Mental Health Concerns

Perhaps your counselor or psychiatrist has mentioned this option to you, or you've wondered whether an antidepressant medication might be helpful based on what you've "heard" or the experiences of friends or family members.

This section is designed to answer some of the most frequently asked questions about antidepressants. We hope that the information will serve as a starting point for a more in-depth discussion.

If you decide to explore the option of medication further, you will want to meet with a physician and, if possible with a psychiatrist. A psychiatrist is a medical doctor whose specialty is the diagnosis and treatment of emotional and mental health problems. A psychiatrist is specially trained in the use of medication to treat depression.

Frequently Asked Questions About Antidepressants

• What are the signs that I may be depressed and therefore might need medication? Most of us feel temporarily discouraged or "down" at times. This brochure is about treatment for a very different kind of depression. If you are experiencing this kind of depression, you may have been feeling sad, irritable or depressed most of every day for weeks, if not months. Activities or people you used to enjoy might not seem interesting anymore. You might stop attending class and feel tired all the time. You might find you have increased or decreased appetite, or you might find that you have lost or gained weight. A couple of days of insomnia, sleeping all day, or wanting to "just stay in bed" occasionally happen for us all. But when this happens consistently over a period of weeks it suggests a more serious problem.  If you're depressed, you may have difficulty concentrating or making decisions. Friends may comment that you're extra "sensitive" or crying a lot. When you are this depressed, it is not unusual to feel hopeless and helpless, as if you're "stuck in a dark hole" and can't get out. Other people may notice you no longer seem to care about your responsibilities or your appearance. You may think about death a lot and even consider killing yourself. These are all signs of a serious depression.
• Signs of Depression:
• Sad Mood
• Appetite Change
• Concentration Loss
• Suicidal Thoughts
• Is depression a sign of personal "weakness"? Depression is one of the most common concerns reported by students.  It is not a sign of personal weakness. Abraham Lincoln, Queen Victoria and Winston Churchill are only a few of the strong people history suggests struggled with depression. It's not a condition that you can will or wish away. People suffering from depression cannot merely expect to "pull themselves together" and get better. Without treatment, symptoms of depression may persist or get worse. With treatment, you may begin to experience significant relief within four to six weeks. You're not alone. Many university students experience depression. 
• Shouldn't I be able to feel better without taking medication? Don't other people get through this without medication? Eventually, some people will feel better, even without treatment. Unfortunately, "feeling better" can take a year or more, and if untreated, depression can get worse and seriously interfere with your ability to study, work and enjoy relationships. Depression can also be a life-threatening illness when there is a risk of suicide. Medication will not "fix" everything, but it may help lighten your mood and help you to function so that you can begin working through other problems.
• How does an antidepressant work? Depression is an illness in which factors such as genetics, chemical changes in the body and external events may play an important role. Research suggests that depression may be linked to changes in the functioning of brain chemicals called neurotransmitters. Current research focuses on the serotonin, norepinephrine and dopamine systems. Certain genetic factors and changes in body hormones have also been implicated in some depressive conditions. These complex biological changes can produce profound changes in your mood and behavior. Antidepressants are thought to correct some of the chemical imbalances present in a depressive illness.
• Is there a blood test for depression? The diagnosis of depression is based on the recognition of certain characteristic signs and symptoms affecting your mood state, thinking patterns and physical well-being. At present, there is no blood test that can confirm or eliminate the diagnosis of depression.
• How long will I have to take a medication? You and your treatment professional(s) will meet regularly after medication is prescribed to assess any changes and/or concerns and to evaluate how the medication is working for you. Typically, people take antidepressant medications for eight to twelve months or longer. While it is often tempting to stop taking the medication when you feel better, it is important to continue until you and your doctor agree your depression is treated. Stopping the medication early can result in the return of your original symptoms. You may be asked to gradually decrease or "taper off" the medication. "Tapering off" is particularly important with some medications to allow your body an adjustment period.
• Will the depression come back when I stop taking medication? In the majority of cases, depression is an illness that can be effectively treated with medication and counseling. However, there is always a chance that your depression may return once a medication is stopped. Continuing antidepressants and/or therapy for the recommended time period minimizes this possibility. Unfortunately, in a small number of cases, depression reoccurs after treatment is complete. Recognizing the signs of a new depressive episode and seeking treatment early are very important.
• Is the medication addictive? Will I get "high"? The currently prescribed medications that are approved for the treatment of depression are not considered addictive. Drug addiction implies that you would crave increasing amounts of a substance. While certain medications used in treating unusual forms of depression do have potentially addictive qualities, these medications are not considered standard antidepressants and are not the subject of this brochure. Although antidepressants are not addictive, you may experience some symptoms that lead you to wonder whether you are getting "high." Early on in treatment, antidepressants may cause you to feel unusually energized, especially compared to your previous state. As with most prescription medications, there are also potential drug side effects with antidepressants. Feeling "high" or intoxicated suggests an unusual reaction to your medication, an interaction with another medication, complications from drug or alcohol use, or other unwanted side effects. In addition, some patients with manic-depressive illness may experience an unwanted episode of euphoria. Should you experience any of these problems, contact your psychiatrist immediately. Antidepressants are not addictive.
• Will the medication change my personality? Medication will not change who you are as a person, your unique personal characteristics, or your life circumstances. The goal of antidepressant therapy is to allow you to work toward positive changes in your mood state and thinking patterns. Antidepressant medication assists people in experiencing the full range of human emotions without feeling overwhelmed. Although these positive changes may seem like personality changes, most often they are a sign that you are recovering your ability to react to people and situations in a non-depressed way. Sometimes antidepressant medication produces temporary side effects that feel like negative changes in personality. In particular, you may feel less emotionally sensitive or less "intense" than you did before taking medication. In the event that this occurs and is distressing for you, don't hesitate to discuss your concerns with your counselor and psychiatrist. Refer to question #12 in this brochure to learn more about potential side effects.
• What might my doctor ask me to do before prescribing medication? The first step is usually an appointment with a psychiatrist to discuss your depressive symptoms. Your psychiatrist may ask the same questions you have already been asked by another professional. While you may find this repetition frustrating, keep in mind that questions are repeated so that your doctor can gain a thorough understanding of your symptoms, medical history, medication use, and drug or alcohol use. For female patients it will also be important to discuss the issues of pregnancy and birth control use since medication may be potentially harmful to a fetus or nursing infant. Since certain drugs, as well as some medical conditions, can produce depressive symptoms, you may also be referred to another physician for a complete physical exam and laboratory tests.
• How will my doctor choose which medication to prescribe? There are approximately 20 antidepressants currently available and approved for the treatment of depression. Antidepressants are generally classified by the chemical properties of the drug and the way in which they are thought to work. Groups of medication your doctor may refer to include: Selective Serotonin Reuptake Inhibitors (SSRIs), Tricyclic Antidepressants (TCAs) or Monomine Oxidase Inhibitors (MAOIs). Some clinicians may refer to medications discovered in the last 10 to 15 years as "new" medications and those medications which have been available in the last 30 years as "older" medication. Like shoe sizes, not every medication is the right fit for every individual; a medication that worked well for a friend may not be the best match for you.  Your psychiatrist will consider potential adverse effects of medication. The goal of treatment is to effectively eliminate depression with a medication that produces minimal problems or adverse effects. Unfortunately, an "ideal" medication that does not pose some potential problem or risk is not yet available. Side effects are generally mild and decrease with time. Research is focusing on more selective medications for depression that produce fewer and less problematic side effects. It is important that you ask your doctor about any concerns you might have about a medication or its potential side effects.
• What are the possible side effects of antidepressant medication? Antidepressants are a relatively safe treatment option in otherwise healthy individuals being treated for depression. Like most prescribed (and some over-the-counter medications), antidepressants may cause mild, and usually temporary side effects in some people. Most of the time, side effects are mild, manageable and disappear over time. Common side effects include nausea, loose stools or constipation, dizziness, drowsiness, nervousness, sleep changes, dry mouth, headache and blurred vision. Some people experience a change in sexual interest or functioning. While more severe problems are less common, they are possible.  Your doctor or pharmacist will have information sheets that outline a range of potential side effects. Each time you meet with your doctor for follow-up sessions, she or he will ask about your response to the medication and check for problematic effects. Unusual side effects or those that could interfere with your ability to work or study should be reported to your doctor immediately so that changes in the medication can be made. Most side effects are reversible and gradually disappear after a medication is stopped.
• How long will it be before the medication helps me? How will I know that the medication is working? All antidepressants take time to work. Don't be discouraged if you don't feel better right away. Therapeutic response typically occurs within two to four weeks after treatment is started, although some people feel better sooner. It is not unusual for your friends and family to notice signs of improvement before you do. When the medication begins to work, you may find yourself increasingly able to accomplish things and enjoy life in a way that is more "normal" for you. If you do not respond to one medication, your doctor may recommend a change of dosage or a change to other medication(s).  Each person is unique in his or her response to medication. Treatment of depression is an ongoing process, with your doctor monitoring and "fine tuning" your medication, depending on how it is working for you. Each person is unique in his or her response to medication.
• Can I take other medications along with antidepressants? An important question! Sometimes when antidepressants are taken in combination with other drugs, the chances of side effects or drug interactions increase. It is very important to consult with your prescribing physician, particularly about allergy medications. Be sure to tell your doctor about any medications you use, even over-the-counter or "natural" vitamins and herbal products.
• Will the medication interfere with my birth control pills? There is no evidence that antidepressants decrease contraceptive protection. However, like other medications, antidepressants are potentially harmful to the fetus if you are or become pregnant.
• Are there "natural" substances I can use to treat depression? There has been a great deal of publicity about herbal preparations such as St. John's Wort for the treatment of depression. Unfortunately, in the United States there are currently no adequate studies to prove that this or other herbal remedies are an effective treatment, especially when compared to standard antidepressants for certain forms of clinical depression. In addition, herbal preparations may not have any significant impact on severe forms of depression. Currently it is not recommended that traditional antidepressants be mixed with herbal antidepressants. If you are curious about any new developments in the research on herbal preparations, talk with your psychiatrist before "self-medicating."
• How much will antidepressant medication cost? Although the cost of medication may be difficult for some students to budget, the costs of not treating a depression are also high. You've invested considerable time and money to attend TWU. Your ability to function in school, relationships and outside employment may be significantly affected by an untreated episode of depression. The average cost of medication for depression will be about $10 to $70 per month (taking one medication at the average dose level). Many insurance companies pay a portion of medication costs. You may be required to pay a "co-pay" (often $4 to $12) for your portion of the cost. Other insurance companies pay a certain percentage of the cost. You will need to check your individual insurance policy to find out what medication expenses are covered.
• Why can't I use alcohol when taking medication? Did you know that alcohol itself is an extremely potent depressant? You certainly don't want to feel more depressed! The use of alcohol and drugs can complicate the diagnosis and treatment of a depressive illness. Many depressive conditions are associated with the excessive use of alcohol and some drugs. Using drugs or alcohol can increase the risk of dangerous behaviors including suicide or cause complicated interactions with your prescribed medication. In sum, alcohol or drug us

The death of someone we love, a close friend or family member, is an event we all have to face sometime. Learning to survive the feelings of sadness and loss is a process that is normal and usually time-limited. The process involves both emotional and behavioral reactions. It takes us through the initial response of shock and sadness, through acceptance and understanding, and eventually to the rebuilding of our lives.

There are many ways, some better than others, in which people learn to adjust to the death of a loved one. This brochure will help you understand your grief and give you some ideas about how you may be able to help yourself through the grieving process.

What Are the Tasks of Mourning?

The death of someone we care about most often means the loss of a valued personal relationship. In response to this loss, we experience many physical, emotional, and behavioral reactions. Yet grieving for the loss of a loved one and allowing ourselves to experience the pain is natural and necessary.

Accepting the reality of the loss - This first task is often difficult because of the sense of shock and numbness we experience. It is common to maintain hope that somehow "all of this is a mistake" and that the deceased is not really dead. As we struggle to accept the reality of the death, we may even misidentify others and believe that we have seen the deceased individual. Typically, this feeling that the death is somehow not real tends to lessen, although there may be some recurrences as the process continues.

Experiencing the pain of grief - This task that must be accomplished for the process of healing to occur. Because the feelings of loss tend to be very painful, we may feel like avoiding the intensity of these difficult emotions. It is as if by not experiencing the pain we can somehow avoid the reality that someone we care about is dead.

The reality, however, is that we cannot avoid the pain of grief forever. We will experience confusion, sadness, dismay, yearning, and probably anger. We may even experience physical symptoms such as palpitations, nausea, dizziness, tightness in the throat, and digestive problems. Sadness and an overwhelming sense of loss may be fairly pervasive feelings during mourning. Expressing the sadness is often difficult. While some of us may be able to cry, others may feel a need to hold in their feelings. This may be particularly true of men; however, it is also common for all of us to be praised for "holding up well" and not expressing feelings.

The difficulty is that by holding in feelings, we can do nothing about them except hold them. In essence, we put our emotional life on hold, which prevents us from healing. On the other hand, by expressing our feelings, by crying and thus physically releasing the sadness, we can begin to move forward and to heal from the loss.

It is often difficult to admit that part of our grief and sense of loss is also mixed with anger that we have been abandoned by someone we cared about. Depending on the level of closeness, the feelings of abandonment can be devastating and can arouse a sense of anger. We may become angry at God, at the unfairness of the world, at the deceased, and even at ourselves. We may question our own behavior and be angry for not having been the "right kind" of friend, spouse, partner, lover, brother, or sister. All of this anger is normal, and it is all probably accompanied by a tremendous sense of guilt.

Most of us come to associate anger with something that is bad. So when we experience anger directed at someone we care about, we quickly feel guilty. This is particularly true when the object of our anger is deceased. Another type of guilt that may also be present is survivor guilt: guilt that we are alive when one we care about is dead. Often this sentiment is expressed in statements such as "I wish it had been me," or "Why was I spared?" These feelings, too, are normal. Yet resolution of grief may hinge, at least in part, on our willingness to admit and resolve our anger and our guilt.

Adjusting to Life Without the Deceased

This will entail a variety of emotional and behavioral changes. A sense of despair, disorganization, and anxiety may emerge, and taking care of everyday tasks may become difficult. New behaviors and skills may need to be developed and that may be distressing. Yet redefining these experiences in a way that promotes the healing needed to fulfill these new roles and tasks appears to ease this adjustment.

Emotionally detaching from the deceased and investing that emotional energy into other relationships - The final task of mourning, this is often the most difficult. Most of us feel guilty at the thought of detaching from the deceased. We feel we are not being loyal or faithful to what was, especially when the deceased provided emotional nurturance. But if we do not detach, life for us as survivors may stop emotionally. Holding onto past attachments prevents us from finding new sources of nurturance and support. This does not mean we are abandoning our memories and thoughts, or that we love the deceased any less. It does mean that we must realize that there are other people to be loved.

When the tasks of mourning are accomplished, we can then remember the deceased without pain, though we may still experience some sadness.

What Can I Do To Accomplish the Tasks of Mourning?

Moving through the process of mourning can sometimes be eased by finding support from our social and cultural practices as well as from perhaps more personal resources. Seeking support and using these resources can help us recover from the death of a loved one.

Participate in Social and Cultural Rituals - Cultural practices seem to acknowledge the wisdom of expressing grief, though not all cultures handle this expression in the same way. Many cultures surround the death of one of its members with elaborate ceremony while others acknowledge the loss more privately. The cultural rituals for dealing with death (e.g., wakes, funerals, etc.) seem designed to offer us an opportunity to express our sadness in the socially and culturally accepted manner. They can give other people the opportunity to comfort us and show concern as a way to remind us that we have other loving connections, that life goes on, and that we are not alone in our feelings of loss and grief. Participating in the ceremony and ritual of bereavement also seems to aid family and friends in the adjustment to such a personal loss.

Some families and friends choose to create their own rituals to commemorate the birthday or day of death of their loved one. A visit to the gravesite, lighting a candle. and special gatherings are ways bereaved individuals can support one another and share memories.

Find and Use Support Systems

Finding the support of family members and sharing the pain of loss with them can make a tremendous difference, even though not every family member will handle the loss in the same way. Sometimes when a member of the family dies, other family members have difficulty talking with each other about the death. This is partly due to the painful feelings and also partly due to the belief that somehow talking will "upset" others even more. Thus family members may feel cut off from each other at precisely the time when they need to feel close and be supportive of each other. Individuals who have survived the death of a family member or others close to the family consistently stress the importance of talking, remembering, crying, and sharing feelings with their family. This seems to have been a very significant part of recovering from the grief.

Friends are another source of support. One of the best ways to help yourself is to talk about your loss with someone who is caring and concerned, someone who can understand your need to talk about it. Often just talking with a close friend can soften the feelings of losing a spouse, lover, good friend, or family member. Sharing thoughts and feelings can help to maintain relationships that can counteract some of the feelings of loneliness a death evokes.

Counselors and others who have been trained to help in the grieving process can also provide support and assistance. Typically, we need to go over and over the feelings and the experiences before we can begin to accept what has happened. Sometimes as survivors we feel as though we may be burdening our family and friends with our need to talk. If this feeling occurs, seeking help from a counselor is probably a good idea. Perhaps only with someone outside of the circle of family and friends can we allow ourselves to talk about our angry feelings, our self-blame and guilt, and our sadness.

Depending on the particular nature of our spiritual selves, some of us will seek the guidance and support of a spiritual leader. The person may be called pastor. priest, shaman. rabbi, healer, spiritual guide, mother, imam, elder, bishop, father, or holy person; seeking their support can often aid us in dealing with death. For most, when someone we love dies, questions of faith, the presence or absence of an afterlife, and the meaning of life and death often surface. Talking with someone about these issues can often aid us in understanding the death of someone we love as well as our own loss.

Return To Life - We each have our own way of surviving losses. Some of us will seek solitude and find that the well-intentioned inquiries and expressions of sympathy from others only revive the pain. However, as in recovering from any trauma, physical or mental, a progressive return to our usual life of work, family, and friends is most important. The longer we put it off, the slower our recovery will be. We can begin to help ourselves by thinking through the challenges of starting to live without the deceased person. Perhaps outlining a schedule of the day-to-day tasks can help us to structure our day and get us moving back into a normal routine. Reconnecting with friends, going back to work or school, and beginning to pick up the threads of our lives can help us to deal with feelings of numbness, lethargy, and paralysis.

Attending to our physical needs is essential during this time. Get enough sleep. Go to bed a bit earlier and sleep a bit later. Plan your meals so that you are eating properly. Work some exercise into your daily routine. Remember just as our emotional self is affected by the loss of a loved one, so is our physical self. Even having a physical exam by a physician can help us to take care of ourselves as we continue to heal.

When is Grieving Finished?

Although there are no timetables for determining when grieving is over, many experts agree that it is not unusual for the mourning process to take at least a year. Of course this varies depending on your relationship with the deceased, amount of support, and other personal factors. Remember it takes about a year to go through all of the birthdays, holidays, special events, and other important dates that will be experienced for the first time without the loved one. Though the intensity of the loss may ebb and flow during this period of time, grief lasting for at least a year is not uncommon and can be expected. Generally, the longer a close relationship had existed before the death, the longer the recovery process takes.

When Grieving Becomes More Complicated

Sometimes the normal grieving process becomes more complicated. Sleep and appetite disturbances, reduced sex drive, and marked preoccupation with thoughts about the deceased may be signs of increased difficulty in dealing with the death. Sometimes our feeling of loss may seem so tragic and pervasive that we believe we can no longer go on. Such feelings of despair and hopelessness may even lead us to think about suicide. Sometimes because of special life circumstances, our grieving may be marked by confusion because we seem not to be feeling how we think we should. Perhaps we feel relief or maybe even a hint of joy. Regardless of the specific feeling, if we are feeling contrary to the way that we think we should feel, then confusion and guilt may arise. If you are experiencing some of these problems, you may need some special help.

Counseling can give you an opportunity to talk about the lost relationship with all of its ups and downs. Sometimes even talking about parallels to previous relationships with unhappy outcomes can free us to move forward with life and new love relationships. Working through the many feelings surrounding the death of a loved one is crucial. It is important to know that no matter how badly we feel, we can overcome the grief and can go on to live full and happy lives again. At this time, however, we may need a little more help than we usually do. Even the use of a mild medication prescribed by a psychiatrist can be helpful in this kind of situation.

If your distress is persistent and is disrupting your life and your ability to carry on basic functions, please get help! Don't keep yourself isolated and alone with your pain!

Things to Remember

Do:

• Talk to others who have experienced loss.
• Speak of the meaning of the loss to you, the ways in which you will miss the deceased.
• Seek support directly from those that are able to give it. A hug may be important.
• Stay with a routine, stick to a schedule, even if you feel you are just going through the motions.
• Recognize the feelings for what they are rather than why they are. Knowing what the feeling is can help in dealing with it.
• Use writing, art, and music to let out your feelings and thoughts.
• Be forgiving and patient with yourself. It is all right to make mistakes or lose your concentration.
• Be good to yourself. Take the rest you need, the walk you enjoy, the gift you would like.
• Give yourself time. Time does heal, but how long it takes is an individual thing.
• Seek guidance from a source that can offer you both wisdom and empathy.

Do not:

• Try to make major life decisions too quickly.
• Numb your pain with depressive chemicals such as alcohol or other drugs.
• Deny your feelings.
• Isolate or hide out from yourself and others
• Expect every day to get better. Accept ups and downs.

Listen - The first thing a person in a mental crisis needs is someone who will listen and really hear what he or she is saying.  Every effort should be made to understand the feelings behind the words.

Evaluate the seriousness of the individual’s thoughts and feelings - If the person has made clear self-destructive plans, the problem is usually more serious than when his or her thinking is less definite. 

Evaluate the intensity or severity of the emotional disturbance - It is possible that the person may be extremely upset but not suicidal.  If a person has been depressed and then becomes agitated and moves about restlessly, it is usually a cause of alarm.

Take every complaint and feeling the person expresses seriously - Do not dismiss or undervalue what the person is saying.  In some instance, the person may express his or her difficulty in a low key, but beneath his or her seeming calm may be profoundly distressed feelings.  All suicidal talk should be taken seriously.

Do not be afraid to ask directly if the individual has entertained thoughts of suicide - Suicide may be suggested but not openly mentioned in the crisis period.  Experience shows that inquiring directly into such thoughts at an appropriate time rarely does harm.  As a matter of fact, the individual frequently welcomes the query and is glad to have the opportunity to open up and bring it out.

Evaluate the resources available - Does the individual have others you can contact?  If so, contact family and close friends to help.

Help the person to increase his perception of alternatives to suicide - Look at what the individual hopes to accomplish by suicide and generate alternative ways of reaching the same goals. Suicidal persons have often prematurely ruled out perfectly viable options or have generated only one or two solutions to a problem before giving up hope.

Act specifically - Do something tangible; that is give the person something definite to hang onto, such as arranging to see him or her later or subsequently contacting another person.  Nothing is more frustrating to the person than to feel as though nothing has happened as a result of talking.

Ask for assistance or consultation - Call upon whoever is needed.  Do not try to handle everything alone.  Convey an attitude of firmness and composure to the person, and call for help or encourage the person to seek help.

Additional preventive techniques

• Arrange for a receptive individual to stay with the person during the acute crisis.
• Do not treat the individual with horror or deny his or her thinking.
• Make the environment as safe and provocation-free as possible.
• Never challenge the individual in an attempt to shock him out of his or her ideas.
• Do not try to win arguments about suicide.  They cannot be won.
• Offer and supply emotional support.
• Give reassurance that depressed feelings are temporary and will pass.
• Point out that, while life exists, there is always a chance for help and resolution of problems, but that death is final.
• Focus on survivors by reminding the person about the rights of others.  He or she will leave family members and friends with the emotional aftermath of suicide.
• Do not leave the person isolated or unobserved for any appreciable time if he or she is acutely distressed.

What is Anxiety?

Some anxiety is normal. Chronic, exaggerated worry is not. Everyone experiences some worry, even on a daily basis. However, people who struggle with anxiety experience constant concerns which often have no apparent cause. Anxiety may be mild and manageable, but, for some people, it is debilitating. It can also cause and/or aggravate additional health problems, both physical and psychological.

Why Worry?

People with anxiety often worry about the same problems as everyone else: money, health, families, jobs, relationships, etc. The problem is some people worry excessively and constantly. People without anxiety have the ability to put worries on hold and focus on daily activity without being consumed. People with anxiety are often distracted by their worries and find it difficult to think about anything else. Many people with anxiety also feel constant anxiety with no apparent cause. They may wake up feeling anxious and can never pinpoint why, and the feelings last throughout the day.

Anxiety likely has more than one cause. It appears to run in families, so there is likely a genetic factor. A major traumatic or stressful event may sometimes trigger anxiety. Another theory is that the person with anxiety has internal psychological conflicts which have yet to be resolved. It may begin in childhood or later in life. Most likely, anxiety has both physiological and psychological components.

Symptoms of Anxiety

• Headaches                   
• Trembling, twitching
• Lightheadedness
• Difficulty concentrating
• Nausea
• Difficulty breathing
• Sweating, hot flashes
• Change in appetite
• Frequent need to use bathroom
• Startle easily
• Lump in throat, difficulty swallowing
• Knot in stomach
• Sleeplessness
• Restlessness
• Muscle tension
• Fatigue
• Feeling panicky
• A sense that the “walls are closing in”

Treatment

A person with excessive anxiety should seek treatment by first having a medical examination. An exam will rule out other possible causes of anxiety. Once good physical health is confirmed, the person should meet with a mental health provider. There might also be other psychological problems present, such as depression, and the mental health provider should be aware of all problems. Treatment generally includes therapy, medication, or a combination of both. No one treatment method or medication works best for everyone. Cognitive-behavioral therapy (CBT) is an effective treatment for many people with anxiety disorders. With CBT, the person learns relaxation and coping skills. Psychodynamic therapy may also be effective in helping the person resolve and cope with various issues and conflicts. Self-help methods and support groups may be helpful in addition to professional treatment. Regular exercise, enough sleep, healthy eating, managing stress, and a strong support network can reduce the intensity and frequency of anxiety symptoms.

Adapted from: http://panicdisorder.about.com/cs/gadbasics/a/introtogad.htm

Am I depressed, or do I just have the blues?

We all have times when we feel down. It’s normal to feel sad when a relationship ends, a good friend moves away or someone we care about dies. The stress of a heavy study load, financial difficulties or unemployment also affects our mood. However, the gloomy feelings usually pass and we still experience happy times with friends or family.

Sometimes the sad feelings don’t go away - we stop enjoying things that used to be fun. We might have difficulty keeping up with school work, have an uncommonly “short fuse,” or find it hard to even get out of bed in the morning. This could mean we have become depressed.

How will I know if I’m depressed?

If you’ve been feeling miserable or irritable more often than not over the past two weeks or more, and you’ve stopped enjoying things that used to be fun, you might be depressed. Check the symptoms below - if you check three or more it is likely you are experiencing depression.

• Finding it hard to get motivated and feel interested in things
• Wanting to avoid friends and everyday activities
• Difficulty concentrating or making decisions
• Losing interest in eating, or overeating
• Losing weight, without dieting, or gaining weight
• Finding it difficult to get to sleep, waking during the night, or waking too early and not being able to get back to sleep. Alternatively, wanting to sleep all the time.
• Thinking about, or planning suicide
• Having unpleasant, negative thoughts (like feeling guilty or that you are a bad or unworthy person)
• Getting pains in your body or headaches that don’t seem to have any physical cause

How did I get depressed?

Stress can build up in our lives and with time, can overwhelm our ability to cope. You may have experienced a transition like losing someone you love, having a baby, returning to school, or caring for an aging parent. Or, you could simply have been too busy for too long. Ongoing stress such as coping on a low income, facing rising debt, or feeling lonely and isolated can also lead to depression.

Sometimes people get depressed for no obvious reason; the heavy feelings just seem to come out of the blue. This sometimes happens when people come from families who seem more vulnerable to becoming depressed. A family history of depression can increase the odds you will become depressed as well. No matter how you became depressed, the effects are debilitating and will affect your study if left untreated.

What if it’s the blues?

It may still be useful for you to discuss your worries and low mood with a mental health professional. At the TWU Counseling Center we encourage you to come for assistance before little problems become big ones. This may help you get the most out of your life and tuition dollars.

Am I the only one who feels this way?

No. Depression is more common than most people think. In fact, it is about as common as asthma! One in seven people will experience a bout of depression at some stage in their lives.

Ok, so I’m depressed...what now?

Depression can be treated. It’s important to treat it like any other illness and seek help. Depression involves changes in brain chemistry and can influence the way we respond to our world. Talking with a therapist will:

• Help you figure out if its depression or the blues.
• Help you learn or tune-up your skills for solving problems, planning ahead and improving interactions with others.
• Help you see the positive side of yourself, others, and your circumstances.
• Help you see ways you may be holding yourself back in life or relationships.

Often therapy, together with lifestyle changes such as regular exercise, enough sleep, healthy eating, managing stress, and building a strong support network are very useful for reducing depression. In some cases medication may be necessary to help resolve a severe or longstanding bout of depression. Consider seeing a psychiatrist to discuss the possibility of using antidepressant, and refer to the TWUCC self-help handout “Are You Considering Medication?” for additional information.

Handout adapted from Counseling Center Village, Massey University.