Depression can be an isolating illness. Despite progress in knowledge, stigma reduction, and treatment options, it is not uncommon for someone struggling with depression—or that person’s family and friends—to feel alone. The goal of this blog series is to break through that isolation and connect the various people who play a role in any person’s depression: the person themselves, a parent or caregiver, a school counselor, a clinician, and individuals who work in policy and advocacy.
Though these specific individuals can only share their own journeys, each story is part of a larger narrative that illuminates what the entire worlds of depression and treatment can look like. The ultimate goal of this project is to share individual stories with a larger audience and to allow each stakeholder the chance to give advice to those who occupy different spaces in the journey and struggle of depression.
Each interviewee was given the choice to have their story told with their name or to remain anonymous. Those who remain anonymous have chosen to do so in order to protect the confidentiality of their friends and family whose lives intertwine with their struggles. In those cases, the interviewee’s name will be replaced with a random initial.
We welcome your thoughts and comments in our comment section! And, of course, thank you so very much to all of the brave individuals who so generously and vulnerably shared their stories with us.
Dr. David Schreiber is the Executive Director and Co-Founder of Compass Health Center, an intensive out-patient treatment center with locations in Northbrook and Chicago, IL. He also sits on the Professional Advisory Board of Erika’s Lighthouse. Compass is a center well known for its thorough care and commitment to changing the climate of intensive mental health care with a focus on treating depression and anxiety in children, adolescents, young adults, and adults. David describes his patients as high-functioning individuals who need more intensive treatment for their mental illnesses. There is an emphasis on keeping patients in their homes so that accessing care doesn’t mean being completely separate from one’s sense of normalcy.
David began his career in mental health as a medical student. Though he was initially interested in pediatric oncology, he was advised by a mentor that if he really wanted to make change in medicine, psychiatry was the best place to be. David trained at this mentor’s psychiatric hospital and found his calling in the field of mental health.
Compass Health Center had David beginning to feel that there were ways—both small and large— to improve the kind of care individuals could get in the realm of mental health. Something as easy as changing the paint color used on a facility’s walls can, David says, take a room from feeling overly clinical to feeling welcoming and open. When the place you’re being treated feels like the stereotype of a psychiatric ward, stigma around accessing care is maintained and patients feel less comfortable accessing the help and care they need. At Compass, David has chosen everything from the wall colors to the choices of magazines in the waiting room in a clinically-informed way so that the space itself is never a barrier to accessing care.
David argues that a big change that needs to be made is the fact that in the field of mental health, people group illnesses together in a way that the world of physical health never does. For example, we wouldn’t lump oncology and diabetes care together, but in mental health depression, anxiety, autism, schizophrenia, and PTSD are often treated together in the same program. This is a disservice to those being treated, as the kind of care needed varies greatly among mental illness. David believes that care improves when mental illnesses are treated more like physical ones with specialists who treat different diagnoses in different ways and in different spaces.
For depression and anxiety, Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT) are the most common choice for therapy treatment and have evidence to show their efficacy. These are modalities used for all ages, though David says that the way they are taught varies by age. Adolescents, young adults, and adults are all taught about these therapies in detail while at Compass, and know the names for the techniques that are helping them to feel better. For younger children, David describes the brilliance of compass clinicians who can make DBT skills like the “Wise Mind” into a game that can be used to manage emotions and communicate more effectively. Parents are also asked to join parent groups where they are educated about these techniques so that they have the language to help their children outside of treatment.
David highlights the need for community engagement in all medicine, but most especially in the mental health community. It is partnerships with and in the community that make treatment centers—and treatment itself—most successful. It takes more than a village, according to David, to work towards a society with much less stigma and much more care for mental health. By working with schools, mental health professionals, community stakeholders, and nonprofits, David is able to best understand and work with those who he wants to help access care.
Community partnerships are also a chance for clinicians to educate the community and help break down stigma. David gives the example of helping students return to school after a time at Compass; the social workers and counselors “get it,” he says, but without proper education, it isn’t fair to expect that everyone else will. By doing in-services for teachers, or giving school staff a chance to ask questions, clinicians can help break down stigma by broadening understanding.
A sense of community is also forged in the waiting room of Compass and other mental health care settings, where patients and their family members can find support, understanding, and friendship with other people who have this shared experience of mental illness. This is also a place where people can let go of stigma and can be a model for a larger community that is comfortable talking about mental health, sharing experiences, and normalizing mental health diagnoses. The challenge, according to David, is finding a balance between maintaining the confidentiality patients want, while helping patients and their families activate broader support networks so that there is a larger safety net if the patient needs it at home, at school, or in the community.
What David wants you to know…
What should a young adult/child know? You are not alone & you are more than your diagnosis. Depression might be a part of you, but it is not the whole you, and you can learn to manage & treat your depression and live a really fulfilling, successful life. Also, where you are with your depression isn’t forever. Treatment is only improving and we are constantly learning more; where we are now is better than where we were ten years ago, and where we will be in ten years is even better than the care we can provide now.
What would you want a parent to know? Help to normalize this all and try not to over-pathologize your child. We don’t want to create patients; we want to help people who are living with depression. Yes, depression is going to be part of their life, but we need to be here to teach them how live with it and find ways to work through it and enjoy themselves. Their whole lives don’t need to be about treatment, they can also have fun and do the things they love.
What would you want a school counselor/social worker to know? The work you do is so important, especially because you are with your students so much and are often the first ones to recognize that something is wrong. You can help them access the help they need and know how to ask for help.
What would you want another clinician to know? Make sure you’re involved in the community in some way. It’s an exciting time in mental health, and part of the reason we’re progressing is because we’ve learned to loop the community in and make this a group effort.
What would you want a policy maker/advocate to know? Don’t be discouraged. Despite the bureaucracy, there is so much opportunity to make really important differences. The system has a lot of problems, but we are at a great place and a great time to make changes and move forward in a way that expands access to mental health care.
Story #5 of this blog series will be posted in a few short weeks! Missed the first few? Check out the rest of the series on our blog. .