Month: July 2017

The Subtle Signs of Depression

Depression doesn’t always “present” as it should. Prolonged sadness, lack of hope, or loss of interest in previously enjoyed activities are the most commonly mentioned symptoms on mental health websites and in antidepressant ads, and they can certainly be the most affecting. But sometimes the disorder is subtler, and harder to identify, since it can make itself known in stranger ways than we’d like. Below are some of the less obvious, but nonetheless important, symptoms of depression – those you should be aware of (and which you should make your psychologist/psychiatrist aware of, if you’re seeing one). Knowing that depression can play out in counterintuitive ways is important, since knowing that you’re depressed is the first step in seeking help for it.

Externalized Symptoms

Depression can poke through in unexpected ways, both physical and behavioral – it’s kind of like depression is finding a way out, if it isn’t being acknowledged otherwise. “Some people, particularly men, are more likely to externalize their depression,” says psychologist and author of When Depression Hurts Your Relationship, Shannon Kolakowski, PsyD. “Depression symptoms come out through excessively drinking alcohol, seeking out an affair outside of the relationship, becoming aggressive, or withdrawing from those you love. Similarly, physical symptoms like backaches or low sexual desire are less recognized as depression because they’re externalized.” Extreme fatigue – both mental and physical – is a common symptom (of course it can be indicative of other things, so it’s important to get checked out), as are changes in eating habits (not eating, or conversely, overeating) or sleep patterns.

Lashing out

This is an extension of the one above, but worth highlighting, since it’s more specific, and may actually indicate a more severe form of depression. Sometimes the disorder can emerge as irritability or anger – when some part of you is at a loss internally or feeling helpless or hopeless, it’s easy to lash out. “Experiencing irritability, hostility, anger, and being sensitive to rejection are all common symptoms when depressed,” says Kolakowski. “Less well known is the fact that not only is irritability a sign of depression, but that it often signals a more severe level of depression. Hostility and irritability are also linked to a higher likelihood of having other mental illness, like anxiety. Other emotions such as sadness, shame, or helplessness often underlie the irritability, but irritability is what shows up on the surface.” If you’re noticing that you’re very short-tempered, or yelling at your spouse or kids a lot, or otherwise lashing out, take some time to think about what might emotion/s might be driving that behavior.

Perfectionism

Perfectionism and depression have been long connected to each other, and research studies have underlined the association for years. “Having all-or-nothing, rigid, and exceptionally high or unrealistic expectations are all symptoms of perfectionism, and can all contribute to depression,” says Kolakowski. “Perfectionism in depression tends to belie the idea that others will only love and accept someone if they’re perfect.” Self-esteem is what seems to mediate the link between perfectionism and depression, since perfectionists often think that they must be “perfect” to be acceptable, both to peers and themselves. “To perfectionists, to make a mistake is a sign of a personal defect or flaw, rather than the fact that it’s human to make mistakes, and that we all make mistakes. To counter the self-blame, fear of failure, and shame that comes with this, practicing self-acceptance and compassion are essential.” That may be very hard to learn to do on your own, so might need the help of a capable psychologist.

Inability to Concentrate

Everyone has problems concentrating from time to time, especially if something specific is on your mind. But pronounced concentration issues – so much that they affect your work or relationships – can also be a sign of underlying depression. “Concentration difficulties are a common symptom of depression, yet one that people may not associate with depression (think ADHD),” says psychologist Jon Rottenberg, PhD, author of The Depths: The Evolutionary Origins of the Depression Epidemic. “Many of the symptoms of depression are private experiences like sadness or feeling worthless, problems that people can conceal from others. What’s striking about concentration difficulties is that they directly impair functioning – these difficulties make it harder to work or go to school. Concentration problems can make people miss assignments or deadlines.”

He adds that it’s often these issues that prompt a person to get help in the end, since they’re less easy to hide from one’s coworkers, boss, or family. Concentration may be compromised because of another serious symptom of depression – rumination – in which a person turns certain topics over and over again in one’s head (past regrets, future worries), which can be time-consuming, futile, and depressogenic itself. And it can severely compromise one’s ability to concentrate on the present.

Extreme Guilt (about Ridiculous Stuff)

Guilt is obviously a natural sensation at times, but sometimes a deep feeling of guilt about many or most areas in your life can signal depression. Rottenberg calls it “pathological guilt,” and says, “what’s different for the depressed person is that the guilt can become all-consuming. He or she scans the past and sees only a series of failings. Sometimes the guilty thinking can become quite fanciful. The depressed person can feel guilty for being born, guilty for having had depression, and be unable to think of any major life role (friend, son or daughter, parent) without being consumed by feelings of regret.”

You Don’t See ‘Smiley Faces’

Being a “Debbie Downer” is sort of a funny joke, but there’s a much more macabre side to it: When you immediately pick out every negative element of a situation, and roundly ignore the positive, this pattern can escalate till it’s sabotaging. Humans are primed to pick up on negative cues, because they might indicate that action is required in the face of danger. So in a sense, negativity is an occupational hazard of being human – but when finding the negative colors your entire life, it starts to blur into depression. “It is striking that recent research suggests that someone with depression is less likely to visually focus on happy faces than a non-depressed person,” says psychologist Suzanne Roff-Wexler, PhD, founder of CompassPoint Consulting. “If we observed carefully, could we notice how a depressed person avoids happy faces or situations while being more ‘comfortable’ with the opposite? I wonder if someone with depression is even aware of this visual bias toward the negative.”

Being a “realist” can subtly shift into being pessimistic which can subtly shift into being negative and even feeling “at home” with depression. Watch yourself for how you react to neutral or even good news – does it seem good, or do you immediately discount it because it will surely turn out poorly in your mind?

Toggling

This is a critical one, because the “toggle” can be a big clue that something more serious is going on. When you’re depressed, a happy event can take you out of it, and things can seem fine, for a little while – but the depression typically returns once you acclimate to the event. “An interesting ‘symptom’ of depression that may not be well known,” says Roff-Wexler, “is when someone with depression is temporarily lifted out of that state due to a positive event, opportunity, or interpersonal connection. The depression is real and does not go away with a positive experience but it seems briefly alleviated, later to return. Think of it as toggling between being depressed and then not feeling depressed given outside circumstances.”

Self-Medicating

This is not such a subtle symptom, but is definitely worth mentioning. Depression often carries with it the comorbidity of addiction – people with depression are more likely to drink alcohol heavily, smoke, have eating disorders, and have other dependencies and addictions. After all, when you’re depressed, it’s natural to want to use the tools at your disposal to cope with it – the problem is that we’re not very good at picking healthy tools. It’s much easier to smoke and drink than to go to therapy and exercise. Of course, the former methods will ultimately make the depression worse, while the latter two will put you on track for recovery. If you notice that you’re engaging in any kind of substance or behavior more than you used to, or so much that it’s messing up your life in other ways, think seriously about talking to someone about it.

The subtler symptoms of depression definitely deserve attention if you’re experiencing any (or several) of them. Talk to a friend, or even better, reach out to a psychologist if you think you might be depressed. There’s no magic bullet for depression, but there are certainly treatments that are effective. It’s often just a matter of finding the right one, or the right combination. And remember you’re not alone: Lots of people deal with and recover from depression – and the more people talk about it, the easier the road to recovery becomes.

Why Mental Health in Workplace is so Crucial?

Last week, Walgreens Boots Alliance announced that it will expand its mental health services beyond simply filling prescriptions. Now, it will offer essential tools like screening and treatment, including teletherapy services. This is definitely something to cheer about during Mental Health Month—or in any month, really. A giant like Walgreens can give a huge boost to mental health awareness.

Why is awareness so crucial? Because one in five Americans currently suffer from mental health conditions, more than those suffering from medical conditions like diabetes and heart disease. In 2013, the United States spent more on mental health care than it did on any other category of medical care, according to a study published last week in Health Affairs.

This is more than just a goodwill play on Walgreen’s part: Today, patient adherence to prescriptions is worse for mental health conditions than for physical illnesses. Screening, awareness, and treatment will be good for their business.

But wait! It’s good news for everyone’s business. And as leaders, advocating for mental health is as important as any wellness or health benefit initiative. We absolutely must take mental health out of the closet. Serious mental health issues require serious care. Our colleagues must be encouraged through education and support to get help when they need it. If you aren’t convinced, read on:

1. Mental health issues often go unaddressed until it’s too late. The Association for Psychological Science reports that only 59% of people with mental illness—depression, anxiety, et cetera—receive treatment.

2. Stigma around mental health treatment, while lessening, still exists. When people don’t feel safe, they don’t take action.

3. Mental health is still treated as a taboo subject. If you don’t agree, just ask yourself: When’s the last time one of your colleagues went on disability for depression? Did you know about it? Doubtful.

4. Recently published, longitudinal studies show that work stress—in the form of psychological demands—is predictive of new cases of depression and general anxiety disorder.

5. Those in high-stress environments are twice as likely to develop new mental health problems as those in lower-stress environments.

No, it’s not likely that every person in need of help will also enroll in therapy. Walgreens, for example, has set a goal of screening three million people by 2017. But leaders can take action in other supportive ways: Reviews of effective ways to mitigate the stress reaction suggest that cognitive behavioral therapy—learning to recognize triggers and respond differently—has the best effects. Resilience training, via digital delivery, is an essential, accessible first start and a promising initial line of defense in mitigating or preventing mental health issues before they take root.

Resilience—the ability to cope and thrive in stressful situations—is associated with better attendance and job satisfaction. It’s also been shown to improve performance and reduce turnover. Resilient workers report less stress in their lives, are four times more likely to be satisfied on the job, and they’re 50% less likely to miss work in the first place.

Clearly, promoting mental health in the workplace needs to be part of any company’s wellness initiatives, and resilience is a key way to integrate good mental health with productivity. In an era when mental health awareness is slowly but surely creeping out of the closet, we owe it to our employees, to our businesses, and to ourselves to lead the way.

3 Ways Focusing On Mental Health Has Made Me A Better Entrepreneur

This May during Mental Health Awareness Month, I’ve been taking time to reflect on my own mental health. Specifically, how mental health and self-care practices impact my ability to lead my startup company. Entrepreneurship is both draining and exhilarating, all in one – and it’s common for those of us bringing emerging technologies, services and innovation to market to experience the stress and burden of our big ideas and dreams.

Investing in mental health as a social entrepreneur is of critical importance. With goals and ambitions to make the world a better place, you must ensure you’re filled up and in a strong place emotionally, mentally and spiritually to take on the challenge that is changing the world.

This year, I started to realize the drastic impact my self-care practices had on my company – and on my team. So I made it a priority to invest in myself – in taking a break, addressing mental health hurdles, and creating space in my schedule where I could focus on taking a breath and carving out time to reflect. As a result of these simple practices, especially the practice of mindfulness, I’ve been impacted for the better. Here’s how:

Self-Awareness
Leaders who remain self-aware and are honest about their strengths and weaknesses are inspirational to their teams – and they build trust along the way. This year, as I invest in my own mental health despite the deadlines and urgencies of the startup world, the reward and downstream impact of self-awareness has become apparent. Over time, self-awareness will help you avoid negative leadership slips – as you remain aware to your surroundings, your attitude and your overall state of being. These elements impact the way you speak to your team and the decisions you make – being self-aware is critically important to the culture you’re building. Most importantly, self-awareness helps you stay in tune with yourself and your needs – as a person and a professional.

Humility
One of the biggest benefits of strong mental health is the increased ability to embrace humility. There is strength in being vulnerable, and for many entrepreneurs who are used to toughing it out through stress and deadlines, humility and vulnerability come with embracing healthy mental health practices. This has been pivotal in my journey. In addition to building greater self-esteem, self-awareness and overall security, humility helps you embrace the simple truth that your company isn’t the only thing that needs attention – you do, too. By embracing this truth, it will flow downstream to your teams. Humble leaders – those willing to admit mistakes, get vulnerable about their needs and shortcomings, and those who encourage others to do the same can be some of the best leaders to work for.

Resiliency
A key topic in today’s workplace conversation, resiliency is the art of making it through the tough moments of life and coming out alive. We all face them – no matter what industry or company we’re in, we all face hurdles and roadblocks. Focusing on mental health can keep you grounded and well-equipped to handle the unknown elements of life so when they do occur, you have the coping skills and strategies to handle them healthily through resiliency. As a leader, resiliency is important – it sets an example for your team to do the same – and it is fostered overtime by addressing mental health needs and practices.

The outcome of taking time to focus on mental health and self-care cannot be understated. Said by John Maxwell, “A leader is one who knows the way, goes the way, and shows the way.” While embracing the ebb and flow of entrepreneurship, equip yourself appropriately by ensuring you’re taking time to focus on self-care, mental health and resiliency. These practices will not only help you improve and sustain healthy mental health and sense of self, but they will make you a stronger leader, ready to equip your team and set an example to be followed.