Fade to Black 3 of 4 (Dr. Brent Lindquist)

Hello again. Welcome to my third program in a 4 part series that I've called Fade to Black.  It looks at not a very positive situation - the 'blackness' that people feel inside that they have a difficult time labelling.  It is sort of this unformed thing that's going on.  In the first program we talked about trying to identify what it was, make a log...  This last time we looked at what was inside the 'black'.  I talked about positive substitutions, going and doing something positive that can take you out of that particular space.

This program I want to talk about - Do I need help?  That's what I've called it.  People say that I explain things and make it easier for them to talk about things. They often will talk to me and they'll say, 'Do I need help?  Is what I'm struggling with something that I need to enter into therapy for?'  The problem is that most of you that are listening aren't probably around a place where you could go into therapy, as it were. There are not a lot of resources around there for you and for me to say, 'Yeah, get therapy' is not going to be appropriate.  We have to figure out, first of all, how to help you right now.  Then we'll look at that.  To answer the question - Do I need help? - I think you have to look at yourself and maybe you can do this all by yourself.  Maybe you need a spouse or a trusted friend to give you help on this. I think you need to ask yourself, 'Is what I'm going through overwhelming me?'  Now, what does being overwhelmed mean?  Well, overwhelming you is meaning that you can't do anything about it. When you think about it you can't concentrate on anything else.  Some people that are overwhelmed actually kind of tune out.  Others say, 'You know I was talking to you and you just stopped talking'...and you say, 'Well, it just makes me so upset I can't concentrate'. Is it overwhelming?  Can you concentrate on other things?  Does it impact your daily life?  I think a big thing about something like depression is - how does it impact your daily life?  Are you able to get things done?  Can you go to work?  Can you cook? Can you manage a relationship? Can you parent the kids?  If what is in the 'black' is preventing you from doing any of those things then that's probably a good indicator that you need to do something about it.

There are different categories of doing something.  If you were completely  vulnerable and you weren't sure you could protect yourself you might need to go into a hospital, for example.  Most of the time, however, when we're feeling overwhelmed it's kind of situational. Maybe we fall asleep and we wake up and we're doing a little better, or we have something to eat and we feel a little better.  If it's regularly overwhelming and regularly impacting your daily life then you do need to get help and the sooner the better.

Where do you go for help when there is none?  That's a good question.  One of the biggest places to go get help is anywhere that's not you.  In other words, when you keep it all inside you're putting yourself at the most risk.  Anybody is going to be a better help than keeping what's going on inside of you a secret. That means that friends, family, coworkers, anybody around like that can be a help to stabilize what's going on.

Now let's say that you're not that bad off.  There's not that big of a concern.  What do you do?  How do you find help?  Well, it depends on what you're doing.  Some people have work assignments that put them in a particular place for a particular amount of time and as they're getting close to that they're getting depressed or whatever.  Sometimes it's okay to wait until they've finished their assignment and then go on vacation or something to get help.  Other people may need not to wait.  Maybe they need to be communicating, emailing supervisors back home or whatever saying, 'This is what's going on.  I can't manage it.  I need help'. Allowing other people to participate in the decision making is a very important thing to do.  If you weren't feeling bad and all of a sudden you're feeling bad I think you need to start, in the first place, with a physician.  A physician needs to identify physical issues that might be going on.  There are a lot of physical things, reactions, illnesses or depletions that mimic or show up in mental health ways.  Our thyroid, for example, if it's out of balance and not working right can make us very depressed.  Other things like fatigue can really make us very depressed which could be related to some kind of vitamin deficiency or dietary insufficiency.  All of those we need to look at.  We need to understand if there's something physical going on.

The next thing is to talk to that trusted person, whether they are our pastor, our coworker, somebody that lives in our home country...and they can help figure out some things too if you're close to them.  Then we need to look at family.  Some of us at times may say, 'My family is not that much of a resource to me'. I think families can be a resource particularly if we are really having struggles.  I think back of someone that I met that increasingly got more and more depressed.  He thought that he didn't have anybody to reach out to.  He couldn't reach out to his wife or his family or children because he thought they would think less of him.  He thought they didn't see what was going on.  When he finally was open about it, he discovered that they'd known all along and that they were trying to get him to talk about it but he was very successful at avoiding talking about it.  When he finally acknowledged his problems, what he discovered was that they were there for him.  That made a big difference in his recovery because all of a sudden his biggest fear that they would reject him in his weakness was unfounded.  Then he said, 'Well what else am I believing that isn't true?' So some of the other stuff that were just fantasies changed completely because he then knew he had resources and that things weren't the way that he was seeing them.  I think that's important.  Your perceptions right now may not be as clear as they would when you weren't under as much stress or as much 'blackness'.  You need the wisdom of other people to help you figure out what's true and what's real.  As you work on those kinds of things, it is really important that you seek the information, the feedback, from those people around you.

Now what do we do? I've said that you may not be going crazy.  You may not be needing a lot of outside, professional help, but you do need regular talking times with people.   You do need to do the behaviours.  Last time I asked you to find some good things to do, some positive substitutions, and you need to do that, but you need to have the communication as well. Indeed, in the treatment of depression, if you will, the most effective way of treating depression is a multi-modal kind of thing that focuses on behaviours, thinking, communication and good physical health.  All of that works together to bring out the best in you and make you the most able to grow.

If all of this makes sense to you and you're really thinking that you need somebody to talk to, then I suggest that your homework is that you identify somebody that you can begin to talk to.  You may not know a physician in the area where you live, you may not trust anybody like that, but you can trust a coworker.  You can be open with people.  You can choose openness as well as choosing closedness.  If you're struggling I really encourage you to do that. If you have people around then I encourage you to keep doing that.  It's not easy.  This is very difficult, hard work but it does get better and it does get more comforting when you open up to somebody and see them supporting you.  Think about that, find somebody to talk to and we'll talk to you next time.