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How to Talk About Your Depression

Dr. Ashley Collins shares how to discuss depression, who someone should talk to about their depression, and why it's important to discuss it with a healthcare provider.
How to Talk About Your Depression
Featured Speaker:
Ashley Collins, DO
Dr. Ashley Collins completed her residency training at Marshall University in Huntington, West Virginia. She obtained her degree from the West Virginia School of Osteopathic Medicine.

Melanie Cole, MS (Host): Sadness, feeling down, having a loss of interest or pleasure in your daily activities, these are symptoms that we all get. But if they persist and they affect your quality of life, it really may be time to seek professional help. My guest today is Dr. Ashley Collins. She’s a psychiatrist with Memorial Health System. Dr. Collins, let’s talk first about the definition of depression because, as I said in the intro, people feel sad and down a lot. It may not really be clinical depression.

Ashley Collins D.O. (Guest): Right. There are often times in our lives when things happen, and we do feel sad and down for a while. Usually during those times that we would consider that normal sadness or just normal feeling down. Usually some kind of life stressor has been there, or some kind of event has happened to cause somebody to feel more sad. Oftentimes where it becomes more concerning when we feel that people are starting to develop a depression, there’s not really any identifiable event or trigger for it. People often describe it as it just coming on out of the blue. Oftentimes people really can't even pinpoint something, and they feel almost guilty because they try to rationalize it and say, “My life is good in so many ways. Why am I feeling this way now?”

Host:   That’s such a great point because we do all kind of think that, and you're just never quite sure. So how can individuals approach the subject of their depression? Who do they turn to first?

Dr. Collins: Whenever somebody’s feeling depressed, I encourage anyone to bring it up to their primary care doctor because those are the people that they're usually seeing first line. If somebody already has a psychiatrist that they're seeing, that’s even better because we can definitely get that taken care of. Our primary care doctors are the first line people that see the patients that are feeling these symptoms and get them treated initially or referred if they feel like that’s what the patient needs. I feel like many more doctors are open to talking about the subject. I encourage people to just—Even if you don’t know the exact symptoms or don’t know what to say, you can at least tell your doctor that you're not feeling like yourself. That you feel something’s off, and they can help you explore the different symptoms that may be there that may lead to that diagnosis of depression.

Host:   Well, I think that’s a great point. However, people sometimes hesitate to bring these kinds of things up. Whether it’s postpartum depression or somebody’s just feeling sad, anxious, worrying, just depressed because there’s a stigma to it. Do you think that there still is a stigma and that that’s what keeps some people from getting help, recognizing their symptoms, and more importantly asking for help.

Dr. Collins: Yes, unfortunately I do feel like there is still a stigma there. I know we are working hard to reduce that, eliminate that stigma, but it definitely is still there. You're right. A lot of times it’s hard for people to say that the reason I'm not getting out of bed or the reason I'm not going to work is because of my back pain rather than saying I'm not getting out of bed, I'm not showering, I'm not going to work because I'm severely depressed. I think a lot of times the people around us may not understand that either. So some people are afraid that they're going to burden their friends or family members if they say anything to them. Then I also think that they may worry about judgement from other people or their physicians if they don’t completely feel comfortable with them initially.

Host:   That’s true. So if they do seek help, what kind of treatments are out there? If someone comes to you, what do you do first for them? What is the first line of defenses? Because some people don’t want to go on depression medication. They're not quite sure what that’s going to do to them. There's a lot of myths out there. We could do a whole show on the myths of depression medications and things. So tell us what you might try first and bust up a few of those so that people understand what's going on.

Dr. Collins: We have lots of options. That’s the great news with depression. It’s very treatable. Usually when they're coming to see a psychiatrist, we’re dealing with the medication management piece. So we would choose one of our antidepressants. We have so many choices. We can work with people on specific concerns that they have about the medications. If there's a side effect that they're worried about, that’s something that we would discuss initially before starting any kind of treatment. We have different classes of antidepressants that work in different ways. It’s a very individualized treatment. So we go through every person’s history and find a medication that may work best for them.

But like you said, some people just don’t want to do medications. That’s understandable too. Maybe they’ve had side effects in the past or just not good experiences. We have other options as well. Therapy is always a good option. Oftentimes we combine therapy and our medication to help treat depression. There are also other options if people have tried numerous medications and have not really had any sustained benefit from them. There’s different what we call neuromodulation therapies, like TMS which is transcranial magnetic stimulation. That’s something that’s non-invasive. It can be done on an outpatient basis that we can refer people to as well if they would meet the criteria for that treatment.

Host:   What about lifestyle? What things do you want people to try and do at home? Whether it’s yoga and exercise. Sleep quality is a big contributor to that anxiety and depression people suffer from. What would you like them to know about nutrition, meditation, any supplements? Are there any of these things that you like to try?

Dr. Collins: Yes, definitely. We always try to recommend some lifestyle changes along with other treatment. I definitely think, like you said, that sleep is a big issue. Often times it goes hand in hand with depression and anxiety. Often it improves—Like one affects the other. So we always encourage good sleep hygiene. Like not using your phone or the computer or having the TV in your bedroom. We recommend just using your bedroom for sleep. You know not sitting in bed and working to try to maximize that environment to help you sleep. A lot of people want to try those options before they try medications for sleeping.

Then in terms of exercise, that’s always beneficial not only physically but for our mood as well. I always encourage people. If it’s a half an hour to an hour daily to just get out and do something that you enjoy. During that time is a good time to kind of clear your mind and be able to meditate even as you're doing that. To be focused on something else rather than constantly thinking about the negatives or the issues that you're worried about. It’s definitely been shown that people who spend some time in meditation each day—even if it’s just five minutes of just taking time to focus on something else—that that greatly improves their mood, their focus, and overall mental health.

Host:   That’s really great advice. As we wrap up, what would you like people to know about mental health? Getting past that stigma and fear of seeking out help and getting professional help for their depression so that they can live a higher quality of life.

Dr. Collins: Well, I always encourage people and I applaud people that actually come and do get help because I know it’s not easy with the stigma there. I think the people that are coming, they have courage there to come and get help and change their lives. We know there are so many treatments and things that we can do to help out. I've really seen patients that their lives have changed after getting treatment and they can get back to the person that they used to be or the life that they want to have where they feel good. So I think I would tell patients to bring it up with their doctors. I think they will be surprised at finding the response that they have. That they're open and that they will try to get them the help that they need.

Host:   That’s great information. Thank you so much, doctor, for being with us today and sharing that great advice on something that so many people suffer from but may be hesitant to ask for help. So thank you, again. That wraps up this episode of Memorial Health Radio with Memorial Health System. Head on over to our website at for more information and to get connected with one of our providers. If you found this podcast informative, please share. You probably know many people that suffer from depression. So share this show with them so they know it’s okay to seek help and be sure to check out all the other cool podcasts in our library. Until next time, I'm Melanie Cole.