(Editor’s note: This story is the third part of a multi-part series “Mind Wars” examining the struggles of the mental illness, depression, that began with Issue #7 and concludes in Issue #12. Several staff members took it upon themselves to interview, take photographs and conduct research. Te results of their combined efforts folow.)
by CHESANIE BRANTLEY/Editor-in-Chief
Worry. Hopelessness. Insomnia.
These are things that are felt by people who suffer from depression and anxiety.
The Anxiety and Depression Association of America (ADAA) has set out to improve the lives of people who suffer from depression, anxiety or both. Dr. Beth Salcedo, a general psychiatrist from the Ross Center for Anxiety and Related Disorders in Washington, D.C, is one of the people setting out on that mission.
According to Dr. Salcedo, she was introduced to the ADAA through Jerilyn Ross, founder of the ADAA, and she began to practice there.
“As a physician, you have to get a certain number of continuing medical education credits every year, so most people will go to a conference,” said Dr. Salcedo. “The ADAA conference is the place I went to get all of my continuing medical education credits.”
Dr. Salcedo said she also attended the conferences to meet other people with like minds in the field from different areas, and to hear what people are doing with anxiety and depression disorders.
According to Dr. Salcedo, it is important to be well versed in both depression and anxiety. The two tend to go together in about 50 percent of cases, along with Bi-Polar Disorder, Attention Deficit Hyperactivity Disorder (ADHD) and eating disorders.
“I treat people with both (anxiety and depression),” said Dr. Salcedo.
Similar techniques are used when treating anxiety and depression. According to Dr. Salcedo, there are many variables that are dependent on what kind of treatment a patient will go through, such as relationship issues or personality issues that play into the mood disorder.
“I always tell people how important sleep is,” explained Dr. Salcedo. “I make sure they are taking care of themselves on terms of not abusing drugs and alcohol, and making sure they are eating well.”
She also recommends that they exercise at least 10 to 20 minutes a day. Then, from there, if symptoms do not improve with lifestyles changes, therapy, or the potential for medication, is offered to the patient.
“Sometimes cognitive therapy is not really the way to go,” Dr. Salcedo said. “A more long-term dynamic therapy approach may be more applicable. I usually try to recommend an evidence-based therapy and medication as needed.”
According to Dr. Salcedo, patients first go through a diagnostic evaluation. She said that these could take a while, because it can take time to go through the history of a patient’s mood disorder. Once a good diagnostic evaluation is in place, Dr. Salcedo is able to make sure the appropriate diagnosis is made.
“Then, based on the diagnosis and what we know from the research, I will offer them a variety of ways of treating things and get a feel for what they are interested in, able to do and what they are not interested in,” said Dr. Salcedo.
She said that most people know medication is not for them, and other people know that they do not want therapy, at least to start. Treatment options are discussed with the patients. Then Dr. Salcedo goes over logistically what treatment plan would be the most appropriate for this patient. The average length of time for a patient to go through therapy is anywhere between 10 to 16 sessions. Dr. Salcedo explained that by this time a patient usually has gotten a handle on his or her symptoms. Then, a physician might start seeing the patient less, after a month or in another two or three months, and slowly taper off the sessions.
There are different types of therapy that are getting a renewed following, according to Dr. Salcedo. One is mindfulness and medication, and the other is dialectical behavioral therapy. The mindfulness and medication approach is more similar to what Dr. Salcedo practices. The dialectical behavioral therapy is more of a module program that is very specific and done in a group setting.
“I would say definitely dialectical behavioral therapy is going to be the bigger of the two things,” explained Dr. Salcedo. “I think mindfulness and medication are excellent, but I think they are on par with exercise and my style. They can be a great adjust, but they are often not enough to treat a serious disorder.”
Dr. Salcedo explained that awareness for depression and anxiety should begin with schools and college campuses.
“So many people who suffer with anxiety and depression start in young adulthood,” explained Dr. Salcedo. “But I think getting to these young adults, hopefully before they develop symptoms, and teaching them to recognize and become aware of what symptoms look like.”
According to Dr. Salcedo, being able to recognize the signs of anxiety and depression in the early stages of life is important. For example, a child who is anxious will often develop depression later in adulthood.
“So, if you can treat these symptoms of anxiety into remission in childhood,” said Dr. Salcedo, “you can prevent depression in adulthood.”