Independence Radio: Rosemary Salopek: Depression and Disability

What is behavioral health and how does it differ from mental health? What is behavioral health and how does it differ from mental health? Are people with disabilities more prone to depression than others are? What effect does depression have on the physical health of people with disabilities?

These are just a few of the questions Independence Radio host Stephanie Wallace explores with ICS Director of Behavioral Health Rosemary Salopek in the new episode of Independence Radio.

You can listen to this conversation here.

Complex Beings

Rosemary is one of several ICS experts on the complex care management team, which works with members who have particularly challenging sets of physical and psychosocial issues that can compromise their health and independence.

“We’re very complex,” Rosemary says of human beings generally. “We’re not just one thing. Medical issues don’t define a person. People’s histories, their families, their experiences in life all shape how we function in the world.”

The term “behavioral health” is used more nowadays than “mental health,” Rosemary says, “because it represents a combination of mental health issues, substance abuse issues, psychosocial issues, environmental issues—so all of the things that comprise a person’s experience in the world….

“It can have a tremendous impact on someone’s physical health: how they cope with the illness, how they cope with the treatments that are recommended, with the treatment regimens that are recommended, with medications—things like that. When you say behavioral health, I think of things like depression, trauma, anxiety, complex living situations. All of those things impact how a person copes with whatever they’re presented with.”

Disabling Depression

Rosemary cites the effects depression can have on a person with complex medical issues. “Typical symptoms of depression are sadness and loss of interest in doing things; but it can also be fatigue, overeating, undereating, oversleeping, undersleeping. The impact of that on how we function in life can be significant.”

A person with depression may find it difficult to make doctor’s appointments, to concentrate on a medication schedule, or to be willing to be around a personal care assistant. In some cases, depression can lead to suicidal thoughts or even attempts on one’s life.

“Absolutely, the prevalence of depression is significantly higher for people who have disabilities and other medical issues,” Rosemary says. “Higher rates of depression, higher rates of suicidality, of suicidal ideation and, if you will, of successful suicide.”

The Power of Talk

Stephanie uses her own experience as an ICS member and a person with a disability to sensitively explore these subjects with her guest, looking for the borderlines between feeling a little down and being seriously depressed, between idle wishes to be free of your troubles and active planning for suicide. She and Rosemary explore the common resistance many people feel to taking medications to improve mood, and the palliative effects of speaking frankly with someone—a therapist, a care manager, a friend or a helpline—about what you’re feeling.

In addition, Rosemary talks about her role on the Complex Care team and a two-year study she is conducting to understand how common depression is among ICS members and how to help care managers recognize its signs.

“The overall goal for us here,” Rosemary says about the study, “is to decrease the prevalence of depression across our membership.”

Be sure to listen to the rest of this important conversation on Independence Radio.

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