Brought to you by the Depression Is Real Coalition, The Down & Up Show is dedicated to the reality of depression. Our hosts will talk with some of the world's top experts on depression, as well as people who have been impacted by this illness. The reality of depression is that it is a debilitating and potentially deadly medical condition that affects more than 15 million Americans every year. The other reality of depression is that there is hope.

Down & Up Show #12: Depression for Dummies

IAN VO DOWN & UP INTRO

The Down & Up Show on Depression Is Real.org. A talk show dedicated entirely to the subject of depression, and the reality that there is hope for people dealing with this disease.

DR. BAILEY INTROS DR. LAURA SMITH AND DR. CHARLES ELLIOTT

Welcome to the Down and Up Show audiocast. Today's topic is Depression for Dummies. Our guests today are Drs. Laura Smith and Charles Elliott, both Drs. Laura Smith and Charles Elliott are international speakers who have clinical practices specializing in the treatment of depression and anxiety and other mood disorders. I'm Rahn Bailey, Director of the National Medical Association Psychiatry Section. Filling in today for Dr. Ellen Frank.

Throughout the years Drs. Elliott and Smith have dedicated their combined efforts with providing individuals with the resources and knowledge to begin the healing process from within and have published a variety of books about mental health. Today they will be discussing with us one of their latest books, Depression for Dummies, which is really part of this very popular dummies series. Dr. Smith and Dr. Elliott thank you for so much for joining me today.

DR. RAHN BAILEY / DR. SMITH AND DR. ELLIOTT

DR. SMITH & DR. ELLIOTT ANSWER:
Good afternoon.

Thanks for having us.

RAHN BAILEY QUESTION:
(unint.) does a lot of so-called self help books out. But the reality is some certainly offer more value than others. And for me books on depression and mental health offer substantial value; my patients see them and read them, my family and friends and neighbors and co-workers address them. These are books that I think have moments and actually play a role in the lives of the patients, persons and patients I'm actually around. Tell us a little bit about what compelled you to write this book typically as part of this ÒDummiesÓ series?

DR. SMITH & DR. ELLIOTT ANSWER:
Sure, actually the publisher asked us to write them. They first came to us asking us to write about Overcoming Anxiety for Dummies. And we were I think intrigued by the whole dummies series because the whole intent of that publisher's approach is focused on accessibility. You really strive for clarity, you use a variety of techniques like icons and bullets and so on.

But all of that is just designed to really help clarify and focus readers on important elements of sometimes rather complex subjects.

RAHN BAILEY QUESTION:
How long has this book been out and how É how available has it been and how long has it been out and available?

DR. SMITH & DR. ELLIOTT ANSWER:
It was published in 2003 or about four years ago.

RAHN BAILEY QUESTION:
And has your impression been that it's been well received and that many persons have access to it? And from what I've heard about the series it's actually been pretty popular.

DR. SMITH & DR. ELLIOTT ANSWER
It's a very popular series. And actually the public has been very good about buying it and liking it. We get lots of e-mails, lots of responses from people all over the world actually that have read the book and enjoyed it. It's also popular with professionals, psychiatrists, psychologists, social workers, counselors, and it's been translated, the Dummy series has been translated into many different languages all over the world.

RAHN BAILEY QUESTION:
I think the concept really rings true that for all of us we want to be able to capture or to grasp the essence of what a professional or an expert is speaking about, and also in this case, in a manner that's user friendly. It's not easy certainly practical and pragmatic particularly with some utility or usefulness for us in our every day lives. I've always felt that that was one reason why these books are so helpful in psychiatry because it's the rare person if anybody that does experience some element of psychiatry or psychological thought concerns or issues be it in relationship or family or work or housing or neighbors or friends in their own personal lives.

But when you use the term psychiatry or psychology or anything that sounds formalized or organized many people tend to clam up a little bit or maybe get a reluctant or resistant if not afraid and they think about the big ticket issues, their concerns will go to schizophrenia and psychosis and hospitalization and being voluntarily committed.

So I certainly like the approach from what I understand about your work that we would hope would make this again more user friendly and a topic that has utility to everybody, not just that one person in a million who has the most severe form of brain related illness.

RAHN BAILEY QUESTION:
Did you consider mental health issues that are increasingly in the news or obviously there's É whether the gentleman at Virginia Tech, whether he had psychiatric illness whether he was depressed or anxious or had bipolar or the like. Were those concerns that were relevant in addressing some hot button recent issues as well as kind of a long term thoughts, the 40 or 50 year history of the basics of depression?

DR. SMITH & DR. ELLIOTT ANSWER
One of the things that we did throughout the book was indicate warning signs; that if you have any kinds of thoughts of hopelessness or helplessness or ending your life or hurting someone else that you should immediately seek professional help. This is a very good book to go along with other sorts of treatments as in medication or psycho therapy.

So I think you know again throughout the book we talk about, we don't go into specifics, but we give lots of examples of people who really need to seek help.

DR. SMITH & DR. ELLIOTT ANSWER
And one of the things that we do talk about a lot is that depression is an absolutely real thing and that it shouldn't be ignored. We talk about the physical signs of depression, the aches and the pains and the fatigue, as well as the emotional signs and the negative thinking that happens with depression and the interpersonal problems that often happen with depression.

It's a true mind body soul that gets affected by depression. And you're right, I mean, it's a real É it affects the totality of both mind and body.

RAHN BAILEY QUESTION:
And your impression and I imagine for many it's a kind of loaded question for those of us in the mental health professions, but I ask has it been your impression, maybe similar to mine, that with some people they still struggle with whether or not depression is a real or medical illness, if it's tangible, if you can do anything about it. Or if it's like a death sentence and once you get it it's just kind of the end of the road, and that's why so many are reluctant to even be screened or be evaluated and why they present so much resistance toward psychiatry.

DR. SMITH & DR. ELLIOTT ANSWER:
And I think you've hit something that many people used to think is sort of like okay, you're depressed, just get over it, or you have some sort of moral problem or lack of É you're lazy or something like that. And we really are quite clear that depression is real, it's a physical problem as well as an emotional problem and that there are treatments that really do work.

RAHN BAILEY QUESTION:
I also imagine that some listeners today may be wondering if they themselves have kind of a depression. I remember from the book that there was this monitoring mood guide theoretically to encourage listeners to you know have a mood diary so to speak to help them understand more about their perspective, their own feelings, their own emotions, understand their own mental health, maybe really to kind of chronicle whether or not they were moving in an upward direction or a downward direction toward depression themselves.

DR. SMITH & DR. ELLIOTT ANSWER
Exactly. We give people a whole list of the various types of symptoms of depression, but one of them is simply one's mood. And by monitoring that carefully over time people can discover patterns, the types of events that tend to trigger their depressed moods. Sometimes they discover when they tend to get depressed, either what time of day or what day of the week.

They can see how their efforts progress over time and they can determine if they not progressing that they may need to seek additional help. So monitoring of moods is really a core piece of what people need to do.

RAHN BAILEY QUESTION:
I would agree I think that part of our struggle in the mental health professions is we don't do enough prevention. And I truly think, I mean, across the board. And part of that is a struggle we have with patients cooperating with us and part of it is that we really need to put this you know as a higher priority and think about it and educate others about it and make sure that it happens.

DR. SMITH & DR. ELLIOTT ANSWER
Right. And as we know depression often accompanies other physical illness like cardiovascular problems or hormone imbalances and we don't really no for sure whether it's first or second, the chicken or the egg as they say.

It does seem to be some effect of depression on you know the whole bodily system, you know, from cardiovascular to the immune system, but then also vice versa, you know is what Laura is saying. It cuts both ways.

RAHN BAILEY QUESTION:
Yes, clearly. I think, in fact I'm doing a piece at a cardiology conference in October here in Houston. A good friend of mine is a cardiologist; he's always been sensitive to these issues, and of course the cardiology literature is increasingly you know pretty well developed with the co-morbidity concerns of depression and cardiovascular illness and also the outcome determinants that have clearly shown in the last decade that you increase cardiology outcomes if you treat people for depression whether they acknowledge upfront symptom of depression or not.

RAHN BAILEY QUESTION:
É at least three fold the likelihood of getting, having a heart attack if you have high blood pressure and you've not been treated for depression. Having a heart attack if you're not treated with anti-depressants if you have cardiovascular illness and of dying of a heart attack if you have already had one and you have not been put on anti-depressant therapy.

So the reality of this is there is real good data arguing that to put somebody almost (unint.), prevention again on these meds that's such a tremendous value. I would imagine a book like yours gives an opportunity for us to talk about that in a sense that really makes sense to many people.

RAHN BAILEY QUESTION:
Oh, absolutely. I'd like to hear you speak a little bit about your latest book, Anxiety and Depression, A Workbook for Dummies.

DR. SMITH & DR. ELLIOTT ANSWER:
We actually just finished another book for dummies.

RAHN BAILEY QUESTION:
You guys are productive.

DR. SMITH & DR. ELLIOTT ANSWER
Yes, we are. (LAUGHTER) Seasonal Affective Disorder for Dummies, which will be coming out in October. And as you know seasonal affective disorder is another form of depression. But that's an aside. But the Workbook is really meant to be an active adjunct É

Adjunct to therapy where a person can work with their therapist and have lots and lots of exercises and things to do between sessions that can really keep them very goal oriented and moving ahead.

Depression for Dummies has a lot more information about depression. The Workbook is meant to be, as we say a workbook, which is something that people can work through.

RAHN BAILEY QUESTION:
I think the idea of workbook implies a hands on approach that does more than simply you show up one day and somebody tells you you have a depression. One would love to think that what all of us do that the more active the involvement between the health care professional and the identified individual, identified patient the more likely we are to have a good long term outcome.

DR. SMITH & DR. ELLIOTT ANSWER:
Absolutely.

RAHN BAILEY QUESTION:
The more likely they're more invested in what we recommend and interested in coming for care early. All of these seem to be I would imagine positive you know maneuvers to limit the adverse outcomes of brain illnesses.

DR. SMITH & DR. ELLIOTT ANSWER
As you know we're psychologists, so we tend to perhaps favor cognitive therapy. Cognitive therapy is based on the premise that the way you think about something determines the way you feel to a large extent. And what we like about cognitive therapy is that it has been shown to actually improve relapse rate for depression; it's sort of a preventative measure that you can do. And throughout the book we have exercises and cognitive techniques as well as behavioral techniques, as well as information about (unint.) medication.

Which also play an important role for us.

RAHN BAILEY QUESTION:
Well, clearly. As I know your psychologists, that's why I like you. (LAUGHTER) No, I clearly think that in what we do I say we're all part of the, this is all part of the medical profile. In the area of medicine there's therapy and evaluation. We talk to patients, we listen to them, we hear what they have to offer or what their problems are, we share with them what we think may work. We try to a trial and effect approach. I think this is the medical model.

And very often with brain illness I think because they're so complex or complicated very often it's essential that both psychologists and psychiatrists try to work together with multiple approaches, probably more than one is likely to be effective at different times in the care if you will along that line.

DR. SMITH & DR. ELLIOTT ANSWER
True, well said.

RAHN BAILEY QUESTION:
Well, I've thoroughly enjoyed meeting and talking to you. Any closing thoughts for the listeners today and can I get É I'm Oprah Winfrey now; I'm the host rather than the guest, so I want to get some early tidbits of your next new book. (LAUGHTER)

DR. SMITH & DR. ELLIOTT ANSWER
Well, the next book, that's a good question. I think one closing thought that we want to leave people with is just that depression of any kind that lasts more than a couple of weeks is something to really take seriously and do something about it; read about it, learn about it, seek help, because help is available and it truly works and it's truly treatable. The next book is Seasonal Affective Disorder. And after that well, we're working on that. (LAUGHTER)

And I guess I would like to add that if someone in your family shows symptoms of depression that it's a good idea to get them educated about it. I don't want family members to begin treating other people with depression. But the more you know about it, the better you're able to cope with it.

RAHN BAILEY QUESTION:
That's well said. That's why information and education is probably what we do that we have to be good stewards for information and education that we already have and then share it as well as we can with our patients.

DR. SMITH & DR. ELLIOTT ANSWER
Absolutely.

Well, that's just outstanding. I want to thank both of you for joining us today and for writing this book, those books, I should say. It clearly sounds to me, I mean, I've learned from looking at them and I think that everyone listening today can certainly learn about depression. It is real, it is serious, it is a brain illness.

There are cognitive behavioral approaches that can work and I think that people have to believe in that, to give it a chance and present at some point to qualified mental professional hopefully early in the process if there is a likelihood of a good overall positive outcome. I hope that more people will find help for their depression if they have it or if their relatives or friends or spouses, if you will, to find help from the book you wrote I think would be outstanding. So thank you very much for your work and for your interview today.

For the Depression is Real Coalition, I'm Rahn Bailey. Join us next time for another segment of The Down and Up Show from Depressionisreal.org. Thank you very much Drs. Smith and Elliott.

IAN VO CLOSE

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