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Major Depressive Disorder

Dr. Joe Beam:

Kimberly, I want to talk about one thing today which lends to your area of psychology. When we work with couples who are dealing with marriage difficulties, often we’ll find that one, if not both of the spouses, would be depressed. I’ve actually got a definition here from the American Psychiatric Association website. Let’s talk about how it affects relationships and particularly with marriage difficulties. According to the American Psychiatric Association, depression is a major depressive disorder. That seems redundant somehow, doesn’t it?

 

Kimberly Holmes:

Yes, that’s the technical name for it: Major depressive disorder. It’ll be in the DSM that way.

 

Dr. Joe Beam:

It’s a common and serious medical illness and negatively affects how you feel, the way you think, and the way you act.

 

Dr. Joe Beam:

Fortunately, it’s also treatable. Now, depression causes feelings of sadness and/or a loss of interest in activities you once enjoyed. For example, it can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work. It can include things such as:

 

  • Feeling sad or having a depressed mood
  • Loss of interest or pleasure into things you used to enjoy doing
  • Changes in appetite (either eating all the time or not eating at all) 
  • Trouble sleeping or sleeping too much
  • Loss of energy/increased fatigue
  • Increase in purposeless physical activity (In other words, walking around hand-wringing or pacing, nothing that’s actually accomplishing anything.) 
  • Slow movements and/or speech (or sometimes just the opposite people get hyper and they start talking a lot faster)
  • Feeling worthless or feeling guilty
  • Difficulty thinking, concentrating and making decisions
  • And, in its more intense forms, thoughts of death or suicide

 

The PHA9

Dr. Joe Beam:

I’m going to give you one more resource. It’s called the “PHA9” (public health questionnaire nine). You can find it online, however, if you are unable to, let us know and our client representatives can get the copy and send it to you. It’s not ours. It’s actually out there in the public domain. It is not a diagnostic tool- It is a screening tool. 

 

Dr. Joe Beam:

In the PHA9, they ask nine questions. (I’m not going to go through all of them, but it’s very similar to what I just read into the list, like having little interest or no pleasure in doing things, feeling down or hopeless and all those kinds of things we’ve talked about.) 

 

Dr. Joe Beam:

With each of the nine question it asks: 

  • Have you experienced ‘this one’… 
    • Not at all
    • Or, several days over the last two weeks
  • If over the last two weeks, have you experienced it…
    • More than half of the days over the last two weeks 
    • Or, nearly every day for the past two weeks

After this, it will give you a score. The score ranges from minimal depression to severe depression.

 

What We Recommend…

Dr. Joe Beam:

Now, here’s what we recommend: If you are depressed or struggling with any of the things that we’ve been talking about, we strongly recommend that you go online and find that PHQ, public health questionnaire nine. Then, answer the questions honestly about how you felt over the last two weeks. After finishing the questions, evaluate your score. *If the score indicates anything toward severe/extreme, or is up in that range, we strongly recommend that you go see your primary physician if you have one.

 

Dr. Joe Beam:

Go to your primary physician and you take your PHQ. Print it out, take it to them, show them your score and how you scored each one. It’s likely that he or she will prescribe some kind of antidepressant. They may recommend that you go see a counselor or therapist they recommend; someone that they have confidence in. 

 

And why should you get medication or go to counseling/therapy? Why not just “bull” your way through it, and, somehow, make it? What do you think that depression does?

Dr. Joe Beam:

Here’s why… For example, if we have one spouse- and we’ll make it a wife in the sense that we know that statistically speaking, women do suffer from depression more than men do. (Now men do as well, so it’s not a gender thing, but women do statistically suffer more-

 

Dr. Joe Beam:

Say there’s some kind of marriage difficulty going on and she’s in depression…

 

  • Maybe her depression is a result of her husband being involved with somebody else (we can see how that would lead to depression) 
  • Maybe the depression is because of some kind of biochemical disorder, meaning that her system is not not balanced
  • Maybe this is a side effect of a medicine
  • Maybe she’s not eating well, which can also cause all these things

 

Kimberly Holmes:

When you have one person who is not thinking right (*not because they’ve done something wrong, but it’s just the way that their mind is currently thinking) there’s an imbalance, right? There’s an imbalance of certain chemicals in your brain. 

 

Kimberly Holmes:

You can’t “will” yourself out of depression. You might be able to will yourself out of difficult days, but this isn’t a difficult day. Depression is something that needs some type of intervention. 

 

Kimberly Holmes:

While some people use coping mechanisms and get out of depression without taking medicine, if you look at the research of what is the most effective, it’s actually a combination between antidepressants, cognitive behavioral therapy, and physical exercise. Those three things together have the highest efficacy rate in helping a person get past and through depression.

 

Dr. Joe Beam:

Kimberly, How does depression negatively affect them trying to do things for their marriage relationship?

Kimberly Holmes:

When you’re in that place, when you’re experiencing the symptoms we mentioned above- where you’ve lost pleasure in things that you used to love. You’ve become, to your spouse, a different person.

 

Dr. Joe Beam:

That’s right.

 

Kimberly Holmes:

And when they feel like they have no idea how to please you, how to make you happy, they feel like they’re hitting their head against the wall and they don’t know what to do. They’re more likely to retreat, after a certain point, because they don’t want to be sad. When they’re around you, they’re sad. They don’t know what they can do to make you happy.

 

Dr. Joe Beam:

So they tend to move away from you.

 

Kimberly Holmes:

So they tend to end up moving away and it’s not because they don’t care, but it’s because they don’t know what to do.

 

Dr. Joe Beam:

It could be, but what if it’s somebody like the wife we started this conversation with… Maybe her husband is having an affair and he wants to be with the other woman. If the wife goes into depression, it actually decreases the likelihood that she will do the things that can help put the marriage back together for the very same things you’re saying, Kimberly. 

 

Dr. Joe Beam:

Because her husband (*and we’re not justifying him, we’re not saying that he’s right, we’re just trying to understand how people think) looks at his affair partner as the woman that makes him happy. Then he looks at his wife as the woman that is sad and is worried about her health and all those other things.

 

Dr. Joe Beam:

This is why we teach the PIES: the physical, intellectual, emotional, spiritual, to help you become the most attractive person you can be. But you work on the PIES for you, NOT just to get the other person back. But if you’re not getting the help you need for your depression, then it becomes easier for the other person to move away from you.

 

Kimberly Holmes:

It does.

 

Dr. Joe Beam:

So for your own sake, get help for the depression. You don’t want to feel like this. You don’t want to live like this, so go get the help that you need so that you can deal with life again. 

 

The Three Things That Have The Highest Efficacy Rate In Helping A Person Get Past And Through Depression

Dr. Joe Beam:

Now, Kimberly, you said three things. You said medicine.

 

Kimberly Holmes:

Yes, the antidepressants, SSRI (the cognitive behavioral therapy that is the most effective for depression), and physical exercise. Combining all three of those is the best, but even just combining two of those, pick the two you want, is still more effective than any one of those on its own.

 

Dr. Joe Beam:

Right.

 

Kimberly Holmes:

You do all 3 of those things because you’re looking to get the good chemicals in your brain back. Doing things like physical exercise will release certain chemicals into your body that are going to help you to feel better, help you to think a little bit clearer. The medicine is going to add on top of that and the cognitive behavioral therapy is to get you thinking right. 

 

Kimberly Holmes:

Because when you’re going through depression (and it’s something that in my past I’ve had bouts of struggling with) you really aren’t thinking right. It’s very difficult to see things clearly, to see things non-emotionally. And when you add on top of that a spouse who’s wanting out of the marriage and you’re hurt by that… piled on top of the depression…  the motivation to do the things that you need to do and the ability to see hope at the other end of this circumstance would be almost impossible.

 

Dr. Joe Beam:

The point here is this, please do what you need to do in order to deal with this.

 

No matter what’s going on in your marriage, we want to help you be the BEST version of yourself. Check out what we call the “PIES” by clicking here!