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The Many Faces of Depression and How to Recognize Them

Health

We all know someone who has a story of depression. It could be a neighbor or a childhood friend. It could be a story of the returning vet, the family physician, or a colleague from work. Perhaps it is a story that is closer to home: of a cousin, an uncle, a brother or sister, a grandparent, a father, a mother, a child. Or maybe it is our own.


Depression is the primary cause of suicide in the United States. Children and teens are especially vulnerable, as suicide is the second leading cause of death for ages five to 24. Every thirteen minutes another suicide occurs, leading to well over 41,000 a year. As startling as this statistic is, experts warn it may be lower than the actual number of suicides per year. Due to the persistent stigma attached to depression, many of those struggling with the illness do so in shame and silence, and many deaths by suicide go unreported.

Simply put, depression is a national public health crisis in the United States and the world's number one cause of disability. Over 350 million people suffer from depression worldwide. Aside from incalculable human suffering, the cost to society is massive. The economic toll of depression on businesses in the United States is $100 billion annually, of which $23 billion alone are due to lost work days.

Everybody has a story. Yet as a society we are falling short in addressing the epidemic or even talking about it. That's why I started the Hope for Depression Research Foundation eleven years ago to spur brain research and raise awareness. Today, our Depression Task Force of top neuroscientists is conducting the most advanced depression research in the country. They have three new compounds in pilot clinical trials, each of which represent a new way to treat depression. The field has not seen a new category of antidepressants in over thirty years.

"The first steps to a healthy mind and body are to get enough sleep, eat properly, and exercise, whether you do or don't have depression. Every health professional will emphasize these three pillars of mental health. Here's to hope in your future."

We also need to move the dial on our national conversation about depression. We've got to get the word out faster and farther than we ever have before. For those who suffer from mind-brain illness, understanding what they're going through is the first step. The second is finding people to talk to. We need public education and widespread discussion so that those who need it are empowered to seek help, and those who encounter the illness in a friend or loved one have the necessary understanding and compassion to offer meaningful support.

The signs and symptoms below can indicate depression when they are present nearly every day for at least two weeks:

- Sad or crying unexpectedly

- Anxious or irritable

- Loss of interest, pleasure

- Hopeless or helpless

- Low energy, fatigue

- Sleeping too much or too little

- Loss of appetite or weight gain

- Difficulty concentrating

- Aches or pains with no clear physical cause

- Thoughts of suicide

Men may show additional symptoms of depression, such as: womanizing, gambling, drinking excessively, and belligerence. Experts believe that when these symptoms are taken into account, just as many men have depression as women.

If you notice any of these symptoms in someone close to you, here are some suggestions on how you can help:

- Offer an ear: Ask questions and listen to the answers. If you haven't suffered from depression, it can be difficult to understand what it's like, so go easy on the advice.

- Gently suggest getting a doctor's help: If your loved one isn't getting help from either a medical doctor or a therapist, gently suggest that he or she seek help. The first step is to see a primary care physician.

- Form a community: Rally other friends or family members to help support the person with depression. It's hard to take it all on your own shoulders.

- Learn about your loved one's treatment plan: If you're involved in the person's care, make sure you know what the treatment plan is. If possible, have the person give permission to his or her doctor to communicate with you.

- Finally, if someone you know is suicidal, immediately call the suicide prevention hotline at 1-800-273-8255 or call 911.

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Career

How I Went From Managing Complexity to Becoming a U.S. Ambassador and CEO

For the last 30+ years, I have focused on bringing together political parties, corporate competitors and disparate nations to foster quality leadership, diplomacy and results that better society, creating sustainable partnerships and profitable business models. Has it been easy? By no means. Rewarding? Immensely.


Here's what I learned along the way, how I did it, and how you can, too.

When I left Washington to enter the corporate world, I was asked to investigate and determine ways that companies were struggling to be successful in areas where major investments were being made. This meant meeting with and challenging key executives, staff and stakeholders, benchmarking against best in class competitors and making recommendations that change processes, cultural norms and internal ownership. The end goal was always to move the organization or activity to a higher level of performance. In other words, my job was to figure out what were the "boulders in the road" and move them. The boulders in many cases were people or projects they designed and held dear. Not surprisingly, my inquiries caused adverse reactions. Over time, as boulders turned into rocks, and rocks turned into pebbles, consensus came to bear, and goals were met that enabled the organizations, department owners within them, and society to thrive. My work – which had been unwelcomed by some – was accepted, and even appreciated, by those who had once been critical.

As a 26-year-old who was doing this for the first time and facing strong head winds expressed in highly personal ways, I sought advice from my father, an executive operating in a highly politicized arena. His letter is worn, but I keep it on my desk.

"I wish I could be there with you when you have to face these challenges...just remember to look beyond what is currently in your life and try to visualize what is unseen. Count your blessings and it will also help you challenge the crisis you are experiencing...Some of the greatest stumbling blocks I have ever faced have also resulted in being my greatest stepping-stones." His wise words encouraged me to turn managing complexity into an artform. As a U.S. Ambassador and the first female Commissioner General to the World Expo, I was able to create an atmosphere of confidence amongst project investors which resulted in the first financial surplus in the history of US participation in a World's Fair. As CEO of FARE, I guided a major restructure to support food allergy research and received commitments of $75M within 12 months.

Here is what I learned along the way, including guidelines I follow each time I find myself facing a new or complex situation:

  • Recognize that when there are different levels of real-time execution and a sense of urgency, the risk complexity is multiplied. Know what you want the organization or alliance to look like, speak with facts and build a roadmap to get there.
  • Break down each problem, recognize the constants and the variables. Identify what is the same in each situation and what is unique.
  • Itemize the constants. What characteristics are seen across the entire organization which are impediments to change? Fix those first.
  • Identify the unique issues that are compounding the problem, e.g. finances, people, legal, channel relationships, history, culture and politics.
  • Don't pretend to know what you don't know. It hurts your credibility. Keep asking: Why? How does x relate to y? Who makes that decision? Remember, as a change agent, you are not expected to be the subject matter expert, so feel confident and admit you don't know how "the thing" works. Your goal is to understand the pathway for how we ended up where we are today—a place none of us want to be.
  • Move boulders out of the way for your team, so that really smart people who are committed to the new way of doing things can run as fast as they can without being tripped. Your job is to manage the complexity by keeping your eye on standards, governance, revenue, external perceptions, fiduciary responsibilities and long-term consequences. Adjust accordingly to avoid greater problems while continuing to move towards the long-term goal.
  • Align incentives to change by identifying motivations to better maximize resources. View the situation from the perspective of the other person and determine what is most important to them. Unless the organization or situation is completely broken, you can find ways that everyone can feel a sense of ownership in the new way of operating. Although there is a sense of urgency, you can move more quickly by bringing your critics along if you frame your recommendations in a manner that positions change in their vernacular and aligns with their worldview.

The Merriam-Webster dictionary defines complexity as "the quality or state of not being simple; a part of something that is complicated or hard to understand." However, always remember problems can be solved and issues can be resolved as long as you stay committed to the facilitation of success. Inspire the loyalty of those around you. Celebrate the early wins. Systematically, keep key stakeholders apprised of successes and challenges on a regular basis.

Most importantly, focus on helping others succeed. Let your employees know – and demonstrate – that they are a part of a team that matters. To achieve real, meaningful social impact, leaders and their teams must be sure their actions are also real and meaningful.