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The picture you may have in your head when hearing someone is depressed, or has been diagnosed with depression is typically not a true “picture.” People are often surprised to hear that a friend or family member is depressed as they do not “act the way a depressed person should act.”

Depression Facts versus Depression Truths

So just what is the real truth about depression? Having a better handle on what depression looks like may let you give help and support where it truly is needed. Being able to come to terms with one’s own depression with the help of friends and family is the first step in seeking treatment.

• “Depressed people are usually miserable and prefer to be left alone.” Fact? Truth? Very often people with depression feel their best when they are socializing, being the “life of the party,” attending events and activities and staying very active within their community of friends and family. Party goers are seldom viewed as depressed and may go their entire lives without the treatment they so desperately need.

• “Depression and life’s problems fade into the background of living the high life.” Fact? Truth? Staying fun loving and in the lime-light keeps the sadness, fear and panic away — at least for a short while. Moods may change and there may be times when you feel better alone and miserable around friends, however these mood swings may just occur at random times with no discernible pattern.

• “Depression really just means that you are sad.” Fact? Truth? While being depressed may feel like a heavy weight of sadness is weighing down your every thought and move, depression may also take on other less recognizable forms. Depression may make itself known through making one irritable and easy to anger – often to make others feel bad so you can feel better about yourself.

• “Depression makes you sleepy.” Fact? Truth? Contradictory symptoms often makes depression so hard to detect. Depression may affect your sleeping patterns – you may find you have trouble falling asleep, waking up on time or sleeping away most of the day. Loss of weight may be a welcome change, but not because you become so fidgety and anxious you find you can’t sit still long enough to enjoy a meal. Memory issues may develop where you find you are not able to remember simple or routine events on a week to week basis. Your libido or sex drive may dwindle away to nothing or you may become super active sexually. Depression has so many faces that it really is a diagnosis that can go undiagnosed for years and years.

• “Antidepressants will not work.”Fact? Truth? Many people believe that taking antidepressants will not work for them as they may have known friends who took them to no avail, or watched news reports on the millions of people on antidepressants that may or may not make a difference in their lives. It is true that depression rates are rising; however this needs to viewed in the light of mental health professionals becoming better at making the correct diagnosis than in previous years, rather than people being diagnosed with depression for the lack of a better diagnosis. It is true that some antidepressants are not effective for everyone. Individual treatment plans make for better strategies and regimens in a multifaceted treatment process.

Depression – Help a Phone Call Away

Give the office a call to set up a convenient time to meet.

Thousands of people every day wonder if their behavior or emotional state is normal or not. Unfortunately, someone can needlessly suffer for years before their actions or symptoms become out of control and psychiatric help is finally sought.

Mental Health Diagnoses

With more than 200 classified forms of mental health illness, the organization Mental Health Awareness reports that mental health disorders often share similar symptoms. When multiple diagnoses are present, it takes a skilled professional to make an accurate assessment to design an individual treatment plan for recovery.

Following are some of the numerous symptoms and problematic behaviors that indicate further mental health appraisal is in order.

• Exhibiting frequent and dangerous sexual acting out: The issue may be psychological, emotional or trauma based and include sexting, acting as a prostitute, having sex with multiple partners or wanting an open relationship without boundaries.

• Displaying frequent physical and/or verbal aggression: Having a “quick temper” or a “difficult personality” does not automatically point to a mental health disorder. Behaviors alerting you to a possible mental health disorder include frequently lashing out in anger at others, being abusive to others (verbal, physical, or sexual abuse), or acting in a manner that jeopardizes your job or living conditions.

• Planning to harm yourself or commit suicide: All suicidal threats need to be addressed. Threats with a plan need immediate attention.

• Finding yourself extremely fatigued or depressed: Many have experienced being “worn out” from a hectic work or family week, or feeling sad and depressed about their job, financial situation or relationship. A mental health evaluation may be in order if you suffer for example from chronic sleep disturbance, feel hopeless or helpless, do not care about previously enjoyed activities, have weight gain or weight loss, find yourself irritable with others for no real reason, or finding it more and more difficult just making it through the day.

• Preoccupation with physical appearance, money or crime: Many in our society may display narcissism yet still be within “normal” ranges. Clinical narcissism on the other hand, interferes with one’s daily life routine. Examples include acting impulsively, gambling beyond your means, displaying risky sexual behaviors including infidelity, substance abuse / addiction, or being extremely vain.  It is time to make an appointment with a psychiatrist for therapeutic intervention.

• Flashbacks or night terrors: After experiencing or witnessing a traumatic event, it is not uncommon to experience flashbacks or night terrors. Flashbacks about such a traumatic event is known as Secondary Trauma which can often be just as upsetting as or more so than the original event.

• Frequent mood changes: Those that suffer from emotional lability, changing moods, engaging in risky behaviors without restriction, and having intense emotional reactions to normal everyday situations would find receiving the correct mental health diagnosis or the more common dual or combination mental health diagnoses and treatment life changing.

With the multitude of disorders and mental health illness where symptoms may be identical or overlap, a mental health evaluation by a specialist in the field will find the correct diagnosis so that proper treatment can be started.  Call the office for an appointment today.

The majority of time when patients or mental health professionals talk about the diagnosis and treatment of depression, they are referring to unipolar depression. While bipolar depression may be incorrectly diagnosed as unipolar depression, the treatment including medications prescribed are completely different.

Bipolar Disorder Difficult to Diagnose

The correct diagnosis of unipolar or bipolar depression can be missed by inexperienced professionals. When a person with bipolar disorder is in the low phase of their cycle they may be incorrectly diagnosed as having unipolar depression as both types of depression look so similar at that time. ULifeline reports that someone with bipolar depression may experience depressive episodes for years at a time without ever having a period of mania or hypomania, thus never receiving the correct diagnosis and treatment.

The Highs and Lows of Depression 

Those with bipolar depression have periods of time that they experience low moods or depression; however, they also have episodes of high moods or mania where they feel an increased energy, euphoria, impulsive behaviors and insomnia. People who have unipolar depression do not go through the “highs” found with bipolar depression. While both forms of depression can continue for years at a time they both respond to treatment when the proper set of medications are prescribed.

Symptoms of Depression

While any of us may feel sad or depressed for a time, continuing depression and development of associated behaviors point toward the need to seek out professional help. The symptoms of unipolar or bipolar depression that are most common are:

• Extreme sadness or depressed mood
• Apathy
• Low energy levels
• Feelings of loneliness or withdrawal from family and friends
• Lack of interest in normally enjoyable activities
• Sleeping problems (sleeping too much or inability to sleep)
• Suicidal thoughts and feelings

Symptoms of Bipolar Mania

Common symptoms of bipolar mania which may occur after an episode of bipolar depression include:

• Behaviors exhibited of being happy or euphoric, confident, energetic and productive
• Racing thoughts and/or fast speech
• Decreased need for sleep along with not feeling tired
• Irritability, agitation, and aggression
• Impulsive behaviors (i.e., sexual escapades, spending sprees, heavy gambling, abuse of illegal drugs or over-the-counter medications)
• Displaying high-risk behaviors with poor judgment
• Difficulty focusing or concentrating on a task or activity

Unipolar and Bipolar Depression Medication

Having the correct diagnosis in place is critical. While antidepressants are used to treat depression a person with bipolar depression who takes an antidepressant may find the medication triggering a dangerous manic episode. Bipolar depression requires a different set of pharmaceuticals, most commonly a mood stabilizer and anti-manic medications.

Unipolar and Bipolar Atlanta Psychiatrist

A skilled psychiatrist will design your treatment regime to fit you and your needs after a comprehensive evaluation for a correct diagnosis. Call Dr. Hege for a confidential appointment and help find the correct diagnosis.

Research data by the National Center for Biotechnology show that many patients initially prescribed antidepressant medication do not report a timely remission of their depression. Studies have shown that only 33% of those diagnosed with major depression get better with the initial antidepressant medication. Another 30% achieve depression relief after taking a combination of different medications, or through a combination of medicines and cognitive behavioral therapy.  The final roughly 30% of patients do not respond to numerous treatment attempts and may have treatment resistant depression (TRD).

Depression by the Numbers

Clinical depression affects more than 15 million adults in the U.S.  It is being predicted that in the years to come depression will become the second most common illness in the world. For those 30% that do not respond to various treatment options, an experienced psychiatrist may find them to have treatment resistant depression – the diagnosis that is one of the most challenging conditions a psychiatrist may face.

What is Treatment Resistant Depression?

The answer is often hard for mental health professionals to explain or agree upon. Some questions you may ask yourself before calling to set up an appointment with a local psychiatrist experienced in TRD follow:

• Has your depression treatment / medications failed to make you feel better?
• Do you feel your treatment has helped with the depression but you still do not feel like your old self?
• Have you found that your medication’s side effects have been hard to handle?

If you said “yes” to any of the above questions get a specialist involved to develop a treatment plan that “fits” you. Whether or not you have treatment resistant depression, it is important to talk with your mental health professional to examine how your life can become a joy that feels worth living.

Living with Undiagnosed TRD

Depression treatments do not always work. Those with undiagnosed treatment resistant depression may become disheartened when their treatment plan keeps changing but no positive results are seen.  Living with TRD can leave one feeling hopeless, discouraged, and even demoralized. Months and years can go by without finding any relief for your depression. It can take time to work through, but an experienced psychiatrist can help.

Finding the Right Doctor Key to Success

Primary care doctors do treat depression and prescribe 60% to 65% of antidepressants in the U.S.  If you have not had success with the medications prescribed for your depression or think you may have treatment resistant depression it is time to see a TRD specialist.

Call the office for a confidential assessment. Evening and weekend appointments are available for your convenience.

Having been a bully or the victim of a bully is generally thought to be a problem of childhood and adolescence which becomes virtually non-existent with the passage into adulthood. A research study published in the Journal of American Medical Association – Psychiatry (JAMA Psychiatry) reports that effects of bullying continue well into adulthood significantly increasing the risk for psychiatric problems such as depression, social anxiety disorder, and suicidal thoughts as well as the development of substance abuse of illegal drugs and/or prescription medications.

Types of Bullying Behaviors

Bullying defines a group of repetitive, aggressive behaviors used to abuse or intimidate others and establish psychological or physical dominance over its victims. Bullying may take place in person or online. Bullying behaviors include physical intimidation or actual assault, verbal intimidation, or social intimidation.

In adulthood bullying may be seen in work and social settings, where the victim is teased, threatened, punched, kicked, pushed, excluded from the group, or where hurtful rumors are spread. In the “virtual world” bullying can come via text messages, public or shared videos, Facebook posts, private e-mails, or in online group forums.

Bullying versus Victim Statistics

Research studies have looked at three main subgroups related to bullying. One group contained those who admitted to bullying others, a second study group was for victims of bullying, and a third group was for those that were bully-victims. Bully-victims are those that have been both a victim and a bully, picking on others in response to being picked on themselves. The statistics of each subgroup follows:

• Bullies display 4 times the risk of developing antisocial personality disorder than their non-bully social peers. Bullies tend to be the most socially adept and may use their bullying skills to assist them in rising up through social tiers and interactions.
• Victims show 4 times the prevalence of generalized anxiety, agoraphobia and panic disorder as adults when compared to those adults who were not bullied growing up. Victims of bullying report the greatest anxiety problems overall.
• Bully-victims have 14 times the risk of developing panic disorder, 5 times the risk of being diagnosed with depressive disorders and 10 times the risk of having suicidal thoughts and behaviors. Overall bully-victims have the most significant emotional issues which includes suicidal actions.

Successful Treatment of Social Anxiety Disorder

The treatment of social anxiety disorder related to bullying may include a combination of medications, cognitive behavioral therapy and a variety of adjunct therapies dependent upon the severity of social anxiety, other co-existing mental health issues such as depression, suicidal thoughts or substance abuse.

The memory of being a bully or a victim of bullying may have been repressed, yet the suffering continues. Working closely with experienced mental health professionals can lead you through the healing process to a productive life without the fear, anxiety, or depression of your current situation.

Bullying – Victims Social Anxiety Doctor

Call Dr. Hege’s office for a confidential appointment and comprehensive evaluation.

Many do not understand what depression looks like, thinking that persistent sadness is the main symptom to be identified.  While sadness can be a symptom, it is often more likely that a mental health professional will diagnosis depression looking at a variety of other symptoms. Depression may display subtle and confusing signs leading a person to believe that “this is just the way my life is,” not that they have a treatable disease that is casting a shadow over their life and the lives of those around them.

The Statistics of Depression

The Center for Disease Control and Office for National Statistics report that almost 20 million Americans suffer from depression. The data concludes that up to 25% of women and up to 12% of men will become clinically depressed in their lifetime, with the majority never being diagnosed. With a poor understanding of what depression looks like, many endure years with a variety of symptoms that impact their daily lives without ever considering they may be depressed.

Depression Triggers Variety of Symptoms

Depression may trigger symptoms that are not typically thought of with depression. Constant tiredness, insomnia, poor appetite, forgetfulness, or being unable to focus and concentrate often lead one to think they are just working too hard, not getting enough sleep, or feeling stress from daily life. With depression you can still function, continue to work, have relationships, raise a family and continue to push yourself from day to day, month to month.

Signs and Symptoms of Depression

Although each case of depression may appear differently, there are several common factors to look for:

• Changes in weight, sleeping habits or appetite – these symptoms vary from person to person. For example, one person may want to sleep all the time, while others may battle insomnia; losing weight from poor appetite is a symptom for one while weight gain from eating all the time fits another person.
• Physical symptoms that do not go away – includes recurring headaches, back aches, digestive or GI disorders, chronic fatigue, menstrual issues or aches and pains that persist.
• Low mood – This is the most obvious symptom of depression; low mood may also transcend into low self-esteem, becoming self-critical or judgmental, and finding oneself irritable with friends, family and co-workers; a low mood may also “flip” at a certain time of the day where you may feel more animated, anxious, and energetic.
• General apathy and lack of interest or pleasure in normal daily activities – You may feel listless, washed out, the world or your life flat or colorless. Depression often promotes isolation with sufferers not wanting to be around others, not wanting to go out and “have fun,” tending to spend more and more time at home.
• Low sex drive – In addition to being a symptom of depression, low sex drive may have a biological cause as depression is linked with hormonal changes.
• Forgetfulness or difficulty concentrating – decreased ability to recall the details of an event or situation, which impacts on problem solving and decision making skills.
• Pessimistic or hopeless outlook on life – a depressed person is more apt to dwell on negative consequences, or see upcoming events or social activities in a negative manner; they may experience feelings of guilt, helplessness or thoughts of suicide

Women and Depression

In the book “Listening to Depression” women often engage in behaviors that are “masked depression.” Depression for women may include compulsive shopping, working, eating or drinking. Women may also say they are not depressed but rather they just do not care – an attitude of indifference can signal depression.

Depression Help in Atlanta

Call the office for an appointment to discuss your symptoms and determine your next steps. Dr. Hege has decades of successful treatment for those suffering from depression.

Adult ADHD, bipolar disorder, major depressive disorder, schizophrenia and Autism have been genetically linked in the world’s largest study of its kind. Research found that a person’s genome, the complete set of their own DNA, for the above listed psychiatric disorders can be traced back to the same common inherited genetic risk factors. These studies have been intensive, involving countries all around the world and a database of more than 60,000 participants.

Studying the Genetic Link with Mental Health

The National Institute of Mental Health reports that the common genetic code variations account for up to 28% risk for developing the illness. The DNA-Gene code exhibits four regions of the genetic code where variation was linked to all five disorders. Bipolar disorder is noted in the top two areas of overlap with the highest combination of bipolar-depression, and bipolar-schizophrenia. Adult ADHD and depression show a moderate risk factor as well as well as being the category where the majority of patients go for psychiatric help.

Genetic, Dual Diagnosis and Treatment

Discovering your true diagnosis is key to living a functional life rather than forever guessing what might be wrong. A comprehensive mental health evaluation will allow experts to plan out the proper treatment, medications, cognitive behavioral therapy and other adjunct therapies if indicated. Bipolar disorder and depression overlapping 10% of genetic variation accounts for significant numbers of those with a dual diagnosis receiving only a piece of the treatment puzzle.

Statistics show that inheritability is 80% with schizophrenia using long-term twin and family studies and 23% where the common genetic variation is accounted for. When two psychiatric disorders overlap through shared common inherited genetic risk variations is when choosing a qualified and experienced psychiatrist becomes critical.

Give the office a call today – evening and weekend appointments are available to fit your busy life.

Research has found that sleep problems which used to be viewed as a symptom of mental health disruption may actually be a contributing factor for psychiatric disorders. Studies at Harvard Medical School confirm that sleep problems affect between 10% to 18% of adults in the general U.S. population; the percentage of adult patients seen in psychiatric practices with chronic sleep issues jumps to 80%.

Sleep Problems Point to Increased Risk for Psychiatric Disorders

Patients with a diagnosis of anxiety, depression, bipolar disorder and ADHD commonly report being plagued with sleep problems. While sleep dysfunction was once viewed as a symptom, clinical data supports the hypothesis that adult sleep problems raise the risk for developing a psychiatric disorder. In long term studies it was found that adults who reported a history of insomnia were four times as likely to develop major depression on re-evaluation three years later, indicating the sleep disruptions developed before the mental health disorder.

Sleep Problems versus use of Antipsychotics

Sleep issues and insomnia began to be more closely looked at in the 1970’s. The sleep problems were thought to be directly tied to use of antipsychotics at the time; however, data indicates a long history of sleep disturbance complaints long before use of antipsychotics began. Today it is more widely believed that chronic sleep problems puts one more at risk for the development of psychiatric issues and that treating the sleep disorder can actually assist in alleviating symptoms of a co-occurring mental health problem.

Sleep Disorders in Psychiatric Patients

Of the more than 70 types of sleep disorders the most common problems are insomnia, obstructive sleep apnea, unpleasant sleep movement syndromes and narcolepsy. The University of Brazil Medical School reports the type and impact of the sleep problems vary by the psychiatric diagnosis with examples noted below:

• Up to 90% of adults with major depression experience a sleep problem
• One-in-five adults with depression suffer from obstructive sleep apnea
• Depressed adults with insomnia less likely to respond to treatment, at a higher risk for relapse and are more likely to die by suicide
• Up to 99% of adults with bipolar disorder experience insomnia or restless sleep
• In adults with bipolar depression up to 78% sleep in excessive amounts
• More than 50% of adults with anxiety disorders have dysfunctional sleep patterns
• Sleep problems precede anxiety disorders 27% of the time
• Sleep dysfunction precedes depression 69% of the time
• 68% of adults with PTSD report sleeping problems
• Long term studies indicate that insomnia or other sleep disruptions worsen before a manic episode or bipolar depression

Sleep and mental health are interconnected though not yet completely understood. Neurochemistry studies do indicate that having a good night’s sleep promotes a healthier outlook, while chronic sleep problems can set up an arena for negative thought processes and emotional vulnerability. Call the office for a comprehensive evaluation with Dr. Hege who will work with you to get your sleep patterns and mental health issues back into functional ranges.

The National Institute of Mental Health is evaluating research data on insomnia and depression from major U.S. schools such as Stanford, Duke, the University of Pittsburgh, as well as Ryerson University in Toronto. The research from all schools conclude that while it has been long held belief that depression causes insomnia, insomnia can actually precede and directly contribute to causing depression. The link between depression and insomnia works in both directions, however treating both can make a huge difference in curing both depression and insomnia.

Common Signs of Insomnia with Undiagnosed Depression

Some of the most common signs reported for an insomnia diagnosis include:

• Fatigue during the daytime with loss of energy
• Irritability with others
• Difficulty concentrating and focusing
• Feeling like you never get “enough” sleep
• Trouble falling asleep
• Difficulty going back to sleep after waking up during the night
• Waking up at all hours of the night
• Waking up before the alarm clock goes off

Common signs of Major Depression

Some of the most common symptoms of major depression also include signs that point to insomnia:

• Change in sleep patterns
• Fatigue or loss of energy
• Impaired concentration with complaints of poor memory
• Insomnia or its reverse hypersomnia (excessive sleeping)
• Difficulty falling asleep
• Problems staying asleep all night

While there is cross-over of symptoms between insomnia and depression it does not mean you have one or both of these two diagnoses. Only an experienced psychiatrist can correctly diagnosis and successfully treat either insomnia, depression, or a combination of the two discovering if it was insomnia that preceded the depression or vise-versa.

Combination Treatment Effective

Depression and insomnia do respond to use of one or a combination of medication and cognitive behavioral therapy (CBT). While pharmacological and CBT can be used to treat both depression and insomnia, treatment of insomnia or sleep problems are typically an integral component used in the treatment of depression.

Getting Help

Self-diagnosis or incorrect diagnosis and treatment may cause more harm than good, delay proper treatment, and risk developing other physical, medical or mental health issues.

Call Dr. Hege for a confidential day, evening or weekend appointment.

Prescription drug addiction affects more than 15 million people in the U.S. The numbers of adult abuse of prescription drugs now far exceeds all of those that abuse cocaine, inhalants, heroin and hallucinogens combined.  The National Institute on Drug Abuse estimates that 48 million have used prescription medication for non-medical purposes at some point in their lifetime; this number indicates that around 20% of the U.S. population have abused at least one of their prescription drugs.

Prescription Drugs and OTC Medications Commonly Abused

In recent years WebMD reports that studies of the reasons for doctor or ER visits show a dramatic increase in the abuse of prescription and OTC (over-the-counter) medications. Addiction drug treatment programs show just as sharp an increase in drug addiction admissions. The drugs most commonly abused are:

• Opioid Pain Relievers such as Vicodin, Opana, or OxyContin, codeine, morphine
• Stimulants used for ADHD such as Adderall, Concerta, or Ritalin
• Depressants for relieving anxiety or sleep disorders such as Valium, Xanax, Ativan, Klonopin

The OTC drugs that are most commonly abused are:

• Cough and cold OTC remedies that contain dextromethorphan

What is Prescription Drug Addiction?

Addiction is a chronic brain disease that typically has numerous periods of relapse into abuse. Abusing drugs, including prescription medication leads to actual changes in the function and structure of the adult brain.

Following the dosage and frequency of a prescription may become more and more difficult to follow, affecting self control and the ability to make good sound decisions. Visits to the ER or to multiple doctors for more medications is abuse and the intense impulses to take more drugs become more and more frequent.

There is Help for Prescription Drug Addiction

Prescription and OTC medications are very effective when they are taken as ordered. Long term pain relief medication use however, such as with an opioid, can lead to drug abuse with both physical dependence and addiction. Professional help is crucial for a sound recovery.

An experienced psychiatrist and other medical professionals can help change the direction your prescription drug use is heading. Call the office for an appointment.