It can be hard for people to realize or even admit they’re experiencing trauma right now. Despite things slowing down somewhat, many have been forced to keep working, raise children, and fulfill a host of other personal and professional obligations that may not leave much time for a self check-in. But Whether your poor mental state is temporary and due to circumstances beyond your control, like a pandemic, or it’s a life-long issue that’s always followed you, depression is something that needs to be addressed. Unfortunately, not everyone knows when to seek professional help.
We spoke with New York-based psychiatrist Margaret Seide, MS, MD, who specializes in major depression, anxiety, and panic disorders about when it’s time to speak to a professional. Here’s what she said.
Why it’s hard to know
An interesting point Dr. Seide brought up is that when speaking to a physician or a podiatrist, for example, there is no debate around symptoms. “You have high blood pressure, you have a problem,” Dr. Seide said. The symptoms are quantitative. Patients can’t argue with the numbers on that blood pressure machine, and it’s agreed upon that certain numbers equal a problem.
There’s no official measurement for depression
When it comes to symptoms of depression, there is no official tools for measuring them or any one symptom that is always a sign of depression. One person can always be tired because she’s depressed, and another can always be tired because she works long hours and doesn’t sleep enough. The same symptom is a sign of depression for one, but not the other.
Is a vice always a problem?
To further complicate the matter of identifying symptoms of depression, there are even some behaviors that, while categorized by our society as “taboo” or at least “vices,” some individuals display in a controlled, non-destructive manner. You can have someone who gambles, but specifically puts aside money for gambling purposes, and doesn’t dip into any other funds to indulge the habit. Then you have gamblers who spend their rent or car payment money on gambling.
There’s some self-diagnosis
“It’s often up to the individual to decide when they have a problem,” Dr. Seide explained. Being chronically fatigued isn’t always enough, but a patient may finally seek help when they’re so depressed they cannot get out of bed and go to work. At that point, depression is affecting other areas of their life. That’s when they typically finally seek help.
Therapy is “for emergencies”
Dr. Seide touched on the problematic reality that many people only seek professional help for depression once things have gotten really bad. With other doctors, like dentists or physicians, we take preventative measures and we go in for set checkups each year, whether or not anything is wrong. But with therapy, we often only seek help when symptoms have become severe.
“Going to see a mental health expert is seen as an emergency measure, which is unfortunate that it’s seen that way. I don’t meet people who say ‘I’m just checking in.’”
Telling the whole story is intimidating
Waiting to see someone until things have gotten really bad can be part of what holds us back from seeing someone, Dr. Seide added. Feeling that you need to tell a new therapist your entire life story can be intimidating and overwhelming for someone who is already in a dark place.
That’s why check-ins are good
Dr. Seide recommended people establish a relationship with a therapist they like and do regular check-ins. These can be monthly or even just a few times a year. Touching base when things aren’t bad and keeping the narrative going with one person, makes the thought of speaking to someone when things are bad far less intimidating. Then you already know to whom you’ll go, and that therapist already knows your background.
As subjective as it is, Dr. Seide said there are some symptoms that, should they arise, often mean it’s time to see someone. Feeling so nervous that one avoids any kind of social interaction is one. Struggling to perform at work or deliver on obligations is another –then you are reaching a point when the depression is causing destruction.
There are hard-line symptoms
Thoughts of ending one’s life is a serious sign it’s time to speak to someone, and it should not be ignored. Even if one isn’t thinking in a detailed manner about how they’d end their life, thinking something like, “It would be nice if I didn’t wake up tomorrow,” is a sign it’s time to speak to someone, Dr. Seide said. The desire to no longer be alive, even if the planning of a suicide isn’t present, is still a major concern.
Normalizing suicide is also a concern
Dr. Seide said that she speaks to some patients who ask, “Doesn’t everyone think of ending their life?” and she’s surprised to hear that some individuals believe it is very normal and common to think about that.
“It is not common,” Dr. Seide said. If you feel that you or a loved one needs help, Dr. Seide recommended PsychologyToday.com and ZocDoc.com as wonderful resources to find a mental health professional. You can filter your search by insurance company, payment method, location, and even specializations like depression, anxiety, or eating disorders, to name a few. She also stated that TeleMedicine is a great option for those not comfortable going into an office during the Covid-19 pandemic.