Dr. Sterling Potter evaluates his patient notes in order to discern which medication or combination of medications would be best for their symptoms. Mood disorders are often treated with more than one substance as well as cognitive and behavioral therapy.
Depression affects more Utahns than those in any other state.
Registered Nurse, Tisa Pendergrass explains a patients diagnosis to colleague Charity Gregersen.
Several sources including Mental Health America rank Utah as the most depressed state in the union. After interviewing sources in and around the local area, it is apparent that Carbon County is not immune to the black curtain that has fallen over a goodly portion of the state.
According to depression.com, along with the black curtain the covers the lives of many suffering from the disease, most people feel like they have no energy and can't concentrate. Others feel irritable all the time for no apparent reason. The symptoms most definitely vary from person to person.
"If you feel down for more than two weeks and these feelings are interfering with your daily life you may be clinically depressed," explained the sight.
Local physician Dr. Sterling Potter, who sees approximately 2,000 patients stated that there are between 250 and 500 that are treated for depression at one time or another.
"There is a lot of denial with depression," said Dr. Potter's staff member Kerrie Sherman. "Patients come in and ask Dr. Potter, what is wrong with me? All I do is fight with my husband or wife, why am I so mean to my kids? Why am I so irritable? And then you tell them they may be suffering from depression and they look at you like you are crazy."
Both Potter and Sherman agreed that depression can be tricky to diagnose and everyone can be different in their manifestation of the disease.
"One of the main symptoms we look for in patients that may be experiencing depression is a loss of interest in activities that they once enjoyed," said Potter. "Many times you can also see it in someone's face. We also ask if a patient either feels like or simply does burst into tears at random times."
Potter reported that he offers three types of therapy for those experiencing depression:
â¢Straight medical therapy with an anti-depressant or anti-anxiety medication.
â¢Cognitive therapy with a licensed therapist.
â¢Or a combination of the two.
According to Potter there are several studies that show a genetic link concerning depression.
"At least half of the patients I see for depression have a family history of dealing with the same disease," explained Potter. "But depression is tricky because most people don't like to admit that they have a problem, that they have an imbalance in their mind."
Additionally, depression can lead individuals to self medicate starting a whole other cycle of problems both mentally and socially.
"Substance abuse, especially of methamphetamine and opiate narcotics can lead to imbalances," said Potter.
Self medication, at times, can be counterbalanced quite easily however, he said, by simple physical activity.
"Many mood disorders are not diagnosed until later in life," said Potter. "But studies have shown that 30 minutes of exercise per day can have the same effect on teenagers as medication."
The exercise produces the neurological chemicals that will combat depressive symptoms.
To complicate the matter further, more than 70 percent of substance abusers have mental issues which can also lead to depression.
"These people really tend to head toward self medication," said Potter. "The kids with depression issues tend to use pain killers because they give people a euphoric affect. Also kids with attention deficit disorder tend to use meth because it works on their mind nearly the same as most prescription medications for ADHD. If we get these kids in here with substance abuse issues and don't treat the underlying problem, there is a good chance they will return to substance abuse."
To look at the disease from a different view, the Sun Advocate contacted Tisa Pendergrass from Community Nursing Services who is a registered nurse and specializes in hospice care.
Pendergrass typically handles approximately 8-10 patients at once and CNS handles about 30, all who have been diagnosed with a terminal disease and have decided to switch from curative care to palliative care. The switch means that hospice personnel concentrate more on a patient's comfort than recovery from a disease which there is no cure.
"It's is interesting to see that once a patient has decided to go to hospice care, it is their family that has the immediate problem with anxiety and depression not the patient," she explained.
Pendergrass reported that approximately 90 percent of individuals under hospice care are on some type of anti-depressant or anti-anxiety medication.
She stated that while most hospice patients have made peace with their status in life, they are contacted by a social worker within 48 hour after going on hospice to have a professional discern their mental state.
Along with the patient and their families, the nurses who work for hospice also can have a hard time dealing with the fact that their patients have a nearly 100 percent mortality rate.
"It can be tough on them," said Jedd Olsen. "When you get a nurse who loses four or five patients in one week they can have a hard time for awhile."
Pendergrass, however, stated that most of the individuals who work for hospice have an attitude that enables them to better handle what some would see as a very depressing situation.
"We all work in hospice for the same reason," she said. "We take pride in the fact that we enable an individual the opportunity to say all the things that needs to be said to their families before they pass on. It does make us sad at times but we take solace in the fact that we make their last days as comfortable and dignified as we possibly can."
Dr. Potter is the resident physician for hospice care and had further information about those who will be dealing with the disease for a longer period of time.
"You know it is interesting," he said. "There are a good number of patients whose depressive symptoms will go away untreated after six months or so, however, it is important to watch anyone who has been diagnosed with depression, especially early on, because seriously depressed people who have decided to end their life tend to get a feeling of euphoria. Once they have made the decision to kill themselves, they have found a solution and they feel better."
Potter reported that those who use medical treatment alone tend to have significant recovery about two-thirds of the time. Those who choose cognitive therapy with no medication tend to see significant recovery one-third of the time and those who have sought out treatment via both venues raise their recovery rate from 66 to 68 percent.
"However, those who start medical treatment tend to have a higher rate of relapse once they leave the medication if they have chronic issues," said Potter.
Everyone has tough situations in their lives, he said, they go through divorce or job stress or a death in the family and these personal stresses can lead to the imbalance that causes depression. Most people will seek help for their feelings, get it treated and then get off the meds and be fine after about three months.
"If the stresser is gone they tend to have great success," said Potter. "But some have more serious long-term issues that do require long-term treatment, In my opinion the difference can be traced largely to genetics."
The good news is that there is literally a cornucopia of different medication that can be tailor fit to any person's situation. Additionally, for those who have problems taking medication, cognitive therapy can be very effective in the treatment of depression.