For too long, depression has been a topic that people don't want to talk about, are afraid to talk about or are told not to talk about.

Depression has a wide continuum, from being sad or depressed about a particular event or circumstance to being clinically depressed with the need for professional assistance.

So let's talk about all of that today.

The expert for this month's Healthy Actions column is Chivonna Childs, a psychologist at Portage Path Behavioral Health in Akron.

“Depression isn't a bad word but there is such a bad stigma around depression,” Childs said. “We are in a society where you have to pull ourself up by the bootstraps, boys don't cry and we're not allowed to feel depressed or anxious.

“A lot of times, we mask it and say, ‘I'm OK.'?”

Some of that has to do with cultural issues, or people who have grown up being told: “You do not air your dirty laundry to someone outside the family. What happens in the home, stays in the home.”

But there are millions of people around the world who suffer from depression, Childs said.

That depression could be triggered by an event, such as a loved one dying or the loss of a relationship or a job.

Childs said depression can progress to the point where people feel “I can't get up, I can't shower, I can't brush my teeth. I don't have energy, nothing interests me, I wish I weren't here.”

“That's where we get to suicidal [thoughts],” she said.

Sadness is OK

Childs said people often may think they're depressed when it's more of a sadness.

“We all get sad and that is OK. That is normal. We're going to be sad,” she said. “Depression is more than sad. In a layman's terms, it's being in this big black hole and you're falling and there's no bottom to it. You can't reach out to the sides to stable yourself. You can't reach out because there's nobody there.

“The fact of the matter is most people are depressed at some point,” she said. “It will change from sad and progress [to clinical depression] when you're losing interest in things you normally like to do, your weight increases or decreases, you have sleep disturbances, feeling hopeless or helpless or lacking energy or motivation lasting more than two weeks.”

While there are some guidelines, everyone is different in how he or she processes depression and whether it will go away without the need for professional help, Childs said.

For instance, she said, “you can't tell somebody, OK start grieving on Tuesday and by Friday you're done. Grief is grief. It lasts as long as it lasts. It's a form of depression. They can still function and for some people it turns into the clinical piece” to seek help.

Talking to a professional can be good because it “is totally objective. There's no judgment … no one is going to say you're crazy. We're here to meet you where you are and get you back to the prior level of functioning,” Childs said.

Therapy may be a combination of talk therapy and medication, which would be prescribed by a psychiatrist, Childs said.

“Medication can be wonderful. It's not a panacea. Sometimes, people just need to get things off their chest. I have people who come in to vent. I am totally OK with that,” Childs said.

She acknowledged that depending upon the practice, there can be a wait to see a professional and that can be a problem. Portage Path Behavioral Health tries to have walk-in appointments available. The agency sees patients with private insurance, those who are uninsured (there is a sliding fee scale) and people covered by Medicare and Medicaid.

“If you had a broken arm, would you expect to go to the ER and wait for two weeks?” Childs asked. “Absolutely not. Why should you wait two weeks for your mental health?”

Stress relief

So let's say you're sad or depressed or anxious about something — or a lot of things.

There are many tools that can be helpful, Childs said.

Meditation or relaxation exercises can be calming.

“Do something to focus,” Childs said. “We need to compartmentalize our lives. We're so busy taking care of other people. If you don't take care of yourself, who is going to take care of them?”

Spirituality also can be key, she said. “If you're a spiritual person, it doesn't mean you have to go to church at 10 a.m. every Sunday, but you have a connection with your higher power, then pray. If getting out in nature is spiritual to you, go to the park.

“Get up, get out and do something. When we're active, it increases our endorphins,” she said.

Music can be a wonderful piece for depression and anxiety, Childs said.

“You should have a soundtrack that improves your life. You should have a superhero soundtrack — music that let's you know who you are,” she said. “For my women in particular, pick your favorite female artist that empowers you. One I suggest is Beyonce. For my guys, choose whatever makes you feel empowered.”

If you're depressed, pick music that will bring you up. If you're anxious, choose music that will calm you.

Helpful friends

Another good source of assistance can be your spouse, family and friends. But you need positive people. “Negative people will give negative advice,” she said.

If you have a “Negative Nellie” in your life, set boundaries so it doesn't add to your stress, anxiety or depression.

What if you're that friend who wants to help your struggling friend?

“Nine times out of 10, they don't want you to fix it, they just want you to listen. Listening can be a powerful tool for the person helping,” Childs said.

“Just be that ear that's not judgmental,” she said.

Ask if there's anything you can do. Offer to go with the person to talk to a professional or help make an appointment.

You might need to give the person some space, but continue to call or text to let them know the door is always open, Childs said.

Other resources

Here are some resources that could be helpful:

•?Summit County's 211 service (dial 2-1-1 or call 330-376-6660) can help find the local resources available for help.

•?Portage Path Behavioral Health has Psychiatric Emergency Services line, which is available for mental health emergencies or if someone needs to talk, at 330-762-6110.

•?Portage Path also runs the county's free Support Hotline at 330-434-9144.

•?The National Suicide Prevention Lifeline is 800-273-TALK (8255), or text 4HOPE to 741741.

Consumer columnist and medical writer Betty Lin-Fisher can be reached at 330-996-3724 or blinfisher@thebeaconjournal.com. Follow her @blinfisherABJ on Twitter or www.facebook.com/BettyLinFisherABJ and see all her stories at www.ohio.com/betty