Brought to you by the Depression Is Real Coalition, The Down & Up Show is dedicated to the reality of depression. Each week our hosts will talk with some of the world's top experts on depression, as well as people who have been impacted by this illness. The reality of depression is that it is a debilitating and potentially deadly medical condition that affects more than 15 million Americans every year. The other reality of depression is that there is hope.

Down & Up Show #31: Defeating Depression

DR. RAHN BAILEY:
I'm Dr. Rahn Kennedy Bailey, a psychiatrist here in Houston. I'm very happy to be joining you today as the host. Today we'll be speaking with Dr. Howard Stone. Dr. Stone is a professor emeritus from Texas Christian University here in Fort Worth, Texas.

He's published over a dozen books on topics including depression, suicide, grief, counseling theology and hope. Today we'll talk to him about his recently published book ÒDefeating Depression,Ó which is a unique book because it speaks directly to both the person experiencing depression as well as to that person's network of family, friends and associates. Welcome, Dr. Stone.

DR. HOWARD STONE:
Thank you very much. I'm glad to be here.

DR. RAHN BAILEY:
Oh, we're very happy to have you here today. I have your book in front of me and I must admit it's really outstanding and I've enjoyed looking at what some of your thoughts are and really what you're sharing, in the introduction, the ability to really capture these concerns as both the identified patient, if you will, as well as their identified network of family and resources would see it, is really pretty challenging but so necessary because, very often depression is a type of illness that really encapsulates everybody.

DR. HOWARD STONE:
Yes, that was actually one of the reasons why I wrote the book was because so many individuals who were depressed came to me first with a spouse or another family member and that's what really caused me to write for both audiences. And I think both are very important.

DR. RAHN BAILEY:
You make a very important point when you speak about depression requiring an active rather than a passive approach. It certainly resonated with me in my private practice here in Houston and the (inaud.) area. You know, we're often trying to help patients actualize their own affect and be able to do some things that proactively help in the process.

What are some of your thoughts or what really led you to that perspective that patients should be active about the treatment of depression.

DR. HOWARD STONE:
Well, it came partially from my own experience when I went through one very severe bout of depression. And the person that I was seeing at that time really helped me and urged me to be more active. And I found that being active helped me feel better, helped me stay more in the life that was going on around me.

But I have also seen in 40-some years of seeing people clinically that being more active helps people have more of a sense that they can, in fact, in some way have an impact and change the depression and somewhat manage it a little bit more which I think is really key.

DR. RAHN BAILEY:
I am interested more in your thoughts about how your own depression which you have already mentioned affected this work and really your work in this field.

DR. HOWARD STONE:
Well, obviously it got me more interested in it and one of the ways when I respond to something that's troubling me is to do research and to read and to write.

On the positive side, what it really did for me is it helped me understand depression from both sides, not just as a helper but as someone who's being helped. And I certainly don't recommend people go out and have experiences so that they're more sensitive in the counseling that they do but I think it just helped me immeasurably to be aware of sometimes just the very severe pain that depression has, that desolation that you experience.

DR. RAHN BAILEY:
You offer, I think, the reader in this book some very active and hands-on approaches, so-called, what to do steps and how to sequentially go about defeating the process and winning at the endeavor of having depression but living through it and living successfully and hopefully find a remission.

To you, what are some of the most important such steps?

DR. HOWARD STONE:
Well, in the book, ÒDefeating Depression,Ó I probably talk about 30 or 40 different things that people can do. I certainly don't expect anyone to do all of them. I think one thing that I think of about ÒDefeating DepressionÓ is that some books will talk about one thing. They'll talk about changing your thinking.

Or another book will talk about physiological changes or taking medications as help. Maybe another book will talk about the importance of interpersonal. But there appear to be really four faces of depression that need to be addressed and they are behavioral, cognitive or thinking, interpersonal, you know, your relationships and the physiological which involves medication certainly but other changes.

People often are looking for something to do. They want a roadmap, so to speak. They want something pragmatic, practical, as I said earlier. And I think you addressed that fairly well so I want to give you a chance to come and maybe address maybe those four particularly and how you conceptualize them and help the person who has depression.

DR. HOWARD STONE:
Okay. Well, first of all, the question of what do you do when it comes to the physiology or physiological changes. Just picking up on a couple of them, one there is regular cardiovascular exercise. Long before running became really in vogue, there were studies and there've been well over fifty years that noted that regular cardiovascular exercise, that's running or walking, playing tennis, playing racquetball, swimming, something like that done three, four times a week, tends to both trim anxiety and elevate mood.

DR. RAHN BAILEY:
I'd agree with that before you go on. It's something that I see in my own practice. So often, if you can get the persons back to living, I like to say, in addition to the therapy and the meds and all of the more psychosomatic treatments we may have to offer, living is about exercising and running.

It's about reengaging in activity. But there's nothing better, I think you're right, than something that we do individually for ourselves like exercising, particularly for the cardiovascular, like running. I think it does a world of good in addition to the more, again, professional approaches. I would substantiate that in my own experience.

DR. HOWARD STONE:
Related to that, too, is I generally urge people to really cut down on their drinking or abstain from drinking while they're depressed because sometimes alcohol tends to deal with the anxiety that sometimes is associated with depression. In the long run, a lot of times, many people have described it just depresses them even more.

And so I urge them. Now that's not always an easy one to do. I can usually help people get diet changes a little bit better than I can having them abstain from alcohol. So those are just a couple examples of the things I talk about.

DR. RAHN BAILEY:
Cardiovascular exercise and diet for sure.

DR. HOWARD STONE:
That's right. And of course, the one obvious one is I want every person I see or everyone I sense is at all depressed to see a physician because you get three good things to happen when you see a physician. One is that you get checked out to see if it is indeed depression or if it's some physical cause you're feeling.

But the reality is the people, you make a great point, there's additional tangible benefits to see the psychiatrist that oftentimes, many patients don't want to appreciate it. They think that, well, I can handle it on my own or I will singularly see my therapist or physician maybe to bring some additional concerns into the picture that maybe they hadn't thought about.

DR. RAHN BAILEY:
But I must ask you about the issue of suicide and you have a chapter on suicide prevention called ÒHow to Save a Life.Ó What are some comments you'd make to our audience today that they should be considering if they think that perhaps someone is considering committing suicide?

DR. HOWARD STONE:
Well, yes. About three out of every four people who are depressed at some time consider suicide so if you're living with someone who is depressed, it's something you need to keep an eye out for, maybe even discuss with the person. Just a couple thoughts. First of all, in chapter one of ÒDefeating Depression,Ó I have a little quiz in there that the depressed person could take.

But I also have it set up so that a family member can take it or that depressed person to get a sense if, in fact, they are depressed.

But for suicide, the bottom line is if you don't know what else to do, call 911

DR. RAHN BAILEY:
In regard to family members and what some of the strategies for them to employ might be, how they can be useful as well.

DR. HOWARD STONE:
Okay, excellent. That's if you're speaking about depression in general and not just suicide, correct?

DR. RAHN BAILEY:
Yes.

DR. HOWARD STONE:
That's what I was thinking. Yes, I think there's a number of things that family members can do, in fact, really need to do, if nothing else, just to protect themselves so that they don't get kind of caught in that downward spiral of the person who's depressed.

And at the end of each chapter in ÒDefeating Depression,Ó I have some sidebars and I have a section in there that says one is for the family. Another one is action steps that the depressed person can do. So in each chapter, I have a number of specific things that family members can do.

At the beginning, that's just getting some information. Some of the early chapters just talk about getting some information from the depressed person. Find out how they're experiencing and what they're experiencing. Instead of being afraid to ask, ask the question.

DR. RAHN BAILEY:
You also comment about spirituality.

DR. HOWARD STONE:
Yes.

DR. RAHN BAILEY:
And I think that's an important part for so many, cannot be underemphasized or negated, the role that it plays in whether someone will ever get past, unfortunately, the stigma that is unfortunately attached to having brain-related illnesses and whether to pursue treatment or even acknowledge problems in the first place and/or whether or not they can figure out a way to integrate the two.

I want to, as I see my time nears, give you a chance to make any closing comments.

I mean, clearly you have a multi-factorial and a multi-dimensional view of depression and it's one that's very refreshing and rewarding for me to see and to consider as I read your book. I'd love to give you a chance to make any final comments.

DR. HOWARD STONE:
Oh, I want to say I've just really appreciated chatting with you. It's been helpful to me and a benefit to me and I hope it is helpful to other people.

DR. RAHN BAILEY:
I'm sure it is.

DR. HOWARD STONE:
ÒDefeating Depression,Ó you can pick it up at Barnesandnoble.com or Amazon.com or anyplace, I hope that not only individuals who are depressed or family members or friends will take and use some of the things that I've discussed there as well as are discussed in other podcasts here with the Down and Up Show. Thank you very much.

DR. RAHN BAILEY:
Absolutely. Well, I think that's well said and I clearly think, as we close, that your points today have been very beneficial, I think to me and the audience as well. We need practically oriented documents that give people a chance, that resonate and I think with all the persons whom we interface with, patients as well as family and friends and that can be useful and helpful in helping them assist in their daily lives.

So again, thank you very much for being with us today, Dr. Stone. We really appreciate your time and your effort and all the effort that I know you put into writing a book. I've not written a book. I've written several articles in my career. And I can lose a whole month or two of my time.

So I can only imagine the effort that you put into developing a book of this type so I commend you for that piece as well. So, for Depression is Real, the Depression is Real Coalition, I'm Dr. Ron Kennedy Bailey here in Houston. Please join us next time for another segment of the Down and Up show on depressionisreal.org. Thank you very much.
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