Showing posts with label psychiatry. Show all posts
Showing posts with label psychiatry. Show all posts

Tuesday, 24 May 2016

Princess Health and Doctor speaks up about battle with depression, leading cause of disability for people 15-44; only 20% with symptoms are treated. Princessiccia

By Danielle Ray
Kentucky Health News

Pitman (Paducah Sun photo)
Dr. Jay Pitman knows what it's like to feel isolated. Pitman spoke out about his battle with depression in a recent essay in The Paducah Sun.

"I'm writing a piece about my depression, about things people don't like to talk about," he told Steve Wilson, editor of the newspaper. "I'm thinking it might help some people." Wilson wrote in his column about Pitman, whose essay was published a week earlier, along with a story about him.

Pitman's depression deepened after he was the victim of a near-fatal hit-and-run accident in 2013. He was found lying unconscious in a pool of blood. He had suffered a concussion, brain hemorrhage and a broken shoulder. His physical recovery was remarkable. In fact, he recovered well enough to compete in a triathlon the next year. But he has had a much longer road to emotional healing.

Pitman is not alone in his struggle. The Anxiety and Depression Association of America estimates that about 18 million Americans suffer from depression, and notes that depression is the leading cause of disability in people aged 15 to 44. The organization distinguishes two categories of depression: major depression and persistent depressive disorder, which is characterized by symptoms that last at least two years.

Pitman's essay garnered a lot of support, but he's more concerned with opening up an honest dialogue about the issue.

"My hope is that those coping with depression will seek help and talk openly about their disease without feeling ashamed or embarrassed," he told Wilson. "I've lost several friends to suicide."

Despite its prevalence, only about 20 percent of people with depression symptoms seek professional help, according to the online health network Healthline.

Tiffany Bryant, a Lexington counselor who specializes in treating depression, said many people don't seek help or speak out about depression because of a lingering stigma surrounding mental illness. She believes popular culture has created an environment that discourages people from representing themselves honestly, flaws and struggles and all.

"I think you can blame, to a certain extent, social media, because everybody wants to show their very best," she said. "A lot of people have this mask that they wear for other people, and they never really take it off."

Even with a fairly low rate of patients seeking treatment, Healthline estimates that the number of patients diagnosed with depression increases by about 20 percent each year.

The federal Centers for Disease Control and Prevention recommends early treatment. If not effectively treated, depression can become a chronic disease. Experiencing just one episode of depression places a person at a 50 percent risk for experiencing another episode in the future, according to the CDC.

While it can affect anyone at any time, women typically experience higher rates of depression than men. The CDC also noted that nearly 10 percent of people in their 40s and 50s report current depression. The good news is that 60 to 80 percent of all depression cases can be treated with either psychotherapy ("talk therapy"), antidepressant medication or a combination of both, says Healthline.

The American Psychiatric Association defines depression as a condition with any five of these seven symptoms for a continuous period of at least two weeks:
  • sadness;
  • loss of interest in activities that used to be enjoyable;
  • change in weight or appetite, change in activity level;
  • sleeping too much or too little;
  • loss of energy;
  • feelings of guilt or worthlessness;
  • difficulty concentrating or having thoughts of death or suicide.
Depression has a variety of causes, including genetic, environmental, psychological, and biochemical factors. The CDC notes that everyone gets "down in the dumps" at times, but it becomes pathological when symptoms are persistent and interrupt daily life. To learn more about it, from the National Institute of Mental Health, click here.

Thursday, 22 May 2014

Princess Health and Princess Health andPsychiatric patients' demand for emergency-room care presents a problem the Affordable Care Act won't solve.Princessiccia

Princess Health and Princess Health andPsychiatric patients' demand for emergency-room care presents a problem the Affordable Care Act won't solve.Princessiccia

Psychiatric patients' demand for emergency-room care has been a concern in hospitals, and it's going to get worse. Even though ERs are not properly equipped to help psychiatric patients, people still often go there with psychiatric concerns. Most ERs simply lack room to deal with such situations. According to a survey, 84 percent of emergency physicians say they have psychiatric patients "boarded" in their emergency departments awaiting transfer to a mental-health facility, Adrianna McIntyre writes for Vox.

"People having a mental-health crisis seek care in emergency departments because other parts of the health care system have failed them," said Alex Rosenau, president of the American College of Emergency Physicians.

A psychiatric patient who shows up to the emergency room may require immediate care at the hospital, and sometimes there isn't an open bed in the right department. Those shortages often necessitate psychiatric patients to wait in the emergency room, or board, until space elsewhere opens for them. Both the closure of psychiatric facilities and diminished state funding have contributed to the issue. "Between 1955 and 1997, total state spending on mental health fell 30 percent, a period during which most health spending grew rapidly," McIntyre writes.

If hospitals don't figure out how to deal with the problem, it's going to get worse. In fact, experts say the implementation of the Patient Protection and Affordable Care Act will only exacerbate the problem. Some studies reveal that insured patients are more inclined to go to the emergency room�even for non-urgent issues�because the cost usually isn't as high. Lower-income people are even more likely to do that, and this population will comprise many of the newly insured citizens.

Though hospitals want people to use the health system properly, they also want to make sure patients do visit the ER when it really is necessary. "We don't want to impose any barriers on people going to the emergency room," said Hans House, a clinical professor at the Iowa University Carver College of Medicine. "We don't want people to be afraid to go to the ER."

The Affordable Care Act has provided more funding for reimbursement of emergency psychiatric care in Medicaid, a service the public program doesn't generally cover. However, this doesn't address the lack of space in emergency departments. "We know that a lack of psychiatrists available and staffing patient beds is a barrier," House said. "That's a personnel issue." (Read more)