Warning Signs of Depression

Vermont is ranked as the third most depressed state in the country. Only Kentucky and West Virginia have higher rates of depression. One in four Vermonters (25 percent) report they’ve had a depressive disorder. That compares to 19 percent among all U.S. adults. 

Why is Vermont’s depression rate so high? Our long, cold winters might have something to do with it. Another reason is Vermont has increased use of depression screening. As part of a routine checkup, patients are often asked about feelings of sadness and other depression symptoms. This has helped find more cases of depression. 

Blue Cross Vermont has expanded access to mental health services, so our members with depression and other mental health conditions can quickly receive treatment. We’ve also removed prior authorization requirements for mental health treatment at in-state, in-network facilities (prior approval is still required for some psychological and neuropsychological testing). 

Despite our success in identifying depression and making treatment more available, many Vermonters continue to struggle with depression and its effect on their lives. In this article, we’ll give you the warning signs and symptoms of depression to watch for. We’ll also tell you what you can do to keep depression from taking control of your life. 

What is Depression? 

Depression is a serious mood disorder that can interfere with a person’s ability to function day-to-day. People with depression feel sad and lose interest in doing things. A person with depression may become withdrawn or detached and isolate themselves from family and friends. They may have difficulty meeting responsibilities at work, school, or home. Depression can even cause long-term physical health problems. 

Depression is a tricky condition to overcome, says Sunny Naughton, a Vermont-based mental health consultant. Symptoms of depression like fatigue and loss of appetite make it difficult for people to recover on their own, she says. 

“Depression tells us not to do things that are going to make us feel better,” Naughton says. “For example, getting sunlight, going for a walk, exercising, eating nourishing meals, taking time to sleep — those things that help us in basic everyday life. Depression tells us we might not have the energy to engage in things that are going to make us feel better.” 

Signs and Symptoms of Depression 

With so many Vermonters affected by depression, it’s important for all of us to be aware of its signs and symptoms. They include: 

• Feeling sad or empty 
• Hopeless or pessimistic feelings
• Angry outbursts, irritability, or frustration — even over little things 
• Loss of interest or pleasure in hobbies and activities 
• Changes in sleep patterns, such as insomnia or sleeping too much 
• Tiredness or lack of energy 
• Changes in eating habits, either reduced appetite or eating too much 
• Anxiety or restlessness 
• Feeling worthless 
• Fixation on past failures or blaming yourself 
• Difficulty thinking or concentrating 
• Trouble making decisions or remembering things 
• Suicidal thoughts or attempts 

Some people may experience only a few of these symptoms, while others may have more of them. Depression’s symptoms may also manifest themselves as physical problems, such as back pain, digestive issues, or ongoing headaches. 

What You Can Do 

Paying attention to your feelings and what may be causing them is a good first step in fighting depression, says Naughton, who also teaches mental health first aid. The classes give people skills to recognize and respond to mental health challenges. 

Look at what is happening in your life, she says, and identify things that may be leading you to feeling depressed. For example, you could be grieving a loss or there may be major stressors that are contributing to what you’re feeling. 

As you continue with your daily schedule, keep monitoring your feelings and see if it passes, she says. “If this lasts for longer than two weeks, you’ll want to reach out for some sort of professional help.” 

Talking with your primary care provider can help you decide what kind of treatment to seek. Traditional approaches include meeting with a psychiatrist or psychologist, but there are many other ways to get assistance, Naughton says. “I think that we’re in a moment of change, culturally, where more people are understanding their mental health and also understanding there are a variety of ways to ask for help.” 

Enlisting support from a faith leader, a supervisor at work, or a trusted family member can be beneficial, she says. Communicating with people in your life is an important therapy for depression, Naughton adds. “Maybe setting up a weekly phone call with a friend, or writing a letter, sending someone a note. That allows us to express ourselves but also continue connection.” 

While such self-care can be helpful, it’s still worthwhile to meet with a medical professional and develop a treatment plan, Naughton emphasizes. A medical professional should be involved because complications from depression can lead to thoughts of suicide or self-medication with substances, she says. “You do want to have some sort of medical professional overseeing your care if this is getting in the way of your ability to live, laugh, and love. If your feelings are not allowing you to live life the way that you want to, you want to talk to a professional about it.” 

Don’t wait too long to have that discussion, she adds. “The earlier you seek help, the more improved your treatment outcomes will be.” You’ll also prevent depression from causing other health complications, such as heart disease. “If you sprain your wrist, you would get it taken care of. You wouldn’t wait for it to turn into something else. We want to do that with mental health as well,” Naughton says. 

New Treatment Options 

Blue Cross Vermont now offers several options for mental health telemedicine to help our members get treatment for depression or other mental health conditions. We have partnered with: 

• Amwell, which provides members with 24/7 access to a psychologist or counselor via their mobile app or website. Schedule an appointment at bluecrossvt.amwell.com and use the service code VERMONT. 
• SonderMind helps members find a mental health provider in their area or can connect them virtually. Call SonderMind at 1-844-843-7279 to get started. 
• Valera Health offers virtual therapy and psychiatry services for adults and children ages 12 or older. Complete Valera Health’s onboarding form for a free consultation and to connect with a care team. 

For more information, visit the mental health telemedicine support page on our website. 

Self-Care Tips 

Along with seeking help from a medical professional, here are several things you can do at home to feel better and cope with depression. 

• Physical activity such as walking 30 minutes a day, preferably outdoors when the weather is good. 
• Good sleep habits including going to bed and waking up at the same time each day. 
• Eat healthy meals on a regular schedule and limit snacking. 
• Pay attention to hygiene. Make sure to take a shower, brush your teeth, and get dressed for the day, even if you don’t feel like doing it. 
• Delay important decisions such as changing jobs until you feel better. Discuss major decisions beforehand with family or close friends. 
• Avoid using alcohol or drugs. These substances can make you feel even more depressed. 
• Do small tasks. To avoid feeling overwhelmed, break bigger tasks up into several smaller ones, and do the tasks you feel you can. 
• Try something new. Creative pursuits like painting, photography, or joining a group activity can boost your mood and decrease feelings of loneliness. 
• Spend time in nature. Getting outside in the fresh air and listening to the birds or watching animals can lift your spirits. If you can’t get outside, try sitting by a window in the sunshine. 
• Keep a mood diary. Using a mood tracker can help you identify changes in your symptoms. It can also help determine if certain things or activities make you feel better or worse. 

One of the best things you can do is remain aware of your feelings and talk with someone about them, Naughton says. “Connection and communication are the antidote to so many of the things we experience with our mental health,” she says. “Really finding a safe person that you’re comfortable talking about your mental health with can save your life.” 

For more information about mental health first aid courses, visit Sunny Naughton’s website.