Learning to live, and exhale, with depression

By Natalie Andrews

May 12, 2005 | She was worried that she might have a problem trusting people. Or that problems from her past may be the cause of her anxiety. She feared overcoming abandonment issues.

And after examining all that, she's learned to breathe.

"It's almost like your nervous system is short-circuiting. You think that other people can see it. It's an inner-trembling," she said.

Mae-she wanted to use a nickname when discussing her emotional past-looks at breathing and relaxation as the best things she could have learned from talking to Bryan Bushman at the Utah State University Counseling Center.

Mae struggles with an illness that, according to the Counseling Center, one in every five adults in America will someday have to face, but fewer than half will seek treatment for.

Depression.

It is often associated with an ongoing sad, anxious, or down mood, but the symptoms vary-from loss of energy to restlessness. One can sleep too little or sleep too much, see changes in weight from changes in appetite-whether eating too little or too much. The symptoms are steady and must last at least two weeks. They advance to feelings of hopelessness, guilt, and thoughts of suicide or death.

Mae first sought help when she was a young teenager, from the ages of 13 and 15. When she started at USU in the fall of 2004, she realized she needed balance in her life and returned to counseling because it had helped her before. This time, she felt heightened anxiety and wanted to talk to someone about it.

When someone wants counseling at the USU Counseling Center, the first step is an intake process. During intake, a member of the Counseling Center staff meets with the prospective client, who also fills out assessments, writing down answers to various questions.

The questions fish around, looking at a person's recent actions to try to figure out how they are currently doing. They ask things like, have your daily habits changed, are you thinking about leaving school, are you thinking about hurting yourself or someone else, etc.

"We want to know how immediate the concerns are, how severe the person's symptoms are," Dr. Mary Doty, director of the counseling center, said. She warns that this can be a frustrating time for students, who just want to solve their problem.

The student is then assigned to a counselor.

The center houses a doctorate staff of six, three psychology interns, and two graduate assistants. The client's symptoms-severity and type-determine to which counselor the client will be assigned to. For Mae, Bushman conducted her intake, and after talking to her, asked if he could be her counselor. Her move from intake to regular sessions was a smooth process. Some students take longer trying to find the perfect fit, Doty said.

Now a counselor looks more intensely for depression, if that is the problem. Concrete evidence, such as not attending classes, social withdrawal and decreased productivity help, a Counseling Center pamphlet states.

Depression's cause is often a combination of several things, Doty said, while drawing boxes in a horizontal line on a notepad. Inside the boxes, she wrote "physiological," "societal," "family of origin," "Individual," and "Interpersonal," refering to a person's actions with those around him or her.

Doty drew lines connecting the boxes and explained that these make up every person's life. The boxes can also contribute in different ways to depression, and can make depression a complex problem to solve.

One person could come in and 90 percent of their depression could be biochemical and 10 percent could be societal. Another person could come in, with 50 percent of their depression coming from the family of origin, and the remaining 50 percent being a mixture of the boxes. Mae worried that her feelings of anxiety and depression came from the family of origin box. Her parents divorced when she was five, and her mother raised her and her siblings-two older sisters and a younger brother-on her own. When she went to the counseling center, she had just started a relationship and wanted to make it work.

"It was mainly to make sure I wasn't being unfair," Mae says. Right now, her problems mostly consist of high anxiety and panic attacks. To combat them, she has learned breathing techniques and meditation. Settling down into an apartment and establishing a daily routine helped as well.

When a panic attack comes, Mae loses control of her emotions like a limp noodle loses shape. Logic doesn't make sense. Afterward, she feels embarrassed about what she said to people or about what she did. Talking through those experiences has been one reason why she's enjoyed counseling.

"I look at my situation with [Bryan] and think everybody should go to a counselor," Mae said.

The counseling center at USU is free to students enrolled in at least six credits. Doty estimates they have about 700 students per year, about 25 percent of them have depression. Probably 40 percent of the 700 students are for one or two appointments.

"I think that we don't really scratch the surface. Even though the counseling center has existed for decades, there's still lots of students that don't know that it's here. There is still a stigma attached to counseling. People are fearful."

The best treatment is what works best for the patient, Doty says. They don't prescribe medication at the counseling center, but often send people to the USU Health Center, where they can receive a prescription for an anti-depressant. Depressed people often lack the three mood neurotransmitters serotonin, norepinephrine and dopamine and anti-depressants can supply the right chemicals to the brain.

Medication didn't work for Mae, but learning how to meditate did. She likes to listen to soothing music, drink Traditional Medicinals herbal teas and pot plants. She loves to grow things. Her major is complementary medicine with a botany emphasis, and her apartment is full of green plants-on the floor, doubled up on shelves, on the television, the plants take precedence.

Another important thing for depressed people to do to watch is the food they eat. Amy Straley, the registered dietician that works at the USU Health Center, says that eating protein foods, like meat and dairy products will also increase the levels of neurotransmitters in a person's brain.

On the other hand, carbohydrates boost serotonin, but both Doty and Straley recommend moderation. Straley says to choose complex carbohydrates, like whole-grain products and vegetables to stop cases of the "afternoon lows," where a person feels low repeatedly in the afternoon.

A fitness routine also helps boost the chemicals in the brain. "Exercise increases the body's production of endorphins-which relieve depression," Straley says.

Mae will take a long walk, or do something "mindless" to combat the anxiety and depressed emotions that she feels.

A person can get over depression, but the tendency toward depression doesn't go away, Doty said. After counseling and medication, it is up to the individual to want to get better. Mae recognizes this, and has learned combative techniques.

Now, after more than a year of counseling -- both at USU and Snow College -- Mae can recognize when she falls into a depressive lull. She says to herself, "I'm not happy right now and something needs to change," and gives herself 24 to 48 hours to bring herself out of it. "You have control of your life and if you don't like the way you feel, you need to change it. I say, get stubborn," Mae said.

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