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By Dr. Mehrdod Ehteshami, contributor 

It’s 6:55am and I’m walking through the doors of the emergency department. I get my routine sign-out from the night shift physician, hear the hustle-and-bustle of the day shift nurses come on, and in the background some murmurs I noticed that I hadn’t heard before.

“There’s talk about this new virus”, I hear one of the nurses express to one of his colleagues. “Yeah, it sounds rather odd. Anyways, let’s talk about this psychiatric patient we’ve got,”

I hear another nurse discuss. The rest was history.

The challenges that we’ve faced as a community over the past year can’t be understated. According to the Centers for Disease Control and Prevention, about 25 percent of people reported some symptoms of anxiety and 24 percent reported symptoms of depression during the second quarter of 2020. This is compared to 8.1 percent of the former and 6.5 percent of the latter during the same period of 2019.

So, the question is, now what? I’ve heard the stories of so many people tiptoeing on the edge of that deep cliff of depression.

“My tenants moved out, I lost my full-time job, and I can’t pay for my mortgage any longer. I’ve got $20 in my bank account. How do I face my family? How do I put food on the table? I’m the sole bread winner in my house,” said a 72- year-old patient of mine. Yes, at 72, he was still working. And yes, at 72, he started having thoughts of suicide. The worst part? This isn’t a novel thing.

Per the National Institute of Mental Health, if you have been experiencing some of the following signs and symptoms most of the day, nearly every day, for at least two weeks, you may be suffering from depression: sadness, anxiety, feelings of hopelessness, irritability, guilt, worthlessness, loss of interest in hobbies and activities, fatigue, restlessness, difficulty concentrating, difficulty sleeping, appetite change, suicidal ideation or thoughts of death, or body aches/digestive problems/headaches without a clear physical cause that is not easily treated.

Now of course, depression can be viewed as a spectrum. What I tell my patients, family, and friends (and even myself) is that just because you haven’t been diagnosed with major depression as a clinical illness, it doesn’t mean that your emotions and experiences don’t matter or should be ignored. In fact, I’d say that it’s, at times, more like a snowball. The longer you let it fester, it just exponentially grows to the point where it becomes a huge ball wreaking havoc on you and everyone around you.

So, as we bring mental health to the forefront of conversation in May during Mental Health Awareness Month, I’d like to take a few minutes to give you some tips from both my professional and personal life. Today, I challenge you to draw a line in the sand and tell yourself that on one side is the old you, but on the other side of the line is a person that is yearning for a happiness that you deserve.

Your emotion has a name and wants to be acknowledged. As I said earlier, just because you haven’t been diagnosed with anything, it doesn’t mean it doesn’t exist. This is a fact that I frequently teach my medical students. “Daddy wasn’t ever sick! I don’t know how he could’ve had a heart attack!” I hear this all the time. You’re not sick, until you are. The same goes true with your emotional journey. Don’t be afraid to name what it is you’re feeling. For a lot of people, that name is Grief. When you name your emotions, you’re changing where the power lies (hint: it’s with you).

Ask your friends and family the hard questions. OK, this one is a bit more challenging. Admittedly, it’s a very uncomfortable thing to do. “Hey Jim, so how are you, really?” This is such an overlooked question. My favorite thing about living in the Decatur area is that we share this strong sense of community. But I ask you, what is community without support? What is community if we’re unwilling to ask our friends how we can serve them?

Strategize! Just because something may seem difficult to achieve that day, focus on smaller tasks that you think are achievable. Acknowledge to yourself that even small tasks may be tough. By doing this, you’re using positive reinforcement to tell your brain that you can do it.

Find a thing. Anything. Something. Just find a thing to look forward to. It could be that cup of coffee in the morning or that doughnut with the friend who just recently got vaccinated. Find a thing, then tell someone that you’re going to do this. Tell that person to ask you if you actually did that thing. It’s a way of accountability, but it also gives you something to look forward to. I like to tell people to try to get sunlight in their activities as studies do show the sun helps increase our happiness as well.

It takes a village. Up until I had kids, I didn’t fully appreciate this concept. And up until I experienced depressive symptoms myself, I also didn’t fully get it–regardless of how much medical training I have had. Being a part of a community is so important. Capitalize off your relationships. What is a community without support?

Allow yourself time to heal. Time, the great healer, is often one of the hardest parts. We want a quick fix. Where’s my magic pill? “You’re a doc, put your healing hand on me,” I remember one patient being tongue-and-cheek with me. Arguably, this is the hardest part. Allowing yourself time to heal and understanding that even with medications, therapy, a strong social support, that you need time.

Call for help. Another of my favorite parts about living here is that we are privileged that we have so many resources. Check with your insurance company which therapists and psychiatrists are in your network. In DeKalb County, there are also free and sliding scale-based resources available as well. The Dekalb board of health, the Oakhurst Health Center, and Emory’s department of counseling and psychological services are all great places to start. As with everything else, the most important step is that first one.

And one last thing. You are worth it.

Dr. Mehrdod Ehteshami, DO, MPH is a practicing emergency medicine physician in the Atlanta metro area and parts of rural Georgia. He and his family live in the Oak Grove area.

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