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Healing Minds. Changing Attitudes

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This program was previously recorded. Please do not attempt to phone in your questions.

In recognition of Mental Illness Awareness Week, October 6th - 12th, AETN continues to increase awareness about mental illness by taking a look at depression in adults. According to the the National Istitute of Mental Health about 6.7 percent of U.S. adults experience major depressive disorder each year. It is one of the most common mental disorders in the nation. The first hour will feature a documentary,"A New State of Mind: Ending The Stigma of Mental Illness". It examines the stigma and discrimination that people with mental health challenges face. Following, a panel of experts will discuss what depression is, the causes, signs and symptoms, diagnosis, and treatments. Viewers are encouraged to call in their questions to the phone bank during the program. Healing Minds. Changing Attitudes. is underwritten by the Arkansas Mental Health Research and Training Institute of the Division of Behavioral Health Services, Arkansas Department of Human Services.

Panelist

  • Kim Arnold, Executive Director for the Arkansas Chapter of NAMI - The National Alliance on Mental Illness
  • Loretta Cochran, PhD, Chair of the Arkansas Behavioral Health Planning and Advisory Council, Associate Professor of Management at Arkansas Tech University, and living with depression
  • Bill Detmers, PhD, NAMI Arkansas Board Vice President and living with depression Frank Vega, Acting Assistant Clinical Director with the Division of Behavioral Health Services of the Arkansas Department of Human Services
  • Erick Messias, MD, PhD, Associate Professor of Psychiatry at the Psychiatric Research Institute, University of Arkansas for Medical Sciences and Medical Director of the Walker Family Clinic
  • Justin Hunt, MD, MS, Assistant Professor at UAMS College of Medicine, Department of Psychiatry and Medical Director for Comprehensive Diagnostic Service at UAMS Psychiatric Research Institute
This program is underwritten by Arkansas Mental Health Research and Training Institute, Division of Behavioral Health Services of the Arkansas Department of Human Services.

Transcript

WE ARE NOW GOING TO NARROW OUR FOCUS TO TALK ABOUT DEPRESSION AND SET THE STAGE FOR THIS IMPORTANT DIALOGUE. THANKS VERY MUCH FOR THE OPPORTUNITY TO VISIT WITH YOU, KIM. WE HAD THESE CONVERSATIONS OVER THE YEARS. IT SEEMS THIS IS THE TOPIC AT THE FOREFRONT OR AT HE'S NEEDS TO BE.

ANYTIME WE CAN TALK ABOUT PEOPLE GETTING HELP THEY NEED, WE SHOULD BE TALKING ABOUT IT. IT'S A DIFFICULT TOPIC BECAUSE DEPRESSION IS ONE WHERE YOU DON'T KNOW. DO YOU JUST FEEL BLUE OR SAD TODAY OR IS THERE SOMETHING LONGER TERM THAT YOU NEED THERAPY FOR. WE NEED TO TALK ABOUT IT. WE'VE BEEN HERE MANY TIMES DOING THAT. I'M HAPPY TO BE HERE WITH YOU AGAIN.

I THINK THE MAIN FOCUS OF THE FILM TALKS ABOUT STIGMA AND WHY THAT IS SUCH A CHALLENGE EVEN IN 2013.

WHEN WE TALK ABOUT STIGMA, IT'S SO EASY ESPECIALLY WITH DEPRESSION. IT'S IN YOUR HEAD. I WEAR EYEGLASSES. IT'S EASY TO SEE AND WITHOUT THEM I MAY NOT SEE AS WELL. WHEN WE HAVE SOMEONE BEHAVING IN A CERTAIN WAY OR PERHAPS NOT BEHAVING IN A CERTAIN WAY. IF THEY ARE DEPRESSED, THEY ARE LAZY. THEY ARE NOT GETTING ANYTHING DONE. OR YOU WILL FEEL BETTER IF YOU DO THIS. A LOT OF PEOPLE WE TALK TO WITH DEPRESSION SAY I WOULD LOVE TO BUT I JUST CAN'T DO THAT.

YOU WERE SAYING DURING THE PROGRAM AS IT WAS ON AIR THAT SOMETIMES IT'S THE SIMPLEST THINGS THAT PEOPLE DON'T UNDERSTAND WHY FOLKS CAN'T CONNECT THE DOTS.

AS WE WERE SAYING, SOMETIMES PEOPLE WILL CALL OUR OFFICE AND SAY "I CAN'T BRUSH MY TEETH, I CAN'T GET UP AND BRUSH MY TEETH". SOMETIMES IT'S DIFFICULT FOR FAMILIES BECAUSE THEY SAY IF THEY CAN JUST GET OUTSIDE. SOME PEOPLE SUFFERING WITH DEPRESSION SAY I JUST CAN'T DO THAT.

ABOUT THIS FILM IN PARTICULAR IS IT SHOWS HOW PERVASIVE THIS DEPRESSION CAN BE AND IT IMPACTS ALL PEOPLE FROM LIFE AND NO MATTER WHAT BACKGROUND.

ABSOLUTELY. WHEN WE TALKED ABOUT IN GENERAL ONE IN FOUR INDIVIDUALS HAVE A MENTAL ILLNESS. THAT STATISTIC DOESN'T HAVE ANYTHING TO DO WITH THE FAMILIES AND CO-WORKERS THAT ARE ALSO AFFECTED. WHEN WE TALK ABOUT THAT ONE SPECIFIC, THERE IS SO MANY MORE PEOPLE THAT ARE AFFECTED BY MENTAL ILLNESS AND DEPRESSION.

THAT IS REALLY WHY THE WORK THAT YOU DO AT NAMI AND BEHALF ON THE PEOPLE, THAT'S WHY THAT WORK IS SO IMPORTANT.

WE TALKED TO A LOT OF PEOPLE. WE TALKED TO FAMILY MEMBERS, WE TALKED TO INDIVIDUALS WITH MENTAL ILLNESS. BASICALLY I THINK IF YOU ARE CALLING OUR OFFICE, YOU PROBABLY NEED OUR HELP. WE'LL TALK TO YOU. THAT'S WHAT WE WANT TO DO AND THAT'S WHY WE ARE THERE.

THIS IS A VERY IMPORTANT MONTH FOR YOU GUYS. IN PARTICULAR YOU JUST CELEBRATED A NUMBER OF MILESTONES RELATED TO YOUR CANDLE LIGHT VIGILS AND SOME OTHER IMPORTANT EVENTS. LET'S TALK ABOUT THAT.

THE FIRST WEEK IN OCTOBER WAS MENTAL ILLNESS AWARENESS WEEK. WE HAVE SOMETHING GOING JUST ABOUT THEFRD EVERYDAY THIS WEEK STARTING AT THE CAPITOL AND WE'LL END ON FRIDAY. IN BETWEEN WE'VE HAD A SHOWING OF THE BEAUTIFUL MIND LAST NIGHT AND THEN WE ARE DOING A DEPRESSION SCREENING THAT IS COMING UP THURSDAY AND WE'LL ALSO HAVE THAT SCREENING ON OUR WEBSITE THAT PEOPLE CAN DO AND WE ALSO HAVE A FUNDRAISER ON FRIDAY. AN AUCTION AND BANQUET.

CAN PEOPLE GET TICKETS FOR THOSE?

ABSOLUTELY. THEY CAN CALL THE OFFICE OR AT THE DOOR AT THE CAFE OR GO TO EVENT RIGHT.COM OR CALL OUR OFFICE AND WE'LL HELP THEM DO THAT AS WELL.

WE WANT TO REMIND EVERYBODY THE SILENT AUCTION AND THE SCREENING.

THE SCREENING IS ON THURSDAY, THE CONFERENCE ON THE 12TH.

OKAY, WE'LL GET THOSE DATES STRAIGHT AND IF PEOPLE NEED MORE INFORMATION THEY CAN CONTACT YOU.

IT'S ALL OVER OUR WEBSITE.

THANKS FOR BEING HERE WITH US AGAIN. I HOPE TO CHAT WITH YOU A LITTLE BIT LATER. BEFORE WE HEAR FROM OUR PANEL TONIGHT LET'S TAKE A LOOK AT THIS BRIEF VIDEO FIGHTING DEPRESSION.

I DIDN'T WANT TO FACE ANYONE OR TALK TO ANYONE. I DIDN'T WANT TO DO ANYTHING FOR MYSELF BECAUSE I FELT LIKE SUCH AN AWFUL PERSON THAT THERE'S NO REAL REASON FOR ME TO DO ANYTHING FOR MYSELF.

DEPRESSION IS MORE THAN JUST A FEEL OF BEING DOWN IN THE DUMPS AND BLUE FOR A SERIES OF DAYS. SYMPTOMS CAN VARY BUT MANY PEOPLE LOSE INTEREST IN ACTIVITIES THEY ENJOY AND HAVE FEELINGS OF SADNESS AND WORTHLESS.

I COULDN'T SIT DOWN FOR A MINUTE TO DO ANYTHING. THAT TOOK DEEP CONCENTRATION . I TRIED TO JOURNAL, I TRIED TO DO THINGS BUT I COULDN'T. I BARELY WENT TO CLASS. I WOULDN'T GET OUT OF THE HOUSE. I WENT TO COLLEGE AND COULDN'T GO TO CLASSES AT ALL. I GAINED A LOT OF WEIGHT.

A PERSON WITH DEPRESSION CAN FEEL IRRITABLE AND DEPRESSED AND HAVE SLEEP PROBLEMS.

I COULDN'T SLEEP FOR WEEKS. MOST OF THE TIME THE OPPOSITE WOULD HAPPEN WHERE I WOULD SLEEP 10-15 HOURS A DAY.

PEOPLE WHO ARE DEPRESSED CAN FEEL NUMB AND TIRED ALL THE TIME AND IN SOME CASES IT CAN LEAD TO THOUGHTS OF SUICIDE.

I HAD THIS HUGE WEIGHT ON MY LIFE. IF I CAN GET A LITTLE BIT AIR AND SURVIVE, I WOULD GO BACK DOWN. I WAS JUST CONSTANTLY FIGHTING AND FIGHTING AND FIGHTING.

DEPRESSION IS A REAL COMPLEX ILLNESS THAT IS NOT YET COMPLETELY UNDERSTOOD. WE DO KNOW THE BRAINS OF PEOPLE WITH DEPRESSION ARE DIFFERENT THAN THOSE WHO ARE NOT. WE AREN'T SURE WHY. SCIENTIST IGN AT NATIONAL INSTITUTE OF HEALTH ARE TRYING TO STUDY DEPRESSION AND TRYING TO UNDERSTAND WHY IT AFFECTS SOME PEOPLE AND NOT OTHERS. TREATMENT FOR DEPRESSION DO WORK. ONE TYPE OF PSYCHO THERAPY IS COGNITIVE PSYCHO THERAPY. CBT. IT CAN HELP YOU CHANGE WAYS OF THINKING AND BEHAVING.

I HAD ONE REALLY GOOD THERAPIST AND THROUGH HER I REALLY STARTED THINKING ABOUT IT AND WHY HAVE DEPRESSION.

MEDICATIONS ALSO HELP. NIH IS FIGURING OUT HOW THESE MEDICATIONS WORK AND WHO BENEFIT FROM IT THE MOST AND HOW TO MAKE BETTER EFFECTIVE ONES. FOR MANY PEOPLE, A COMBINATION OF MEDICATION AND PSYCHOTHERAPY MAYBE THE CHOICE. DEPRESSION CAN BE TREATED IN MANY PEOPLE, BUT SOMETIME TREATMENTS FALL SHORT. FOR THIS REASON, NIMH CONTINUES TO STUDY THE GENETIC, BIOLOGICAL AND PSYCHOLOGICAL FACTORS SO NEW MEDICATION AND TREATMENT CAN BE DEVELOPED.

I THINK IT'S A LOT EASIER WHEN PEOPLE KNOW. I THINK IT'S THE KEY THING THAT HELPED ME.

IF YOU HAVE DEPRESSION, TELLING FRIENDS AND FAMILY OR SOMEONE YOU TRUST AND FINDING A DOCTOR OR THERAPIST ARE THE FIRST STEPS ON THE ROAD TO RECOVERY. DEPRESSION FOR TREATMENT CAN TAKE TIME TO WORK. SO DON'T GIVE UP. READ MORE ABOUT DEPRESSION ON THIS WEB PAGE. IF THE SYMPTOMS FIT, GET HELP NOW.

WELCOME BACK AND THANK YOU FOR STAYING WITH US FOR THE PANEL DISCUSSION PORTION OF "HEALING MINDS. CHANGING ATTITUDES.". I AM YOUR HOST PAMELA SMITH. WE ARE TALKING ABOUT ADULT DEPRESSION. JOINING US TO SPEAK ON THIS TOPIC ARE DR. DETTMER AND WALKER, DR. ERICK MESSIAS, ASSOCIATE PROFESSOR OF PSYCH TRY AT THE PSYCHIATRIC RESEARCH INSTITUTE OF UNIVERSITY OF ARKANSAS FOR SOCIAL SCIENCES AND FRANK VEGA ACTING ASSISTANT CLINICAL DIRECTOR FOR BEHAVIORAL HEALTH SERVICES AND FINALLY DR. JUSTIN HUNT ASSISTANT PROFESSOR DEPARTMENT OF PSYCHIATRY AND MEDICAL DIRECTOR FOR COMPREHENSIVE DIAGNOSTIC SERVICE AT UAMS PSYCHIATRIC RESEARCH INSTITUTE. WE WANT TO SAY THANK YOU AT HOME FOR WATCHING AND THANK YOU TO OUR PANEL FOR BEING HERE TONIGHT. WE WANT TO REMIND YOU THAT WE ARE AVAILABLE FOR YOUR CALLS. VIEWERS MAY SUBMIT QUESTIONS BY: PHONE, 800-662-2386; E-MAIL: PAFFAIRS@AETN.ORG; OR ON TWITTER, WITH THE HASHTAG #ARASK.. YOU ARE WELCOME TO JOIN US FOR THIS IMPORTANT DISCUSSION TOEVENLT WE -- TONIGHT. WE ARE GOING TO BEGIN BECAUSE WE HAD THE OPPORTUNITY TO TALK ABOUT DEPRESSION WITH KIM. LET'S HELP PEOPLE AT HOME REALLY UNDERSTAND WHAT DRIVES DEPRESSION. LET'S TALK ABOUT THAT.

WELL, THERE ARE MULTIPLE FACTORS THAT ARE INVOLVED. GENERALLY, FROM THE PSYCHIATRIC PERSPECTIVE, WE THINK ABOUT THE BIOLOGICAL, PSYCHOLOGICAL AND SOCIAL FACTORS THAT PLAY INTO DEVELOPMENT OF DEPRESSION. A PERSON MIGHT HAVE A GENETIC PREDISPOSITION, THEY MAY HAVE A PSYCHOLOGICAL WAY OF LOOKING AT THE WORLD AND SOCIAL STRESSORS THAT DRIVE THE DEPRESSION. THAT'S A VERY COMMON MODEL AND THE UNDERLYING ROOTS OF DEPRESSION.

ARE THERE ANY DISTINCTIONS BETWEEN MEN AND WOMEN?

SOMETIMES WOMEN CAN PRESENT IN DIFFERENT WAYS. OF COURSE EACH INDIVIDUAL IS A VERY COMPLEX BEING AND EVERYBODY PRESENTS IT IN A DIFFERENT WAY. BUT MEN SOMETIMES CAN PRESENT WITH BEHAVIORS THAT ARE MORE LIKE IRRITABILITY AND ANGER AT TIMES AND THEN WOMEN, BECAUSE SOMETIMES IT'S MORE SOCIALLY ACCEPTABLE FOR WOMEN TO SHOW THEIR EMOTIONS, THEY MIGHT PRESENT MORE OF A TEARFUL AFFECT .

DO YOU FEEL, ANY OF YOU CAN CHIME IN IF YOU LIKE. DO YOU FEEL THAT WOMEN MIGHT BE MORE INCLINED TO SEEK HELP THAT MEN WOULD BE?

YES. WOMEN ARE MORE LIKELY TO DISCUSS AND LOOK FOR HELP. WHAT DR. HUNT SAID, WHAT WE THINK ABOUT IS THAT MEN TEND TO ACT OUT, MORE AGGRESSIVE OR FOR EXAMPLE DRINKING AND DRUGS AND WOMEN SEEM TO ACT IN AND BE MORE SAD AND ANXIOUS AND DEPRESSED. SO SOMETIMES IT'S EASIER FOR THE WOMEN TO BE MORE PSYCHOLOGICALLY MINDED, WHEN MEN TEND TO JUST ACTON IT BY AGGRESSION AND BY ACTING OUT OR DRINKING OR USING DRUGS.

WE'VE SEEN A LOT IN THE HEAD LINES RECENTLY ABOUT BEHAVIOR THAT THE EXPERTS HAVE BEEN AN ATTRIBUTING TO SOME SORT OF MENTAL ILLNESS AND DEPRESSION IN SOME CASES. DO YOU THINK WE ARE HEARING MORE ABOUT IT BECAUSE THEY ARE MAKING THE HEAD LINES BECAUSE SOME HAS DEMONSTRATED LIBERTY MORE EXTREME OR ARE WE HAVING MORE PROBLEMS?

I THINK IT'S PROBABLY A LITTLE BIT OF BOTH. INDIVIDUALS THAT HAVE THE STRUGGLE WITH MENTAL ILLNESSES DON'T NECESSARILY ALWAYS ACT NOW THE AGGRESSIVE MANNERS. IT'S THE SENSATIONALIZED ONES THAT WE HEAR IN THE HEAD LINES. MANY FOLKS THAT ARE DEPRESSED HAVE A DIFFICULT TIME JUST DOING DAILY FUNCTION LIKE BRUSHING THEIR TEETH OR GETTING OUT OF BED OR BATHING OR PUTTING ON CLEAN CLOTHES. AGAIN, IT'S THOSE REAL SENSATIONALIZED INDIVIDUALS THAT WE SEE IN THE HEAD LINES. SOMETIMES OVER BLOWN TO SOME DEGREE. THAT'S REALLY WORTH OUR ROLE AS PROFESSIONALS AND JUST INDIVIDUALS IN THE COMMUNITY THAT BEGIN TO DISPEL SOME OF THE MYTHS AND MISS CONCEPTIONS AND THE STIGMA THESE DAYS.

SPEAKING ABOUT THE MYTH AND STIGMA, WE KNOW THERE ARE CHALLENGES BUT AS YOU AND FOLKS AT HOME HAVE HEARD AND DOING QUITE WELL AND LIVING TESTIMONY AS WELL THAT YOU CAN HAVE SOME CHALLENGES BUT YOU CAN OVERCOME AND YOU CAN GET HELP. DR. DETTMER, LET'S TALK A LITTLE BIT ABOUT YOUR SITUATION IF YOU DON'T MIND. OBVIOUSLY QUITE ACCOMPLISHED. BUT YOU PROBABLY WOULDN'T PRESENT IN A NORMAL FASHION OF SOME N WHO WOULD BE PERCEIVED AS DEPRESSED. TALK ABOUT THAT IF YOU WOULD?

THAT'S HARD FOR ME KNOWING ABOUT BECAUSE GROWING UP, I GREW UP IN A FAMILY WHERE DEPRESSION WAS SORT OF THE NORM. IT'S GENETIC. MY GRANDFATHER HAD DEPRESSION AS I RECALL AND MY DAD SUFFERED FROM DEPRESSION. I SUFFER FROM DEPRESSION. GOT KIDS THAT SUFFER FROM DEPRESSION. AND YET, AS IT PRESENTED, AS I LOOK BACK ON MY CHILDHOOD, I WOULD QUO THROUGH PERIODS AND I HAD OTHER PROBLEMS, MEDICAL PROBLEMS. THAT FROM WHAT I HAVE READ AND TALKED TO DOCTORS ABOUT IS SOMETHING THAT CAN CONTRIBUTE TO THE WAY IT PRESENTS. BUT, I WOULD GO THROUGH PERIODS WHERE I FELT FAIRLY, I GUESS YOU WOULD SAY NORMAL. I HAD NO IDEA WHAT NORMAL IS AND THERE WOULD BE THESE TIMES WHERE I WOULD GO INTO THESE DEEP DARK RAGES AND THEN THINGS WOULD BE OKAY AGAIN AND THEN SOMETHING WOULD SET ME OFF AND I WOULD GO INTO A RAGE AND THAT LASTED FOR MANY MANY YEARS. AND I HAD NO IDEA WHAT WAS GOING ON. THE ONE EFFECT IT DID HAVE WAS THAT ESPECIALLY WHEN I WAS GROWING UP, I CAN BE HAVING A REALLY GOOD TIME WITH OTHER KIDS, A LITTLE JEALOUS THAT THEY CAN DO THINGS THAT I COULDN'T BECAUSE OF MY OTHER CONDITIONS, BUT AT SOME POINT, SOMEBODY WOULD SAY SOMETHING OR SOMEBODY WOULD DO SOMETHING OR MAYBE THE WIND WOULD BHOE -- BLOW IN THE WRONG DIRECTION AND I WOULD GO INTO THESE HUGE RAGES AND DRIVE EVERYBODY AWAY. PEOPLE GOT SO A LOT OF THEM JUST LIKE THIS, I GUESS THAT'S STILL SOMETHING THAT COMES ON FROM TIME TO TIME. BUT, AS I FINALLY GOT INTO MY TEACHING CAREER AND HIGHER EDUCATION, I WAS ABLE TO EVEN THAT OUT A LITTLE BIT.

YOU WERE ABLE TO, I MEAN, WHAT WAS THE TURNING POINT FOR YOU?

I WASN'T DIAGNOSED UNTIL I WAS IN MY 50s. AND WHEN I WAS DIAGNOSED, I SUPPOSE I -- DO I HAVE MY WIFE'S PERMISSION.

HIS WIFE IS IN THE AUDIENCE, BY THE WAY,

I AM A MEMBER OF A GROUP OF WHICH I WAS INVOLVED IN. I'M INVOLVED WITH AL-ANON. IN THAT, IT WAS SUGGESTED THAT I MIGHT, BECAUSE I FELT SUICIDAL. MY WIFE AND OTHERS CONVINCE MED TO GO AND TALK TO A PSYCHIATRIST AND I WAS DIAGNOSED AS CLINICALLY DEPRESSED AND PUT ON MEDICATION AND CONTINUED GOING TO THOSE GROUPS. THEY ARE DOING WONDERS FOR YOU. THAT'S TRUE. THAT HELPS ME MANAGE AS MUCH AS THE OR MAYBE MORE THAN THE MEDICATION. I'M ON PROZAC AND THEY HAD TO UP THAT A FEW YEARS AGO WHEN I HAD ANOTHER BOUT WITH FEELING SUICIDAL. AND I HAVE NO IDEA WHY I FELT SUICIDAL AT THAT TIME.

WOULD YOU SAY YOUR MANAGEMENT LEVEL IS BETTER NOW?

OH YEAH, MUCH BETTER. OF COURSE SOME OF THAT COMES WITH AGE, I THINK THAT I HAVE LEARNED OVER THE YEARS THAT I JUST NEED TO TAKE LIFE AS IT COMES.

LET'S VISIT WITH LORETTA IF YOU DON'T MIND VERY BRIEFLY BECAUSE YOU OBVIOUSLY ARE COMMITTED TO BRINGING AWARENESS TO SOMETHING THAT IS PERSONAL TO YOU AS WELL?

YES. I HAVE BEEN IN RECOVERY FROM DEPRESSION FOR ABOUT 25 YEARS. I WAS DIAGNOSED IN UNDERGRADUATE.

HOW EASY WAS IT FOR YOU TO COME TO TERMS WITH THAT?

I REALLY WASN'T. I DIDN'T KNOW WHAT WAS WRONG WITH ME. I HAD A COLLEGE FRIEND THAT SAID MY MOM WORKS WITH PEOPLE LIKE YOU. HIS MOTHER WAS A SOCIAL WORKER AND HE SUGGESTED THAT MAYBE I SHOULD SEE SOMEONE.

WHEN YOU SAY LIKE YOU, FOR THE BENEFIT OF PEOPLE AT HOME, WHAT DOES THAT MEAN?

WELL, I THINK I HAD A DIFFERENT VIEW OF LIFE AND I REALLY HAD A DIFFICULT TIME JUST FUNCTIONING DAY-TO-DAY AND I WAS IN COLLEGE AND ACADEMICALLY SUCCESSFUL BUT SOCIALLY, THERE WAS SOMETHING A MISS. I HAD FRIENDS WHO CARED ENOUGH TO BRING IT TO MY ATTENTION THAT THERE WAS SOME HELP. THERE WAS SOMETHING AVAILABLE. SO I'M VERY GRATEFUL FOR THAT INTERVENTION, I THINK. SO THROUGH THE YEARS, AND ALSO VERY FORTUNATE THAT IN MY GRADUATE WORK AT CLEMENSON, WE HAD EXCELLENT MEDICAL AND PSYCHOLOGICAL SERVICES TEAM ON CAMPUS THAT I WAS ABLE TO TAKE ADVANTAGE OF AND BENEFIT FROM. I THINK THROUGH THAT, IT'S BEEN A LONG JOURNEY; BUT A GOOD ONE, I THINK. IT'S NOT ONE SINGLE THING FOR ME THAT'S MADE A DIFFERENCE. IT'S BEEN A COMBINATION OF GOOD SUPPORT, PARTICULARLY GOOD FRIENDS THAT HAVE WALKED THIS WALK BEFORE THAT CAN HELP ME SEE WHEN THINGS ARE NOT GOING WELL. ALSO, A MED AND BEHAVIORAL HEALTH TEAM THAT HAVE NOT GIVEN UP.

YOU ARE STILL CONNECTED TO THEM?

YES. I UTILIZE A THERAPIST, PSYCHIATRIST AND FRIENDS THAT I WOULD NOT TRADE FOR ANYTHING.

LET ME VISIT WITH THE GENTLEMAN ON THAT END OF THE SOFA NOW. YOU ARE HEARING THEIR STORIES AND THEY ARE OBVIOUSLY MANAGING WELL AND HOPEFULLY LIVING WHAT WE HOPE TO BE FULFILLED LIVES AND LIVING WITH FAMILIES AND SUPPORT GROUPS AND HOLDING DOWN EMPLOYMENT. HOW COMMON IS THAT IN TERMS OF PEOPLE HAVING THOSE KINDS OF SUCCESS STORIES?

AMAZING. IT'S SWHAERNL -- CERTAINLY WHAT WE EXPECT IN TREATMENT. WHEN PEOPLE COME TO US, WE DON'T SEE IT AS A HOPELESS SITUATION BUT A HOPEFUL ONE. WE HAVE PEOPLE IN VARIOUS AREAS NOW THAT CAN HELP PEOPLE ACHIEVE RECOVERY AND MEDICATIONS ARE GETTING BETTER AND BETTER. THIS IS THE RULE AS OPPOSED TO THE EXCEPTION.

IT'S GOOD TO HEAR BECAUSE PEOPLE AT HOME UNDERSTAND THAT YOU CAN HAVE A DIAGNOSIS, BUT YOU CAN SEEK TREATMENT AND YOU CAN GET HELP. IT PROBABLY IMPORTANT ALSO TO STRESS THE IMPORTANCE OF A FAMILY AND ADVOCACY, WOULDN'T YOU SAY SO?

PART OF HELPING FOLKS TO UNDERSTAND WHAT DEPRESSION IS THAT YOU REALLY HAVE TO BEGIN TO CHALLENGE THE WAY YOU THINK BECAUSE YOU BEGIN TO BELIEVE SOME OF THE NEGATIVE THOUGHTS THAT ARE COMMON IN DEPRESSION THAT I CAN'T SUCCEED, THERE MUST BE SOMETHING WRONG WITH ME. IT'S ALL MY FAULT. SO CHALLENGING THOSE THOUGHTS AND TRYING TO REPLACE THOSE THOUGHTS WITH A MORE POSITIVE OUT HOOK AND A MORE POSITIVE PERSPECTIVE, DR. HUNT HAS MENTIONED SOME OF THE EVIDENCE BASED TREATMENTS AND WHAT THE EVIDENCE SUGGEST IS COGNITIVE BEHAVIORAL THERAPY. THE EASIEST WAY FOR FOLKS AT HOME TO THINK ABOUT COGNITIVE BEHAVIORAL THERAPY IS THINKING, DOING AND FEELING. IT'S AN ACTION YOU DO. THAT'S THE EVIDENCE BASED PRACTICES THAT REALLY ARE VERY SUCCESSFUL IN TREATING DEPRESSION AND HELPING FOLKS ACHIEVE RECOVERY.

SO LET'S GO BACK A FEW STEPS AND HELP FOLKS AT HOME UNDERSTAND MAYBE SOME OF THE BEGINNING SIGNS OF HOW YOU KNOW YOU NEED TO SEEK TREATMENT. I KNOW I'M DEPRESSED IF?

THERE IS SIGNS. ONE IS A MOOD WHERE YOU FEEL SAD ALL THE TIME. WE ALL HAVE A MOOD FROM DAY-TO-DAY. BUT IF YOU CONTINUE DEPRESSED IN THAT LOW STAGE, IT'S ONE SIGN. IF YOU DON'T ENJOY THINGS YOU USED TO ENJOY, THAT'S ANOTHER SIGN. IF YOU START TO HAVE CHANGES IN APPETITE, EATING TOO MUCH OR TOO LITTLE BECAUSE DEPRESSION CAN DO BOTH. IF YOU HAVE PROBLEMS SLEEPING, EITHER TOO LITTLE OR TOO MUCH AND YOU DON'T HAVE ANY ENERGY TO DO WHAT YOU ARE SUPPOSED TO DO, IF YOU HAVE FEELINGS OF WORTH LESSNESS OR GUILT, ALL THESE THINGS THAT HAPPENED IN THE PAST, ALL THOSE ARE SIGNS. THE BEST THING IS TO TALK TO A FRIEND OR FAMILY MEMBER OR LOOK FOR HELP THAT CAN BE A SOCIAL WORKER OR PSYCHOLOGIST OR PSYCHIATRIST.

FOR FOLKS LIKE MISS COCHRAN, SHE HAD PEOPLE LOOKING OUT FOR HER AND HELPED IDENTIFY SOME OF THOSE AREAS OF CONCERN. WHAT ABOUT THE FAMILY MEMBER OR THE LOVED ONE WHO IS SEEING THESE THINGS AND MAYBE THEY WANT TO GIVE A GENTLE NUDGE IF YOU WILL TO GET THEIR SIGNIFICANT OTHER OR FRIEND OR FAMILY OR LOVED ONE TO GET HELP.

I WOULD SUGGEST TO GET SOME HELP. THIS IS GOING TO BE A LIFELONG PROCESS WHICH A LOT OF TIMES IT WILL BE, AND THAT'S OKAY. TO SAY LET'S JUST TALK TO THIS PERSON ONCE. OUR JOB IS TO BREAK THE STIGMA, EXPLAIN THE MODEL THAT DR. HUNT MENTIONED, THE BIOSOCIAL MODEL AND GET TREATMENT. IT'S WHAT WE DO EVERYDAY. TO CONVINCE SOMEONE TO COME TO THAT ONE CONSULTATION WILL CHANGE THE PERSPECTIVE. IF YOU HAVE THOSE VISIONS OF EVERYTHING DARK, IT'S COMPLETELY DIFFERENT TODAY. THE CLINICS THAT WE HAVE THAT ARE OFFERING CARE ARE MUCH MORE, A MUCH BETTER PLACE TO BE TODAY THAN IT USED TO BE.

DID YOU WANT TO ADD SOMETHING?

AS A SUFFERER, WHEN I'M HAVING PROBLEMS, IT ALMOST FEELS LIKE, I KNOW YOU HAVE BEEN ON STAGE. IT'S LIKE THAT CURTAIN COMES DOWN, THAT DARK HEAVY CURRENT -- CURTAIN AND LAYS -- ON YOUR SHOULDERS AND THERE IS PROBLEMS. I HAVE LEARNED DIFFERENT WAYS OF DEALING WITH THAT AND USUALLY I CAN POP RIGHT OUT OF IT AND IF I CAN'T, THAT'S WHEN I GO TO THEM.

THAT'S A SPECIAL POINT. I WAS THINKING ABOUT WHAT HE TOLD ME. THE AIR IS TOO HEAVY TO BREATHE. THE ACT OF BREATHING BECOMES AND EFFORT. WHEN YOU ARE DEPRESSED EVERYTHING IS AN EFFORT. GETTING OUT OF BED IS AN EFFORT, EVEN THINGS YOU ENJOY, THEY REQUIRE EXTRA EFFORT. THAT'S ONE OF THE KEY THINGS TO DEPRESSION.

WOULD IT BE SAFE TO SAY THAT DEPRESSION CAN DEVELOP OVER TIME OR IS IT ALWAYS SOMETHING THAT WAS AN UNDERLYING FACTOR AND YOU JUST RECOGNIZED IT LATER IN LIFE BECAUSE AS DR. DETTMER SAID HE DIDN'T GET DIAGNOSED UNTIL HIS 50s. IS THAT SOMETHING HE WAS DEALING WITH FOR A LONG TIME AND HE JUST RECOGNIZED IT OR CAN IT DEVELOP AT ANY POINT?

I THINK IT SHOWS LIKE THAT TO EDUCATE THE PUBLIC ON WHAT ARE THE ACTUAL TIMES AND SYMPTOMS OF DEPRESSION. BECAUSE MANY PEOPLE IN ARKANSAS RIGHT NOW ARE SUFFERING FROM MULTIPLE SYMPTOMS OF DEPRESSION AND THEY JUST DON'T KNOW THAT THEY ARE SUFFERING FROM A CLINICAL ILLNESS THAT CAN CLINICALLY BE TREATED AND JUST UNDERSTANDING IN IDENTIFYING THE SYMPTOMS IS A HUGE FIRST STEP. OF COURSE FAMILY MEMBERS CAN HELP IDENTIFY THOSE SYMPTOMS AND OF COURSE THE PATIENT THEMSELVES CAN TOO.

IN ARKANSAS WE HAVE ONE OF THE HIGHEST RATES OF DEPRESSION IN THE UNITED STATES. THE HIGHEST RATE IS IN PUERTO RICO AT 15 PERCENT OF THE POPULATION. IN ARKANSAS IT'S A LARGER POPULATION THAT ARE DIAGNOSED WITH THIS DISORDER.

HOW SO?

I'M NOT SURE. THERE WAS SOME INFORMATION ON THE NIMH WEBSITE. IN THE EASTERN PART OF THE STATES HAS A HIGHER DEPRESSION RATE THAN ANYWHERE IN THE REGION AND THE COUNTRY. THERE IS TIES TO POVERTY AND OTHER SOCIOECONOMIC FACTORS THAT CONTRIBUTE TO DEPRESSION. AS I WAS LOOKING AT THAT INFORMATION TODAY AS A MATTER OF FACT THAT WE DO HAVE A SIGNIFICANT RATE DEPRESSION HERE IN OUR STATE.

INCOMING EQUALITY.

PERHAPS STIGMA COULD BE HIGHER IN CERTAIN REAMS -- REGIONS OF THE COUNTRY TOO. I HAVE DONE CLINICAL WORK IN THE SOUTH AND IN THE NORTH M MICHIGAN AND I SAW STUDENTS THERE THAT CAME FROM NEW YORK METROPOLITAN AREA AND THEY WERE MORE THAN OPEN TO TALK ABOUT THEIR PSYCHO ANALYST IN NEW YORK CITY AND HOW THEY WERE SEARCHING FOR SOMEONE IN THE MICHIGAN AREA AND I DON'T SEE THAT LEVEL OF OPENNESS HERE IN THE SOUTH.

DO YOU THINK IT'S THAT KIND OF STIGMA THAT YOU CAN'T JUST ADMIT TO NEEDING HELP?

EVEN WHEN YOU GET HELP THERE IS STILL A STIGMA. WHEN I WOULD GO INTO A LOCAL PSYCHIATRIST OFFICE, I WOULD MEET SOMEONE AND THEY WOULD HIDE BEHIND THE NEWSPAPER. AS THE FAMILY PRACTICE, EVERYBODY WOULD SAY HELLO. I'M TIRED OF BEING EMBARRASSED AND ASHAMED OF HAVING A DISEASE THAT I ACTIVELY MANAGE AND RECOVER FROM. I THINK IT'S TIME WE STOP HIDING. IT'S SOMETHING IDEAL WITH ON A DAILY BASIS. I'M NOT ASHAMED OF RHEUMATOID ARTHRITIS.

THANK YOU FOR CALLING TONIGHT. THIS PERSON HAS DEPRESSION, ATTEMPTED SUICIDE, AND NOT SURE ABOUT THE REST. WHERE CAN THEY GO FOR HELP? BORDER LINE PERSONALITY. WHERE CAN THEY GO FOR HELP. THIS IS COMING FROM THE SPRINGDALE AREA?

ACTUALLY IN SPRINGDALE AREA THE COMMUNITY CENTER IS THE GUIDANCE CENTER AND THEY WOULD BE ABLE TO PROVIDE THEM WITH AN ASSESSMENT AND DETERMINE WHAT TYPE OF TREATMENT THEY ACTUALLY NEED. I'M SORRY I DON'T KNOW THE TELEPHONE NUMBER OFF THE TOP OF MY HEAD. IT'S OZARK GUIDANCE CENTER.

THERE ARE FACILITIES THROUGHOUT THE STATE AND WE CERTAINLY ENCOURAGE FOLKS AT HOME WHO MAY HAVE CONCERNS TO SEEK THOSE OUT.

THEY CAN ALSO CALL THE NAMI OFFICE. I JUST WENT BLANK ON THE PHONE NUMBER.

WE ARE ALL GOING TO DO THAT AT SOME POINT HOPEFULLY.

THAT'S A GOOD THING, I THINK. BUT, IF THEY CALL THE NAMI HELP LINE.

I THINK I HAVE A PHONE NUMBER. 1 8000 844-0381. GRAB YOUR PEN AND PAPER AND WE'LL REPEAT IT. HOW TO DEAL WITH PEOPLE'S MISS PERCEPTIONS ON DEPRESSION. MR. GARCIA, LET'S TALK ABOUT THAT.

I THINK IT'S IMPORTANT TO UNDERSTAND IT'S A BRAIN DISEASE. LIKE IF YOUR KIDNEYS ARE MAKING URINE, IF THERE IS SOMETHING THAT IS WRONG IN YOUR URINE I CAN DO A TEST AND CHECK YOUR KIDNEYS. YOUR BRAIN IS CREATING THOUGHTS, BEHAVIOR, ACTIONS, SPEECH, IT'S CREATING ALL THAT. IF THERE IS SOMETHING OFF IN BEHAVIORS IN SPEECH AND MOODS, THERE IS SOMETHING WRONG WITH THE BRAIN IN THE ORGAN IN YOUR BODY. TAKING THAT PERSPECTIVE HELPS A LOT TO UNDERSTAND THAT THIS IS A BRAIN DISEASE AND THAT WE CAN, WE HAVE SOME MEDICATIONS THAT CAN TRY TO FINE TUNE THOSE BRAIN CIRCUITS A LITTLE BIT BETTER. SO THERAPY CAN DO THAT TOO AND THERE IS RESEARCH THAT SHOWS THAT THERAPY CHANGES HOW THE BRAIN IS WORKING. THERAPY IS A BIOLOGICAL THERAPY. IT WORKS CHANGING THE BRAIN, HOW TO BRAIN IS WIRED. WE HAVE THOSE MECHANISMS. THE FIRST THING IS TO UNDERSTAND IT'S A BRAIN DISEASE AND UNDERSTAND THERE IS A TREATMENT AVAILABLE AND THE TREATMENT WORKS FOR MENTAL ILLNESS.

WE ARE TALKING ABOUT STIGMA BUT ONE OF THE OTHER STIGMAS IS ASSOCIATED WITH MEDICATION AND PEOPLE NOT BEING ABLE TO UNDERSTAND WHAT THEIR LEVEL OF FUNCTIONALITY WILL BE IF THEY TAKE MEDICATION OR BECOMING OVER MEDICATED. ADDRESS THAT IF YOU WILL?

SOME MEDICATIONS WILL MAKE YOU VERY SE DATED. WE DON'T USE THOSE MUCH ANYMORE. MOST MEDICATION USED IN PSYCHIATRY ARE NOT ADDICTIVE AND NOT CHANGE YOUR PERSONALITY AND NOT MAKE YOU A ZOMBIE. QUITE THE CONTRARY THEY ARE GOING TO ALLOW YOU TO BE YOURSELF AGAIN BECAUSE YOU DON'T REALIZE WHEN YOU ARE DEPRESSED, DEPRESSION IS CHANGING WHO YOU ARE. THE MEDICATION IS GOING TO TAKE OVER YOU TO HELP YOU REMEMBER TO TAKE OVER.

IT'S ALWAYS A WEIGHING OF THE POSITIVES AND NEGATIVES WHEN YOU ARE WORKING WITH THE MEDICATION TO ASSIGN THE RIGHT DOSE AND MEDICATION FOR THE PERSON. THE RIGHT DOSING SCHEDULE DURING THE DAY TO WHEN THEY CAN BE MOST FUNCTIONAL AND THAT'S WHAT PATIENTS USE WHEN THEY ARE WORKING CLOSELY WITH DOCTORS AND PATIENCE.

I THINK THE KEY IS TO HAVE A DIALOGUE WITH YOUR DOCTOR. I HAVE A VERY GOOD RELATIONSHIP WITH MY PSYCHIATRIST AND IF SOMETHING IS NOT WORKING WITH ME, WE TALK ABOUT PROS AND CONS. WE LOOK AT THE OPTIONS BECAUSE FOR ME THE MEDICATION RAISES THE FLOOR SO I CAN PARTICIPATE IN MY RECOVERY. IT'S NOT LIKE THE MEDICATION PICKS ME. I HAVE A LOT OF WORK TO DO IN MY RECOVERY. THE MEDICATION HELPS ME DO THAT. THAT'S A CHOICE I GET TO MAKE JUST LIKE EVERY INDIVIDUAL OUT THERE WHO WALKS IN THE DOOR TO GET TO HAVE AN ENGAGED CONVERSATION WITH THAT PHYSICIAN AND MAKE THAT CHOICE. NO ONE CAN MAKE THAT FOR THEM. THAT'S MINE.

YOU SEEM SO POSITIVE.

1 DAY AT A TIME.

I MIGHT ADD TOO THAT HAVING THAT CONVERSATION WHEN THEY DECIDED TO UP THE DOSAGE ON MY PROZAC THE LAST TIME, YOU KNOW, WHAT WE TALKED ABOUT WAS QUALITY OF LIFE. AND, HE SAID THESE ARE THE RISKS THAT YOU TAKE WITH THAT WHICH WERE FEW AND THIS WOULD PROBABLY BE THE OUTCOME. ANYTHING THAT IMPROVES MY QUALITY OF LIFE, I'M ALL FOR IT.

ABSOLUTELY. THANK YOU BOTH FOR SHARING THAT. THIS IS A QUESTION FROM PLANSKY COUNTY ABOUT FIBRO MYALGIA. CAN IT CAUSE DEPRESSION?

CHRONIC PAIN AND DEPRESSION GO TOGETHER. SOMETIME THE FIBRO MYALGIA COMMUNITY DON'T WANT TO SEE IT AS A PSYCHOLOGICAL ILLNESS. I TREAT PEOPLE WITH DEPRESSION WITH FIBRO MYALGIA AND I TRY TO THINK THAT I'M DOING THE BEST FOR MY PATIENTS BY TRYING TO ADDRESS BOTH. THEY TEND TO CLICK TOGETHER QUITE A BIT.

IT'S ALSO VERY COMMON FOR DEPRESSION TO CO-OCCUR WITH OTHER PHYSICAL HEALTH ISSUES LIKE DIABETES, CANCER AND OTHER KINDS OF PHYSICAL HEALTH ISSUES CAN CONTRIBUTE TO A MENTAL HEALTH ISSUE BECAUSE WHEN WE ARE STRUGGLING WITH THOSE KINDS OF THINGS AND WE DON'T KNOW WHAT OUR QUALITY OF LIFE IS GOING TO BE OR THE OUTCOME OR THE THOUGHT OF HAVING TO GIVE YOURSELF DAILY INJECTIONS SO THAT YOU CAN CAN CONTINUE TO FUNCTION IS A FAIRLY HEAVY BURDEN FOR MANY FOLKS TO COMPREHEND.

I THINK I'M GOING TO JUMP ON THE POINT IS THAT ANOTHER INTERESTING THING IS THAT THE FOOT PERSPECTIVE THAT SOMETIMES MENTAL ILLNESSES CAN HAVE A DETRIMENTAL EFFECT ON YOUR MENTAL HEALTH BECAUSE YOU THINK ABOUT DEPRESSION AND DECREASED ENERGY AND DECREASED CONCENTRATION AND IF YOU HAVE A BRITTLE TYPE TWO DIABETES AND YOU ARE HAVING TO MANAGE IT VERY CLOSELY, THAT'S ACTUALLY VERY DIFFICULT TO DO IF YOU ARE SUFFERING FROM DEPRESSION AND YOU WILL SEE NEGATIVE REPERCUSSIONS FROM DIABETES WHEN YOU HAVE PROBLEMS WITH CLOGGED VESSELS AND KIDNEY TROUBLES BECAUSE OF THE MENTAL HEALTH PROBLEMS GET NTH WAY OF TREATING THE PHYSICAL HEALTH PROBLEMS.

WE'VE GOT TO MOVE FOR TREATING PEOPLE IN SILOS BECAUSE WE KNOW PHYSICAL HEALTH ISSUES PLAY OFF EACH OTHER. THERE WAS A STUDY DONE THAT INDIVIDUALS WITH SERIOUS MENTAL ILLNESS DIE ALMOST 30 YEARS SOONER THAN THEIR COHORT OR FOLKS IN THEIR AGE GROUP. IT'S GENERALLY NOT THE MENTAL HEALTH ISSUE OR THE BEHAVIORAL HEALTH ISSUE THAT CAUSES THAT DEATH. IT'S THE LACK OF TREATMENT FOR THE PHYSICAL HEALTH. WE'VE GOT TO BEGIN TO LOOK AT PEOPLE HOLISTICALLY AND REALLY BEGIN TO TREAT MENTAL HEALTH OR BEHAVIORAL HEALTH ISSUES IN THE EXACT SAME WAY THAT WE TREAT PHYSICAL HEALTH.

THANK YOU FOR THAT. THIS QUESTION FROM GARLAND COUNTY. IS BEING ABLE TO STOP LIVING IN THE PAST AND RELIVING ABUSIVE NEGLECT, WOULD THAT FIT INTO A CATEGORY OF DEPRESSION. THEY ARE DESCRIBING SOCIAL WITHDRAWALS, PHYSICAL AILMENTS AND SOME OTHER AILMENT.

ANY TYPE OF TRAUMA, ESPECIALLY EARLY TRAUMA WILL INCREASE THE RISK FOR DEPRESSION AND OTHER TYPES OF MENTAL ILLNESS. THERE IS THIS COMBINATION OF EXPOSURE TO TRAUMA AND THE MENTAL HEALTH DOWNWARD EFFECTS OF THAT. PEOPLE WITH TRAUMA ARE MUCH LIKELY TO DEVELOP THESE CONDITIONS AND TO ADDRESS THE TRAUMA AND PTSD YOU HAVE TO GO BACK TO YOUR HOLISTIC APPROACH. IF THERE IS A SOCIAL COMPONENT, THERE IS A PSYCHOLOGICAL COMPONENT AND BIOLOGICAL COMPONENT.

WELL, SPEAKING OF THAT WE ARE GOING TO KIND OF SEGWAY INTO THIS QUESTION AND PIGGY BACK ON WHAT YOU SAID ABOUT THE BEST WAY TO BRING UP THE TOPIC OF DEPRESSION WITH MY PRIMARY CARE PHYSICIAN BECAUSE OBVIOUSLY WE NEED EVERYBODY WORKING IN CONCERT WITH EACH OTHER. WHAT'S THE BEST WAY TO DO THAT?

TO BE OPEN AND HONEST AS YOU CAN BE. WE KNOW THAT MOST DEPRESSION IN THE UNITED STATES IS ACTUALLY TREATED BY PRIMARY CARE PHYSICIANS. WE WERE DISCUSSING BEFORE THE SHOW THE EVENING THAT ANTIDEPRESSANT ARE THE FIRST MEDICATION PRESCRIBED IN THE UNITED STATES. WE KNOW IT COMES FROM PRIMARY CARE. ALSO UP TO 80 PERCENT OF ALL PRIMARY CARE BENEFITS HAVE A HEALTH COMPONENT THAT'S WHAT DRIVES PEOPLE TO SEEK MEDICAL TREATMENT. IF YOU ARE FEELING DOWN, IF YOU ARE HAVING A DIFFICULT TIME COMPLETING THINGS THAT YOU HAVE ENJOYED IN THE PAST OR THAT LACK OF ENERGY, BE OPEN AND HONEST WITH YOUR PRIMARY CARE PHYSICIAN BECAUSE THEY CAN BE THE GATEWAY TO RECOVERY.

THAT'S GREAT ADVICE.

I AM PRIMARY CARE PHYSICIANS CAN HANDLE TYPICAL DEPRESSION. AND IF THEY DON'T HAVE THE VIEWS AFTER THE TRIALS, THEY CAN CONSULT ANOTHER PSYCHIATRIST ABOUT THAT POINT.

PART OF THAT IS LIKE YOU MENTIONED EARLIER THOUGH IS TAKING A LITTLE BIT OF OWNERSHIP AND MAYBE HAVING THAT FRANK CONVERSATION WITH YOUR DOCTOR SAYING, I NEED HELP. AND BEING OPEN ABOUT THAT.

IT'S VERY IMPORTANT NOT TO GIVE UP. I THINK THAT SOMETIMES THAT WE DO HAVE PHYSICIANS WITH VERY BUSINESS PRACTICES. AND YOUR HEALTH AND YOU CAN'T GIVE UP. IF YOU ARE NOT FINDING THOSE ANSWERS, KEEP GOING. WHEN WE MOVED BACK TO SOUTH CAROLINA THERE WASN'T A DOCTORS OFFICE AND MY CARE WAS MANAGED BY A PRIMARY CARE PHYSICIAN. HE SAID I'M OUT OF MY SKILL SET AND I'M GOING TO FIND SOMEONE TO HELP YOU. HE DID THAT. WE HAVE GREAT DOCTORS. YOU SHOULD NOT GIVE UP BECAUSE YOU MAY NOT GET INTO AN APPOINTMENT QUICKLY. JUST NOT WALK AWAY FROM THAT. DON'T ABANDON THAT. IT'S EASY TO DO THAT IN A DEPRESSED STATE. PLEASE, IT'S VERY IMPORTANT TO CONTINUE FORWARD.

THAT'S SOME GREAT ADVICE. ALL RIGHT, THIS QUESTION NOW AND THIS IS A GOOD ONE FOR YOU, DR. DETTMER. A BROTHER NEEDS HELP WITH DEPRESSION AND ALCOHOL AND THEY WANT TO KNOW WHAT PROGRAMS ARE AVAILABLE AND UNFORTUNATELY THEY DON'T HAVE INSURANCE.

YEAH. THAT'S UNFORTUNATE, BUT, IT'S NOT SOMETHING THAT CAN'T BE OVERCOME. PERSONALLY, I'M NOT SPEAKING AS A PHYSICIAN, I'M NOT A PHYSICIAN, I'M NOT A LAWYER. SO, I CAN'T GET INTO THAT, BUT I THINK IN THE CASE OF DUAL DIAGNOSIS, IF THEY KNOW THERE IS ALCOHOLISM OR DRUG ADDICTION ALONG WITH ALCOHOLISM, AND DEPRESSION, THEN, WE HAVE TO TREAT BOTH SIMULTANEOUSLY AND IT'S VERY DIFFICULT TO GET THAT TO HAPPEN. NOW WHERE YOU CAN GO --

WHY DO YOU SAY THAT?

BECAUSE I HAVE A NUMBER OF FRIENDS THAT ARE IN THAT POSITION. AND BEING PART OF NAMI HAS ALLOWED ME TO COME IN CONTACT WITH THE SYSTEM ENOUGH TO REALIZE THAT THEY WILL TREAT ONE AND THEN THE OTHER OR ONE AND THEN IGNORE THE OTHER. DENIAL, YOU WERE TALKING ABOUT THE PRIMARY CARE PHYSICIAN, I THINK SOME OF THEM WOULD RATHER ACTUALLY STAND THERE AND LISTEN TO YOU TALK ABOUT YOUR DEPRESSION AND STUFF AND NOT EVEN DEAL WITH ALCOHOLISM OR DRUG ADDICTION. I MEAN WE TALK ABOUT THE STIGMA ATTACHED TO MENTAL ILLNESS, THERE IS STIGMAS ATTACHED TO THAT AS WELL.

I SEE YOU NODDING YOUR HEAD.

WE HAVE RESOURCES AVAILABLE ACROSS THE STATE. THERE ARE SEVERAL PROVIDERS THAT HAVE CONTRACTS WITH US AT THE DIVISION OF BEHAVIORAL HEALTH SERVICES THAT WILL DO A FINANCIAL ASSESSMENT FOR INDIVIDUALS SEEKING TREATMENT AND THEY COULD EITHER BE ELIGIBLE FOR STATE FUNDED TREATMENT OR HAVE SOME SMALL RESPONSIBILITY FOR PAYING FOR SERVICES. IF THEY WILL GO TO THE DHS WEBSITE AND LOOK FOR THE DIVISION OF BEHAVIORAL HEALTH SERVICES, WE HAVE A LIST OF ALL OF OUR PROVIDERS THAT ARE BROKEN DOWN BY AREA. IT DEPENDS ON WHAT AREA OF THE STATE THEY LIVE IN OR THEY CAN CALL THE DIVISION OF BEHAVIORAL HEALTH SERVICES AND WE'LL BE HAPPY TO REFER THEM TO THE PROVIDER THAT SERVICES THEIR AREA.

THAT PERSON SHOULD ALSO MAKE SURE TO CHECK WITH THE HEALTH CARE.GOV WEBSITE TO SEE IF THEY WOULD QUALIFY FOR THE EXCHANGE. THEY WOULD GET INSURANCE.

AR HEALTH CONNECTOR.ORG. YOU CAN GO ON THAT WEBSITE AND DETERMINE IF YOU WILL BE ELIGIBLE FOR PRIVATE OPTION OR EXPANSION OR GET INSURANCE THROUGH THE HEALTH INSURANCE EXCHANGE. THERE MIGHT BE A PATH TOWARDS INSURANCE STARTING JANUARY 1ST AND ENROLLMENT IS TAKING PLACE NOW.

THERE IS 12 STEP PROGRAMS THAT DO NOT CHARGE A FEE FOR SUBSTANCE ABUSE AND ALCOHOLISM. I KNOW IN THEIR LITERATURE THEY SUPPORT INDIVIDUALS WHO ARE IN RECOVERY FOR ALCOHOLISM AND DRUG ADDICTION TO CONTINUE TO SEEK TREATMENT FOR OTHER BEHAVIORAL HEALTH NEEDS. AND THEY DO NOT CHARGE AND THOSE ARE AVAILABLE IN MOST COMMUNITIES IN ARKANSAS.

THERE IS EVIDENCE THAT A A WORKS. THERE IS EVIDENCE THAT GROUPS LIKE AA AND AL-ANON HELPS.

WE APPRECIATE THAT. JUST A QUICK REMINDER OF THAT WEBSITE AGAIN?

IT'S AR HEALTH CONNECTOR.ORG. ARKANSAS HEALTH CONNECTOR.ORG. I FOUND IT TO BE A VERY USEFUL WEBSITE. AT UAMS WE HAVE A LOT OF PEOPLE WITHOUT INSURANCE AND WE'VE BEEN VERY AGGRESSIVE TO CONNECTING THIS EM WITH GOOD INSURANCE OPTIONS.

THIS PHONE NUMBER. 1800844 0381. THERE IS THAT INFORMATION ON YOUR SCREEN. FOR THE SCREENING DAY WE HOPE THAT YOU WILL BE ABLE TO TAKE ADVANTAGE OF THAT. THAT'S OCTOBER 10. WE WILL HAVE THIS INFORMATION AVAILABLE FOR YOU ONLINE AS WELL. LET'S TAKE ANOTHER QUESTION. OH MY GOODNESS, THIS IS A VERY SERIOUS CONCERN, A LIFE ALONG CONCERN FOR THIS PERSON FROM JEFFERSON COUNTY. THANK YOU SO MUCH FOR CALLING IN. A 72-YEAR-OLD WAS RAPED AT THE AGE OF SIX HAS HAD LIFELONG DEPRESSION BUT NEVER GOT TREATMENT. WHAT CAN BE DONE FOR THIS PERSON NOW?

IT'S NOT TOO LATE. THEY SHOULD SEEK HELP. THIS AGE, I'M ACTUALLY LOOKING AT THIS DATA, DATA NOW LOOKING AT EARLY CHILDHOOD TRAUMA AND DEPRESSION IN THE LATER YEARS AND IT'S VERY PREVALENT, BUT IT'S NOT TOO LATE. IT MAY HELP DECREASE THE RISK OF DEMENTIA, BECAUSE DEMENTIA WHICH IS VERY PREVALENT IN THE POPULATION WITH DEPRESSION CAN RUN TOGETHER AND IT'S EVIDENT THAT SOME OF THE ANTIDEPRESSANTS MAY HELP. IT DECREASES THE RISK FOR DEMENTIA. I THINK FOR THAT POPULATION, THEY SHOULD DISCUSS WITH THEIR PRIMARY CARE PHYSICIANS OR GERIATRICS, AND IF NEEDED LOOK FOR A PSYCHIATRIST AND START TREATMENT. IT'S NOT TOO LATE.

I WOULD LOVE TO HEAR THAT AND I'M SURE THE CALLER IS APPRECIATIVE OF HEARING THAT. IT'S NOT TOO LATE. THIS QUESTION FROM CRAIG COUNTY. WHY DO PEOPLE CONSIDER YOU A HYPOCHONDRIAC IF YOU ARE HAVING A MENTAL ILLNESS.

I THINK IT'S EASIER TO SEE A BROKEN ARM RATHER THAN TO SEE A BRAIN DISORDER. I THINK IT LACK OF KNOWLEDGE FOR SOME OF THE BEHAVIORAL DIAGNOSIS AT LEAST THAT'S BEEN MY EXPERIENCE. I THINK THE MORE WE TALK ABOUT IT, THE MORE WE IDENTIFY IF WE DO HAVE A BEHAVIORAL HEALTH DIAGNOSIS AND PAINT A DIFFERENT PICTURE THAT HELPS UNDERSTANDING. I THINK IT'S DIFFICULT SOMETIMES TO TRULY UNDERSTAND WHAT DEPRESSION IS UNTIL YOU HAVE WALKED A MILE -- IN THEIR SHOES, BUT NOT BEING ABLE TO GET OUT OF BED AND NOT BEING ABLE TO REMEMBER WHAT DAY IT IS BECAUSE YOUR DEPRESSION IS SO SEVERE. UNTIL YOU HAVE DONE THAT, SOMETIMES IT'S HARD TO COMPREHEND THAT. I HAVE A COLLEAGUE WITH SCHIZOPHRENIA AND I CAN'T FIGURE OUT WHAT THAT'S LIKE BECAUSE I HAVE NEVER EXPERIENCED THAT. IT'S LACK OF KNOWLEDGE AND UNDERSTANDING OF IT MORE THAN ANYTHING. UNDERSTANDING THIS AND HEALTH AWARENESS WEEK ARE VERY IMPORTANT TO CHANGE HOW BIG WE LOOK AT INDIVIDUALS. ALSO I HAVE TO TAKE OWNERSHIP OF THE FACT THAT I DO HAVE A DISORDER THAT I MUST ACTIVELY MANAGE AND I CAN'T PUT THAT RESPONSIBILITY ON SOMEONE ELSE.

IT HAS TO BE ON YOU?

IT HAS TO BE ON MY ARTHRITIS. I HAVE TO KEEP MY WEIGHT DOWN AND MANAGE MY DEPRESSION.

THAT LEADS TO A QUESTION FROM BENTON. HE SAYS I FEEL DOWN A LOT, I DON'T FEEL LIKE TALKING TO PEOPLE, NOT BEING AROUND A LOT OF PEOPLE, I HAVE USED DRUGS IN THE PAST. DOES MY HISTORY HAVE ANYTHING TO DO WITH MY DEPRESSION?

YES AND KNOW. -- NO. WE KNOW THAT HISTORY PLAYS A PART IN DEPRESSION BUT WE ALSO KNOW THAT MANY OF THE TREATMENT ESPECIALLY COGNITIVE BEHAVIORAL THERAPY AND INTERPERSONAL THERAPY FOCUSES ON WHERE YOU ARE AT TODAY. IF WE CAN ASSIST PEOPLE OF MOVING PAST TO WHERE THEY HAVE BEEN AND CAN LEARN TO LIVE TODAY THEN YOU CAN ACCOMPLISH THE UNDERLYING DPRECHLTHS -- DPRECHLTHS DEPRESSION. YOU ARE LIVING TODAY, NOT YESTERDAY.

WE ARE GOING TO TRY TO GET THROUGH AT LEAST THREE MORE OF THEM. THIS PERSON WANTS TO KNOW IF THEY CAN HAVE DEPRESSION. THEY FEEL GUILTY ABOUT HOW THEY HANDLE THE DISCIPLINE SITUATION WITH A CHILD. DIDN'T TEACH THEM AND WISH THEY COULD HAVE DONE A LOT BETTER AND BEATING THEMSELVES OVER THAT.

THERE IS A DIFFERENCE BETWEEN REGRET AND TRUE DEPRESSION. IT SOUNDS LIKE A POINT OF REGRET IN NOT HANDLING A SITUATION IN AN IDEAL MANNER. IN DEPRESSION, WE'VE DISCUSSED MANY OF THE SYMPTOMS ALREADY THAT GO ALONG WITH MAJOR DEPRESSION. FROM A CLINICAL STANDPOINT WE WOULD LIKE TO SEE THOSE AT LEAST FOR 2-WEEK EPISODES BEFORE WE DIAGNOSE AND OFFICIAL EPISODES OF DPRECHLGS MAYBE HAVING FLEETING REGRET OVER 2 DAYS OVER A SITUATION THAT WASN'T HANDLED PERFECTLY MAY NOT BE DEPRESSION.

HERE IS A QUESTION FROM SEBASTIAN COUNTY. WHAT MEDICATION ARE AVAILABLE FOR DEPRESSION FOR A PERSON WHO HAS A -- A DEPRESSED IMMUNE SYSTEM?

DEPENDING ON WHAT THE PERSON IS TAKING THEY CAN TAKE MANY ANTIDEPRESSANTS. THERE ARE MORE THAN 20 OF THEM. WE HAVE A LONG LIST OF ANTIDEPRESSANTS TODAY.

HERE IS A QUESTION, THEY CAN'T TAKE ANTIDEPRESSANTS AND THEIR BRAIN CHEMISTRY WON'T TOLERATE IT.

THERE ARE PEOPLE WHO ARE SENSITIVE TO ANTIDEPRESSANTS SUCH AS PEOPLE WHO HAVE BIPOLAR DISORDER. SO YOU HAVE TO LOOK AT DIFFERENT OPTIONS. THERE ARE A CLASSES OF MEDICATION THAT ARE CALLED MOOD STABILIZEERS. THEY ARE MADE YOUR MOOD MORE STABLE. IF THE QUESTION IS ABOUT MOOD STABILITY, IT MAYBE A QUESTION TO USE MOOD STABILIZER THAN AN AND DEPRESSANT.

ALSO IN LITERATURE, THERE IS INFORMATION THAT IT REWIRES YOUR BRAIN. SO MEDICATION IN MANY CASES MAY NOT BE NECESSARY TO TREAT DEPRESSION. WHEN YOU GET INTO MORE MAJOR DEPRESSION AND SERIOUS ISSUES WITH DEPRESSION THEN THERE IS MEDICATION. THE FIRST LINE OF TREATMENT IS COGNITIVE BEHAVIORAL THERAPY.

IN 30 SECONDS WHAT SHOULD A PERSON FOLLOW IF THEY FEEL THEY ARE DEPRESS?

TALK TO SOMEONE.

THAT WAS LESS THAN 30 SECONDS. OKAY. LORETTA, WE ARE GOING TO LET YOU HAVE PARTING WORDS FOR US. SOME WORDS OF ENCOURAGEMENT FOR FOLKS LIVING WITH DEPRESSION AND THEY FEEL LIKE THEY JUST CAN'T GO ON TONIGHT. WHAT WOULD YOU SAY TO THEM?

A FRIEND OF MINE WHO HELPED ME THROUGH CRISIS TOLD ME THAT GOD DIDN'T CREATE ANY TRASH. I WASN'T ALLOWED TO TALK NEGATIVE ABOUT MYSELF. IF YOU ARE TALKING NEGATIVE ABOUT YOURSELF, YOU CAN'T. THAT'S NOT ALLOWED. THAT STOPPED A LOT OF THE CYCLES THAT I GOT INTO. HE WAS A FRIEND OF MINE AND WOULDN'T ALLOW ME TO SPEAK NEGATIVE ABOUT MYSELF. IF YOU ARE FEELING THAT WAY, UNDERSTAND THAT I DON'T WANT TO YOU DO THAT. YOU HAVE VALUE AS A HUMAN BEING AND YOU HAVE WORTH AND YOU HAVE A PURPOSE. THAT'S WHAT WE HAVE FOR THE NEXT DAY. PICK UP THE PHONE.

THERE IS HOPE, ABSOLUTELY.

THANK YOU ALL SO MUCH PARTICULARLY YOU TWO HERE ON THE END FOR SHARING YOUR VERY PERSONAL STORY AND ENCOURAGEMENT TO FOLKS TONIGHT. WE HOPE SOMEBODY HEARD SOMETHING THEY WERE ABLE TO BENEFIT FROM. THANKS AGAIN FOR WATCHING. WE HOPE THAT YOU WILL BE ABLE TO LEAD MORE HEALTHIER AND MORE FULFILLED LIVES. THANKS FOR WATCHING. HAVE A GOOD NIGHT.

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