TIPS ON RECOGNIZING AND DEALING WITH DEPRESSION

By Dr. Mike Rosmann

May 28, 2012

After reading previous columns about depression and suicide among farmers, several readers asked, “How do I know when someone is depressed or suicidal and what can I do?”

While all persons and situations differ, there often are observable signs of excessive stress, depression and suicide.

• Verbalizations about hopelessness such as “It’s no use, nothing I do is working” or “I feel like giving up.”
• Verbalizations about loss of interest or pleasure in everything such as “I don’t care about anything anymore” or “I haven’t laughed in a long time.”
• Dramatic statements and threats such as “I feel like shooting every animal on the farm” or I’m going to get that jerk if it’s the last thing I do.”
• Avoiding social or public events such as church or kids’ sports, especially when the person usually attends these activities.
• Persistent flat mood, isolation and retreating behavior.
• Deterioration in appearance of the livestock or farm, too high somatic cell counts in dairy animals’ milk, equipment and fences in worsening state of disrepair.
• Decline in personal appearance from the usual.
• Too many stressors occurring simultaneously such as inability to make payments on time, losses of loved ones, natural disasters like tornados. Note: Most of us can handle two major stressors at a time and sometimes even three temporarily, but seldom more without help.
• Persistent trouble falling or staying asleep or sleeping too much.
• Near tears, such as the “lump in the throat” phenomenon, but without actually crying.
• Emotional paralysis, such as inability to make a decision or go about working.

Proper antidepressant medication and professional counseling are “treatments of choice” for depression and prevention of suicide. But sometimes antidepressant medications can actually worsen the condition when the depressed individual has been exposed to certain pesticides.

It is important that physicians (doctors, nurse practitioners, physician assistants) managing antidepressants for farm people ask questions about possible recent pesticide exposures and even take blood samples for analysis.

Physicians, nurses, pharmacists, veterinarians and other professionals can learn about these precautions in a continuing education course called Agricultural Medicine, which is taught at several universities and medical programs in agricultural regions around the country. The Agricultural Medicine course began at the University of Iowa about 20 years ago.

Besides Iowa, the Universities of Illinois, East Carolina, Vermont, North Dakota, the Nebraska Medical Center, and the National Farm Medicine Center are among the institutions that offer this training. The nearest available location for the course can be found through an online search of “agricultural medicine.”

AgriSafe Clinics (www.agrisafe.org) also are able to help interested persons learn about this specialized training and can help farm people with health issues, including behavioral health screening and personal protective equipment.

Sometimes seriously depressed persons experience a rebound after beginning antidepressant medication and are at higher than usual risk for self harm. Robert Lincoln of Sydney, Australia, described this situation:

When they start a new medication their [energy level] returns before they start feeling better and that is when they are in the danger zone. The problem is that doctors, counselors and pharmacists fail to educate patients and their families what the road to recovery entails. Almost always, these events are complex and multi-faceted. In the end we can better understand the contributors but never fully understand what was going through a person’s mind when things like [suicide] happen.

Prevention of exposure to harmful chemicals is best. Dr. Paul Gunderson, Director of the Center for Technology-Optimized Agriculture in North Dakota, strongly urges chemical applicators to minimize exposure to crop protection products by wearing nitrile gloves, goggles, and aprons when mixing/handling products or adjusting spray nozzles. Applicators should use respirators when entering active spray paths and routinely wash hands. To insure good respirator fit, rid faces of beards and don’t wear caps or long hair.

What helps us when we feel depressed? We can help ourselves and our loved ones with tips and support. Behaviors that increase our own production of serotonin and norepinepherine, the essential body chemicals needed to “feel normal,” include:

• Enjoyable physical work or play.
• Hearty laughter.
• Deep sleep with active dreaming.
• Meaningful prayer and meditation.
• Vigorous physical exercise.
• Talking to, writing, texting persons you trust.
• Physical/sexual intimacy with a loving partner.
• Receiving comforting touches.
• Interacting positively with pets.

The more we know about stress and depression, the better able we are to farm smarter and healthier.

Nine states have farmer-friendly hotlines/helplines. See the list at: www.agriwellness.org. The National Suicide Prevention Lifeline number is: 1-800-784-2433. Thank you to all who let me know what you want to read about.

Dr. Rosmann is a Harlan, Iowa psychologist and farmer. Contact him at: mike@agbehavioralhealth.com.

Read more at: www.agbehavioralhealth.com.