Jan Koenemann's Story

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Beyond Blue - Jan Koenemann's Story

Can you guess which of these people is depressed? The 47-year-old real estate agent who can’t make a decision without second-guessing himself over and over again? The 26-year-old legal secretary who is always on edge and prefers to eat lunch in her office alone rather than join her co-workers? The 32-year-old teacher who just can’t find the energy to play catch with his son in the evening?

The fact is, each of these people shows signs of depression, but only a fraction of them will recognize the symptoms and get help.

The majority of people who suffer from depression can be helped with medication, therapy or a combination of the two, but unfortunately, fewer than half of them seek treatment.

"People are getting better about talking about depression, but there is still a social stigma about it out there,” says Kathy Shortt, RN, BSN, of St. John’s depression management program. “People are afraid of appearing weak, so they don’t talk to anyone about how badly they are feeling. If someone has diabetes, they take medicine to control their disease. Depression is the same way – it’s a treatable illness, but one that won’t go away without medication and/or therapy.”

St. John’s psychiatrist Paul Dobard, M.D., says that although major depression and diabetes are both physical illnesses, due to the often intense emotional component, depression may not feel like an illness – and is often mistaken for a weakness of character, weakness of faith, or just not being able to cope.

“Also, the physical components of depression, such as changes in energy, concentration, sleep patterns or appetite, are often attributed to something other than depression. Historically, the stigma of depression probably relates to the time predating modern treatment of mental illness, when medically there really wasn’t a treatment available, and the fear of being committed to an asylum against one’s will was a valid one,” Dobard says.

Sixty-year-old Janice Koenemann, (pictured above) a retired nurse who lives in Springfield, has suffered from depression on and off for about 20 years.

She attributes the onset of her depression to a combination of job stress and caring for her terminally ill father. A hysterectomy at 30 also contributed to her depression, Koenemann says.

“I was out of balance both mentally and physically,” she says. “I’m single, never married, and at that time, I was a workaholic and never took time out to have any fun. I was helping my mother care for my father in their home during his 20-year battle with Parkinson’s disease. By the time I sought help, I felt like I was in a fog, completely empty, hopeless and helpless. I was also exhausted all of the time.”

A combination of medication, therapy, journaling, support groups, prayer and even some integrative health care treatments such as essential oils has helped Koenemann manage her depression. She also volunteers in the day care at Schweitzer United Methodist Church two days a week.

“Prayer helps, but sometimes you need medication,” she says. “I also find that I really need to be in the right frame of mind to handle certain situations well. My mother, who now has Alzheimer’s, is in a nursing home in Mount Vernon. During the drive there, I listen to special music and focus on positive self-talk so I can be in the right frame of mind to be supportive to her.

COMMON MISPERCEPTION

Shortt says a common misperception about antidepressants is that they are addicting or habit-forming.

“Not true. Antidepressants do take some time to work, so it’s important that you keep taking them even after you begin to feel better. The biggest problem we see is people stopping their medication once they start feeling better. In a few weeks, their symptoms have returned and they start taking it again, but this time it doesn’t work as well or at all,” Shortt says.

She added than it can take up to two weeks before depression symptoms lessen and up to eight weeks before the full effect is realized.

“We usually prescribe antidepressants for a minimum of six to 12 months,” she says. “Overcoming depression is a long-term process.”

Dysthymia is the second most common form of depression. The symptoms are milder than those of major depression, but because of its duration – often two or more years – dysthymia can be more serious than major depression.

“The symptoms of dysthymia are fewer and they aren’t as intense, so it’s often overlooked. But we all know someone with this condition,” Shortt says.

Bipolar depression is the third most common form of depression and is the depressive phase of manic/depressive illness. While other types of depression are treated in basically the same way, bipolar depression requires mood-stabilizing medication in addition to an antidepressant.
“Bipolar depression is caused by a different chemical in a different part of the brain,” Shortt says.

Seasonal affective disorder and postpartum depression are also common forms of depression.

SAD follows a seasonal rhythm and usually diminishes in spring and summer. It’s often treated with light therapy, Shortt says. Postpartum depression is not just “the baby blues.”

“Postpartum depression can be very serious. It can have all types of duration, from a few days or weeks to a year. One major symptom of this type of depression is feeling detached from or anxious about being able to take care of the baby,” Shortt says. “If you’re having those feelings, it’s important to talk to your physician about them.” ”Talk therapy is often the most effective treatment for postpartum depression, but antidepressants are usually prescribed and are effective."

Characteristics of depression

Major depression can be a single episode as a result of a life event such as a death or divorce. Major depression is the most common form of depression, Shortt says, and is characterized by at least five of the following symptoms, lasting two or more weeks.

Symptoms

Feeling depressed, sad, hopeless or worthless
Irritability, easily frustrated or agitated
Loss of interest or pleasure
Changes in sleep and/or appetite
Withdrawing socially or from family
Decreased energy or fatigue
Poor concentration or difficulty making decisions
Thoughts of death or suicide.

Depression Quiz

1. In the past two weeks, have you consistently felt sad or blue?
2. In the past two weeks, have you consistently experienced a lack of pleasure or interest in activities you used to enjoy?

If you answered Yes to both questions, discuss your symptoms with your physician for further evaluation and treatment. If you have been experiencing symptoms of depression for two weeks or more, please call St. John’s Behavioral Health Services at 417-820-7447. We can help!

Anyone having thoughts of ending their own life should go to an ER for assistance. A psychiatric registered nurse is available for consultation 24 hours a day, seven days a week at St. John’s Emergency Trauma Center.