When someone is suffering from depression, a family member is often called upon to help make important treatment decisions.  In the midst of a major depression, your loved one may be too disturbed to make practical decisions about his or her care.

One of the most important decisions to make is the selection of the right depression treatment center to meet your loved one’s needs.  During the screening process, we recommend that you ask the following questions to potential providers:

1. Is the inpatient depression treatment program individualized?

No one wants a cookie-cutter approach to a loved one’s care.  For depression treatment, one size does not fit all. Varying levels of care and types of treatment modalities should be available. Individuals with imminent suicidal risk may require inpatient care, while others may be treated on an outpatient basis. Some patients may respond well to counseling, while others may also need antidepressant medications. The availability of a full treatment menu, with an individualized approach to care, is critical to finding the best treatment options for your loved one.

2. How involved are the patient and family with the inpatient depression treatment program?

Effective treatment programs tend to be ones that actively engage the patient and family in the assessment, planning, and treatment process. Terms like “person-centered” and “family involvement” mean that a center understands the importance of including everyone in the process – not just the professionals.  Even though they are troubled, patients with depression can contribute to an understanding of their illness and are better motivate if they are actively involved in treatment.  Family members can learn ways to better support a loved one coping with a depressive disorder, and they can also benefit from support for their own concerns and frustrations.

3.  What are the depression treatment center staff qualifications?

A professional’s best treatment tools come from a combination of training and experience.  Check the credentials of professional staff on your loved one’s treatment team.  Generally, you should look for clinical staff to have licensure in a professional field such as psychiatry, psychology, social work, marriage and family therapy, or counseling.

4.  What types of counseling and therapy for depression are provided?

When most lay people think about psychology, the first name that comes to mind is Sigmund Freud.  While he may have been a pioneer in the treatment of mental disorders, counseling and therapy have come a long way in the past century.  Many counseling techniques developed in the last few decades are designed to work with the negative feelings and self-defeating individuals with depression often have. Current therapeutic approaches considered the most effective with depression include:

  • Cognitive behavioral therapy (CBT);
  • Dialectical behavioral therapy (DBT);
  • Insight oriented therapy (IOT).

Beware of any provider that considers medication to be the sole method for treating a loved one’s depression. While modern antidepressants can have a very beneficial effect upon resistant depression, treatment should usually include other modalities such as counseling, training, or peer supports.

5.  What is the inpatient depression treatment program’s overall treatment philosophy?

A treatment center should have a clear philosophy about appropriate treatment. In discussing a program’s treatment approach, listen for terms such as the following:

  • Person-centered or patient-centered planning and care (see above);
  • Family involvement (see above);
  • Symptom management – provides patients with tools to help manage their own feelings and behaviors;
  • Least restrictive environment – provides the least intensive level of treatment necessary, while respecting the patient’s freedom;
  • Wellness and recovery – focuses on a total wellness approach to healthy living and a belief that recovery is possible.

Getting the right answers to the above questions can be a productive step in setting your own loved one on a journey to recovery.

Almost everyone has felt “down in the dumps” at times or had a case of “the blues.” In this state, you may have referred to yourself as feeling depressed.  But is this really clinical depression?

An estimated 25 percent of Americans suffer from major depression. So what distinguishes the common “down” feelings felt by most of us with true depression?  Actual depression is different from “the blues” in several key ways.

Symptoms of Feeling Blue vs. Being Depressed

Feeling “blue” or being down in the dumps” are ways we describe feelings of sadness or melancholy.  True depression has a host of other symptoms in addition to sadness.  They may include: significant weight loss or gain, insomnia, loss of interest in daily activities, feelings of guilt, helplessness or hopelessness, fatigue/loss of energy, and poor concentration.

Causes of Feeling Blue vs. Being Depressed

Brief periods of feeling “blue” are usually caused by life events that leave us feeling discouraged.  From a broken date to the loss of a loved one, the causes can range from minor to major events.  Depression can be triggered by a stressful life event, but research indicates that depression is also associated with a variety of genetic and biochemical factors.  Some individuals appear to be more “hard-wired” to get depression.  The “blues,” on the other hand, are feelings with which almost everyone can relate.

Duration of Feeling Blue vs. Depression

To be considered depressed, an individual must be experiencing significant symptoms for at least two weeks on an ongoing basis.  Individuals who are feeling a bit “down” usually shake off these feelings in a few days, if not hours.  The “down in the dumps” sensation we’ve all had is noteworthy for being temporary.  Without treatment, true depression, on the other hand, can last for months or years, or it can re-occur frequently.

Intensity of Depression Symptoms 

In addition to being longer lasting, true clinical depression is also more intense than a case of the “blues.”  Usually, individuals who are feeling “blue” or “down” manage to perform their regular daily activities.  Individuals experiencing an episode of depression often are unable to function normally. The depression interferes with work, relationship, and daily activities.  In extreme cases, depression can lead to feelings of complete hopelessness and suicidal thoughts or acts.

If you or a loved one frequently feels “down in the dumps” or “blue,” consider whether the condition may actually be depression.  A physician or mental health professional can conduct an assessment to determine if depression is present and recommend appropriate treatment.

Understanding the difference between feeling “blue” and being depressed can make a difference in the quality of life for an affected individual.  With proper treatment, depression can be managed, and individuals can live more enjoyable and productive lives.

Millions of Americans suffer from depression each year.  While medication and psychotherapy can provide great benefit to those suffering from the disorder, researchers have found that less traditional treatment methods are worth another look.  In particular, exercise has been found to boost mood and contribute to overall mind/body wellness.  Whether used as a supplement to traditional methods of treatment for those with clinical depression or as a quick mood booster for a case of the blues, physical activity can pay dividends in anyone’s wellness routine.

The Power of Exercise

The effect of physical activity in easing depression has long been documented, and exercise is a wellness movement cornerstone for patients with mental illness.  Exercise is considered a self-care strategy that is frequently recommended to help patients manage their depression.

There are numerous ways in which regular exercise helps reduce depression, including:

  • Releasing endorphins and neurotransmitters that boost mood;
  • Reducing chemicals in the immune system that tend to worsen depression;
  • Raising body temperature, which can have a calming effect;
  • Decreasing stress and insomnia, both associated with depression;
  • Improving self-confidence as body image improves and exercise goals are met;
  • Providing distraction from negative thoughts;
  • Creating opportunities for social interaction.

Traditional exercise, ranging from brisk walks to team sports activities, can provide psychological benefits to everyone, including those who struggle with depression. As little as twenty minutes of exercise per day can have a meaningful impact on one’s mental health.

Exercise and Mindfulness

Research points to the particular benefits of exercise that combines physical activity with mental focus. “Mindfulness” activities use such techniques as deep breathing or meditation to help clear the mind of distracting or stressful thoughts.

Mindfulness refers to a state of having open and active attention to the present, without judging one’s thoughts and feelings. It means truly living in the moment and being more awake to one’s experiences.

Today, several practices combine tools from exercise, meditation, and mindfulness principles to offer physical fitness routines that are also calming to the mind.  Two popular examples are yoga and tai chi.

Yoga therapy has long been known to provide many health benefits, including pain and stress reduction.  Now researchers and practitioners have found that yoga can help individuals who suffer from depression.  Its calming and gentle nature is appealing to many for whom rigorous physical exercise may seem more challenging.

Yoga practice emphasizes concentration, breathing, and smooth movements that may calm both the mind and body.  Participants are often encouraged to focus on positive images or to block negative thoughts, thereby reducing stress and anxiety.

One way in which yoga appears to impact depression is through the increase of serotonin, an important brain chemical that is often deficient in individuals with depression.  Higher levels of serotonin in the brain can boost mood – a principle utilized by many modern antidepressant medications.

Tai chi is another type of workout that has been found to ease depression.  While this Chinese practice was originally developed centuries ago as a form of self-defense, tai chi is now used as a particularly gentle and graceful form of exercise.  It is often utilized for stress reduction and many health conditions.

Tai chi is designed to promote serenity through its flowing, stretching movements, which are performed in a focused and slow manner.  Deep breathing accompanies the movements. Classic tai chi combines elements of meditation, exercise, and focused breathing, all of which are associated with reductions in depression and anxiety. Numerous research studies support the mood benefits of practicing tai chi.

The practice of tai chi is often promoted among older adults because it is such a gentle, low-impact exercise.  Tai chi has been found effective in reducing depression in older adults with major depression, as well as improving cognition.

Almost any form of exercise can be a valuable part of a wellness routine for those who suffer from depression.  But exercises which also incorporate mindfulness activities may offer superior benefits for both physical and mental health.

If you are the parent of a teenager, dealing with moodiness may seem like a fact of life.  But for many teens, something more serious than moodiness is affecting their behavior. Today, at least one in eight teenagers may experience depression. Severe depression in teens can even lead to suicide, the second leading cause of death among adolescents.

As a parent, you may wonder what you can do to determine if your own teenager has problems with depression.  Learn more about the nature of depression and how to respond if your teen exhibits warning signs, and you may make a difference in the life of someone you love.

Signs and Symptoms of Depression

Depression can affect people of any age, and it often first strikes individuals in adolescence.  The disorder crosses all gender, racial, and socioeconomic lines.  Depression in young people is of particular concern because of the increased impulsivity adolescents often display, as well as the lack of a mature, grounded sense of self.

While most people tend to associate depression with sadness and tearfulness, teenagers often exhibit different symptoms than adults or express feelings in different ways. For example, depressed teens often:

  • Demonstrate rebellious behavior, such as skipping school, sexually acting out, or shoplifting. Rather than showing sadness, teens tend to demonstrate anger, frustration, and irritability.
  • Have many somatic or physical complaints, such as frequent stomachaches, headaches, or fatigue. Other physical changes can include sleep problems, such as insomnia or excessive sleeping, as well as changes in eating habits, often associated with sudden weight loss or gain.
  • Engage in underage drinking or abuse drugs. While teens may use alcohol or drugs to dull their negative feelings, their effects often have the opposite effect.
  • Spend increased time alone, behind closed doors. Teens normally enjoy time with peers and busy schedules, so loss of interest in friends and activities should be of concern.

In addition to the above behaviors, watch for any of the following in your teen:

  • Sudden drops in school grades
  • Restlessness or difficulty concentrating
  • Feelings of hopelessness, worthlessness, and/or excessive guilt
  • Frequent sadness, crying, or anxiety
  • Increased sensitivity to criticism

While any symptoms of depression or other sudden behavior changes should be taken seriously, parents should be particularly alert to warning signs of suicide, such as:

  • Preoccupation with death and dying
  • Giving away possessions to others
  • Talking as if no one cares about them
  • Expressing feelings of hopelessness about the future
  • Expressing suicidal thoughts or threats

How Parents Can Help

The most critical way a parent can help a depressed teen is by recognizing the above symptoms.  By knowing signs and symptoms and by maintaining regular communication with your teen, you can potentially identify depression in its early stages.

If your teenager displays any of the symptoms of depression for an extended period, or if symptoms seem severe, don’t be afraid to intervene.  Begin by talking with your teen. Don’t let depression be the elephant in the room. Explain what you have observed, acknowledge that you are concerned, and explain why.  Make sure you talk in a non-judgmental and caring way.  Encourage your teen to open up to you or another respected adult about his or her feelings.

If your teen is reluctant to talk to you, it may be time to consider professional help. The experience may be less threatening if you begin with a visit to the pediatrician or family physician.  Your doctor can conduct a depression screening, which may include a physical examination and an interview with your teen.  You may then be referred to a mental health professional for follow-up.  Include your teen in the decision-making process so that greater buy-in will be achieved. Treatment may include psychotherapy and/or medication.

While depression can be a confusing and frightening experience for both teens and their parents, prompt treatment is generally successful. A depressed teenager today can go on to live a normal adult life and learn to cope more successfully with both his or her own moods and life’s challenges.

By its very nature, adolescence is a time of volatile moods.  Hormonal changes, social pressure, and the move toward greater independence can make navigating the teenage years a minefield for both teens and parents alike.  But how can a parent know when a teen is experiencing more than just routine moodiness?  The alarming suicide rate for adolescents – it is the third leading cause of death among 10- to 24-year-olds — makes it imperative that parents recognize the signs and symptoms of suicidal risk.

Risk Factors

While suicide and suicide attempts often seem unpredictable, there are some known risk factors associated with suicide among young people.  They include the following:

  • History of previous suicide attempt(s);
  • History of suicide by a family member or friend;
  • Family history of depression;
  • Presence of a mental disorder or substance abuse;
  • Presence of a physical illness;
  • Sexual orientation issues in an unsupportive environment;
  • History of abuse, bullying, or other mistreatment;
  • Social isolation or lack of social or parental support;
  • Recent loss; e.g., break-up with boyfriend/girlfriend, death of family member;
  • Access to means or methods of suicide.

Some risk factors are biologically or genetically based; e.g., up to 95% of people who commit suicide have a psychological disorder.  However, environmental risk factors can often be addressed directly.

Warning Signs

Regardless of underlying risk factors, teenagers are considered most at risk for a suicide attempt after a particularly stressful life event, such as a relationship break-up, death of a loved one, parental divorce, or school bullying.

If a teenager displays any of the following, particularly following a major stressor or trauma, it may be an indication of suicidal thoughts:

  • Feelings of hopelessness or worthlessness;
  • Increased agitation, impulsiveness, aggression, or risk-taking;
  • Poor concentration;
  • Confused thoughts;
  • Frequent talk about death or suicide;
  • Hints about not being around much longer;
  • Giving away treasured possessions;
  • Avoiding family or friends;
  • Losing interest in school, sports, or favorite activities;
  • Significant changes in eating or sleeping habits;

Reducing Suicidal Risk

While all suicides cannot be prevented, parents can take practical steps to help reduce adolescent risk:

Be watchful.  Parents should keep a close eye on a teenager who has recently experienced a loss or major stressor.  They should watch for warning signs of depression, in particular. NOTE: Symptoms of depression in adolescents often include irritability, sleep disturbance, or withdrawal, rather than crying and sadness.

Increase communication.  Even if they don’t show it, adolescents need parents’ concern, love, and support. Parents should encourage teens to confide in them and show that they deserve their trust. Minimizing concerns, making fun, or avoiding serious discussions will only increase a teen’s frustration. If unwilling to talk with a parent, teens should be encouraged to talk with another relative or a trusted adult such as a school counselor, physician, or minister.

Parents should not be afraid to ask if a teen is having suicidal thoughts.  Asking the question will not plant the idea in someone’s head, but may open the door to honest communication. If a teenager directly expresses suicidal intent, the threat should be taken seriously. While only 1 in 25 suicide attempts by teens are successful, those odds are not ones with which any parents should be comfortable.

Seek professional assistance.  If warning signs are present and parental intervention is not sufficient, it’s time to reach out for professional help.  Assistance is available through mental health centers, doctors’ offices, or clinicians such as psychologists, psychiatrists, social workers, or counselors.  Emergency assistance is also available by telephone; e.g., the National Suicide Prevention Lifeline at 1-800-273-TALK.

Both professionals and parents can assist teens in learning important life skills such as problem solving.  The more effectively a teenager can navigate through conflicts and social problems, the more resilient he or she will become. School counselors or healthcare professionals can direct parents to relevant training materials.

Restrict access to means and methods.  Suicidal risk increases dramatically with access to reliable means and methods. Almost 60% of suicides in the U.S. are committed with a gun, so any guns in the home should be locked up and out of reach. Prescription and non-prescription medicine overdoses are also common, so parents should monitor all medications in the home.

By being more aware, practicing reasonable precautions and seeking professional help when needed, parents can significantly reduce suicidal risk in their teenagers.  One impulsive act can have fatal consequences, but one act of parental concern can have far ranging and positive effects on a loved one’s future.

Technology capable of reaching deeper brain areas may provide relief of symptoms for patients resistant to medication

Cincinnati, Ohio – For more than four million Americans in the United States, the symptoms of depression are not relieved by the use of antidepressant medications. This class of depression falls into one of two categories, treatment resistant depression (TRD)or treatment intolerant depression (TID). The TRD group often tries and fails several different types of medications – either alone or in combination – while the TID group has medication side effects so debilitating that they cannot tolerate the treatment.

For these patients, an entirely new type of treatment is being studied at the Lindner Center of HOPE, led by John Hawkins, M.D., chief of psychiatry at the center. The technology, called multicoil repetitive transcranial magnetic stimulation (rTMS) or simply TMS, is a non-medication, non-systemic and non-invasive approach to treating depression.

“TMS offers patients that either do not respond to, or cannot tolerate medication, a new treatment option,” said Dr. Hawkins. “Our clinic is currently studying a new approach to this technology and we are hopeful that it will provide relief for these patients that have been suffering from depression in some cases for several years.”

Depression is thought to occur because of less than optimalchemical activity in the brain. TheTMS treatment currently under study by Dr. Hawkins and his team uses multiple magnetic fields, generated by coils placed on a patient’s scalp, to stimulate specific brain regions both on the surface and in deeper regions of the brain. This research is important in understanding whether TMS treatment restores normal brain chemical activity, thereby reducing the symptoms of depression. To date, more than 100 patients have been studied using this approach without the occurrence of serious side effects related to the device.

Depression is a mental disorder characterized by loss of interest or pleasure in activities that were previously enjoyable, a decrease in energy, feelings of low self-worth, disturbed sleep or appetite and difficultyin concentrating.1 Depression often comes with symptoms of anxiety and these problems can become chronic, substantially impairing the ability of an individual to take care of everyday responsibilities.  On a global scale, depression affects more than 350 million people and is the leading cause of disability worldwide.2

To find out more information about the TMS study at Lindner Center of HOPE contact 513-536-0712 or visit http://clinicaltrials.gov/ct2/show/NCT01909232.

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1Marcus, M. et al. Depression: A Global Public Health Concern. World Health Organization 2012, Department of Mental Health and Substance Abuse. http://www.who.int/mental_health/management/depression/who_paper_depression_wfmh_2012.pdf.Accessed 04.6.2013.

2Marcus, M. et al.

When the subject of disabilities surfaces in our thoughts or conversations, it is common to first consider those caused by some type of physical ailment or affliction. Conditions such as arthritis, heart disease and back problems are certainly primary causes of long-term disabilities in our nation. However, mental illness is the leading cause of disability in U.S. citizens ranging in ages from 15 to 44, according to National Institute of Mental Health (NIMH) statistics.

What these numbers show is that many Americans and people around the world are affected by illnesses such as depression, bipolar disorder, schizophrenia and a host of other mood and anxiety disorders in the prime of their working lives. Unfortunately, these numbers show no sign of subsiding anytime soon. In fact, they continue to rise, as do the number of filings with the U.S. Social Security Administration (SSA) for disability benefits due to mental illnesses.

The SSA and Mental Illness Claims

The SSA has established specific criteria that qualify those suffering with mental disorders for disability benefits. Basically, it must be determined that an existing mental condition limits or impairs one’s ability to fulfill their work obligations. In most situations, assessments and evaluations must be performed by mental health professionals. Additionally, evidence must be submitted to the SSA that indicates the individual in question is unable to perform their assigned job duties as a consequence of their condition.

Getting Back on their Feet

It is important for those with mental health issues to make their employers aware of their situation. All too often, workers are hesitant or afraid to address their condition with their employers for fear of negative repercussions. But behavioral or productivity problems could lead to termination, which also often results in the loss of insurance, creating even more problems for these individuals in regard to receiving treatment.

When documented mental health issues are reported to an employer, they are obligated under Americans with Disabilities Act (ADA) regulations to accommodate that employee with whatever they need to successfully perform their job duties, or to make their working situation as comfortable as possible. In lieu of applying for disability benefits, this can allow an employee to continue to work while receiving mental health treatment and take measures that will eventually enable them to effectively manage their condition.


This blog is written and published by Lindner Center of HOPE.



This blog is written and published by Lindner Center of HOPE.

Are you struggling from Depression?

Are you experiencing sadness, lost of interest, feelings of emptiness or trouble sleeping?

If so, and you are between the ages of 18-65, you may be interested in participating in a clinical research study of an investigational medication or placebo for adults suffering from depression. An investigational medication is one which has not been approved by the United States Food and Drug Administration (FDA). A placebo contains no active medication. Participants will receive study-related evaluations, visits and tests without charge.

For more information please contact Jessica at 513-536-0704 or visit www.lcoh.info

All inquiries are kept confidential.


This blog is written and published by Lindner Center of HOPE.

As most parents are well aware, the teen years can be trying and tumultuous times for both the adolescent and the adults in their lives. When a parent watches their once happy-go-lucky, gregarious child transforms into a moody teen, it can be a disquieting and often somewhat bewildering experience. Although moodiness is quite normal in teens, parents must also stay alert for signs of depression during their child’s adolescent years.

As a child moves through puberty, their bodies and brains undergo a series of rapid changes. Coupled with societal and peer influences — and depending on the environment at home — this can be a confusing and difficult period for an adolescent, often marked by anxiety and even moments of despair. But in normal situations, although they will surface from time to time, these symptoms come and go and are usually short-lived as the teen continues to progress toward achieving a balance in their life.

Signs of Depression

Teen depression affects approximately 10 to 15 percent of adolescents. Signs of potential sufferers of adolescent depression include:

– a persistent sad and melancholy demeanor

– expressed feelings of worthlessness or hopelessness

– constant fatigue

– hints at thoughts of suicide.

If left unaddressed, this affliction can have dire consequences. In fact, suicide is the third leading cause of death in teenagers.

Differences in Teen and Adult Depression

A number of contrasts exist between depression symptoms in adolescents and adults. For instance, adults will often withdraw from those around them and become more isolated. However teens, while withdrawing to a degree from the adults in their lives, will often continue to associate with their close friends.

Though a depressed teen may experience changes in sleeping patterns, they will still find time to sleep, even at odd hours. Adults are more prone to experience insomnia when they are depressed. In addition, depressed adolescents will generally express their feelings and emotions through anger and irritability, as opposed to depressed adults who are often more sad and withdrawn.

Parents must remain vigilant and “in-tune” with their child’s behaviors and attitudes throughout their teen years. If problems exist that appear to go beyond what is expected of the “normal” adolescent, parents should not hesitate to contact a mental health professional for advice.

Through expert diagnosis and counseling, and possibly the administration of anti-depressant medications, adolescent depression can be successfully treated, paving the way toward a healthy, productive adult life.

Click here to learn more.


This blog is written and published by Lindner Center of HOPE.