Common Emotional Health Issues

What You Need to Know About Depression「認識憂鬱症」臨床心理醫師李偉倩主講 | El Camino Health

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There are times in all of our lives when normal day-to-day stresses become magnified and hard to deal with. People experience added stress in different ways. Some might act angry or appear withdrawn. Others may exhibit changes in their normal behavior, such as eating too little or begin eating too much. Some might turn to alcohol or other substances for relief. It’s important to be aware of the signs so you can recognize them in yourself – and others.

The Chinese Health Initiative has collaborated with behavioral health professionals to assemble the following resources to help when you or someone you care about is experiencing added stress. These resources also include useful information about other about common mental and emotional health issues, such as depression, anxiety, and anger, designed to educate and offer strategies that can help you feel better.

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Patient Health Questionnaire (PHQ-9)

This is a 9-question tool that can help you begin to explore whether the feelings, thoughts or behaviors you may be experiencing could be depression. The second page will contain instructions on how to interpret your score.

This screening is not a substitute for a clinical evaluation and cannot provide an actual diagnosis. If feelings persist or worsen, please consider contacting a health professional for more information and a complete evaluation.

Download now.

Generalized Anxiety Disorder-7 (GAD-7)

This is a 7-question tool that can help you assess symptoms of anxiety disorder. The second page will contain instructions on how to interpret your score.

This screening is not a substitute for a clinical evaluation and cannot provide an actual diagnosis. If feelings persist or worsen, please consider contacting a health professional for more information and a complete evaluation.

Download now.

What do you need to know about depression?

Most frequently asked questions about depression
Answered by Wei-chien Lee, PhD
Dr. Lee’s bio: PhD. Counseling Psychology from Purdue University. Stanford Postdoc. Licensed Clinical Psychologist and National Certified Counselor. Faculty at San Jose State. Provided more than 500 trainings and workshops to community members, mental health providers, and organizations to improve mental health.

1. What Is Depression?

Depression is a common, complex, and serious health condition that impacts the whole person and needs to be diagnosed and treated by appropriate professionals.

The followings are the key points about depression:

Depression is a serious health condition. Depression impacts our thinking, feeling, health, energy level, sleep, eating, relationship, work, self-perceptions, motivation, cognitive functioning, and safety (for example, accident, suicide, substance use).
Depression impacts all people; everyone could be impacted by depression.
Depression symptoms and signs differ from people to people. For example, some people with depression may have problem sleeping, but others with depression may sleep a lot and still feel tired. Some may gain weight, and some may lose weight. Some may feel sad, and some may feel numb.
There are many types of depression – such as seasonal depression, peripartum depression, and anxious depression.
Depression has complex causes, multi-faceted expressions, and pervasive impacts on a person’s life. Moreover, some other diseases may also look like depression. Therefore, professional assessment and treatment are vital for people with depression symptoms.

2. Signs, symptoms (or Warning Signs)

Depression affects different people in different ways. Some signs and symptoms may include feeling several of the following for at least two weeks:

Feeling some or one of these feelings: sad, numb, irritated, hopeless, pessimistic, anxious/keyed up, lonely, and/or indifferent
Changes in sleep (can’t sleep or sleep a lot)
Changes in appetite (eat a lot or have no appetite)
Lack of concentration or focus
Changes in memory or decision making
Loss of energy
Lack of interest in activities or lost motivation
Hopelessness or guilty thoughts
Changes in movement (less activity or agitation)
Physical aches and pains
Self-harming thoughts or behaviors
Suicidal thoughts

3. Is depression prevalent in Chinese Community?

The prevalence of Depression in Chinese community is difficult to measure because of the stigma relate to mental health issues and because how Chinese American community perceive, express, and cope with depression symptoms. For example, in a 2015 review study, Kim et al (2015) estimated that 15.7% of Chinese American had depression, but in another study Zhang et al (2013) found that the life-time depression prevalence rate was 23% for Chinese American born in US.

Many Chinese American have experienced depression. We need to work on reducing the numbers of people suffer silently, being wrongly blamed for being “lazy” or “did not try hard enough.” We, as a caring community, can help people with depression get treatment and live their life fully.

4. How is depression diagnosed and treated?

It is imperative for people with depression symptoms to get professional diagnosis and treatment. Because people with other physical or psychological health conditions may show signs of depression (e.g., thyroid problems, anemia, sleep problems, anxiety disorder), and because there are many other mental health issues may also be mistaken as depression. Obtaining full assessed by a medical professional is necessary to diagnose depression. Your health provider(s) will ask you questions, may order blood test, and may ask you complete some assessments.

There are many options in treating depression: therapy (individual, group, or family), medication, Electroconvulsive Therapy (ECT), and Transcranial magnetic stimulation (TMS). Your health providers may also suggest you some auxiliary ways to support your recovery (such as exercise, self-help book, sleep hygiene, nutrition).

5. Are there warning signs of suicide?

Signs vary for many factors such as age, cultures, resources. People may try to hide their signs. Therefore, it is essential for us to take the actions to ask and to show care.

Many credible websites provide information about suicide warning signs. According to National Institute of Mental Health, suicide warning signs include:

1. Talking about

wanting to die,
feeling great guilt or shame,
being a burden to others.

2. Feeling

empty, hopeless, trapped, or having no reason to live;
extremely sad, more anxious, agitated, or full of rage;
unbearable emotional or physical pain.

3. Changing behavior, such as

making a plan or researching ways to die,
withdrawing from friends, saying good bye,
giving away important items, or making a will;
taking dangerous risks such as driving extremely fast;
displaying extreme mood swings; eating or sleeping more or less;
using drugs or alcohol more often.

6. I believe someone I love may have depression. As a family member or friend, what can I do?

Before taking action, please remember that depression impacts the whole person – including the person’s thinking, feeling, and judgments. So please do not take their reactions personally and remember to be patient with them and yourself.

There are many different approaches you can take. The key is helping them know that you care about them and you would like to help them to get better. I am sharing one of the common processes with you below.

A. Approach them in a caring and concerning way to communicate your care and your observations that lead to your worries.

Do NOT say, “I think you are depressed.”
Say:
- “I noticed some changes in you” (e.g., not laughing as much, staying in your room most of the time, stopped playing games, changes in appetite, sleep, or mood).
- “I have known you for some time, and these changes make me worrying about how you are doing.”

B. If they share with you what is happening to them

Listen nonjudgmentally.
Do not provide advice such as “you should do this…”
After listening, share with them that you heard that
Many reasons may lead to these signs and symptoms.
Have these feelings or changes do not mean this person is weak or not trying their hardest.
You wonder if they would like to get treatment, because you would like them to feel like themselves again.
If they say yes, you can call your primary doctor to ask for referral, call the community resources (see #7).
Check in with them later and ask if there is anything you can do.

C. If they did not want to talk

Do not take it personally.
Tell them you understand.
Ask them if you could check in with them later.
Tell them that you are willing to listen and talk when they want to.
Tell them that they are important to you.
Ask them if there is someone else they feel they can talk to.
Offer them resources (such as lifeline, warm line).

You can also:

Consider taking “Mental Health First Aid” class to learn these skills
Look at the NAMI websites for more suggestions and actions
Talk to your own health providers or a counselor about how to approach.

7. When To See a Doctor?

The earlier, the better! Because

early treatment is like to bring better prognosis,
professional health providers can provide an accurate diagnosis and effective treatment
you will “know” instead of “worrying”

If symptoms of depression are causing problems with your relationships, work, or family, see a professional, especially if you are also experiencing changes in sleep, energy, appetite, concentration, and motivation. Chinese Health Initiative provides extensive mental health resources on their website.

Seek help immediately if you are experiencing thoughts of harming yourself, which are common with depression. Call 911 or go to the nearest hospital emergency room or call the National Suicide Prevention Lifeline at 988.

Reference cited:

Kim, H. J., Park, E., Storr, C. L., Tran, K., & Juon, H. S. (2015). Depression among Asian-American Adults in the Community: Systematic Review and Meta-Analysis. PLoS One, 10(6), e0127760. https://doi.org/10.1371/journal.pone.0127760

Zhang, J., Fang, L., Wu, Y. W., & Wieczorek, W. F. (2013). Depression, anxiety, and suicidal ideation among Chinese Americans: a study of immigration-related factors. The Journal of nervous and mental disease, 201(1), 17–22. https://doi.org/10.1097/NMD.0b013e31827ab2e2