• How did I feel prior to this situation? (In the case of the coronavirus outbreak, if you were doing well before the pan- demic, chances are your depression is situational.)

• Do I often find myself feeling depressed during stressful times? (If the depression lifts when the stress subsides, it's probably situational.)

• During difficult times, does hopeful news lift my spirits? (Clinical depression is not often eased by hopeful news.)

Madan says the big question is, are you able to cope? “If

you're not functioning well, if you're not doing your job, if you're not able to pay attention to things, if you're up all night crying a lot, if you're breaking down, if you're getting into fights with your friends, then that's when I really feel like people should seek out help, because their functioning is impaired."

Treatment Regardless of the source or type of depression, don't be re-

luctant to consult a mental health professional if you're struggling. Depending on the severity of the depression, treatment options that a professional may suggest include lifestyle changes, psy- chotherapy or cognitive behavior therapy, which involves work- ing with a therapist to change patterns of distorted, negative thinking, as well as medication. Madan says that if symptoms are mild, you could start with lifestyle changes. “One of the best treatments we know in terms of lifestyle changes is exercise,” he adds.

When depression is mild to moderate, says Madan, “I start

introducing the idea of doing cognitive behavior therapy and possibly adding medications if things are not improving.” If de- pression is more severe, he will consider suggesting a combina- tion of treatments.

Healthy lifestyle

In addition to counseling sessions and any other indicated medical treatment, it's important to focus on key contributors to well-being during difficult times: exercising, eating right, main- taining a regular sleep routine and getting fresh air every day, even if that just means opening the windows and letting in some sunlight. If you can take a walk outdoors safely, do so: “Nature is soothing and helps lift our mood,” says Parulekar. If your mo- bility is limited, look for simple stretching exercises online that require no more equipment than a chair. But if you — or a loved one — haven't slept for a week, have hardly eaten, are feeling aggressive or are having thoughts of suicide or self-harm, experts say, call your doctor or 911 imme- diately.

"Emergency rooms are open for all of us in emergencies, not

just COVID-19 patients,” says Manisha Parulekar, M.D., division chief for geriatrics at Hackensack University Medical Center in New Jersey. “Please call and let us make that decision.” You can also call the National Suicide Prevention Lifeline 24/7 at 800-273-8255.

How to help others "Right now it's important for all of us to be vigilant about monitoring ourselves or loved ones for depression,” says Parule- kar. Those predisposed to depression are often advised to spend

Dixon & Associates Therapy Services

We look at each patient as a unique individual, not a diagnosis. Personal attention is what our success is based on,

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We file medical insurance and Medicare • BlueCross/Blue Shield Provider 336.889.5676

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JANUARY 2021 7

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