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People flocking to therapists in depressed economy
Local increase in mental-health patients follows national trend

by Sue Dremann

The economic downturn is sending more people to the psychologist's couch, both nationally and locally, according to mental-health professionals.

Many patients are saying they are stressed by recent economic woes. And therapists are seeing a rise in depression and anxiety, they said. Nationally, eight out of 10 Americans said the economy is a significant cause of stress, up 66 percent from April, according to a poll by the American Psychological Association.

"There is a whole general feeling of doom in the recession, which makes nobody happy. This is something that is affecting everyone. People say they become paralyzed. They don't know what to do," said Joyce Brothers Kart, manager of the department of psychiatry and behavioral health at Palo Alto Medical Foundation.

People don't wake up in the morning and say, "I'm depressed," Kart said.

Symptoms arise over time and include difficulty sleeping or sleeping too much, drinking more, general apathy, having a hard time getting up in the morning, quitting eating or eating too much, difficulty making decisions and a sense of paralysis, she said.

And people tend to blame themselves.

"They say, 'I've lost 40 percent of my retirement. Why didn't I just spend it?' There's a feeling of helplessness," she added.

Three therapists at PAMF said they are seeing more patients — and more suicidal patients, according to Kart. Of four of her new patients, one expressed a desire to end his or her life, she said.

"One patient in particular had a wealthy family and felt their entire lifestyle was going to be wiped out. He didn't want to talk to family members; he was so embarrassed that this happened," she said.

More patients seem to be coming in to Stanford Psychiatry and Behavioral Sciences, according to Dr. David Spiegel, professor of psychiatry at the Stanford University School of Medicine, although he said he doesn't have statistical data. But economic burdens are compounding stress for patients who already have depression and anxiety, he said.

Spiegel said a study done many years ago looked at the mental hospitalization rates for a 100-year period and found they were directly correlated to the rate of economic depression.

"There is a robust relationship between economic dislocation and illness. You're now 'worth less' — both financially and emotionally," he added.

Joyce Nash, a Menlo Park therapist, said her patients are expressing anxiety about potential job loss.

"A person with a company is worried he might not get second-level funding. Another with substantial assets has lost 30 percent of his assets," she said.

Nash is seeing women in middle-management who fear losing their jobs. Some men are afraid to tell their wives how bad things are or wives are worrying so much that it is affecting the relationship, Nash said.

Support-group membership is also growing, according to Katherine Lerer, facilitator of Depression and Bipolar Support Alliance Palo Alto (www.DBSAPaloAlto.org), which offers peer-support to people with mood disorders.

"Our depression and bipolar mood-disorder group [attendance] has almost doubled in the past three months. Job loss, our future potential and family stress are the main concerns," Lerer said. On Jan. 27, 2009, Lerer will have a meeting for people interested in starting a friends-and-family support group.

There has been a surprising up side to the spate of new group members, she said.

"In the past 10 years, I've never seen such intensely bonded groups in and out of the meetings. We find peace in the firestorm together," she said.

But at the time when they might need therapy most, some patients are dropping out or cutting back as part of their economic belt tightening, Nash and others have said.

Free or low-cost help is available, however.

Palo Alto Medical Foundation has free support groups for drug and alcohol dependence and other concerns. And many resources are available through 2-1-1 Santa Clara County, an information-and-referral network available by phone by calling 211 and online at www.211.org. The 2-1-1 program offers referrals to resources — such as services for mental health, foreclosure, employment, food, aging parent and teen addiction-prevention, housing and more — according to Kim Ferm, director of 2-1-1 Santa Clara County, a program of the United Way Silicon Valley.

Fear of the stigma of having a mental illness often prevents people from finding a constructive way out of their misery, according to Kart, of Palo Alto Medical Foundation.

But "psychiatric records are extremely well-protected by confidentiality beyond regular medical protections," she said.

And Kart hardly knows anybody who hasn't had counseling some time in his or her life. Seeing a therapist does not mean a person is crazy, she added.

"Eighty percent of people who come in come for a life-stress problem," she said, such as conflict in the family, work problems or issues from the past.

"It's kind of like a car tune-up. People do that with their lives. They get run down, and they need help and it's much more severe if you let it go. [Therapy] helps people to stay in shape. The psyche and body both need to be worked on," she said.

Staff Writer Sue Dremann can be e-mailed at sdremann@paweekly.com.