How to tell if you are depressed and when to get help
Depression is a well-studied condition that has tested and effective therapeutic modalities
October is Depression Awareness Month. Major depression is one of the most common mental illnesses, affecting more than 16 million American adults each year. While there has been increasing awareness of the need for police officers to have access to behavioral health support, many cops still feel there is a stigma associated with asking for help. If you are feeling suicidal, help is available. Call the National Suicide Prevention Hotline at 800/273-8255, or visit suicidepreventionlifeline.org.
Here are five facts about depression every police officer needs to know:
- Depression is not a life sentence
- Depression is not a sign of weakness
- Depression is not something you “just get over”
- Depression is not something you should be ashamed of
- If you suffer from depression, you are not a failure, weak or defective.
Depression is estimated to affect one in four people over the course of a lifetime, and as many as 40 percent of all Americans will experience a diagnosable mental illness at some point, including depression and anxiety. About one in 10 persons will try to commit suicide at least once, with the majority doing so while experiencing profound depression.
But there is hope.
What we want you to take away from this article is that depression is common and treatable. There is hope even when someone feels at the end of their rope. We know this to be true because as two clinicians – one a police wife and the other a cop – we have walked along with hundreds on their journey, and seen them go from despair to feeling like their old selves, or even a better version of themselves.
How depression moves from despair to worthlessness to suicide
When you are in the depths of depression, despair sets in along with hopelessness, worthlessness and an overall feeling of failure. These feelings wreak havoc on the mind, body and soul.
Depression sneaks in slowly, beginning with minor mood changes, then getting progressively worse, until one day in a worst-case scenario the person wonders, what is the use in living?
Chronic depression is a liar, often making those suffering believe they are a burden to the people who love and care about them. This feeling becomes so extreme that the person begins thinking they add no value to anyone’s life and their friends and family would be better off without them. This is contrary to the greatest myth about suicide, where we mistakenly believe the person who takes their life is selfish because they are not considering those around them.
In our experience and that of many others in the mental health field, suicide attempts can come from a place of selflessness when someone believes they are a source of pain for those around them, and the only way to end their loved one’s suffering is for that person to disappear. The depressed person’s hopelessness is so strong you cannot talk them out of this belief.
What to do when you or someone you know is depressed
First, recognize depression is a treatable medical condition. What is not effective is trying to talk yourself or someone else out of feeling depressed. As much as we wished that worked, it only leads to feelings of shame and frustration. Trust us on this: Depressed people try talking themselves out of it repeatedly, but it does not work!
The best practice is to connect with a team of professionals, such as your primary care physician, a licensed mental health counselor to provide talk therapy, or a psychiatrist for medication management. Depression is a well-studied condition that has tested and effective therapeutic modalities. Seeking help is the first step toward getting better. Acceptance of the need for help is powerful, whether we grant it to ourselves or another person.
However, if someone is having thoughts of ending their life – or you are experiencing such thoughts yourself – take this very seriously. An immediate evaluation at an emergency room or other safe environment is critical, where medical professionals can ask the right questions to assess the severity of the risk and the level of care required. Never try to talk them (or yourself) “off the ledge.” Trained mental health professionals know this is ineffective. The greatest need is providing a safe environment until the depression can be medically stabilized.
How do we diagnose depression?
The protocol for diagnosing depression and anxiety is to complete a psychosocial assessment that looks at current functioning and stressors, life and family situations, past history and even family history to determine any genetic predisposition.
We ask about anyone in the family tree who has committed or attempted suicide. Not everyone seeks out treatment due to shame and fear of stigma and family history is the greatest predictor to know if someone is at risk.
Many law enforcement experts believe that PTSD is the greatest predictor of depression. As healers of depression, we disagree with this assertion. We believe it is easier for law enforcement to make sense of and admit to PTSD. That means someone survived a traumatic situation (an outside event) and places the source of depression on “something that happened.” The law enforcement community still has a lot of shame and stigma around admitting police officers become depressed; placing the source “outside” is a denial strategy.
How can we prevent depression?
Depressed people become stuck in concrete thinking, viewing the world and their situation as black or white, right or wrong, good or bad, and have strong opinions while closed off to new ideas and perspectives. They are afraid to feel for they believe if they feel sad, that they will not be able to function.
When people are depressed and/or anxious their mind creates walls that are hard to break though and they live within a defined box. Depressed and anxious people become emotionally inflexible because they hold tightly onto their set of beliefs, believing that will keep them emotionally and mentally safe. In reality, this is very harmful and destructive.
Instead, the goal is to adapt a mindset of psychological flexibility, which is key to becoming emotionally fit and mentally nimble. You will be better at handling painful thoughts and feelings and more effective at making changes in your life so that you can develop a rich and meaningful life. If it not possible to “think” yourself into a satisfying life, you choose behaviors that create good feelings, thoughts and memories.
Traditionally, emotional resilience has been defined as the ability to “bounce back” when hit with adverse circumstances, so resiliency skills are generally only implemented when in crisis or chaos. By that time, it is too late.
A common practice in trying to find happiness is to avoid and control unwanted feelings such as sadness, nervousness, anger and hurt; however, the more we try to control these emotions, instead of allowing ourselves to feel them, the more intense the emotions are and the more unhappy we become. We need to remember that happiness is often more abnormal than normal.
The best defense against depression and/or anxiety is being able to stay in the moment with uncomfortable or unwanted emotions without labeling them good or bad. Just accept them for what they are and do not try to change the moment into something else. This practice is known as mindfulness. For example if you find yourself feeling lonely, just feel lonely! Do not pick up your cell phone to be entertained or fill a void, simply experience the loneliness and accept it. If you tend to be nervous in certain social settings with unfamiliar people, simply experience the nerves instead of reaching for a beer to feel relaxed. If you are sad about a loss or disappointment, be sad without looking to numb the pain.
We must also realize that thoughts are just words floating around in our head. They do not define us and they are rarely true. Research has shown 80% of our thoughts contain negative messages and when we are depressed, it is easier to believe those messages are true because the feelings attached to those words really hurt. When we are psychologically flexible, we realize they are just stories our minds create. We learn to give less meaning to them and thus they have less impact on our mood. Trying to control thoughts and feelings will lead to more anxiety and depression rather than bringing us to a happy place.
Self-care is also important for resiliency. Here are some easy ways for police officers to practice self-care:
- Develop good sleep and eating habits.
- Incorporate physical activity such as a walk around the block, weight lifting, a run or a yoga class into your daily routine.
- Surround yourself with positive people who make you laugh.
- Do the next right thing. The past is done. Do not dwell. Learn to heal.
- Learn about and incorporate the practice of mindfulness, where you are able to be in the moment without judgement.
- Start a gratitude journal for one year. Name three things you are grateful for daily. Add new items every day. Do not repeat an item from before. This activity changes the neuropathways in the brain.
- Realize you have no control over thoughts, emotions and memories; instead come back to mindfulness to experience your present moment.
- Accept that because you have a thought that does not make it true. Thoughts such as I am a failure are just words and stories in your head. We all have them. They do not define us. If you have a hurtful story, try to defuse it. One technique is to repeat for three minutes, “I’m a failure” It will soon lose meaning.
Culture can defeat depression
The greatest prevention of depression is a stigma-free culture where police officers can admit freely and readily that they are having a bad day, that life hurts, that they are psychologically bruised from the call they just handled, or they are sad for no reason.
Police officers need to feel free to seek talk therapy, hospitalization and/or medication management without the fear of their job being at risk or being seen as emotionally weak. We need to be a culture where we do not try to save our own, but know when to defer and refer to those who are trained and licensed in the mental health field. We need to know when trying to save someone actually puts them at more risk and feeds into the shame and fears they already carry.
We need to remember that depression is common, it is treatable and there is no shame in being depressed.