Depression
Interview of Robert K. Dolgoff, M.D.
This is a transcript of the Audio: Depression. To listen you may download Windows Media Player 
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Dr. Robert Dolgoff: My name is Dr. Bob Dolgoff and I'm a psychiatrist at Alta Bates Summit Medical Center. First of all, depression is an illness. Depression is not just a state of mind and we use depression as a common term to say, oh, I'm feeling depressed, but I'm feeling depressed is not the same thing as I have the illness depression. The symptoms are somewhat different. Anybody can be depressed in the common lay term of it for a few hours of the day or even a day or two. But clinical depression is an illness that will last for a long time, usually at least two weeks, during which time you're feeling down every day, nearly every day, most of the day and it's characterized by symptoms that are very specific. For example, trouble enjoying activities which you usually enjoy, negative feelings about yourself, feelings of hopelessness, sometimes wishes to die or feeling that life is not worth living. There are a number of other symptoms as well, but those are the ones that are probably most important for people to be aware of. It's common, it's treatable, and people, most of the time can be successfully treated and not suffer anymore.
There's lots of treatment for depression and the treatment works. Psychotherapy works, medication works and the combination actually works better than either one alone and most people with depression can get benefit from treatment. They feel better, usually within a few weeks. Sometimes it may take a couple of months, but people do feel better and their whole outlook on life changes after they've been treated successfully for depression. Most people feel that if you have one serious episode of depression that you ought to be treated for six months after that. And then there's a choice about whether to continue treatment or whether to stop it. Many people stop it. Others say there's such a high likelihood of recurrence that you should continue on medication for the next couple of years, but there's debate about that. The question is, would you need to continue on medication if you didn't need it. The idea here would be that if you're feeling better, you may not need to continue on it and people don't want to take a medication unnecessarily if they don't need it.
Male Interviewer: If you need help, where can you go to get help?
Dr. Dolgoff: Probably the first place to start is with your primary care physician. Most of the primary care physicians will have relationships with psychologists or psychiatrists that they can consult with and they can refer you. And then you can be seen and you can have your mental state assessed so you can see whether you are suffering from a depression or not and then if you are, what's the best treatment for you. On our inpatient geriatric psychiatric unit at the Herrick campus not too long ago we had a retired nurse who was admitted after a suicide attempt. She actually also tried to euthanize her cat at the same time. This was a serious suicide attempt and she intended to die and didn't want her cat to be left without anybody to take care of the cat. It turns out that she'd been depressed and didn't really know it, or at least she didn't know that she had the clinical illness depression. She had become incontinent and this was very disturbing to her and she thought to herself, I don't want to live like this. Actually, because she was depressed, her judgment was poor and she didn't realize that this could be evaluated and treated and she didn't have to be incontinent forever, because depression is an illness that affects your judgment and your thinking, as well as your feelings. In any case, we evaluated her. We found out the reason for her incontinence, which was treated. She got medication for depression, as well as counseling, and she did very well and was very glad that her suicide attempt had not succeeded.
(Recording Ends)
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