“As we know, psychiatric disorders or mental health issues are highly stigmatised in society, so people try to avoid speaking about them and be transparent because they are afraid of social disadvantages.” – Dr. med. Katayun Specialist in Psychiatry and Psychotherapy at The Kusnacht Practice.
With the negative connotations generally associated with mental health issues, people are often reluctant to seek treatment. As such, depression is a condition that is highly underdiagnosed.
In the sixth episode of our new podcast series, we are talking with Dr. med. Katayun Hassanpour, specialist in Psychiatry and Psychotherapy about depression and the recent announcement of Lady Gaga’s struggle with the illness. Dr. Hassanpour discusses the early signs and symptoms of a person suffering, the clinical treatments available, and the importance of ‘establishing a daily routine’ to aid in recovery.
Presenter: Hello, welcome everybody, this is The Kusnacht Practice podcast that you are listening to. We are here this morning with Dr. med. Katayun Hassanpour. She is the lead psychiatrist specialist, and psychiatry and psychotherapy specialist in trauma. Good morning.
Katayun Hassanpour: Good morning. Thank you so much for the kind introduction.
Presenter: Very nice. We’re here this morning Katayun to discuss Lady Gaga’s battle with depression. This is very interesting for us and I would like to hold this occasion, of this headline in the press, so that we can bring a cast a little bit of light on depression.
Can you tell us more about this? With Lady Gaga admitting that she suffers from depression, what kind of signs should loved ones’ look out for which indicate this condition?
KH: So what might be visible for family members or friends is, for example – a withdrawal from social contact. That person withdraws, maybe not reacts to calls anymore, does not want to meet up anymore. So the person is withdrawing from the contact.
We have specific and less specific symptoms. What people might notice quite early is, for example, a disturbance of sleep. This means falling asleep, sleeping through so, being woken up at night. And also early morning awakening – that you wake up before the alarm clock rings and you cannot fall asleep anymore.
Then there might be a loss of appetite, which also might be visible to others. There are other symptoms that might not be visible to anybody from outside if the person doesn’t share them, for example – hopelessness. We really have to address this in our assessments, but maybe the person, even themself is not aware of it.
What also might be visible is a loss of joy – anhedonia we call this, that you don’t find joy in the activities that were pleasurable before, and also a lack of energy and drive. Which means people also as they withdraw, for example, spend significant time at home, lying on the sofa, lying in bed, which also become visible to the environment.
These symptoms that I mentioned are the symptoms that might be visible to others. And of course sadness, crying, also crying without any reasons might occur and be visible, and then of course there are symptoms that need a profound discussion on that.
Presenter: Now, from the symptoms that are common in depression, what kind of treatments do you recommend to those suffering from it then?
KH: It’s very important to detect the depression first, or first diagnose the depression. So this is done by a psychiatrist, psychotherapist, it can also be a psychologist of course, but this needs profound diagnosis. Here we have also a psychometric test to support this, but the most important is a clinical impression.
Then there are therapeutic options, the options we have are: some pharmacological treatment with an antidepressant, and also psychotherapy, which are both recommended and combined in the therapy of depression.
Presenter: Lady Gaga describes her state at times as catatonic, and she admits that she has daily suicidal thoughts. Do you think these characteristics are commonly associated with depression?
KH: These are typical symptoms we see in severe depression. So we find, in severe depression, we find that the person describes being paralysed, as Lady Gaga describes it as catatonic, for example, lying in bed not being able to move. This can be accompanied by inner restlessness, which is very hard to stand actually. And also suicidal thoughts, which are always a great risk, if people have also intentions to act out and risk their life. So this is of course a situation when we as psychiatrists are on high alert and have to intervene to rescue the person’s life.
Presenter: Now, within your role precisely, at The Kusnacht Practice, and particularly in that trauma speciality that is, have you seen an increase in the number of cases of depression, particularly in the light of the global pandemic, for instance?
KH: Yes, I do. I don’t have an exact number I can provide you with, but patients that address it, that we assess, for example, all that also come to treatment, mention that one of the factors that contribute to the deterioration is the pandemic situation. Also, as regarding social isolation, the virus may cause anxiety, so there are many aspects of this that contribute to a deterioration.
Presenter: And Lady Gaga admits that throwing herself back into her art helped ease her depression. Can music and art be an effective tool in this way? And what coping strategies can an individual suffering from depression employ to help to deal with?
KH: So, it is very important to establish a day structure. So to wake up at a certain time, to have the meal times, then to activate the patient – that means encouraging the individual to also do sports, to work out, this is very, very helpful. To stick to a daily routine basically, so not staying in bed but getting out, whatever the energy level allows, but at least to spend a couple of hours being in motion, and doing things and getting back to a day structure.
So, this is very helpful, and it depends on the individual and what the individual is responsive to. So, in the case of Lady Gaga, it’s art that helped her, but this also can be other occupations. Sometimes it can be helpful if it’s something meaningful, but this is not completely necessary. We use in our treatment music therapy and art therapy basically to access the emotion of a patient. So, the emotion of the individual, what is inside you, but you are probably unable to express verbally.
Presenter: And when public figures, such as Lady Gaga, come forward to speak about their depression in this way do you think it helps others to face up to and deal with their own issues with depression? Do you think it’s encouraging them to speak about what they feel?
KH: Yes, I absolutely think so. I think it’s also great that Lady Gaga opens up on this. As we know, psychiatric disorders or mental health issues are highly stigmatised in society, so people try to avoid speaking about it and be transparent about it because they are afraid of social disadvantages. So, for example, also people who are employed, for example, at their job, or when it’s about a career and the next steps of recruitment. So people still suffer from disadvantages being open about these, about mental health issues. And I think talking about this, also talking about this with you, and getting awareness in society, I think it already helps people to address, to see a doctor, to get help, immensely.
Presenter: And would you expect to see the number of people coming forward with depression and diagnosis to increase in the light of the admission that someone as high profile as Lady Gaga suffers from it? Do you see this increasing in the near future?
KH: I think the numbers might increase absolutely but this is not due to the increase of depression in general but because it’s a diagnosis which is highly underdiagnosed, because people don’t get into treatment. People that have depression are not diagnosed with depression. Depression is a common disease, so many people suffer from it but don’t access a psychiatrist, or don’t address their symptoms to anybody that might provide them with help and get them into treatment. And so there is a high number of undiagnosed depressive human beings in society which we hope to address and we are eager to provide help to them.
Presenter: Thank you Katayun. I was this morning with Katayun Hassanpour, she is the lead psychiatrist, specialist in psychiatry and psychotherapy here at The Kusnacht Practice. We are reinventing the experience of care here at The Kusnacht Practice. We are the global leaders in innovative care services.