realizing that I will never look like those models, even if I attached wings to my back.

How can we look years younger? Wear a bra that fits. Rather than sag or look like some sort of circus freak (I am sure my fellow curlers might think that), we can look perky. And being perky does take years off of our figures. I plan to find my tape measure and send into this wonderful website I found on line. I had guesstimated my size since I did not have the tape measure handy, thinking the answer would be, SORRY, you should have done handstands. But they actually carry cup sizes I never knew of. Hurray for us. And I am sorry to the male baby boomers reading this article. Although the content applies to women only, you might want to share it with your wife.

Here is Linda, the Bra Lady's website: http://www.lindasonline.com/bra-school.html

As we say on the ice, Good Curling. I know mine will be a lot more comfortable! Dr. Elaine