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the following program is brought to you
courtesy of a grant provided by the bank of princeton
good evening of both the a welcome to another division the focus on
tonight my guest is dumping data plan with a clinical psychologist in private
practice and prince did
I will be talking about are depression
and bipolar disorder and how it affects individuals
and work to be done some resources that individuals can look at we talking about
so the
said those and some other treatments and how individuals
can address this help it was good help individuals address this
I as we are at the post holiday season right now first want to wish everybody a
happy and healthy New Year
and as we do everything from our new year's resolutions to committing
ourselves to lose weight
to big get healthy year ok with the show will be able to focus
are what we could do to make sure that we don't feel
isolated for those individuals who may feel that they're depressed
or have thoughts about the pressure or feel that they have so
something different than everybody else and there are ways to deal with their
ways to deal with it
first-ball duck the plane I want to thank you for coming on the show thank
you for having me
thank you were before we get to some other questions want to talk a little
bit
about your background I had basically *** right now you're visiting faculty
member
at the Graduate School apply the Professional Psychology at workers
where he teaches supervise graduate level psychologists a trainee
and you work with the Graduate School of Social Work at workers
and other agencies across the state provided cultural competency training
for mental health clinicians
ido recently you were out of the last three years directors Council
Psychological Services at princeton university
and you've also provide community workshops available health issues
you work with school sisters public libraries and other organizations to
provide training and workshops
I double health diversity issues so it is a pleasure you having you here
welcome you to the show tonight thank you very much I'm happy to be here
that's great I guess the first question that we were talking about is maybe the
finding you know what is depression and how do we define dead
you know how we go about that the play your depression right so
thank you would say we're going to talk about depression and bipolar disorder
and these are bold
I what up gold mood disorders
and they have to do predominantly the disturbances
in mood you know and of course we all feel moody some days then
up and down in our moods in everyday life
but when we're talking about depression or bipolar disorder we're talking about
persistent
move disturbed so not your everyday up and down
but when so for depression when
I'm a bad mood persists for a long period of time
usually at least two weeks but mostly when we see people
they've been sad poor several weeks maybe even months sometimes years
and depression is sorta really a
cluster of symptoms so the moon
part the sad mood being the main identifying feature
but often that is accompanied by feelings of hopelessness
feelings of helplessness sometimes
disturbance in sleep sometimes people are sleeping too much sometimes people
sleep too little
sometimes they can fall back to sleep after the wake up
in the early morning hours sometimes there overeating sometimes there under
eating but basically the idea is that there's a disturbance that
is causing these kinds of changes in everyday life
arm often people feel sluggish
and I think when the most common complaint is tiredness
and higher have a hard time getting out of bed
even if I pull myself outta bed then I'm just exhausted
the smallest things make me tired and then
they dentist at losing pleasure in things that were
enjoyable in the past talking to friends being with their partner
going to movies playing games
working everything seems like it has no meaning it has lost
pleasure and in addition to that
the cognitive disturbances like difficulty concentrating on work or
school tasks
or being unable to motivate themselves to do things do take initiative
and to all of this sort of forms a cluster
and that many persists over a period of time
you can imagine it be very debilitating
and is be called that depression we talked about you talk about society's
said yes love I'll your depression and bipolar disorder
up is there a difference between you know the mood swings
right so in the depression
that's what we call you new boiler a good
depression because mostly people are fine and then
there would be this did in their mood would all out these associated symptoms
in bipolar disorder its bipolar select
two bowls for so people can go
to the other extreme of depression so that the
body gets completely revved up and in
me meow witch's the a purple of the mood change
um people feel euphoric actually and not
just happy but in a way uncomfortably happy
and sometimes that is accompanied by
feelings a grand your even maybe some dens delivery a.m.
or a feeling that you can do anything in the world it's just
anything is possible I could just fly out in out the window and reach the moon
I'm concomitant Lee with that
as opposed to depression the body gets revved up so
people's minds will seem to move very very quickly
you know points coming one after the other and bacall them racing towards
or people to talk very very quickly you know sometimes we talk would be even
better
anxious right but this is different this is
leg almost tripping over there besides
and people notice them and the internal experiences like you
climbing the wall and you added a did and you are
going going going anyone to just do more
so people tend not to sleep very much during this
period of mania there is often
irritability associated with this condition
and sometimes people will engage in risky behaviors so did not be able to
assess the risk
so they may sad gambling spending too much money
having *** liaisons that they would otherwise not have
all in this very bed up stated mania
okay handled off to the main outcome
the crash and then we go to the other ball
which is the depressive experience
so that bipolar disorder which takes you into these
ups and downs and what I've described
is so true arm in 10 bipolar disorder
mania and then severe depression but people good have
not bad hi often have been down but on
a high Paul Mannix like he left then flew mania
and not so depressed a kinda episode is bad
and every other combination of the two in between
okay this really play a factor hum
so there are studies that show that people who have
a family history of bipolar disorder schizophrenia depression alcoholism
dent to also arm and
sure vulnerability to with bipolar disorder
up the bipolarity is
much more of a arm condition but you are genetically vulnerable
although depression then our family and studies that show that people who come
from families but there's depression that can be
depression manifest in them to but
you can also have depression without having a family history
usually with bipolar disorder one can
traceback some sort of a family history of mental illness
okay head with tracing their back
I'll we talk a lot about how individuals
we know why individuals get depressed want to just have bipolar disorder
I'll it'd be perfectly normal workday
yet added you set this up triggered that
yes the person thinking about something at the bridge that them
right so that we're a.m. usually
that doesn't happen so people who are going to manifest at least
studio versions are these conditions I'll
will have shown some vulnerability
before I you know depression can definitely be set off by
severe stresses in life United job loss
marital separation and loss of a loved one and difficulties in school
chronic stress illnesses in older people
if one is has a vulnerability then those kinds of stresses
get and still uses old in a depressive state
because you sandals start to lose the ability to manage and cope with the
stress
and then that makes you feel depressed about yourself and then you can go
Beavan yes
and so you can go down and negative I really like that
with bipolar disorder the first
manic attack can appear to come out of the blue
with a stressor but ones bad
episode accord one can usually look back and see that there was some
vulnerability
sometimes it's hard to tell then other times
bud the the ways in which
a.m. mania presents itself you conceded that both had a tendency to words highs
and lows
then there'll be a long period of not feeding and
lack of sleep often precipitated in is vulnerable person
a manic episode back to sleep lack of sleep and I think that you know I just
heard on NPR today that
we don't a home game sleep enough credit
to manage on mental health and sleep is
absolutely critical regular
good sleep his critical for
stress management for general happiness
but definitely for conditions like depression and bipolar disorder
and other mental health shoes is there certainly were hours
the you're supposed to sleep that would help you right so most studies say that
you know 728 hours those good sleep
with enough %um I is
advocated by I think when you're sleeping less than six hours you not
recovering
from the stresses of life and just general tiredness
and regularity of sleep is also extremely important so that
you know it isn't like for five days you don't sleep and then you sleep 12 hours
and make it up and that averages to six hours
a night for the that doesn't work you have to be and the more that people can
develop
systems where you regularly most nights they go to bed at a decent time and
getting enough sleep and wake up
rested that is a gray great
prevented that's good we talked a lot about the symptoms
it would talk a little about your treatment now
yes Dave get to the year the trip or it
how people though with the seek help play
so I wouldn't say that you know there's a range
and the continuum along which one can experience
either depression or bipolar disorder so
Edith a difference between our personalities
our families the way we go quit playing are stressors
and there's a difference in the way we manifest inexperience symptoms
so its across-the-board that are
there's a great deal of variation not every depressed both
looks the same or feels the same so
you know the small ups and downs in life are normal and we all have coping
mechanisms for that
friend family members relaxation techniques mindfulness practices
exercise healthy eating all these things help to maintain our mood
but if people feel that
their functioning is getting affected in the way
that big blonde am to manage the day-to-day
activities life without feeling overwhelmed or sad or distressed
then it's certainly time to seek have
have so I would say functionality is a
keep peace know if you're doing okay some parts of your life
are not going so well at the pad are compensating for the pot
they're not going well and you feel generally OK and you feel genuinely
able to manage night then good
of course therapy is certainly helpful even in those
circumstances bad if they'd really feel
Lake for the most part 1 is not feeling good about play
then one should seek help and in the most severe situations if
that I ever bought some self harm or one is donating
to alcohol or drugs or other ways
goal being that are not healthy then it is time to seek
okay now it seeking help a lot of people have a stigma attached to seek help from
service right because they figure I should be able to forget this %uh bus
hey should be the third person but
does held to go to a person who is removed from your family
head is third-person to look at intro
who can sit there and talk to you and you know provide you
you know with the resources discuss the issues that
about the inside you you know and I think that's exactly right I think both
of us don't want to disclose up private thoughts and feelings to somebody we
don't know
but therapy is really arm created to provide
a safe space so that we can in fact
getting that's not only with getting another perspective from
a neutral toned body like you said or somebody
who you know depression and don't have difficulty in life
life doesn't come with a manual right so we don't
all get the steps on how to live this life and we'd be happy
arm to someone else can certainly help
figure that how and sometimes one needs to just face the things that are coming
up
ourselves and therapy can provide this space
we can sit down and think through what's going on for us what's happening what do
we need in life that we don't have
and how do we put bad in plays
arm there'd be is very supportive I mean the clinicians are trained
to first ball mill where one lives along a continuum of
mental health but also to
aid people moving forward to there are
certain skills that one can deny and there are certainly isn't thinking about
things there's a certain
change in one's perspective and just help
and actually there is so much to be said for just sitting with someone who
actually cares
and is listening and is interested in your welfare
mixture I'll question I want those
also been occasions me I know you're not you know
in a sec I try mean I'm but he just
take us through the process about medications that may be available
right so um mostly
treatment for most mood disorders depression and bipolar disorder the
combination treatment
I however if the depression is very mild one can get away with it
doing therapy alone I
usually recommend for people that if they are not functioning
well enough even to sit with their therapist and learned something
different and new and
make the changes that they need to for this severity maybe
such that medication can help at least for a period of time
so you know form depression there are
all kinds of different a medications the most common ones that we hear all the
ads on TV for the SSRI
but there are also older medications that are available
and the best person to determine what would be best for
a particular individual is the psychiatrist
and although family physicians can certainly provide
medication prescriptions as well sometimes it's helpful have the most
times it's useful to get at least one psychiatric consultation
go psychiatrists a specialist in these particular medications their side effect
profile than what works with what
other meds and so on for bipolar disorder
her specially when her manic episodes have a code
medication is almost and essential
because them when the mood a in
a disturbance that caused people can end up in very very risky places and at that
time
para people not working in a cube manic episode
so often medication is part of in long-term regime for that particular
illness
but in depression you know people do take medication for a while
you know meds take a while to work but they work faster than therapy
and then people learn um how to manage life
differently in therapy and then they can get off the medication
and continue living their life
p a lot of times
individuals could see another person that say you know what
prism really need some help yeah but the person
the other person doesn't think he or she needs help and resist
help that's being offered how do you give advice
to say family that we're or Fred
wants to help somebody but that person's resisting their help
what strategies they used to try it converts the percs to be because this is
the right word to take but
to happier person see yet their behavior really needs to be addressed
in addressed in a positive way because
you can't change the past you can change the future a
you know every problem has a solution yes so
I would a person go about you know trying to get dispersed understand that
he or she really should go
it seeks a counselor home
the death in excellent question because it is hard to go and seek help
and to actually say something is wrong
I need help that's a really difficult position for all of us to be in
so I think bad support and
empathy are key I think that we sometimes get frustrated you need to go
get help I N
that obviously doesn't work um
people have to be ready to actually engage with the treatments for it to be
effective
but one can certainly encouraged the person
sometimes it helps to have someone come with you for the first appointment
because it doesn't feel so
scary and so lonely and so offered to go with them
hum I would say encouragement and
seducing this is how your
life your behavior your depression your
mood changes are affecting me it would help me
if you could go for help rather than something is wrong with you
you go for help right um I think that just being
aware of in giving people hope specially when there's depression
help people understand that therapy does head
that treatment can help and helping them
go to website send you know the name age has wonderful website
the CDC has very good information online
we know that depression you know 'cause in at least nine percent of the US
population
it's a common issue which has good
treatment available there is also the National Alliance for the mentally ill
now me and the jersey they have and
family support systems and group therapy for family members of people who are so
they have wonderful ideas as well
available on their website and they just a phone call away
just for those who made up its way with the terminology they just use
the CDC is to sit there for Disease Control and Prevention yes
it I am NIMH is National Institutes of mental health
right they provide a a lot of money for
mental had to be so it and they have excellent information for the layperson
on their website so that can
up to be sometimes it just takes people reading about
that online to get themselves ready and prepared to come to therapy
and I have had a lot of family members bring
their partner day child their friend
um and you know the college counseling centers that you mentioned I worked at
friends were constantly bringing each other and it matters spend Bo's
del each other that you can get help
what we're getting help we talked we touched a little bit about
you a suicidal thoughts day house suicide related to
to depression ed and why the people
feel that there's no way out that's the only way
out because there they feel sometimes that the situation is so bad
a kid think over the other way held rise to talk about that because there are
ways
out that that that people may not know about or
or resources that are available people ride and I
that in excellent and very important question
you know hopelessness it by heart of depression
its almost a symptom so when things get so bad
and one is trying and trying and trying and it's impossible to get out
of that negative spiral you feel like giving a
and again suicidal thoughts can range from I wish I could just
sleep and never wake up and actually
no people don't do anything to hurt themselves
to actually having thoughts are doing something to harm themselves doings
something to kill themselves so
you know again treatment is effective
treatment is actually over and over again we have researched this
and we know that treatment is effective so
people if they are alive we can actually help them
so if one is feeling suicidal on one is not feeling save
the best thing to do is to go to the nearest emergency room
or if it's a loved one you can call 911
and their I am the I
and dealers arrives and dates the person to the hospital the hospital then can
create
a safe place where medication can be started
therapy can be introduced and it just gives the person
little bit of rested from the difficult deserved a day
and after that been regular ongoing
outpatient treatment can be on started for people
so there is help and i'm relieved really
wish for people to know that 911 will come and if you calling from a cell
phone make sure
it's a feel-good cell phone otherwise you 911 in Texas mood respond
but the land line is a good option or
galling going to the nearest emergency room to get help if the best
option K so as far as getting help you talked with special
about that it talked about some of the options that we have
up what about children
radios talked about children both children who
baby for lack of a better word there
their parents may be depressed ever had both poor disorder
the effects the as well as growing up at that time
family right well so let me back up and %uh
so on through a different question for sure a depression and bipolar disorder
can also occur in children and it sometimes it's hard to tell
our weather this is you know behavior problems that are being manifest or the
behavior problems are because the child is depressed are having difficulty
mental health wise
and again it is absolutely critical to get the right diagnosis
stride because the same symptom can mean
a million different things in a child verses and
adolescent boys as an adult arm getting treatment for the sake of your children
is a HUD
I hope a good motivator because it is difficult for children
if you abandoned are not doing
um well the just the natural
empathy and longing for the parent-child relationship can
affect the job hunt but more than that I had if
wife in the household is depressed this very hard for the child to focus on
growth learning have been is
and those kinds of activities love it's difficult for the child to learn coping
mechanisms that are effective because they're not
seeing those coping mechanisms again
you know if people get treatment the child also learns that his
help out there if I get down ever in my life
I know that I could goal get help for it and get better so
getting treatment can be and excellent learning opportunity for the child
come but it's the it's a complicated experience and sometimes
a.m. when bins are dealing with these symptoms
family therapy at the adjuncts do their own individual treatment is recommended
because it had the family to understand the symptoms
to know what to expect to respond effectively and did not so dove
feel like it my fault that my parents
is not doing well I must have done something wrong which is what children
and that feeling right the tough spot
well as we as we wrap up a chauffeur today I just want to your personal thank
you for coming on
but also try to get in one quick last question for those who may be sitting
out there
you know by themselves doing a very alone feeling very
you're stressed at feeling like they don't have
any place to go to work advice would you give a breakdown I would say
go to the Internet or pick up the phone and call it their best
a psychologist and psychiatrist the clinical social worker
there a plan your website you can read profiles of clinicians
and big somebody you like and go
and see them and a big on see right away they could make referrals
and you can go to community mental health centers we have
the Trinity Counseling Center in town I'll
the if the depression a Bible Arodys CVR one good
contact Princeton house which is a great resource
a for alcohol and drug use this corner house
so there are lots of resources at all levels above the economic strata
and then all different kinds all disciplines in terms of psychiatry and
therapy
productive about thank you very much for coming out today and ensuring us
giving us a lot of your you're with the right resources and knowledge
you know about is very very port areas and hopefully those you for watching
whether you're I'll wash it by yourself to watch with a friend or family member
and you know somebody that could benefit for a but we just discussed today please
you make that call don't feel isolated do its best to
help yourself and stay healthy and get healthy
so that is a show for tonight and I will see you next week other addition to
focus on
it though that logo thing they hope they stay well
they acted and the