Depression

Overview

The word “depression” is often used to describe both sadness which is short term and a normal reaction to a life circumstance (e.g., not making rank). Depression also describes a serious psychiatric disorder.

Depression is a very real medical and psychological condition which has many scientifically proven treatments which are endorsed by the DoD. Depression does not discriminate - it affects all age groups, genders, rates and ranks.

RECOGNIZE THE SYMPTOMS

Depression has an impact on quality of life - frequently on interpersonal relationships and often on quality of work. While depression often is marked by sadness, the mood can often be hidden requiring us to be observant of other signs.

Depression
  • Diminished concentration
  • Lack of energy
  • Low self esteem
  • Restlessness, irritability or easily agitated
  • Thoughts of suicide
  • Increase in unsafe behaviors
  • Decrease in personal hygiene
  • Insomnia

Work and Depression

Depression can have a significant impact on the work place. The most reliable Sailor may become inconsistent and frequently late for duty. Productivity or accuracy may be affected by diminished concentration. Conflict with fellow Sailors or their supervisors may ensue due to the irritability resulting from depression.

  • Overall work decline
  • Attendance
  • Performance
  • Attitude
  • Decreased safety practices
  • More accident prone

TREATING DEPRESSION

Treatment Options

Depression is most often treated on an outpatient basis. Many people with depression are helped with therapy and behavioral changes alone. Others realize better treatment success with medication or a combination of medication and therapy. Often, Sailors who are reluctant to present to Mental Health will seek services through their Primary Care Providers. Generally, if substantial treatment gains are not reached within a twelve month period a Medical Evaluation Board will be initiated.

Barriers to Treatment

A sense of helplessness is a symptom of depression - one that is an obstacle that can be immobilizing; preventing the Sailor from seeking necessary help. Additionally the stigma of depression may actually prevent a Sailor from reaching out toward the treatment needed.

What Leaders Can Do

The role of Commanding Officer, Department Heads, Division Officers, Chiefs and front line supervisors is to assist the service member in getting help.

Leaders are not expected to act as counselors

In order to help unit members with depression keep the following acronym in mind:

CAKE
Communicate • Ask • Know • Educate

Communicate to the Sailor

  • Asking for help is sign of strength not weakness
  • Address concerns (career consequences for seeking and not seeking help)

Ask the Sailor Directly

  • Regarding suicidal thoughts - refer immediately to metal health if suicidal behavior is suspect
  • About emotional state
  • How can you be supportive

Know the signs & symptoms

Educate your chain

  • Rely on those who see the Sailor daily to offer feedback on behavioral changes

REFERENCES

  • Diagnostic and statistical manual of mental disorders; DSM-IV-TR. (2000).Washington DC: American Psychiatric Association.
  • Harold, K., & Benjamin, S. (1995).Comprehensive Textbook of Psychiatry VI eds.Baltimore: Williams and Wilkins.
  • Hoge, C. W., & Lesikar S. E. (2002).Mental disorders among US military personnel in the 1990's:association with high levels of health care utilization and early military attrition. American Journal of Psychiatry, 159, 1576-1583.

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