August 28, 2018

It was 4 p.m. on a Friday af­ternoon, and “Ruth” was my last patient of the day. She was one of my regular el­derly patients and I was hop­ing for a short visit. I noticed that she failed to greet me at the door as she always did. I started discussing her blood pressure readings but she seemed unusually reserved during our conversation. At one point, she mumbled, “You may not see me again.”

At first, I failed to process this comment, but her demeanor made me concerned enough to explore her mood. I went through a questionnaire with her that revealed she was suffer­ing from severe depression. She even admitted to having suicidal thoughts.

“Nobody would miss me or think about me, Dr. Daiza,” Ruth said. “Sometimes I think about hanging myself in the basement.”

I froze.

I immediately urged her to get help. I mentioned mental health professionals, medications, and even inpatient psychiatric treatment. She refused everything and appeared frightened.

“Don’t tell anyone! Don’t send me away!” she sobbed.

I started to counsel her and asked if she would agree to meet with me every few days. I had built a trust with her that I knew she would look forward to our sessions and not harm herself in the interim. Ruth, like many others, had been diagnosed with major depression.

Approximately 16 million adult Americans suffer from depression each year. Over 50 percent of all people who die by suicide suffer from major depression. Traditionally considered a taboo subject, mental health has recently been highlight­ed with suicides of famous names including Kate Spade, Anthony Bourdain, and Robin Williams.

It is important to realize mental illness is truly an ill­ness. A sick mind is capable of causing disability and duress in the same way a sick heart or cancer can. It can have potential harmful effects on your career, relationships, and family, and it can lead to significant physical disability.

Mental health is complicated and unique to each individual. But it is important for all of us – not just the health care providers – to be hyper­aware of the signs and symptoms.

Common signs to look out for in a person suffering from mental disorder include social withdrawal and isola­tion, sense of hopelessness, lack of self-care, or even changes in personality.

Social support through friends and family can play a major role in detec­tion and treatment of mental illness. Medications and counseling therapy through a primary care provider or a specialist can also be easily arranged.

It has been two years since Ruth was diagnosed with depression. Over time, she has been gradually able to recover with the help of medications and counseling. Today, she is an ac­tive member of her church again and serves as an example of a fighting spirit in her community.

If you or someone you know is suffering from signs of depression or have thoughts of suicide, please con­tact your healthcare provider or the National Suicide Prevention Lifeline at 1-800-273-8255.

Dr. Rena Daiza recently completed her medical residency at St. Joseph Mercy Hospital and is now a full-time family medicine physician with Henry Ford Health System. She serves on the board of the Chaldean American Chamber of Commerce and MERCI, the medical group that organizes annual fundraisers to benefit refugees. Citation: https://www.cdc.gov/tobacco/ campaign/tips/diseases/depression-anxiety.html