Generally speaking, we do not worry about a bad day or two, or transient emotional discomfort. Life has its ups and downs, and life has “flat tires” on occasion which we deal with, cope with, and move on. Those times do not mean someone has to seek professional help. But instead, the question is when someone should look for help?
There is not a clear answer for everyone. But, I think sooner is better than later. Getting feedback from someone close to you is helpful. Ask a friend or family member and see what they say. Momentary and minor changes may not be anything to cause worry. However, changes in functioning and relationships that persist and are noted by people close to us do deserve attention.
Recently, someone came to see me at the urging of a family member to whom he had confided personal information. He had been dealing with depression, anxiety, insomnia and worry for months. But it was after an interpersonal insult that he called. The struggles with mood and functioning were tolerated, and it was only when he questioned honesty in a relationship that he sought treatment.
This is certainly a legitimate reason, but what about his emotional struggles and what about, in retrospect, was his deterioration in functioning at home and work?
This has caused me to ponder the timing of when people actually seek treatment versus when people should. Our industry has not effectively created a model for preventive psychiatry. The symptoms mentioned above developed over time and began almost a year ago. I wonder if the difficulties in his personal and business life could have been avoided if he addressed his issues sooner.
People close to us can often notice subtle changes that we may not recognize ourselves. Usually, they are not comfortable confronting us about what they see and may offer a biased opinion.
Thus, we need to cultivate relationships from which we can obtain an honest opinion, and be comfortable and aware of when to go beyond the friends and family zone, and start a dialogue with a professional. This practice creates an environment that allows individuals to thrive and is healthy in lots of ways.
Waiting until a crisis surfaces can result in challenging circumstances such as hospitalization and substance abuse, or tragic situations like suicide. From a preventative standpoint, it is apparent that intervention has to occur sooner.
The Canadian Medical Association Journal recently published an almost 60-year study with the conclusion that depression is associated with shorter lifespans. Now we have evidence that suffering with depression is not just about someone having problems in life, but it also impacts how long we live. Thus, having depression is about the quality of life and quantity of life.
So, what to do? Use your best judgment paying attention to signs and symptoms. Ask loved ones for clarity when there is anything that does not feel right. Learn what to take note of: changes in sleep, appetite, concentration, interests, withdrawal and social isolation, increase in substance use and, undoubtedly, suicidal thoughts.
By being proactive, present and living preventively, we all have a better chance to live life on our terms and achieve our goals.