Depression was the topic of the BRIDGES Support Group Meeting for brain injured/stroke survivors, family members and caregivers on September 20, 2018. Presented by Dorothy Best, Director of NAMI (National Alliance on Mental Illness) Northern Kentucky, and Jim Dahmann, PhD, Licensed Psychologist & NAMI NKY Board Member.

1. DEPRESSION
Does not define me

2. TODAY’S PRESENTORS
• Dorothy Best, Executive Director, NAMI
Northern Kentucky
• Dr. Jim Dahmann, Licensed Psychologist/NAMI
of Northern Kentucky Board Member

3. N.A.M.I.
• National Alliance on Mental Illness
• National, State, and Local
• Advocacy
• Education
• Reducing stigma
• Composed largely of family members of those
with mental illness, but anyone can/should
join

4. • NAMI Northern Kentucky is a grass-roots
organization composed of families, friends,
caregivers, and people with mental illness.
• NAMI provides support and education
services to its members and the general public
• ALL NAMI services are free of charge

5. TODAY’S PRESENTATION
• What is Depression?
• How Common Is It?
• How is it Treated?
• What about Suicide?

6. What Depression Is NOT
• A Weakness
• A Choice
• Unusual or Rare

7. Depression
• Mood Disorder,
disorder of feeling
• Very common—about
1/7 people
• Very debilitating--#1
cause of disability
worldwide
• Associated with
traumatic brain injury

8. Depression Symptoms 1
Symptoms:
• sadness
• irritability
• loss of interests
• sleep change + or –
• Appetite/weight change
• movements: agitated or slow

9. Depression Symptoms 2
• overwhelming fatigue, lack of energy
• feelings of worthlessness, guilt
• problems with concentration
• problems making decisions
• not caring about legal situation
• recurrent thoughts of death;
• suicidal ideation
• sometimes psychosis

11. SAD
• Seasonal Affective Disorder
• Mood impacted by amount of sunlight
• Treatable with broad spectrum light

12. Treatment
• Psychotherapy
• Drugs (NOT self-medication!) GeneSight testing
helpful
• Best: psychotherapy first, add drugs if necessary
• ECT (shock therapy—for severe cases)
• TMS (transcranial magnetic stimulation) approved
October 2008; available locally; not for elderly
• Environment change (SAD)

13. Treatment

14. Talking to Someone Depressed
• DO NOT say things that don’t acknowledge
the person’s pain and inability to help
themselves, or lay on a guilt trip
• DO SAY things that acknowledge the pain,
weakness, need for help, and offer that
assistance.
• DO NOT avoid the suicide concern

15. Suicide
The Face of Suicide

16. Suicide
U.S. Annual Deaths
0
5000
10000
15000
20000
25000
30000
35000
Murders Suicides

17. 0
10
20
30
40
50
60
per 100,000
All U.S. Military Law Enforcement
U.S. Suicide Rates

18. Suicide
Main Three Suicide Risk Factors
Acquired capability
Perception of being a burden
Thwarted belonging

19. Occupational Risk factors
• Corrections/Police officer
• EMT’s
• Physicians (highest risk)
• Emergency room staff
• Psychologists
• Military
• Caregivers
• Anyone routinely exposed to trauma

20. Risk factors
• Presence of a mental disorder, especially
depression, bipolar disorder, schizophrenia,
borderline personality disorder, and anorexia
• Presence of substances/withdrawal—includes
smoking
• Legal system involvement

21. Risk factors
• Losses and/or anniversaries
• Ready access to means
• Crying frequently
• Giving possessions away
• Charges of manslaughter, murder, sex, or against
family member
• Perfectionistic tendencies
• In young, severe acne

22. Suicide
• 80% of suicides give warnings: direct or
indirect
• Warnings often difficult to detect, however
• Prediction accuracy: 50%

23. Assessing Suicide Risk
 Sex
 Age
 Depression
 Prior Attempts
 Ethanol
 Loss of Rationality
 Loss of support system
 Organized plan
 No significant other
 Sickness

24. Dealing with Suicide
• TALKING ABOUT SUICIDE DOES NOT INCREASE
THE RISK OF SUICIDE, IT DECREASES IT
• ALL suicide attempts or thoughts should be
taken seriously

25. Tips for dealing with a suicidal person
• Talk openly and calm
• Do not use guilt
• Do not argue about moral or religious aspects
• Do not impose your belief system on them

26. Dealing with Suicide
Find out if the person has a plan, how detailed is
it?
Do they have the means?
Remember “SAD PERSONS” acronym

27. If Suicide Occurs....
 Don’t sweep it under the rug
 Don’t blame yourself

28. GETTING HELP
Mental Health Professionals:
– Psychiatrists
– Psychologists
– Social Workers
NAMI
NorthKey Community Care

29. QUESTIONS?
• THANK YOU for inviting us!
• Feel free to call us anytime if we can be of
assistance.
NAMI NKY
(859) 392-1730
Email: info@naminky.org