Welcome to Ask a Social Worker, a new monthly column featuring questions from the community and answers from members of NHF’s Social Work Working Group. If you have questions for our social workers, send them to [email protected].
Dear Ashley:
Since the pandemic, I’ve been having some problems managing, well, everything, and sometimes it really leaves me feeling anxious, overwhelmed and angry. I don’t constantly feel this way, but I do sometimes. I can’t tell if what I’m feeling is a normal reaction to the world being turned upside down. Sometimes I just want to crawl into bed and stay under the covers all day. How do I know if I’m depressed or having anxiety—or if I’m just really stressed out?
Signs of mental illness can be difficult to see. We all can have subtle mood changes, which can happen over time and be difficult to notice. It can be easy to dismiss symptoms that could be signs of mental illness as something else. Examples include feeling sad after the winter months, simply not eating as much as normal, worrying more than usual or having less energy. Taking an honest reflection of yourself on a regular basis, or asking friends or family members if they have noticed any changes, can help you figure out if these symptoms are temporary or are something you’ve been living with for a while. This may help you become more aware of your actions, feelings and habits, and when they change from your regular behavior. Here are some ways to look more closely at what you are experiencing:
- Apathy: Have you lost interest in activities that used to bring you joy? Has life lost so much meaning that you feel empty?
- Helplessness or hopelessness: Do you feel there is little you can do to improve your life? Do you lack motivation for making change?
- Changes in habits: Sleeping or eating too much or too little can be a sign of depression. So can engaging in high-risk behavior, such as excessive drinking, drug abuse, unsafe sex and cutting. For some, these behaviors may provide temporary relief from intense emotional pain.
- Persistent fatigue: It’s normal to feel tired at the end of the day. But if you’re tired all the time, it could be due to depression or anxiety.
- Mood swings: If you’re easily irritated, extremely impatient or overly self-critical, or if you experience frequent mood swings, it could be a sign of depression or anxiety.
- Unending worry: Are you constantly thinking about problems and solutions, and is it affecting your ability to enjoy life? This kind of worry could be due to an anxiety disorder.
- Wanting to be alone: This is different from enjoying time to yourself or considering yourself a homebody. Does it take more energy than usual to interact with others, to the point where you would rather stay home? If this is not typical for you, it could be a sign of depression.
It is important to remember that if you feel you have a couple of these symptoms, it does not always mean you will be diagnosed with depression or anxiety. There may be an underlying medical condition contributing to these symptoms, or this may be a temporary change in mood that could get better more quickly with professional support.
Think of the list above and consider whether you are enjoying life less overall, having more trouble with tasks than you used to or no longer following through on things you said you would do at work, at school or in your personal life. It could be a sign that you need additional help.
—Ashley Parmerlee, MSW, LCSW
Parmerlee works at the Indiana Hemophilia & Thrombosis Center in Indianapolis, Indiana. She is a member of the social work working group.
Dear Amy:
I’m worried that I’m depressed, and I really want to talk to someone about it. But I’m not really sure where to go. How do you find someone to talk to?
Your hemophilia treatment center (HTC) social worker would be a great place to start. Social workers have the tools and the knowledge to help you work through any concerns you might have and then make referrals accordingly. Many HTC social workers also have the training and education to provide you with counseling and support around managing your mental health symptoms by teaching new coping skills or new ways to think about your current stressors.
Help for depression and anxiety can come in many forms. Symptoms could be related to underlying medical conditions that can cause excess sadness or worry, so an evaluation from your primary care doctor could be helpful. Sometimes the use of antidepressants or anti-anxiety medications may be recommended by your doctor. Another option is talk therapy or participation in support groups. A combination of those options works the best for many people. For some, the support is ongoing, and for others it is temporary.
Creating a plan for support that works for you can feel overwhelming. Most insurance plans offer coverage for primary care and mental health services. If your plan does not provide coverage or if you are uninsured, there are options for support that are free or offered at a reduced cost. Your HTC social worker can help guide you to these resources.
It may take time to find a doctor, counselor, therapist or support group that you want to work with. Counselors and therapists often have an area of specialty or a certain approach they use with their clients, and support groups usually have a specific focus area. It’s OK to try a few options until you find the right fit.
A great online tool can be found at psychologytoday.com. This site allows you to search for therapists and support groups in your local area and narrow your search to include insurance type, location and specialty, as well as read about their backgrounds, see photos and learn about how to get in contact to make an appointment. SAMHSA (Substance Abuse and Mental Health Services Administration) also has a tool to find mental health resources.
There are plenty of other ways to boost mood and help curb anxiety that you can try now. These include:
- Exercising regularly—even getting out for a walk around the block can be mood-boosting
- Reaching out to your support system
- Journaling
- Using mindfulness or meditation techniques
- Getting adequate sleep
- Trying something new
- Talking things through with a trusted friend or family member
We are in unprecedented times. The prolonged stress experienced by all, especially the high levels of stress directly linked to the pandemic that Americans have reported, is seriously affecting mental and physical health. As scientists and physicians work to treat and cure the physical symptoms, many people are struggling with the emotional long haul of the pandemic. Please know you are not alone, and your HTC staff can help with mental health concerns.
—Amy Wilson, MSW, LICSW, ACM
Wilson works at the M Health Fairview Center for Bleeding and Clotting Disorders in Minneapolis, Minnesota, and is the current chair of the social work working group.
Learn more:
Know the Warning Signs | NAMI: National Alliance on Mental Illness
Are You Missing These Signs of Anxiety or Depression? | Harvard Health Publishing