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Is It More Than The Blues? Warning Signs of Depression      

Nicholas Lee, LPC

We all get “the blues” from time to time and it is normal to feel sad, lonely, anxious, or even depressed. Experiencing traumatic situations or stressors, such as frustration and worry with relationships, finances, career, or college can affect your emotional experience. A major life change like a big move, job change, divorce, having babies, or the death of a loved one may also influence your overall mood. Usually these “down” feelings are fleeting, but with the increased pressures of modern society, these feelings can lead to significant distress that makes it harder to cope with everyday life. If not handled properly, the “blues” can turn into clinical depression.

Depression is a common mood disorder that can cause increased difficulty in managing, functioning, or communicating in daily life. A person with depression may feel disconnected, isolated, and generally feel “down” more often than not. There may be changes in sleep, daily routine, eating habits, and weight, or an increase in substance abuse. Other symptoms of depression include a loss of interest in regular activities, fatigue, agitation, pessimism, restlessness, trouble concentrating, feeling hopeless, guilty or worthless, or having thoughts of death or suicide.

It is important to seek help or encourage a loved one to seek help if five or more symptoms are present daily for two weeks or more, especially if symptoms affect basic needs such as sleeping, eating, working, or interacting with others. Often, people keep these feelings to themselves to avoid attention or stigma surrounding the treatment of mental health.

People suffering from depression may become accustomed to the feeling and perceive it as normal, or believe they do not need assistance. Additional barriers to treatment may include a lack of time or money for services.

In 2020, an estimated 14.8 million U.S. adults and 4.1 million teens ages 12-17 had at least one major depressive episode with severe impairment. It is estimated that 39% of adults and 60% of adolescents with at least one major depression episode did NOT seek treatment. This aspect of depression needs to change!

It is not a weakness or personal defect to seek help for depression, and no one needs to feel shame or embarrassment about telling their health care provider or people they love and trust. Depression affects all ages, races, ethnicities, and genders. Women are diagnosed more with depression than men. Men are at greater risk for being undertreated or under-diagnosed, since they may not recognize, talk about, or seek help for feelings or emotional issues. Rates are even higher among African American men. The LBGTQI+ community, adolescents, and young adults ages 18-29 are also at greater risk of depression.

Reaching out for help is the key to beginning the process of feeling better and improving symptoms. Keeping it all inside and telling no one what is going on typically increases symptoms of depression. The sooner a person gets help, the quicker they can start feeling better. The first step is to talk with your primary health care provider about symptoms, and find at least one trusted family or friend to talk to for emotional support.

The main treatment options for depression are medications, behavioral therapy/counseling, or a combination of the two. Since everyone is different, treatment approaches are individualized and may take some trial and error to find what works best. Don’t give up!

Antidepressants are medications commonly prescribed to treat depression. These medications can take 4-8 weeks to take effect, and often sleep, appetite, or concentration improves before overall mood. Give the medication time to work. It’s also important not to stop the medication abruptly; talk to your health care provider before stopping any antidepressant medication.

A health care provider can refer a patient to therapy, or individuals can find therapy locally or online. Behavioral therapy can be short or long-term and is patient-driven. The goal of therapy is to develop a toolbox of strategies to deal with and process emotions, improve communication, learn how to manage stress and stressful situations, and develop problem-solving and troubleshooting techniques. Through this process, individuals can work on and change inner dialogue, improve healthy habits and mindset, have meaningful conversations, develop a more positive outlook on life, and enrich life experiences.

During the COVID pandemic, the incidence of depression and anxiety increased. Today, many experts agree the U.S. is having a mental health crisis. Adults and teens feel more lonely, isolated, and disconnected, and access to behavioral health services can be challenging. Even four years out from the onset of the pandemic, behavioral health services are still playing catch up, often with gaps in care and long wait times to get into counseling or psychiatric services due to a shortage of providers.

A new way to improve access to therapy is the integrated care model with hospitals, providers, and behavioral therapists/counselors working together to coordinate care. At HopeHealth, providers can invite counselors into patient appointments for a short chat, called a “warm handoff,” to help individuals feel more comfortable and knowledgeable about counseling services.

Don’t wait to get help for depression. Asking for help is a sign of strength and not a sign of weakness, incompetence, inferiority, or being a burden. If a person is not sure what to ask for, reach out to mental health services or talk with your primary care provider about options.

The suicide and crisis lifeline is available 24/7 by calling or texting 988. Finding help for depression is the most important first step to start the process of healing and feeling better!




HopeHealth educates its patients on the importance of having a health care home. As a primary care facility, HopeHealth’s medical team works to prevent and detect illness and the early onset of disease, provide routine physical examinations and promote overall healthy lifestyles.

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HopeHealth 360 North Irby St. Florence, SC 29501 (843) 667-9414
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