Out of the 'deep, dark hole'

Resources help recognize, treat depression

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David Reed, at Steamboat Mental Health, helps patients deal with depression.

Some would find it surprising that life in picturesque mountain communities - ones that lend themselves to blissful, active outdoor lifestyles - lead to above-average suicide rates. Tom Gangel, division director for Colorado West Regional Mental Health's four-county Northwest Colorado region, pointed out that high-altitude, mountainous communities worldwide have higher-than-average rates.

"We wish we knew why," Gangel said. "There's normally an average of 2.5 suicides per 100,000 people every year. In the Yampa Valley, we have 10 every year."

Depression is the primary cause of suicide, and Gangel said depression will hit 20 percent of the population at some point in their lives.

While most people likely would report many of depression's tell-tale symptoms - low energy and motivation, trouble sleeping, expressions of hopelessness - Gangel highlighted that the most important factors surrounding these symptoms are determining whether they last for weeks and result in substantial changes in behavior and thoughts of suicide.

"Real depression becomes a physiological state," Gangel said. "It's not a 'boot-strap' disease - you need treatment and medication to help. There's help out there; you don't need to spend your life feeling like that."

With mental health center offices in Steamboat, Craig, Walden, Meeker and Rangely, Gangel said the centers receive funding assistance from the state, the Human Resource Council and the United Way to supplement their emergency services and to offer a sliding scale on need-based cases for individual, couple, family and group therapy.

The full-service mental health centers in Steamboat and Craig can put patients in touch with psychiatrists and adult-certified and child/adolescent-certified licensed professional counselors. The centers also feature emergency services crisis intervention lines available 24 hours a day and host suicide prevention support groups every month. Depression and bi-polar groups meet every other week in both communities.

For those unsure whether they need treatment, Gangel stressed the constructive advice and insight that these free group meetings can provide.

The Northwest Colorado Visiting Nurse Association also offers the Positive Change Program that sets up counseling "advocates" with depressed or saddened patients.

Sandy Beran, a Craig-based VNA advocate, said the program has an income-dependent billing scale for indigent clients and was designed to supplement a patient's therapy or to provide those who feel they do not need therapy with personalized, skill-based and goal-oriented support sessions.

Although it may be beneficial, individualized therapy alone is not enough for many who suffer from depression. Steamboat psychologist Dr. Tom Traynor said research indicates that depression responds with a combination of appropriate medication and cognitive-behavioral psychotherapy - a specific technique to help patients gain a mastery of the relationship of their thoughts, feelings and behaviors.

Traynor said that depending on a patient's self-reflective skills of verbal reporting and integrative thinking, it can be determined whether he or she will benefit from psychotherapy after a couple of sessions, and if so, the treatment can be effective in as few as 15 to 25 sessions.

"If people believe they're depressed, they should seek treatment," Traynor said. "We all know and respect how difficult that first step is, but for many, it starts working."

Call Steamboat Mental Health Center at 879-2141 or Craig Mental Health Center at 824-6541. The 24-hour crisis line is 870-1244.

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