By GAIL LOWE
WAKEFIELD — In recognition of the 150th anniversary of its founding, the Wakefield-Lynnfield United Methodist Church last night hosted Dr. Jeremy G. Stewart, a psychologist and post-doctoral fellow at McLean Hospital-Harvard Medical School.
Dr. Stewart spoke at length about the high incidence of depression and anxiety disorders in America and what can be done about it.
Last night’s presentation was the second talk on mental health at the church.
Rev. Glenn Mortimer, pastor of the church, said he and church officials decided to make mental health their mission during this milestone year to bring mental illness into the open, with the hope that doing so will help to remove the stigma it continues to carry.
The mission will continue throughout the year, which will include a mental health fair in September. The public will be invited to obtain information and ask questions.
Dr. Stewart’s talk, titled “Depression and Anxiety 101,” drew more than a dozen people who wanted to learn more about symptoms, causes, consequences and treatments.
“By the year 2020, depression is expected to be the leading cause of disability,” he said. “We’re better at treating heart disease than we are at treating depression. Only 20 percent of people get treatment.” This percentage can be linked to the number of people who are in denial or do not realize they have a problem.
Substance abuse, overall health issues and obesity are all linked to depression, he said, adding that depression is the 10th leading cause of death for adults and the second leading cause for adolescents.
At the beginning of his talk, Dr. Stewart asked for a show of hands — “How many of you have experienced a deep feeling of sadness over your lifetime?” he asked. Nearly everyone’s hand shot into the air.
Dr. Stewart then explained that everyone can connect with feeling sad at various points in their lives but there is a vast difference between periodic episodes of sadness and episodes that are far more intense and have a longer duration. It’s what separates normal sadness from more serious conditions, he said, that lead to diagnoses of clinical depression and some form of anxiety disorder.
“It does no good to tell someone to ‘get over it’ or ‘snap out of it’ or to ‘just take a run,’” he said, adding that when people are in a major state of depression, nothing short of professional help will do much good.
Unlike illnesses that affect the body, there are no blood tests or biopsies that can diagnose a mental illness. Rather, psychologists and psychiatrists rely on a list of symptoms ranging from lack of concentration to thoughts of committing suicide to make their diagnoses.
“In most cases, symptoms last for six months or more for clinical depression to be diagnosed,” said Dr. Stewart.
Common complaints reported by those suffering from depression are body aches and pain, headaches and even sexual dysfunction.
“People present with depression in all different ways,” he said. “In fact, there are 1,620 different ways depression can be expressed.”
Up to 15 million adults have reported depression at some point in their lives and women are twice as likely as men to report it, since women can suffer from domestic and sexual abuse and other forms of negative behavior perpetrated by a partner.
“Women react strongly to life events,” Dr. Stewart said, adding that one depressive episode most often leads to another and that some people have remained depressed for between 10 and 18 years.
Much of the problem can be traced to biology, including hormonal imbalances but, generally speaking, there is never only one cause but rather multiple problems happening at the same time.
Dr. Stewart used two imaginary tables as examples of how difficult life events can affect an individual. One table, made of solid oak, could withstand heavy weights while the other table, made of cardboard, would collapse under pressure. He then suggested that a water-filled glass had been placed on top of each table.
“Did this make much difference to either table?” he asked his audience. The overwhelming response was “no.”
But then he suggested that a big turkey dinner had been placed on each table.
“What do you think would happen?” he asked.
The cardboard table would collapse under the weight, everyone agreed. He explained this is how it is with people. Some are strong like oak, while others are more vulnerable to weights of the world.
Dr. Stewart then spoke about the causes of depression and anxiety disorders, including genetics, abuse or neglect in childhood and environmental issues, such as growing up with a parent who showed signs of mental illness but was not treated. Other causes listed were job loss, lack of money and divorce.
The consequences of depression are multiple, including being fired from a job, marital breakdown and a general decline in overall health.
Dr. Stewart also devoted a portion of his talk on anxiety disorders, another prevalent mental health issue.
“Thirty percent of adults develop an anxiety disorder during their lives,” he said, adding that symptoms can be nervousness, a deep sense of urgency and worrying about the future. Fear, he said, is the underlying issue.
“There are physiological features, including high blood pressure, tensing of the body and lack of motivation,” he said.
A certain level of anxiety is necessary to human wellbeing, he explained. “It helps you prepare.”
But unchecked anxiety usually precedes a depressive episode.
Anxiety can take various forms, from social anxiety (fear of eating in public, as an example) to panic attacks.
Dr. Stewart simulated a panic attack by hyperventilating for 30 seconds and invited his audience to join in. In that short space of time, he and others experienced heart palpitations, shortness of breath and tightness in the throat. A feeling that death is imminent and other troubling symptoms are also common.
One panic attack can cause an individual deep worries that they will have another and this fear builds on itself, often bringing another one on.
Generally speaking, anxiety disorders do not run in families. Instead, fears are learned responses within families. As an example, if parents openly state their fears about not having enough money to live on, chances are good that children will grow into adulthood with similar worries.
Dr. Stewart spoke about medications that are often prescribed for depression, including Zoloft, Paxil and Prozac, and explained that the drugs affect neurotransmitters in the brain and help stabilize mood.
“One drug is as effective as another,” he said, adding that medications prescribed today have fewer side effects than drugs dispensed in the 1950s.
Unlike psychiatrists, Dr. Stewart and other psychologists are not licensed to prescribe medications. Instead, he subscribes to cognitive behavior therapy (CBT) to treat depression and anxiety. Basically, CBT is a therapeutic means of changing the way an individual thinks and can eliminate the need for medication.
As an example, he asked what the first thought would be if a boss called someone into his office. Common responses included:
“Uh-oh, what did I do wrong?”
“Oh, no … I’m going to lose my job.”
But these responses typically do not have supporting evidence. Through the use of CBT, Dr. Stewart dissuades people from thinking catastrophically and teaches them to think in a more balanced way.
“A boss might have good news and say that you’re getting a raise,” he said. CBT can be used alone or as an adjunct to talk therapy.
During the time set aside for questions and answers, one member of the audience asked if religious people experience more protection against anxiety and depression.
Dr. Stewart said that religious groups, such as churches, provide people with a supportive environment, which can help keep depression at bay.
He also made suggestions about where to look for help, including the website www.adaa.com, an official site for the Anxiety and Depression Association of America. There is a link on this site that leads to therapists in a given area.
Other sites include www.afsp.org, a site for the American Foundation for Suicide Prevention.
“Depression can lead to suicide,” said Dr. Stewart. “Ask a family member or friend who is suffering from depression how you can help.”
Following through, he said, could save a life.
Dr. Stewart’s primary clinical interests are in the application of CBT interventions for adolescents diagnosed with major depressive disorder. He is currently co-authoring a book on this topic.
