Navigating Healthcare: Depression

By Diane L. Marolla, LICSW

At times, I feel overwhelmed and my depression leads me into darkness. —Dorothy Hamill

The suicides of two celebrities in the same week in June—Anthony Bourdain, an accomplished chef, author and TV personality, and Kate Spade, a successful fashion designer—were shocking to all of us. How could two individuals who were so successful and seemed to have it all take their own lives? Both Anthony Bourdain and Kate Spade suffered from depression. In addition, Bourdain had a history of substance abuse and Spade also suffered from anxiety.

Depression is an illness that does not discriminate. It can affect anybody. It can be genetic, it is biochemical, and life situations can trigger and exacerbate depression. Medical conditions can also be a trigger for depression. Depression is classified as a “mood disorder” that affects an individual both mentally and physically. According to the Anxiety and Depression Association of America, Major Depressive Disorder (MDD) “is the leading cause of disability in the United States for ages 15 to 44. MDD affects more than 16.1 million American adults 18 and older in a given year.” Worldwide, depression is “the leading cause of disability.” Suicide in the United States is on the rise. According to Centers for Disease Control and Prevention (CDC), suicide in this country has been increasing by 30% in 25 states since 1999 and is now the 10th leading cause of death in the United States … middle aged adults are especially at risk.”

I was first exposed to depression through a family member before I was a clinical social worker. The family member was “acting differently”— losing weight, not eating, having difficulty sleeping, couldn’t work and was pervasively sad. I had absolutely no idea what was going on, so it shocked me when I received a phone call from another family member, saying that he was attempting suicide. After he was taken to the hospital, I was told that his insurance company refused to authorize an inpatient stay at Butler Hospital. The insurance company ultimately was forced to authorize it after I called their medical director and berated him. I rarely share this story.

How do I know if I am depressed or if someone I care about is depressed? There are different types of depression. Additionally, depression is different in how it impacts men versus women. Ultimately, depression is a pervasive change in mood that affects someone’s normal day-to-day functions. Symptoms of depression include but are not limited to:

a decrease or increase in appetite
a decrease or increase in sleep
loss of interest
decreased energy
difficulty thinking
thoughts of death
suicidal thoughts or attempts of suicide
body aches and pains that don’t have a physical source

What should I do if I feel I am depressed or that someone I care about is? The first thing to do is make an appointment with a trained professional. This can be your primary care physician (PCP) or someone specially trained in mental health disorders (a psychiatrist, a psychologist, a licensed social worker or counselor). A trained professional will assess you for depression by asking you a series of questions. You must be honest in answering these questions as that is what gives them an accurate picture of your condition and how to treat it. A doctor may prescribe medication and advise you to see a therapist. If you see a psychologist or a licensed social worker or counselor first, they may advise you to take medication, however, a doctor must prescribe it. A therapist can offer ongoing talk therapy. If you are in therapy, be honest about what you are feeling. Your therapist is there to help you, not to judge you.

If someone you care about is depressed, be as supportive and understanding as you can be. Support them in seeing a doctor and/or therapist. The best resource for obtaining that information is through your health insurance company. They can steer you to mental health professionals who are in their network also tell you their specialties. You also want to verify what your coverage is for treating mental health disorders.

To help and support, offer to take your loved one to their appointments. Check in on them and attempt to keep them active even if they consistently refuse. Individuals who are depressed typically isolate themselves and may not even want to see you or talk to you. However, do not take on the role of therapist or give advice. There is a big difference between encouraging and supporting someone versus trying to take the place of a trained professional. If the person is threatening to harm themselves, get them immediate help.

For additional resources on depression and suicide, please visit:,

or call The National Suicide Prevention Lifeline


Free and confidential for those who need to talk with someone, and they also have resources available.