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How to Get Help: Dealing with Anxiety and Depression

May 10, 2018 1:00 PM with Dr. Rebecca Nelson

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When our bodies feel sick, or we’re in physical pain, asking for help is an easy thing to do. When it comes to coping with or getting treated for mental illnesses like anxiety and depression, it doesn’t always feel so easy, and millions go undiagnosed. How can you know when your everyday reactions and difficult emotions might be something more? What can be done to diagnose and manage these symptoms? Start with Dr. Rebecca Nelson, Licensed Clinial Psychologist, who will be taking questions and providing expertise on anxiety and depression, including symptoms, current forms of treatment and therapy and the different specialists who can offer support. 

Rebecca Nelson (NorthShore) - 12:48 PM:
Hi everyone. I'm Dr. Nelson, a Licensed Clinical Psychologist. I'm glad to join you for today's chat. All of us have felt anxious, sad, or upset at some point. For some these feelings are especially intense or don't go away. The more we share, educate and support one another the more we emphasize the importance of mental health and promote a supportive community. What questions can I answer for you?

Kathryn (Moderator) - 1:00 PM:
Our chat on anxiety and depression will start at 1 pm today. Please note that due to the high volume, we will not be able to answer all of the questions today. We will work on providing follow up information.

  Melaine (Chicago, IL) - 1:01 PM:
Does anxiety cause dizziness and your blood pressure to rise? What are other symptoms of having anxiety?
Rebecca Nelson
Yes, those are some very common symptoms. Other symptoms include upset stomach, muscle tightness or tension, general nervousness or jumpiness, irritability, difficulty focusing. More subtle symptoms might include difficulty relaxing, and at night difficulty with sleep: settling to sleep and maintaining sleep.

  James (Chicago, IL) - 1:03 PM:
I often find that it is difficult to concentrate and get things done. Could this be linked to anxiety/depression? I have dealt with both, but not sure why as of lately I seem to be more distracted.
Rebecca Nelson
Possibly, but difficult to know with such little information. You might want to think about what has been on your mind lately, and if there is anything in particular that might be bothering you. If so, does it interfere in other areas (appetite, sleep, energy, work functioning, or relationships). If there is interference then you might want to get some support.

  Christine (Oak Brook, IL) - 1:06 PM:
I have suffered from anxiety and depression on my own, over many years. Since I recently lost someone close to me and have been having an even harder time than usual, I finally made an appointment to see a Psychiatrist. What should I expect on my first visit? I don't know what I am supposed to say or do.
Rebecca Nelson
Thank you for reaching out. I think a lot of people will benefit from your experience and question. What will be helpful for the psychiatrist (who is physician, a M.D.) is for you to describe your symptoms, how severe you feel they are, and how long you have been experiencing them. Let the doctor know if you have any history of any previous mental or medical health challenges or disorders, including substance use or abuse, and are taking any prescription medications. If you feel this is a lot to remember or keep track of, feel free to write your history ahead of time and bring it with you. Bring medications with you if you have them. Also, note any significant events in your life that you feel contributed to your anxiety and depression, such as the loss you noted. Grief and bereavement can contribute notably. And just be yourself. Mental health clinicians are compassionate people. Let her or him know you are a little nervous. S/he will know how to make you feel more comfortable.

  Julia (Highland Park, IL) - 1:14 PM:
My teens are feeling a lot of pressure from school and home. My son has anxiety that has surfaced since he started high school, but he doesn't want to talk to anyone about it. He has opened up a little to the social worker at school, but very little. How do parents help with out making it worse? Thank you.
Rebecca Nelson
High school can be an anxious time for sure. It is good he is on the radar of his school social worker, though school staff tend to have very little time to allocate to individual students. You may want to support him by obtaining private mental health support for him outside of school. Please see my NorthShore blog post specific to kids and teens: How to Help Kids & Teens Manage Their Anxieties. It includes web resources and recommended books as well.

  Michael (IL) - 1:19 PM:
Any tips for getting over the depression after a break up? I'm trying to get over a girl that really hurt me.
Rebecca Nelson
Sorry that experience happened, Michael. Know that it happens to most everyone, and though it's a hurtful experience try not to take it personally (though it feels incredibly personal). Relationship break ups commonly trigger depressive feelings and episodes. This is good time to reach out to your support groups: family, friends, school and/or work buddies, etc. Schedule regular outings and activities, and create new ones. Get a new hobby and learn a new skill or two. If you had some negative habits it's time to replace them with healthier ones. Learn to be by yourself and stay away from rebound relationships. If you find you are getting stuck or having a hard time getting over the relationship, then it's definitely okay to get some help.

  Sara - 1:27 PM:
Sometimes differences in opinions, judgment and past resentments with my mother will make me feel depressed for lengths of times, and it can effect my spouse as well. Do you have any suggestions with techniques to cope with these feelings?
Rebecca Nelson
If you are not already in psychotherapy I would suggest initiating. Specifically (CBT) cognitive-behavioral types of therapy can help you replace negative thought and behavior patterns with healthier ones. Sometimes in long-standing relationships we can get stuck in unhealthy patterns and we can benefit from professional help to get unstuck. Also, you may wish to read articles and books by psychologist Peg Streep, Ph.D. She specializes in women with difficult or unloving mothers.

  Alyssa (Chicago, IL) - 1:34 PM:
I’m in a good place; good grades, good relationship, we are all good in my family, but I have been having these episodes and the doctor says it anxiety attacks. Is it normal to have anxiety when I have no problems socially?
Rebecca Nelson
It is possible. There is a heritable aspect to anxiety disorders. A diagnosed Panic Disorder is a pattern of reoccurring panic attacks, and this tends to be relatively rare (<3%). If this describes you, then please seek therapeutic help, as this must be distressing for you when they occur. A behavioral approach can be enormously effective in treating these attacks.

  Lynn (Skokie, IL) - 1:39 PM:
What type of resources besides therapy can help? My 18 year old has pretty severe anxiety, but can't open up to people. She has been in therapy, but it didn't help. It is also difficult to find a therapist who works nights and weekends!
Rebecca Nelson
I'm sorry to hear about your child's distress. Sometimes it can be a matter of therapist-client fit, and the first therapist is not ideal. Also, issues around scheduling are tough, indeed. Severity also is an important point. When a mental health condition is "severe," combination treatment is generally indicated. That means a combination of psychotherapy and medication. Let me explain. Therapy addresses the problems the symptoms have caused in a confidential therapeutic setting. There are various types of evidence-based therapies that work well for anxiety (and depression) and also traditional therapies. A good working relationship with the therapist is necessary regardless of the type of therapy for treatment to be effective. Medications (by an M.D.) aim for symptom reduction. Starting/ending medications warrant gradual dosaging and close monitoring to ensure safety. Abruptly ending medications can be dangerous.

  Jason - 1:48 PM:
What is the difference between depression and just having low mood days?
Rebecca Nelson
Great question. While I don't have enough room to answer in detail here, essentially depression interferes with your functioning at work and in relationships. You feel sad (irritable often for men ), fatigued or low energy, have difficulty making decisions or concentrating, eat and sleep too much or too little, etc. This is a change from your usual way of being. There may be physical aches and pains. There may be passive or active thoughts of self harm. There is a specific time period for Persistent Depressive Disorder (PDD) and for Major Depressive Disorder (MDD). If you think you might be feeling some depressive symptoms, please contact your primary care physician (PCP) to connect you with a mental health clinician who can further evaluate and provide treatment as appropriate.

Kathryn (Moderator) - 1:52 PM:
We will be extending the time of this chat for a few extra minutes to address some more questions. Please note that we will work on listing additional resources and providing contact information at the end of this chat as well.

  Regina - 1:57 PM:
Where can I go get support? Group therapy? Can you talk about the types of therapy/groups a bit?
Rebecca Nelson
Hi Regina. First, it is advised to contact your PCP as that is your main health care connector. Also, our NorthShore Dept. of Psychiatry and Behavioral Sciences has multiple providers that may be a good fit for your mental health needs, including some groups: 847.425.6400. I briefly described CBT in earlier response. Another popular evidence-based treatment modality is DBT (Dialectical Behavioral Therapy). While similar to CBT, it is often conducted in both individual and group formats, and emphasizes 4 areas: Distress Tolerance, Emotion Regulation, Mindfulness, and Interpersonal Patterns. DBT also works well for those who struggle with eating disorders, suicidal thoughts, substance abuse, PTSD and other related trauma histories, or have some challenging personality features that have not been amenable to traditional therapies.

  Diana (Chicago, IL) - 2:04 PM:
I suffer from depression, anxiety, PMDD and most recently, body dysmorphia. I'm feeling an overwhelming sense of hopelessness and sadness lately and not sure what to do as far as getting help. I've done the meds, CBT and one-on-one therapy and nothing seems to help. What else can you do when your mind overpowers medicine, therapy and self-care?
Rebecca Nelson
Hi Diana, I'm sorry to hear you are in discomforting place. I don't know how coordinated your treatment care is, but sounds like you would benefit from having a talk with your treatment team to ensure everyone is communicating well: psychiatrist, ob/gyne, psychotherapists: individual and group. Also, if you have not previously had a comprehensive psychodiagnostic evaluation you may want to advocate for one given the relatively complex set of challenges you are experiencing. Diagnoses drive treatment plans, so you want to ensure accuracy. In a previous response, I described DBT treatment. This may be a therapeutic approach that might be beneficial for you if not previously tried. Lastly, ensure you regularly reach out to your support group at home: family and friends.

Kathryn (Moderator) - 2:12 PM:
We will take one more question.

  Karen - 2:13 PM:
Are there any tips or suggestions when your spouse suffers from anxiety? My spouse deals with anxiety related to simple, everyday things - being on time, work pressures, family issues, etc. Often, the anxiety will keep my spouse up at night, but I have a hard time understanding.
Rebecca Nelson
I encourage you to have a matter of fact, but calm conversation with your spouse about how their anxiety impacts you and your relationship. Often the partner is so anxious that s/he is unaware or unable to see the adverse impact. Second, encourage your spouse to seek help, and let them know you will accompany them if they would like. When anxiety or depression persists relationship expectations may need to be adjusted. Caregivers may need permission to seek and receive support themselves to prevent relational burnout. Seek care early for your partner and yourself before relationships become too stressful.

Kathryn (Moderator) - 2:21 PM:

This will be the end of our chat. Thank you very much for your questions, and special thanks to Dr. Nelson for stepping in on short notice and making time for extra questions.

For more information about depression and anxiety, to schedule an appointment with a specialist, or to find therapy options and support groups, you can contact NorthShore's Psychiatry & Behavioral Sciences Department

For pediatric and adolescent cases, you can also get in touch with the Developmental-Behavioral Pediatrics Clinic.

If you are having thoughts of performing harm to yourself and others, please contact 911.


Rebecca Nelson (NorthShore) - 2:21 PM:
Thank you everyone! Dr. Nelson. National Suicide Hotline: 1.800.273.TALK (8255) Anxiety and Depression Association of America: www.adaa.org
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