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I have worked as a professional in the mental health field for almost three decades. I’ve seen a lot of changes over the years and have worked with clients of all ages with different kinds of mental health issues. A lot of them suffered with depression and anxiety. I would like to share with you some of the observations I’ve seen and factors that I think can make a difference in treatment and outcomes for these populations.

First, Family history plays a role in depression and anxiety. Often depressed  clients with Bipolar disorder and Major Depression have some relatives who suffer from mood swings and other signs of depression. It is not unusual to find anxiety problems with it as well. I think how family systems react to stress in the environment and the things they choose to do to cope when depressed and anxious  also has an influence.

Some families deal with stress by isolating from society. The stress often becomes directed internally toward other family members in different ways such as domestic violence, child abuse, verbal abuse, alcoholism, or drug abuse. Parenting children can run the gamut of being too controlling, critical, or over involved to lax parental guidance or supervision and even neglect.

In other families, members have learned to reach out to the community for support and the extended family has become involved to offer some stability and routine in the lives of the family members being affected. They help by getting them involved with recreational activities and become good sources of comfort to them, and  help teach them social skills so they can navigate more successfully in schools, jobs, and marriages later in life. These same family members often take on the same coping skills as the parents, or other adults they are in contact with. The  outcomes can be better when family members are encouraged to exercise, get involved in sports, write in journals, read, go to counseling, and even join therapy groups in order to help keep depression at bay or give the family members a way to connect with people who  may have better coping skills to model.

The factors that can improve the outcomes in depression and anxiety are things like good coping skills, supportive family members, and having a regular routine for structuring one’s day. Developing  a  purpose in life and plans to carry it out , having a job, being in a loving relationship with someone or having good friends to spend time with can also help in decreasing depression. Having a strong sense of identity and feeling you matter in this world and can give something important to society can help produce more positive outcomes. Having faith in a higher power can be another resource, and having hobbies or things you like to do that can distract you from negative thoughts, painful memories, and overwhelming emotions can be very helpful. Being able to take part in good therapy is essential.

Medication can also be beneficial for some clients.  It can take time to find the right medication in working with a Doctor and it is often done by trial and error, but once placed on medication that is effective  for the client, after a month or two, they often report sleeping and eating improves, thinking becomes clearer, irritability and anger decreases, mood swings start to even out, and relationships improve. Energy is better and they can often return to work. In order for this to happen, they need to follow the medication instructions of their Dr.

There are some people who seem to have more difficulty in finding medication that works for them. They need to work  closely with a psychiatrist who can try other options that might work. ( Part 2, Depression in the elderly in the next post).