Terri Timberlake, Ph.D., Director of Mental Health Program Services

Depression affects about 20 million people in the U.S.  One in 10 adults will experience some form of depression, a disease that cuts across race, ethnicity, economics and gender. Terri Timberlake, Ph.D., a psychologist and Director of Mental Health Program Services at HHC, talks about the importance of recognizing and treating depression and related illnesses, and offers insight into depression in the African-American community.

Q. What is depression?

A. Depression is a mood disorder. It is multifaceted and has a range of emotional and physical representations. The symptoms, if untreated, will interfere with your normal ability to function, both in your interpersonal relationships as well as your work or school life. Some of the symptoms include sadness, irritability, changes in sleep or eating patterns, unexplained physical aches and pains, difficulty concentrating, and lack of motivation to do the kinds of things that you used to enjoy doing. A person may not necessarily appear sad to others, so it’s important to look at other signs and symptoms as well as the length of time that these symptoms are present.

It is also common in adults and adolescents to see:  weight changes, either gaining weight or losing weight; feelings of lethargy and loss of energy; and difficulty making a decision and following through with a plan. In certain cases where depression may be more chronic, it may begin to lead to thoughts of death and dying, and in some severe cases, thoughts of suicide.

Q. One of your areas of expertise is depression in the African-American community. What are some of the issues there?

A. Let’s start with the fact that the prevalence of depression in African Americans tends to be twice that of the general population. Yet it’s sometimes seen as shameful to admit that you or someone in your family needs mental health treatment. In parts of some communities, it’s preferred that you seek the assistance of your religious leaders as opposed to a professional mental health provider. Some African Americans believe that your faith and religious convictions, or personal strength, should be what you rely on rather than an outside professional. And many lack trust in a professional and are generally skeptical of someone considered to have the power and authority to influence your mind and your emotions. Historically, there are examples of the medical and scientific communities taking advantage of the African-American community, so it is an understandable concern.

Q.  How do you address such obstacles?

A.  At HHC, we are careful to provide medical and mental health services with attention to race, culture and ethnicity. Throughout our facilities we have diversity among our staff. We make sure the literature that we give to patients is culturally diverse. It’s a matter of building trust and reassuring people that taking care of your mental health is a key part of taking care of your overall health.

Q. What is the treatment for depression?

A. Treatment begins with a thorough assessment by your doctor, who may then recommend psychotherapy, that is, counseling, or a combination of psychotherapy and medications. Unfortunately, sometimes people engage in substance use to deal with emotional issues including depression, and a doctor can recommend appropriate treatment. Healthy levels of physical activity and good nutrition also are important factors in treating depression. Family members and friends can help by supporting a person’s decision to seek treatment and encouraging the person to continue psychotherapy and stay on the medications.

Our goal is to provide integrated care that takes into account the mental health, substance use and primary care needs of our communities. We talk with our patients about their mental and physical health. If a person is considering suicide or harm to self in any way, we immediately seek emergency psychiatric care for that person. Otherwise we refer people to the nearest HHC facility for care. People do not have to suffer needlessly. With proper diagnosis and treatment, depression can be well-managed.

October 2010