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Psychiatrists praise Hawk for disclosing depression
Susan Hawk was commended Wednesday for going public about her ongoing struggle with depression, which forced her to take an extended leave from her job as Dallas County’s district attorney.
Two Dallas psychiatrists greeted her announcement as a learning moment for a disease that strikes millions of Americans but still often carries a heavy stigma against those stricken by it. Neither doctor was involved in Hawk’s treatment.
“Depression is extremely common, and being a high-profile figure does not protect you from the disease,” said Dr. Sarita Uhr, who has practiced psychiatry for nearly 30 years and handled many complicated cases. “It’s great that she came out and openly admitted being troubled by it. It gives people permission to come forward.”
Dr. Madhukar Trivedi, director of the Center for Depression Research and Clinical Care at UT Southwestern Medical Center, said it often is difficult for people to acknowledge their depression because of a mistaken assumption that the sufferer could simply exert more self-control.
“As with all high-profile cases, there is an easy leap to judgment about depression. People think it’s the person’s own fault and wonder why they’re not getting over it,” Trivedi said.
Although the illness is largely hidden, about 8 percent of Americans ages 12 and older suffer from depression in any two-week period, according to the Centers for Disease Control and Prevention. The disease, a mood disorder that causes a persistent feeling of sadness and loss of interest, accounts for 8 million visits to doctor’s offices and emergency rooms every year.
Also called major depressive disorder or clinical depression, it affects how a person feels, thinks and behaves and can lead to a variety of emotional and physical problems, according to the Mayo Clinic.
Hawk, who took office in January, previously acknowledged seeking treatment for prescription drug addiction in 2013. Her surprise announcement Tuesday that she was suffering from depression followed nearly a month’s unexplained absence from the DA’s office. She noted this week that she would need an additional four-week leave to battle a “serious episode of depression.”
Uhr said it can be difficult to find a depression treatment that works if the patient also suffers from addiction.
“In general, depression is very treatable, but sometimes it can take months to find medication and therapy to get someone out of it,” she said.
“Someone self-medicates with alcohol or drugs or suffers sexual or physical abuse,” Uhr said of the problems sometimes linked to depression. “Or they could be going through a life-changing event like a divorce or loss of a loved one. All of these can make treatment more resistant.”
More than 50 percent of the people in whom depression is diagnosed will see “significant improvement with one or more standard treatments within two to six weeks,” Trivedi said. “The rest is where the challenge begins.”
About 10 percent to 15 percent of patients struggle much longer, he said. “It would help us if they could recognize their symptoms and seek help earlier. They need to educate themselves on their illness.”
Depression is twice as common in women than men, both psychiatrists noted. “Boys and girls have similar rates of depression until puberty, which is when it goes up in girls until they reach menopause,” Trivedi said.
The disease is misunderstood mainly because it has not been studied to the extent of other illnesses, he said. “With heart disease, which has been studied for 50 to 60 years, we understand the importance of cholesterol, exercise, abdominal girth and smoking and how they all have an effect on the heart,” Trivedi said.
Malfunctions of the brain took longer to capture both scientific and societal attention, he said. “Unfortunately, we don’t even have a lab test for depression. The investment in research has been much smaller than with heart disease or cancer.”
Trivedi is overseeing the UTSW portion of a national study of depression patients using brain scans and blood tests to help define their illnesses. The hope is to find a better way to match each patient with the more than 20 medications that treat depression.
“We have begun to recognize that depression is much harder to understand,” he said. “Knowing this will help doctors and patients to select the treatments that will work, rather than by trial-and-error.”
Articles by Dr. Sarita Uhr
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Dr. Sarita Uhr was interviewed about her revolutionary system for family intervention on the South Texas Radio Talk Show, Recovery 101, KKYX, 680 AM, Saturday October 9th, 2010 at 9AM.
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