Editor’s note: This is the first of two stories speaking with Dr. Tammy Heskeyahu about depression and anxiety. The next installment will be published next Tuesday.
Not everyone who is depressed knows it.
“Some of us recognize when we do have anxiety and depression, but others of us don’t,” said Dr. Tammy Heskeyahu, a clinical psychologist with LVHN-Pocono.
She held an online workshop-style therapeutic support group and talked about the signs of anxiety and depression.
Sometimes a family member or friend is the first to recognize the problem.
Heskeyahu said a video by the World Health Organization called “The Black Dog” has been very helpful to people with depression. The four-minute video is accessible on YouTube and personifies depression as a black dog that is always there.
“If you know someone who is experiencing the signs of depression, this is something you can play for them,” she said.
WHO also made a black dog video to help family and friends of someone who is depressed to know what to say and what not to say. For example, telling a person to not feel bad because other people are worse off actually just makes the person feel worse. Now, they feel guilty for being depressed because other people are worse off.
Signs of anxiety
• Feeling nervous - upset stomach, butterflies, overwhelmed about something that other people might not find overwhelming.
• Overthinking - thinking constantly.
“People can’t shut off their minds. They’re always in their minds, and if they are in their minds, then they can’t be in the present,” Heskeyahu said. “It’s really hard for them to shut that down.”
• Worrying - catastrophizing thoughts, thinking the worst that could happen.
“It’s a way that people distort their thinking. It’s called cognitive distortion,” she said. “I know a lot of us do it, but some people do it to the extreme.”
• Intense fears and panic - shaking, shortness of breath, numbness in the fingers, debilitating panic attacks.
Heskeyahu said that often there is no trigger for a panic attack. It just comes on. Afterward, the person feels really tired, because of the adrenaline rush.
“When you’re overthinking, your mind is on a constant battle with your thoughts. Constantly analyzing this, analyzing that,” she said.
• Poor concentration - because a person’s thoughts are constantly going, it’s very hard to concentrate on what someone is saying.
• Worrying and overthinking at night - some people are fine throughout the day, but their mind runs all night and they can’t sleep.
• Physical symptoms - diarrhea and ulcers can manifest due to high anxiety.
Signs of depression
“You don’t have to be crying all the time to be depressed,” Heskeyahu said.
• Lack of interest in doing activities - don’t enjoy doing things that used to bring happiness.
• Low motivation - having a hard doing things that they want to do, such as taking a shower, paying the bills, or going shopping.
• Poor concentration - focus is off. Forget to do things. Not listening to someone who is talking.
• Irritability - short fused, on edge, upset by things that are not usually upsetting.
“It is a huge sign of depression,” she said. “Their reaction is a lot greater than it really deserves.”
• Appetite issues - some people don’t feel like eating, others overeat.
Not eating can cause an electrolyte imbalance. In extreme cases, it can affect the heart.
Overeating can cause excessive weight gain, which can then cause diabetes, high blood pressure or high cholesterol.
• Sleep issues - sleeping too much or not being able to sleep. Both can cause feelings of lethargy.
• Hopeless - feeling like things will never get better, withdrawn and don’t want to do things with family and friends.
“That kind of perpetuates a cycle of depression, because now they are not doing things that could stimulate their mood,” Heskeyahu said.
• Suicidal thoughts - thinking they are better off dead or want to end their lives.
“You have to remember that’s always a permanent solution to a temporary problem,” she said,
Not all people who are depressed will have suicidal thoughts.
Help is available
If someone is thinking about suicide, Heskeyahu recommends calling a Suicide Prevention Hotline.
The Pennsylvania Department of Health listed these hotlines on its website:
• PA Support and Referral Helpline: 1-855-284-2494 (TTY: 724-631-5600)
• National Suicide Prevention Lifeline: 1-800-273-TALK (8255); for Spanish call 1-888-628-9454
• Crisis Text Line: Text PA to 741741
• Veteran Crisis Line: 1-800-273-TALK (8255)
• Disaster Distress Helpline: 1-800-985-5990
Depression and anxiety can happen when a person doesn't even realize it. METROGRAPHICS
Dr. Tammy Heskeyahu is a clinical psychologist with LVHN-Pocono.