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Experience The

ittiv riee

D

uring the months leading up
to the holidays, family and
friends plan get-togethers
where relationships are renewed. The
onslaught of commercial messages
about happy times can become an ever-
present reminder of important pieces
missing from people's lives. Many have
no family, live too far away or choose to
avoid interacting. They feel increasingly
alone. The cold dark days of
winter bring an increase in
depression, particularly if the
winter holidays don't meet
what we yearn for. Indeed,
for too many, life feels dreary
throughout the year.
Depression, at its core,
stems from a sense of loss.
Some losses are tangible,
especially events with long-
term implications: A loved
one passes away; we get
divorced or lose a job. Some
losses involve mundane
occurrences — a disrup-
tion in plans or something misplaced.
Depression can also involve losses that
are intangible: loss of confidence, sta-
tus or affection. All these losses create
questions about our ability to control
our lives or improve them.
You would be surprised by the num-
ber of people you know who struggle
with depression. The classic symptoms
go beyond the expected sadness. It can
lead to insomnia or excessive sleeping,
eating too much or too little, constant
rumination about recent problems or
unexplained crying or lethargy.
Depression often is accompanied by
anger. Think of depression and anger as
opposite sides of the same coin. Some
people who are depressed direct their
depression outwardly as anger, express-
ing rage instead of dealing with real
feelings. Others are unable to express
what they are feeling outwardly, so the
anger gets turned inward and feeds on
itself.
Some deny that they are depressed,
particularly when others question them
about their down mood. Friends, fam-
ily and peers may try to encourage a
depressed person with admonitions
such as "buck up" or "nothing can be
that bad:' Yet, these statements are
counterproductive as they disregard the
debilitating depth of what the person
feels.
There are two forms of depression:

reactive and endogenous. Reactive
depression, as the word implies, hap-
pens in response to a specific situation
such as a broken relationship, a bad
work environment or even being unable
to find your car in a parking struc-
ture. When the cause for the reaction
is addressed and a remedy found, the
depression subsides over time.
Endogenous depression is more diffi-
cult to accept or treat. With
this type of depression, one
feels engulfed in a dark
cloud of despair. Such feel-
ings can be so overwhelm-
ing they can lead to anxiety
and even panic. Each day
brings new struggles to get
out of bed, go to work or
school and interact with
people. Because there is no
specific source, as in the
reactive depression, find-
ing a treatment solution is
harder.
A person may experience
both depression and mania, which cycle
at various rates. During the depression
phase, a person may feel debilitating
sadness with the potential for self-dam-
age. During the manic phase, someone
may make imprudent decisions, shop
excessively or act irrationally. Personal
safety and detrimental outcomes are
disregarded.
There are different ways to treat the
various types of depression. Getting
counseling by a trained therapist can
reveal issues that trigger depression.
Over time, new insights can promote
confidence and reduce feelings of loss.
In addition, physicians have an array of
anti-depressant medications that can
be used in conjunction with counseling
to reduce appreciably the symptoms
of depression. These drugs can take
several weeks to build up sufficiently in
the body. Knowing about this delay can
ease the person's worry that the medi-
cation isn't work or that nothing helps.
There is no reason to suffer with any
form of depression. Getting support
and seeking professional help are the
first steps to achieving an optimistic
future.

Exceptional Clinical Outcomes
Distinguish St. Joe's
Cardiovascular Program

As a nine-time winner of national awards for
excellence in cardiovascular care and twice
named a Top 50 Cardiovascular Hospital, St.
Joseph
Mercy Oakland (SJMO) offers patients
■
the highest levels of patient safety and quality
care and an optimal experience when they
come for treatment of heart disease.
Our team of board-certified physicians and
Kirit Patel, MD
surgeons, nurses and other clinical staff
are committed to meet and exceed national
Chair, Division
standards of care. The addition of a nationally
of Cardiology
recognized cardiothoracic and vascular
surgeon has elevated our program to be on
par with other well-known cardiovascular
programs across the U.S.
"We are pleased that SJMO continues to be ranked among the top cardiovascular
centers in the country for excellence in cardiac care," says Kirit Patel, MD, Medical
Director of the Cardiac Catheterization Lab at SJMO and Chair of the Division of Cardiology.
One of the most comprehensive heart programs in the country, St. Joe's cardiovascular
program employs state-of-the-art technology to save lives and improve the health of
heart patients. Services include cardiac catheterization, endovascular carotid artery
stenting, peripheral diagnostic and interventional procedures to treat PAD, surgical and
endovascular correction of thoracic abdominal aneurysms, minimally invasive valve repair
and replacement, coronary artery bypass surgery, cardiovascular stents, implantable
cardiac devices, cardiac arrhythmia testing and other advanced treatment options.
Our exceptional performance can be seen in our clinical outcomes:
• Significantly lower 30-day mortality rates
• Significantly lower 30-day hospital readmission rates for patients with heart failure
and heart attacks
• Lower treatment costs while providing higher quality care
• Better clinical efficiency, with patients returning to daily life two-thirds of a day sooner
on average.
In addition to the national honors listed above, we also have been designated as a Top
Hospital and twice received an "A" grade from The Leapfrog Group for patient safety
and quality. We also are in the top five percent of U.S. hospitals that have received the
Distinguished Hospital Award for Clinical Excellence from a national, independent, health
care ratings organization. Locally, we have been distinguished as a Blue Cross Blue Shield
Blue Distinction Center+ for Cardiac Care and as a top-performing hospital in clinical
outcomes and patient care.
When you're looking for a heart specialist, come to St. Joseph Mercy Oakland, where
quality outcomes, patient safety and high value is our promise to you.

By Jack Weiner,
President and CEO
St. Joseph Mercy
Oakland

4.1 ••••

❑

Dr. Daniel Rosenbaum is a clinical social

worker at Counseling Associates Inc. in

West Bloomfield, where he counsels chil-

dren, teens and adults experiencing family

or personal psychological problems.

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February 27 • 2014

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